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Ron and others, Here is a list of things to remember about stimulator programming. For those not familiar --- my brother Steve had the first biSTN DBS in Chicago in April of 1998 and I have been to all his programming sessions. 1. In Europe most patients are kept in the hospital, have their stimulators turned on immediately after surgery and are completely programmed within 10 to 14 days. The idea that the body takes several weeks to get used to the stimulation is BS. It takes 24 to 72 hours --- and that depends on how extensive and strenuous the programming session was. 2. Stimulation is the SUM of the electrical stimulation AND the medication. Every stim setting has a different medication requirement. They have to be balanced. 3. If you develop a problem or negative side effect --- time will NEVER make it better. In Ron's wife's case, shutting off a stimulator eliminates the problem. That means the programming is wrong and needs to be fixed. Get it fixed. WHY WAIT? We left the hospital one day with a setting that seemed to be working well. In 24 hours we were back at the hospital because of problems that developed. The 288 mile round trip was time well spent. 4. Over stimulation can cause the same symptoms as no stimulation at all --- ie. stiffness and rigidity. 5. If you shut off a stimulator and things get progressively worse rather than better you need more stimulation. 6. If you shut off a stimulator and your problems improve you are overstimulated. That can be the result of: A. Too high settings. B. The wrong electrode combination C. Cross-talk (the stimulator sends a signal to the opposite side of the STN from the one it is implanted in)(every program setting may produce a different amount of crosstalk) 7. You need to take an active part in figuring out what needs to be changed. Your options are very limited --- only ON or OFF for each stimulator ---- but the results give a huge amount of information. 8. Take notes!!!!! The doctor only sees you for perhaps an hour or two. He/she does not see what your response is at various times of the day. 9. Why suffer with a problem setting? Get it fixed!!!!!!!!!!! That is the whole point of adjustable electrical stimulation. You have to live with it --- the doctor doesn't. Paul ----- Original Message ----- From: "RON HEIMBACK" <[log in to unmask]> To: <[log in to unmask]> Sent: Friday, August 09, 2002 3:46 PM Subject: Re: surgery and speech My wife had DBS in several months ago. She has a problem speaking when her right stimulator is on, so we leave it off for weeks at a time and only turn it on for an hour when she feels the need. We hope that this can be made better by adjusting that stimulator. We will attempt this soon as we are waiting for her body to fully adjust to the stimulators and don't want to rush things too fast Hope this helps, Ron. ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn