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HI al

The following is a partial  lisat of questions to ask your DBS  
Surgeon.  I have compiled these off the top of my hea and with the 
experience of having DBS imiplanted 10 years ago (. May 1999..) Also,I 
have had    Relacements because of batttery failure 3 times on each side 
ONe of those times was a catistrophic sudden failure. There was a delay 
of 18 hours from  faiure to replaceent  during which ti I experienced 
severe dyskinesia. Also.  I am a  physician now retired  physician.

1.  _Risk/benefits_ As you should  before any major medical/surgical 
intervention.- ask the physician What are the potential  risks to you 
and  the potential benefits? .  In other words what improvements can 
expect you immediately after surgery.  What are the benefits  and 
(possible short term and longterm risks )  with and without the surgery 
vs. what you can expect with and without the  surgery?  Also is the 
timing of surgery now now or in the future optimum,?

2. _The surgeon_ Where is your surgeon trained(?DBS was begun to be 
widely used  in France) How long  has he/she been doing DBS and how many 
DBS implants has he(she) done?   What is her/his   complication and 
mortality rate with this procedure,   DO you like and trust him?  Is  
he/she  open and honest with you or do you find hi/her defensive when 
answering  these questions?  Remember you aren't interviewing him/her to 
be your buddy but yiu should trust him /her and feel comfortable with 
your doctor.

_3. Teaching__  _Who is actrually doing the surgery.? Especially in a 
teaching hospital  part of the surgery.is often done by residents. The 
placement of the leads is the most critical part of the surgery. Others 
may assist but the Surgeon of record should be doing crucial parts of 
the  procedure. Make sure that you are comfortable wtth Residents 
assisting (I am! am presuming the primary surgeon is present,)    Be 
sure that you are comfortable with  that  or  tell your doctor if you 
are not,

4. . _Travel and Follow-up    _ How long should it take to adjust the 
stimulators. and who will do it?  -  if  not an MD then  what is their 
training?  I have had good and bad Physicians Assistants and nurses as 
well as MDs    How many trips should it take to Montreal? -especially 
since it seems that you wil have to travel a long distance.  Does all 
follow-up need to be done by him(her) or is there someone closer to you 
qualified.

_5. Stimulator _  Which model of the Stimulator(s) currently approved is 
going to be and will they be implanted and bilaterally or unilateraly?. 
Will you have the ability to adjust it yourself(within the parameters 
set by your MD.) ?  Is the surgery done by your MD in 1 or 2  
procedures. (This varies among doctors.)


_9. Emergencies  _What do you do if  the Stimulator stops working- 
either  turned off by eg store security osystem or sudden battery or 
lead failure?.   Who do you call (be sure that if it is a hospital ER 
that you have someone on the other end who knows something about DBS. 
(This from bitter experience)


Charles T. Meyer, M.D.
Middleton (Madison) WI


.
kbachn wrote:
> I'm about to go for an evaluation for DBS in Montreal later on this month
>
> What 'd be the questions to ask?  Your responses would be much appreciated.
>
> Regards, Ken (41yrs old, dx 5 yrs)
>
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