On June 1, 1995 I celebrated my year and a half post-Pallidotomy birthday. As there is much discussion concerning the Pallidotomy procedure, its benefits and the lasting effects I will attempt to share with you an 18 month post -opt report with you. The day following my surgery on Dec. 2, 1993 I wrote , I feel like I'm almost in a fantasy land, but with each passing hour the fantasy becomes more a reality and what was the Parkinsonian reality becomes a fantasy. The bilateral Pallidotomy seems to be a complete success. I no longer am plagued with stiffness, immobility, tremor, excessive sweating, akinesia, bradykinesia, dyskinesia, walking difficulties, stooped posture, swallowing difficulties, or speech hindrances. My eyes and mouth remain shut at night while I sleep rather than both remaining partially open. There is no longer an "on-off" phenomena. My voice is strong again. My face is expressive and noticeably different. I no longer have a sense of urgency when I need to urinate. I do not need to lie down for 3 hours in the afternoon because my body is so slowed down. I now sleep through the night and no longer take a sleeping pill before I go to bed to help me try to get a good night's sleep. My appetite has returned and eating is a joy rather than a chore. Both my arms swing freely when I walk. My gait is loose and normal. Karen says my hand feels soft and pliable, rather than stiff and tense. I move about easily, freely and naturally. Then on September 8, 1994, in a newsletter article for the *Movers and Shakers* I wrote, I continue to experience the miraculous benefits of the pallidotomy. My life has been absolutely transformed, given back to me, regained through this procedure under the skillful hands of Dr. Iacono. Since the surgery I have a new appreciation for life that causes me to squeeze every delicious moment out of life. I still have Parkinson's disease, but I have won a battle and it feels great. Since the surgery I have skied in Utah for a week, surfed at San Clemente, skydived from 12,500 feet, hang glided, water skied as well as playing tennis, and golf on a weekly basis. I believe with the pallidotomy we have truly entered a new era in the treatment of Parkinson's disease - one that is filled with great hope. SO HOW AM I TODAY? Unbelievably great and very thankful. In attempting to provide some more objective criteria for the scientist and the medical community I was a 63 on the U.P.D.R.S. pre-opt as a 46 year old with a 12 1/2 year history of Parkinsons. Yesterday I retook the U.P.D.R.S. and being as hard on myself as I possibly could, the most I could come up with was a 6. On the Hoehn and Yahr scale I would have been a stage 3.5 pre-opt and on the Schwab and England Activities of Daily Living Scale a 60%. Today I would put myself at a 0.25 on the Hoehn and Yahr being extremely hard on myself and at 100% on the Schwab and England Activities of Daily Living Scale. Are there any deficits since the surgery, again straining to be totally honest with you valued members of this Parkinson s community I would list the deficits as follows: slight drooling occasionally, speech while over-all stronger and better on occasion especially when I am tired will become slow and slightly slurred, my mouth tends to remain open and I have noticed a difficulty keeping my mouth closed when I am chewing. I have a tendency to dose off while sitting up all a pleasant change after not sleeping well for 8 years. I am a bit more stooped than 18 months ago and do tend to get mask-like and slowed down when I am tired. Whereas the first six months following surgery I would occasionally (every other day) have slight tremor bursts lasting for about a minute I have not experienced any tremor the last six months. I have gained the 20 pounds I had lost during Parkinsons plus about 5 pounds. Whereas before the surgery I could eat anything and everything including rich creamy desserts without any worries about weight gain, I have found that I must now watch my calorie intake like most of my middle aged friends. To keep me honest I had my wife read over this section of the report and make any needed changes. Pre-opt I was taking the following medications on a daily basis. 3 1/2 Sinemet 50/200 C.R., 1/2 Sinemet 25/100, 2 Eldepryl, 3 Amantadine, 4 Permax (.5mg), and 1 Zoloft. Today I am taking 4 Sinemet 50/200 C.R., 1/2 Sinemet 10/100, 1 Eldepryl, 1 Amantadine, 1 1/2 Permax, 1 Zoloft plus 4 Hydergine. Since my surgery I have gone out to Loma Linda every Tuesday I am in town to help out Dr. Iacono in whatever way possible through the Loma Linda Parkinson s clinic. As such I have witnessed firsthand under the most trying of circumstances a doctor completely dedicated to helping the Parkinson s patient. I have seen literally hundreds of patients pass through the doors of Loma Linda many of whom have elected to have a unilateral Pallidotomy, a bilateral Pallidotomy or a combination Pallidotomy/Thalamotomy. Conservatively 85% of these patients have a good result ranging from a C+ to an A+. 10-12% receive minimal help, but no harm is done, and 3-5% have some sort of complication usually a result of bleeding. NO ONE has died as the result of this surgery or attendant complications. These statistics are amazing and will in time be published and validated. In the meantime I appeal to those of you out there in the medical community to quit your petty infighting, turf battles, and professional jealousies. Put them aside for the benefit of the patients you serve, let love and compassion rule the day and let s join together in embracing this surgical procedure that offers for the first time in the history of Parkinson s a very real hope for reversing this ruthless disease. To any neurosurgeons, who are sincerely interested in learning this procedure, I would invite you to come out, visit clinic and observe Dr Iacono operating as increasing numbers of neurosurgeons are doing. Learn to do the procedure using MRI scan, brain maps, ventriculographs and a thermocouple radiofrequency lesion probe in less than three hours without tedious micro-electrode recordings which add many hours to the surgery and nothing to the results. Next to helping the Parkinson s patient Dr Iacono s passion is for teaching others. I have heard him say repeatedly my operating room is open to all. As a Parkinson s community we are working hard to provide funding for Parkinson s research through the efforts of Joan Samuelson, PAN, and Senator Hatfield s sponsorship of the Udall bill. We are seeking greater cooperation and perhaps a uniting of the various Parkinson s National groups. It is equally important that within the medical community there be a whole new level of acceptance and cooperation so that together we can truly ease the burden and find a cure. LET IT BEGIN TODAY. Dr. Don Berns 4943 Del Monte Rd. La Canada, CA 91011 818-790-8812 <[log in to unmask]>