An Adjustment for Tremors: Deep Brain Stimulation

Sitting, facing the team of neurological professionals in front of me, I found myself in a conundrum. In all my posts about Parkinson’s, I’ve always been open about the fear that I feel about deep brain stimulation (DBS). Nobody looks forward to invasive, complicated, and risky surgery, and here all of that was in front of me, sharp instruments and all. Do I dare accept the opportunity to undergo DBS?

Weighing the options

That big procedure I had viewed on YouTube after I incorrectly investigated Parkinson’s on my Avalanche Day (September 27, 2016) was here again, for realsies. If I wanted it, the process could be mine. Then again, there's always the risk of complications or problems.

When Dr. Perez-Vargas (RIP) laid it all out on the line and told me what I was facing by expressing my Parkinson’s diagnosis, I went looking through everything for anything and found that specific something.

Earlier that afternoon, I didn’t know what Parkinson’s was, but by April 5, 2023, I sure know a lot of things about a lot of things. In fact, within less than 6 hours on that first Tuesday, I knew enough about Parkinson’s to know that I was neck deep in some stuff.

The need to provide an answer

I looked to the neurosurgeon, Casey H. Halpern, MD, Chief of Stereotactic and Functional Neurosurgery at Penn Medicine, and I asked him what he would do in the situation I was now faced with. Here, I restate the 4 choices I laid out in my previous post "An Adjustment for Tremors: Focused Ultrasound:"

A. Functional Ultrasound (FUS) on my dominant right hand. DBS my left side next year after the surgery heals.
B. DBS both sides in a few years, like I planned originally.
C. DBS both sides now.
D. Nothing other than medicines I’m using now.

The doctor's professional opinion

He chose answer C, backing it up with the reasoning that by doing it now, I would have a greater quality of life for another few years. If I put it off, well it’s tremors, dystonia, dyskinesia, and crappy back pains that come from walking differently due to all of the aforementioned nastiness.

Enough things had taken time away from me already. The COVID years, Parkinson's, life choices ... Was it worth sacrificing 52, 53, and maybe 54 to Parkinson's symptoms I could do something about?

I then looked at the neurologist, Andrew Siderowf, MD, and asked him the same question, and he chose the same answer, reassuringly stating how confident he was in Penn Medicine’s ability to perform the process.

My next question was whether or not I would be able to go back to work after DBS, since I always feared that being eligible for the process would take place when I was at the beginning of disability. They informed me that I would be able to go back to work. What’s more, I could be back to work really quickly compared to what I once envisioned.

Suddenly my whole world shifted

Here in the clarity of the instant, I told everyone in the room about the history of how nervous the whole process had made me. However, because of their professionalism and confident expression of their capabilities, I was now feeling equally confident about the benefits of this surgery.

Looking to my side, I then asked my wife what she felt, and she, too, agreed that it was the right thing to do. She felt that in the situation I am in, without DBS, I am finding my symptoms are only worsening. If science and technology can help, then it was mine to embrace.

One final question

Now that the doctors and the boss gave their opinions, there was only 1 more question to ask.

"Will I still look good in a swimsuit," I asked in my deadpan humorous way, holding my belly flab. "Because I’ve really been working hard on this."

Catching my odd sense of humor, they chuckled, and Dr. Halpern asked if I ever saw anyone with a pacemaker before. I replied that I didn’t think I had. He informed me that I did, but that these devices had gotten so small and advanced that they weren’t a cumbersome problem anymore.

Moving forward with DBS

With that, I accepted the ticket to the show, which will be taking place on September 5, 2023. Unlike in some cases that are done in 2 appointments, the initial surgery will leave me in the hospital overnight. Both leads will be attached then. Nine days later my battery will be turned on. At that point, I'll just need a hat to put on over my shaved head, at least until the hair grows back!

For now, I can contemplate the post-surgical hat and all of the other have-to steps in the process. Of course, there's the pre-surgical music, which hopefully doesn't include Metallica's "Crash Course in Brain Surgery!" Throughout my future posts, I'll be talking (seriously) about what I'll be doing for all of the parts of the process. Time will keep moving, and I'll soon be there, in the moment, and we'll find out what it's like to be awake to guide the lasers in for the emblazon process.

The future

I’m excited for the post-surgical world of DBS. Sure, the stoicism is still there, but so is the amazing technological world of all that humanity can achieve and conquer. For a guy raised on a steady diet of Tom Friedman’s historical works on computer innovation, I feel like I’m a part of the next sequel to The World is Flat and Thank You for Being Late.

My section will be about the one problem that stands in the way of using the DBS device that will be inserted in me: an iPhone. I’ve never owned an Apple product in my life, and now I will have to!