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Well said, Greg! E ----- Original Message ----- From: "Greg Wasson" <[log in to unmask]> To: <[log in to unmask]> Sent: Monday, April 16, 2007 12:27 PM Subject: Re: DBS for early stage PD? > Harvey, > > I have had PD for 12+ years and although I have to use a countdown timer > watch to make sure I redose my sinemet and comtan every 2 and 1/2 hours to > make sure I don't turn into a statue for a few hours as I get back "on" if > I am late with a redose, I still am not seriously considering DBS yet. > That day may well come, but not yet. > > Yes, many lives have been measurably improved by DBS surgery. But I have > also known many persons to have had to undergo successive surgeries > because of infection, persons whose voices have been severely damaged by a > slight misplacement of the lead wires during the surgery, as well as > people for whom the benefits were minimal at best. Not to mention this is > surgery to the midbrain with one's head bolted to an operating table. > > I would also raise the question of why DBS is now being promoted so > heavily for early stage PD when it was originally promoted as an option to > be considered only when traditional PD medications had ceased to be > realiably effective. Just last night I saw an ad extolling DBS for PD on > television - the surgical version of the much criticised "direct to > patient" advertising by big Pharma for prescription drugs like lipitor and > celebrex and many others (including now Requip). > > I may be cynical, but I think it is important to realize that not only is > DBS a big and very profitable business these days, it is also a product > which clearly has a shelf life. That is, as encouraging clinical trials > continue for ceregene, spheramine, and other therapies that may soon > actually retard or reverse the progress of PD rather than merely mask > symptoms (which is as true for DBS brain surgery as it is for sinemet), > physicians and clinics and companies like Medtronic (which manufactures > the equipment used in the surgery) know that as soon as one of these new > therapies hits the market, the market for DBS will shrink faster than > shallow pool of water on a hot summer day. Market considerations drive the > promotion of any product, and DBS is nothing if not a product. And lest we > overestimate the purity of those in the medical and medical products > community, the recent scandal involving accusations of payoffs in the > millions to Doctors in Wisconsin by Medtronic sales > reps should serve as a sobering example that if Diogenes were still > wandering around looking for an honest man, he probably wouldn't start > with Hippocrates. > > For what it's worth, > > Greg > > > ----- Original Message ---- > From: H Rosenfeld <[log in to unmask]> > To: [log in to unmask] > Sent: Sunday, April 15, 2007 10:50:14 PM > Subject: DBS for early stage PD? > > > In the January, 2007 issue of Neurology contains a reference to the > application of DBS for early stage PD patients. > > Results of the study seem impressive: "Quality of life was improved > by 24% in surgical and 0% in nonsurgical patients (p < 0.05). After > 18 months, the severity of parkinsonian motor signs "off" medication, > levodopa-induced motor complications, and daily levodopa dose were > reduced by 69%, 83%, and 57% in operated patients and increased by > 29%, 15%, and 12% in the group with medical treatment only (p < > 0.001). Adverse events were mild or transient, and overall > psychiatric morbidity and anxiety improved in the surgical group. > > CONCLUSIONS: Subthalamic nucleus stimulation should be considered a > therapeutic option early in the course of Parkinson disease." > > I was diagnosed with PD five years ago. My current symptoms include > annoying tremors of my right hand and right foot which medications > control to some degree. My neurologist has suggested I consult with > another specialist about assessing the potential benefit of DBS. > Many on our list have benefited from DBS, but up to this point DBS > was only applied in later stage PD patients. I would like to reduce > the tremors but I am not thrilled with brain surgery when the > symptoms are annoying and not debilitating. Is the benefit worth the > risks? > > Harvey Rosenfeld > > ---------------------------------------------------------------------- > To sign-off Parkinsn send a message to: > mailto:[log in to unmask] > > ---------------------------------------------------------------------- > To sign-off Parkinsn send a message to: > mailto:[log in to unmask] > In the body of the message put: signoff parkinsn > In the body of the message put: signoff parkinsn > ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn