Beating Parkinson's
By Paroma Basu
August 14, 2001
Keeping the beat with a brain pacemaker.
William Bland can now hear a song just once before effortlessly
strumming it on his guitar. He has the ear, and many years of
musical experience.

But most of all he has control over his hands again after years
of hearing a tune without being able to play it, because his
fingers just wouldn't cooperate.

About 10 years ago, Bland was diagnosed with Parkinson's
disease. The increasingly worse hand tremors, the inability
to walk without shuffling, the endless medications that
wear off anyway—all this he has known well.

Earlier this summer, the 58-year-old resident of Tucson, AZ,
decided it was time to get more aggressive about treatment.
"After diagnosis you get about ten years, and basically it's
a slippery slope from there. I've got too much living to do
to let that happen to me," he says.

On June 27, at the Cleveland Clinic Foundation in Ohio, Bland
had a pacemaker implanted deep in his brain to control his
involuntary shakes and tremors. The electrode supplies an
electric current to nerve cells in an area of the brain thought
to control motor function—the thalamus. Wires running down
the back of Bland's neck connect the electrode to a battery
pack implanted in his chest, right under the collarbone.

Asked about the operation, during which he was kept awake
so that his speech could be used as a navigational aid by the
surgeons implanting the electrode, Bland says, "I was bona
fidely frightened."

The surgery was long—almost ten hours—and Bland doesn't
remember very much beyond the image of three doctors and
a nurse hovering over him and "shouting down, as if through
a tunnel."

He does remember the searing pain in his back as he lay on
the hospital bed with his head locked in a metal cage to hold
it steady. "Imagine your skull is bolted to a big brass metal
bell and there are three doctors banging on it with wrenches
for three days," he recalls.

Deanna Bland, his wife of 25 years, recounts the symptoms
that led Bland to the conclusion that a brain pacemaker was
his best option. He had been losing control of his body
progressively, falling and hurting himself more often. Basic
tasks like cooking had become difficult, or hazardous,
because he would forget what he was doing and leave the
stove on. In addition, the medications he was taking
brought on fatigue, nausea and, in one case, hallucinations.

"Bill was seeing cats in the house where there weren't any,
or people's faces in the bushes," Deanna recalls.

But the last straw was that the Parkinson's was making
it impossible to play music. A guitar maker, Bland is
a natural musician, playing mandolin, piano, electric
bass and harmonica in addition to guitar. For many years,
he played gospel tunes with his daughter Ilya, as well
as folk music in a six-piece band and blues at the Unitarian
church where he is an active member.

"For about ten years I couldn't finger-pick at all," says
Bland, casually finger-picking an Amy Cassidy tune as he
speaks--post-operation. After the surgery, his hands are
less "goofy," he notes. He can walk more easily, too, and
there are no more hallucinations.

After the operation Bland spent five days recuperating
in the hospital, followed by 10 days of cruising on
Lake Erie in a 40-foot sailboat. He celebrated his 58th
birthday during the cruise.

Bland's progress will be closely monitored. He will have to
visit a doctor in Arizona for periodic pacemaker tune-ups,
which feel like "sticking your finger in an outlet," he says.
His pacemaker device is currently operating at 2.8 volts,
but over the next few months Bland's doctors will slowly
fine-tune the setting to find the optimum voltage.

Bland will also require surgery every two years to replace
the batteries in the power pack implanted in his chest.
Oddly, even though he can turn the device on or off by
rubbing a large magnet across his chest, he never knows
if it is, in fact, on or off, because the device doesn't indicate
its status.

His doctor recommends getting a cheap transistor radio
and tuning it to a station with lots of static. If the static
decreases, it means the machine is off. If it becomes
deafening, the pacemaker is up and running, explains Bland
with a big chuckle.

For the most part, Bland is simply grateful the experience
is over, and he did come away from Cleveland with more
in mind than a pacemaker.

"As a result of the trip to Cleveland and sitting on Lake Erie,
I'm now looking for a sailboat!"

Paroma Basu is a reporter for technologyreview.com.

Companion article - Brain Pacemakers
http://www.techreview.com/magazine/sep01/hall.asp

(slide show)

SOURCE:  Technology Review
http://www.techreview.com/web/basu/basu081401.asp

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