Wellness Medical Care

For more than two years, 37-year-old Kellie couldn’t get out of bed. Her muscles ached and would spasm so often that she was essentially paralyzed. She also had severe dystonia, episodes when her muscles would contract and cramp, rendering her entire body painfully twisted for hours ar a time.

“My muscles would turn to stone; my whole body was like a rock,” she said. At least twice a month she had to seek help from the hospital emergency room where she would receive intravenous muscle relaxants for up to 24 hours before she could move.

Kellie needed help taking care of her three young children; she couldn’t walk and rarely left the house. She decided to try deep brain stimulation (DBS), a surgical treatment for Parkinson’s dis­ease. DBS surgery involves inserting a thin wire into the brain; the wire is attached to a computerized pulse generator (similar to a heart pacemaker).

“I had no options,” she said. “I knew I wouldn’t be like before I had Parkinson’s, but if I wanted half a life back, I knew I had to have surgery.”

After more than six months of medical tests and psychological exams, Kellie underwent the six-and-a-half-hour procedure. “I was awake during the surgery,” she said. “My head was in a halo so I couldn’t move, but I could talk to the doctors. I knew they found the right spot in my brain when my tremors stopped. I looked up and saw my doctor smiling.”

A week after the initial surgery to implant the electrodes, Kel­lie had a second procedure to attach wires that ran under her skin from her brain to a pacemaker-like device implanted in her chest. When the electrodes were activated, she was “turned on.”

“There was an immediate change. All I wanted to do was go home and let my children see me walk,” she said. “I wanted them to see that I could get up again.”

Kellie accepts that the benefits of surgery may last only a few years. “No one can tell me how long it will work: two years? five years? I don’t know. I can’t live for tomorrow; I took what the doc­tors could give me. They offered me some of my life back, and I took it.”

Rediscovering Surgery

In the first half of the 20th century, doctors did not have any effective drugs to offer Parkinson’s patients, so they turned to brain surgery as a last resort when symptoms were severe. In essence, surgeons re­lieved the patients’ symptoms by destroying the sections of the brain thought to control the involuntary movement associated with PD.

As you might imagine, this crude surgery was risky and often ineffective. The mortality rate for these procedures stood at around 12 percent, and many more suffered permanent side effects, such as speech difficulty and vision problems.

The treatment of Parkinson’s disease was revolutionized in 1967 when Dr. George Cotzias discovered levodopa, an oral medication used to treat Parkinson’s patients. Not surprisingly, the number of surgical procedures plummeted, since the drug was much safer than surgery.

The medications aren’t without their flaws; over time, many people experience problems with wear­ing off, and some continue to suffer symptoms that the medications couldn’t control. Some people need to take medication every hour or two, and worse yet, some of us develop dyskinesia as a side effect of the medication, making the cure worse than the disease.

But in the world of Parkinson’s, nothing stays still for long. By the 1980s, researchers were developing new equipment and surgical techniques that have made Parkinson’s surgery much safer.

While medication remains the first line of treatment for new patients, I believe we are on the threshold of a new era of medicine that will include both better drugs and better procedures—and one day these new treatments will make Parkinson’s a disease of the past.

DBS, which has become the surgery of choice for most people with Parkinson’s, as well as traditional brain lesion procedures that have been in use for 50 years. It will also cover several experimental surgical procedures that offer promise to Parkinson’s patients in the coming years.