Surgery #2: Did it work?

Yes, it worked!

Many of you know that I had surgery on Feb. 4 to implant a second stimulator in my brain. The stimulator is designed to relieve some of the symptoms of Parkinsons disease. A similar procedure in November 2009 nearly eliminated the tremor and the stiffness on my right side; this time, I was hoping for a similar victory on my left side.

Did we hit a home run, like we did the first time? No. I’d say it’s more like a triple, because I think I’ll still have to take some medication to control the tremor on the left side. I still have some tremor in the “off” medicine state.

But we are now in the process of reducing the meds, and their undesirable side effects. The tremor is vastly reduced in terms of intensity and duration. We still have some room to tweak the settings on the new device. This is all great news.

Both the doctor and I were shocked at how bad my left side had become in recent months. I had come off my meds for about 18 hours before the programming session, and I was a mess. We both noticed, for the first time, that my left leg was involved.

So let’s put this latest advance in its proper context. Without some sort of dramatic intervention, like the surgery, I would be in seriously bad condition. We’re talking about not being able to perform many of the so-called activities of daily living, such as feeding and dressing and toileting one’s self.

This technology is giving me a new lease on life. I am very fortunate, indeed. I look forward to returning the favor.

A welcome side effect

Sometimes following DBS surgery, PD symptoms abate for a period of time. This effect, called micro-lesioning, is something I don’t really understand. But I can tell you that I haven’t taken any Parkinson’s meds since noon, and I am currently tremor free on my left side — the side that we were hoping to fix. I don’t know how long it will last, or if it hints at future success when we do the initial programming. But it is certainly welcome!

Some quick words on surgery #2

I’m not at my best when I’m taking large volumes of Percoset, but I did want to check in with a few notes about the DBS experience this time around.

We’re back at the hotel on this cold Sunday, having been discharged yesteday. The second DBS procedure was a success, despite some issues with the placement of the recording electrode (this is a device that aids in placement of the lead, which is the part that is permanently implanted in the brain; it detects the unique electrical activity of the neurons that are layered near the target zone, and the signal that is detected is played back as audio). I’m keeping solid food down today.

The biggest difference between this surgery and the first was in not having complications from inserting a Foley catheter. The first time around, the Foley did not go in easily, resulting in a literal and procedural mess. The routine was disrupted because a urologist and nurse had to scrub in that morning; to minimize my discomfort and to keep me from freaking out, I received more anesthesia than usual.

So this time, I went with a Texas (condom) catheter, and that meant I was far more alert and aware of what was happening during the, uh, good parts. That included the drilling of the burr hole (surprisingly easy), trimming the edge of that hole (“you’re going to hear me sawing”), and the banter between surgeon and specialist as to whether they had nailed the placement of the lead (the audio signal of each type of neuron is unique, and that’s how the surgeon knows he has hit the target). Every indication is yes, they did nail the placement (to a 1 mm spot near the top of the brain stem).

We will know for sure on Feb. 24, when the device is turned on for the first time and the initial settings are dialed in. I do believe I had two instances of relief during the implantation, and if we are right about this, Feb. 24 will be a happy day indeed!

It’s almost showtime!

At some point today, I’l get the call from the admitting office at Mount Sinai. At this time tomorrow, the procedure for installing another implant in my brain will be in progress.

The run-up to the surgery has been uneventful. No testing needed this time, just show up and that’s it. It leaves me feeling a bit more disconnected from the process, which has been both good and not so good.

The hardest part has been shrugging off the pre-surgery jitters. I’m in “the zone” where I will allow nothing to bother me. Die-hard optimism has worked for me in the past, and it will work for me again!

Time for the last shower I’ll have for a couple of weeks (!), and to get the protein shake that I’ll be drinking at 9 pm. Charge up the iPod, have it ready in case I’m stuck near a moaner. What am I missing?