Birth and Rebirth

A friend who had the DBS procedure a couple of years ahead of me talks of his anniversary as his rebirth day. For good reason, too: Despite his very advanced condition, he has enjoyed a huge amount of relief ever since.

Yesterday was my rebirth day, and today is my birthday. I’ll get a few birthday well-wishes from family and friends, maybe even a few presents (here’s hoping!). The rebirth day was one spent in reflection, doing a few things that I wouldn’t have been doing more than a year ago. I’ve been learning to play the bass guitar, and I had my lesson yesterday. I had the motivation to prep the Porsche for winter storage the way it ought to be prepped. Raked some leaves, too.

Little things, sure, but there’s a joy in each of them that had been dimmed slightly in past years. Here’s to the coming year and all the joys and trials that it will bring.

DBS Journal: Device Tuning #4 (update #2)

I can see a pattern emerging in the device tuning process and aftermath: Initial results are encouraging, but after a week or so some of the unwanted side effects start to edge their way back into the right side arm and leg.

It’s still a good thing, having this hardware in my head. The process feels more like I’m taking two steps forward, then a slow half step back. My right arm is not nearly as sore as it was, although the latent muscle tension is still there. The dystonia in that arm is creeping back. My right knee is tracking better, but not quite as well as the day of the adjustment.

The left side continues to be an issue. Meds control it for about half the day; the other half ranges from mildly uncomfortable to completely unusable, cramped and painful. Surgery within the year? It’s likely.

DBS innovation: Stimulating individual neurons?

This is really quite something to behold: A DBS lead with electrodes small enough to potentially stimulate individual neurons. The genius lies in applying the technology used in semiconductor chip design to create a lead with many tiny electrodes that can then be activated and controlled with an extraordinary level of precision.

Looks like a great buy for one of the major medical device manufacturers.

What’s next for DBS? Weight loss, Alzheimer’s

Deep brain stimulation surgery is quickly becoming the hot new treatment for an ever-widening array of ailments. Initially approved for treatment of motion disorders such as essential tremor and Parkinson’s disease, it was exciting to see the technology applied to other problems, such as epilepsy. Discussion then turned to using DBS for obsessive-compulsive disorder. Since then, we’ve seen the buzz building around DBS for depression. Humanitarian exemptions have been granted for DBS to treat severe Tourette’s. 

This morning’s mail brings word of efforts in Canada to extend DBS to people with weight-management problems, and even Alzheimer’s disease. Makes me wonder about how DBS might be used by otherwise normal people seeking a cognitive edge, like those who take the ADD drugs.

The Choice Matters: Go With the Specialist

An article in The New York Times makes a point that might seem self-evident: Patients fitted with heart devices had fewer problems when those devices were implanted by doctors who had special training. I think this finding is very relevant for devices implanted in other areas of the body, particularly in the brain. Consider this point:

Most implant procedures, about 70 percent, were performed by electrophysiologists, the study reported. The remaining implants were done by other types of cardiologists or other kinds of doctors including thoracic surgeons. The study found that the highest rate of serious complications about 2.5 percent, occurred among thoracic surgeons, who accounted for only 1.7 percent of the procedures reviewed.

Knowing this, if one had the choice, why would you *not* want to have a brain implant done by anyone except a specialist with a long track record of performing that specific procedure? I suspect that it is on this point that the surgeons with the record of excellent results differ from those that are merely very good.

The article also provides a strong argument for the creation of a national electronic medical records system. The findings were based on filings made to a national database created in 1995 when Medicare and Medicaid agreed to paying for more implanted defibrillators. One can only imagine the other bits of hard science to be gleaned from records based on data from millions of eople.