Don.....

I think the proof of Dr. Iacono's success as one of
the premier neurosurgeons and movement disorder
specialists today is in the numbers of successful
surgeries he's performed - certainly a number no
other neurosurgeon can even come close to matching.

Since Parkinson's patients as well as others
suffering similar debilitating degenerative neurological
diseases come from all over the world in a steady
stream to Dr. Iacono for evaluation and treatment, one
can only presume the vilification directed toward him
by his peers is an "ego thing" amongst people without Dr.
Iacono's professional skills.

People come to Dr. Iacono from all over the world for
treatment in ever increasing numbers because his
successful surgeries cannot be kept a secret.  No
matter WHAT other physicians may say, IF Dr. Iacono
was not doing an outstanding job in bringing relief to
Parkinson's sufferers, you could be sure those patients
 wouldn't be there.

It seems to me that more than a little "attitude adjustment"
is needed by these self-involved doctors.

Barb Mallut
[log in to unmask]

----------
From:   Parkinson's Information Exchange on behalf of Karen & Don Berns
Sent:   Monday, April 27, 1998 8:28 PM
To:     Multiple recipients of list PARKINSN
Subject:        ALL PALLIDOTOMIES ARE NOT EQUAL

ALL PALLIDOTOMIES ARE NOT CREATED EQUAL.

I just returned from the The 2nd Pallidotomy Accord held at Princeton Uni=
v.
where I heard neurosurgeons report their results. I want to tell you folk=
s
that there is a huge difference between the results of 30% success rate
reported by most of the neurosurgeons well known to many of you on this
list and the 90% success rate reported by Dr. Iacono.  =


Furthermore it was disheartening and demoralizing to see the way Dr. Iaco=
no
was disenfranchised by his peers.  Seemingly unable to cope with his
positive results, repeated potshots were taken toward the man whose
knowledge and surgical expertise are clearly head and shoulders above the=

other well known doctors from around the country and Canada.

Why is it this group of neurosurgeons cannot put aside their huge egos an=
d
engage in cooperative learning?  As patients we need to be concerned abou=
t
this. After all we are the consumers.  When it comes to putting that whic=
h
is so valuable to us, our brains, we must insist on the best from our
doctors.

Many of these doctors are opting for the less precise deep brain stimulat=
or
implants (citing a variety of reasons to the patient, such as reversibili=
ty
of the technique) when in reality patients are paying an extra $10-15,000=

for the hardware.  Overlooking incentives from the hardware manufacturer,=

the question must be asked, Why would a person want a foreign device
implanted in the body when an *on target* pallidotomy works so much bette=
r?

The one exception is if a stimulator were needed on a second side
thalamotomy.

To listen to these neurosurgeons discount bi-lateral pallidotomy because =
of
cognitive deficits and frontal lobe damage is to discount more than 150
simultaneous bi-lateral pallidotomies done by Dr. Iacono with no cognitiv=
e
deficits.  In fact, in most cases there is improvement in frontal lobe
functions such as reasoning and feeling of over all well-being.  =


The pallidotomy operation if done well is as much an art form as it is a
science.  I believe this is what scares so many of these neurosurgeons an=
d
makes them want to hide behind stimulator implants, or micro-electrode
recordings, because they don't know how to get down within a millimeter o=
f
the optic nerve and internal capsule which is what is necessary to get th=
e
optimum result.  Most of the neurosurgeons reporting at this conference
were not trying to get any closer than 3mm.  Given their current skill
level this is understandable and even acceptable so as not to permanently=

damage the patient, but it is a lot easier to see why they are not gettin=
g
the results Dr. Iacono is getting.  =


Dr. Iacono has spent a lifetime learning and perfecting the functional
stereotactic procedure of a pallidotomy.  He trained under Nashold at Duk=
e,
Shimi (sp?) in Japan, and Laitinen in Sweden.  He has performed over 1100=

pallidotomies and thalamotomies as compared with 50-75-150 done by the
other neursurgeons in attendance.   =


Therefore, it is really not so surprising that he would be getting so muc=
h
better results.  HOWEVER, what was surprising was to see the attitudes
demonstrated that remained a barrier to any sense of collegiality publicl=
y
with a man who has given his life to helping the Parkinson's Disease
patient.  Although I did observe some doctors approach Dr. Iacono private=
ly
to ask more about his technique right  after  publicly castigating him fo=
r
being too anecdotal when he sought to respond to a question about no one
having records of patients more than two years out from surgery.  He was
prevented from showing a video of a patient 4 1/2 years out from surgery.=


Why do I write this?  Because I believe it is time that patients, who
suffer from this hideous disease, rise up and demand better from the
neurosurgeons across the country and in Canada than a 30% success rate wh=
en
90% is obtainable, if some people could put aside prideful egos and begin=

to cooperate.  My hope and prayer is that next year this group of
pallidotomy experts could come together with the purpose of discovering
from one another how they can more effectively perform pallidotomies on
you, the sufferers with Parkinson's Disease. =


Don Berns D.Min 50/17
110 Delano Dr.
Pittsburgh, PA 15236
412-650-6812
<[log in to unmask]>

p.s.    Those in the Pittsburgh area have the rare opportunity to hear Dr=
=2E
Iacono tomorrow evening at
        =

WESTMINISTER PRESBY. CHURCH
2040 WASHINGTON ROAD  (RT 19)
UPPER ST. CLAIR, PA.

WEDNESDAY APRIL 29,1998
  4:30PMM - 6:15PM

DINNER AT 6:15 PM- COST $4.00 CALL FOR RESERVATIONS 412-835-6630