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Deep brain stimulation diary: Kathy's story

Kathy Kathy was diagnosed with Parkinson's in 2001. In February 2010 she underwent deep brain stimulation (DBS), a form of surgery which can treat some of the symptoms of Parkinson's.

Here, Kathy talks about the surgery, and shares her personal experiences in an online diary.



23 February 2010

Well here I am at King's College Hospital in London awaiting my surgery tomorrow. I am first on the list they tell me. But as the operation takes most of the day I guess I am the only one on the list.

Can't wait to get it all over and done with and hopefully start to get my life back together. Having had Parkinson's for about 13 years with severe tremor of the left side of my body, this is really the only option left to me.

Since my neurologist first suggested I consider the possibility of DBS surgery it has taken me almost one year of assessments to get this far but I am sure it will be worth it in the end. 

I was officially diagnosed with Parkinson's in 2001, with a tiny tremor in the little finger of my left hand, but I had already shown symptoms for about 2 years earlier. Since then it progressed into a severe tremor of the whole left side of my body and life had become progressively more difficult. 

My husband Doug and I were aware that I was now on the maximum dose of my Parkinson's medications and things could only get worse. 

So almost without hesitation we agreed to at least explore the possibility of surgery. The first step was a referral to a neurologist at King's in London.

A year of assessments

I was seen at King's in August by a registrar and neurologist: lots of questions and tests - writing, picking things up and checking co-ordination.

It was a blow when a DAT scan result confirmed my Parkinson's would eventually progress to the right side of my body. Symptoms on my right side had not shown before, possibly due to the high levels of medication I was taking they said. 

However they thought I would be an ideal candidate for DBS and explained the risks and benefits, the process and what was involved in the operation itself. 

I would need to be awake throughout the procedure, so that they could assess when the tremor stopped. This would mean only having a local anaesthetic. This was a lot to absorb and the neurologist asked again if I still wished to pursue this. 

Of course I answered yes, especially now I knew my right side symptoms would eventually catch up. What other option did I have? 

Many other people had undergone this type of operation while awake, and were still around to tell the tale, so why should I be any different to them? This was looking like the only way I might at least get some of my life back.

Strange though it may seem, I was now beginning to feel quite excited about the prospect of being able to once again carry out even just the simple tasks like doing up buttons and zips. 

No hospital bed available

The next step was to be a 2-day hospital visit in September for which I had to come off all my Parkinson's medication, so the professionals could see how bad things could really get. From this they would judge if I could continue along this route or not. 

Having come off my meds 2 days before admission I was in an almost uncontrollable state. Then on the day - I was devastated to learn from the hospital there was NO BED available. I immediately went back on medication, however it took another 2 days to get back to my 'normal'. 

Fortunately a a bed was available for my rescheduled appointment in October. The DBS specialist nurse filmed me with her video camera as I carried out various tasks - or tried to.

More tests followed, and I was given medication to see how long it would take to bring my tremor under control. This it seemed would be the deciding factor. After my film shoot and the tests were completed I re-started my Parkinson's meds again and waited for Doug to come and get me for the long drive home to the South Coast.

Meeting the neuropsychiatrist

An appointment to see a neuro-psychiatrist was the last part of the puzzle. 3 hours of memory, recognition, word association tests and building blocks into patterns would determine if I was mentally able to go through with this. Being awake while the surgeons operate on your head is something that wouldn't be relished or tolerated by everyone. 

All the specialists' reports and my video went before a panel who would make the final decision on whether I was suitable to have this operation. 

Finally, at the end of November 2009 I received a letter to say that I was suitable for DBS and that the operation could go ahead. 

... and finally the surgeon

My appointment to meet my surgeon in December was just prior to my husband going into hospital for a triple bypass so the timing could not have been worse. 

Back at King's again we found ourselves speaking to the man who would eventually be making holes in my head. The whole procedure was explained through in great detail with the risks and possible side effects of this type of operation. 

He told me about the different types of operation that I could have and we finally settled - not lightly - on the most major of the 3 options. 

This would mean inserting probes into both sides of my brain. Even though the right side was as yet unaffected, the probes and wires would already be in place to turn on when needed in the future. 

Doug was to go into hospital for his heart surgery in 2 weeks time so we agreed that my operation would be delayed until late February 2010.

Final preparations

2 weeks before my surgery I met the DBS specialist nurse for various tests incuding blood tests and an ECG. If any of the test results were not acceptable I would hear from them before my I was due to come in.

As always there were also lots of forms to complete - and this with my very long list of questions meant we were there for most of the day.