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Dear Susan Romano: To answer your questions to me on Mar 3, l995 - I've known about stereotactic surgery for a long time. During my rotation in surgery as a nursing student (UVA)I circulated during what I now think was a thalamotomy to stop tremors in a non-stop tremoring patient. (It worked). When I "caught" PD 9-10 years ago I started going to PD meetings all over Canada and the US - and subscribed to all the PD organization newsletters. I also bought all the PD books. More and more it was dawning on patients and doctors that the silver bullet levadopa was beginning to tarnish. Pallidotomy was resurrected. Dr. Lauri Laitinen in Stockholm was doing pallidotomies before we started here. He also started training US neurosurgeons - the first being Dr. Iacono. I had a Swedish friend who checked with doctor relatives in Stockholm who knew of Dr. Laitinen's work and they were very impressed and recommended him highly. So I made an appt. and had a right sided pallidotomy done May 21, l993. Bilaterals were not being done then. Robert Iacono started doing bilaterals. Yes, if I had had a choice I would have had both sides done at once. The total cost of my pallidotomy was $12,500. Blue Cross/Blue Shield paid $6500. Some insurance companies won't pay for out of country medical bills. Dr. David Roberts, a neurosurgeon here at Dartmouth is doing pallidotomies now. Several friends of mine were done - all successfully to date. The last cost I discussed with one friend was a total of $13,000. Her medical insurance covered all of it. A scotoma is a small blind spot in one eye which is caused by getting too close to the optic nerve with the electric probe. It only bothers one whilst reading. I have never heard of anyone becoming blind and scotomas are rare since improvements in the pallidotomy procedure. No, I did not have to wait long - two months - to get the pallidotomy in 1993. A friend got date the end of May with a call to Dr. Laitinen two weeks ago - Dr. L. did one side two years ago. I tried to call Dr. Roberts re his backlog, but his phone has been busy all afternoon. Understandable. Oooops - just got through - Dr. Roberts is now scheduling for May. You asked me about risk factors - any surgery (even an extracted tooth) is fraught with danger. The best surgeons cannot foresee a bleed or a stroke. It really doesn't happen often. When I had my pallidotomy the risk for scotoma was 8% and death was 0.5% Now scotomas are hardly mentioned. I don't know of any deaths. Keep in mind as you read "all the news that fits" that some patients expect a pallidotomy to make them whole again - a cure. That doesn't happen. You probably can play golf more comfortably than before, or get in a canoe without toppling over, or eat more daintily, or walk less like the local drunk, or make a bed without falling into it - -and have a more pleasant face, and less shaking limbs, and all in all feel better. If you want a full head of hair and straight white teeth and be able to dance the fandango - forget pallidotomy. It is great but it is not wonderful. I take that back - if you feel like a prisoner in your own body - go for it - you'll feel wonderful. Barbara Yacos <[log in to unmask]> ****** Sleepless in Seattle: Did your sleep disorders speaker say why we with restless leg syndrome (agh!) should eschew dairy products? Avoiding caffeine makes sense. Barb