5 YEAR POST-Pallidotomy REPORT
(Surgery date 12/1/93)
By  Dr. Don Berns
 UPDRS  On      Off
        3       11
        =

        After having suffered through the ravages of Parkinson's Disease
for 12 1/2 years I was privileged to become Dr. Iacono's first simultaneo=
us
Pallidotomy patient.  NOW AT MY FIVE YEAR ANNIVERSARY I MUST SAY TO ALL T=
HE
NAYSAYERS WHO SAID THAT A Pallidotomy WOULD ONLY LAST A YEAR OR TWO AT TH=
E
MOST.
        AT FIVE YEARS I AM STILL GOING STRONG AND CONSIDER THE results to=

be nothing short of MIRACULOUS.

COLUMN CODES    =

1.  SYMPTOM BEFORE SURGERY            =

2.  6 mos. AFTER SURGERY                  =

3.  1 YR. POST-OPT                        =

4.  1 1/2 YR. POST- OPT
5.  2 YR. POST-OPT
6.  3 YR. POST-OPT
7.  4 YR. POST-OPT
8.  5 YR. POST-OPT

SYMPTOM                                   COLUMNS
                  1       2        3       4         6       7           =
8
TREMOR        Severe    GONE     GONE     GONE     GONE     GONE       =

GONE
DYSKINESIA    Excessive GONE     GONE     GONE     GONE     GONE       =

GONE
SWEATING      Excessive GONE     GONE     GONE     GONE     GONE       =

GONE
SLEEP
  DISTURBANCE Definite  GONE     GONE     GONE     GONE     GONE       =

GONE

EYELIDS       Slightly
  During Sleep Open     Closed   Closed   Closed   Closed  Closed      =

CLOSED
SHUFFLE       Definite  GONE     GONE     GONE     GONE     GONE       =

GONE
GAIT FREEZE   Definite  GONE     GONE     GONE     GONE     GONE       =

GONE
SENSE SMELL   GONE      Back     Back     Back     Back     Back       =

BACK
ACHING =

   MUSCLES    Definite  NONE     NONE     NONE     Rarely   Rarely     =

Rarely

BACK PROBLEMS Definite  GONE     GONE     GONE     GONE     GONE       =

GONE
AKINESIA      Definite  GONE     GONE     GONE     GONE     GONE       =

GONE
BRADYKINESIA  Definite  GONE     GONE     Slight   Slight   Slight     =

Slight
SEXUAL STAYING
    POWER     Lessened  Enhancd  Enhancd  Enhancd  Enhancd Enhancd     =

Enhanced
STRESS        Severely  No       No       No       No      No           N=
o
              Affected  Effect   Effect   Effect   Effect  Effect      =

Effect

DROOLING      NONE      Slight   Slight   Seldom   Seldom   Seldom     =

Seldom
URGENCY TO    URINATE   Yes      No       No       Slight   Slight     =

Slight
DYSTONIA      NONE      NONE     NONE     NONE     NONE     NONE       =

None
VOICE         Weak      Improved Improved Improved Varies   Varies     =

Varies
SPEECH        Affected  Improved Improved Improved Varies   Varies     =

Varies

SHORTNESS OF =

    BREATH    Affected  NONE     NONE     NONE     NONE     NONE       =

None
HANDWRITING   Very Bad  Normal   Normal   Normal   Normal   Normal     =

Normal
ON-OFF        Definite  GONE     GONE     GONE     GONE     GONE       =

GONE
APPETITE      Very Poor Normal   Normal   Normal   Normal   Normal     =

Normal


MEDICINE SCHEDULE
                 1       2       3     4     5      6      7    8
___________________________________________________________________
Sinemet CR =

    50-200      3.5     3.5     3.5    4     4      4      5    5
Sinemet 25-100   1
Sinemet 10-100          .5      .5    .5    .5      2      1    6
Eldepryl         2       1       1     1     0      0      0    0
Amantadine       3       1       1     1     1      1      1    1
Permax 5mg       4      1.5     1.5   1.5   1.5    1.5     2    2
Zoloft 50 mg     1       1       1     1     1            =

Paxil                                               1      1    1
Hydergine        0       0       4     4     4      0      0    0

VITAMINS etc.
        In addition to the above meds I take the following on a daily
basis: 800 I.U. of Vitamin E, 1000 mg of vitamin C, 750 mg of Chewable
Calcium, and two Ginkoba tablets.       Since December 1995, I have been
using magnetic therapy in the form of insoles for my shoes, chair pads, a=
nd
sleeping on a magnetic sleep pad.  All of which I believe have benefited =
me
in sleeping sounder and feeling more energized.

OTHER PATIENT RESULTS
Although I no longer go out to Loma Linda to work with Dr. Iacono since I=

have moved to Pittsburgh. Over the years I have seen literally hundreds o=
f
patients who have elected to have a unilateral Pallidotomy, a bilateral
Pallidotomy or a combination Pallidotomy/Thalamotomy.  =

        Conservatively 85% of these patients have a good result ranging
from a C+ to an A+.  10-12% receive minimal help, but no harm is done, an=
d
3-5% have some sort of complication usually a result of bleeding.  NO ONE=
 =

has died as the result of this surgery or attendant complications.  These=

results are based on a very broad patient selection pool.

                FURTHER REFLECTIONS ON PALLIDOTOMY.
        In further reflecting on my Pallidotomy I believe that after five=

years I can make the following statements: =

        The Pallidotomy intervened into my Parkinson's Disease and
re-balanced the brain taking into account the dopamine and seratonin
depletion that existed and given the medicine schedule I was on at the
time.  This in a sense reset my Parkinson's Disease time clock back to
zero.  =

        I now have the luxury of taking a little more medicine when neede=
d
without facing those dreaded dyskinesias.  The greatest deficits I face a=
re
occasional drooling, getting sleepy mid-morning or mid-afternoon, some
slurred speech when I am tired or low on medicine, and being slightly
slowed down in the late evening.  There has been some deterioration in
speech quality over the last year and a half.  You will notice from the
chart above that I have increased my Sinemet intake which has presented n=
o
problems.  AT 4 1/2 YEARS I MADE A SUBSTANTIAL INCREASE IN MY SINEMET FRO=
M
1200 TO 1600 mg/day of LEVADOPA WITH VERY GOOD RESULTS.
        Concerning the stimulator implants, that may be a way to go if yo=
ur
surgeon has not had much experience or very good results with
Pallidotomies.
        I continue to feel my life was given back to me through the
Pallidotomy and tend to view every day as a bonus day, a gracious gift fr=
om
God.

FOR MORE INFO SEE WEB SITES
Website for Dr. Iacono and pallidotomies:
www.pallidotomy.com    909-792-8188
Website for Don Berns story:
www.parkinsonalliance.net/medical/palberns.htm


Dr. Don Berns
110 Delano Dr.
Pittsburgh, PA 15236
412-650-6812
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