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I have had PD for 15 years, I’m now 57.  My views on the cause and treatments for PD have totally changed over the years. I have to agree with Greg, its all about profit. In my area a local Medical Center may be closing their PD dept., instead they will promote their Stroke facilities, more money to be made.

  Check out this site,
   http://www.parkinsons-success.com/

  Google “NUCCA”

  Read everything you can find on nucca.

  Your views may change also.



Greg Wasson <[log in to unmask]> wrote:   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
---------------------------------

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

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