Dear Patient Reader, While showering this morning it occurred to me that I might be boring you to tears[not the 1st time that thought came to mind] Got to be quick about it...so.. Item #1...2nd.side Pallidotomy vs.Deep Brain Stimulation[DBS] PRO PALL a.First side went well b.Know the surgeon and surgical team and trust them. Ditto with the hospital. c. Know the area well.My roots are here. My family,friends, colligues,neighbors,"my" Medical team is down the street; my neurolgist,internist etc and THE surgeon and hospital are 25 miles away d.No long haul follow-ups e.My insurance co. will cover all the cost.It's a HMO but they had little trouble paying for 1st side.A tribute to my Internist,Neurologist and HMO Case Manager. Fine advocates. f.I have some idea of possible surgical complications and I have some thoughts about how to deal with some of them.Speech is a serious concern with 2nd side Palls and dispite my efforts to understand this complication I'm still trying to come to grips with it.And, of course, I have a soft voice.My plan is to arrange for speech therapy BEFORE and after surgery.I'm also relearning how to whistle and will on occasion break into song. The key word here is break. CON PALL a.Usual and possible complications of any surgery. b.Possible complications unique to Pall.[either side] c.posiable complications unique to second side Palls..especially the speech problem. d.By doing 2nd side Pall I would be ruling myself out for other forms of surgery such as DBS and tissue transplantation[maybe].This is a complicated issue. e.It seems to reason that the Pall.surgery will, given it's more invasive nature, be more likely to fail the test of time then will a less invasive surgery. ............................................................................ .......................... PRO DBS a.Less invasive than Pall.and therefore would counter d. and e.of above CON PALL. b.DBS is reversaible. CON DBS a.Usual and possible complications of any surgery. b.Possible complications unique to DBS surgery.I understand that this surgery is longer and more complicating than Pall c.Possibility exist for defective equipment and parts that malfunction etc. d.I will not be able to have another MRI or pass through another airline security post with out setting off alarms. e.DBS is considered experimental in the USA and if you are not one of the 12 [NYU was granted FDA approval to do 12 DBSs; the only site in the USA to be granted approval to do DBS in"lieu of performing the second lesion".Already they have a waiting list of 7. FDA approval arrived last Friday.Bet the phones are lit up Tuesday am. f.Given the experimental nature of the surgery insurence companys are not likely to pay. The ballpark cost at NYU is $50,000.plus travel,hotels,etc Follow-up is "lifetime. g.Hospital stay is at least 7 days vs 2-3 for Palls.More time to pick up hospital's ills. h.Given the cost and the lack of sites we look toward Canada,Europe and Japan.It's not clear what their medical institutiomns/political/health care systems are all about. I have some close family on PEI,Canada who aren't happy with the long wait for certain procedures and if fee-for-service foreigners were filling the beds.Well.... I'm sure i've missed a good deal of PROs and CONs especially with regard to PRO DBS but I'm hoping that you all will fill in some of the blanks.Those of you who live outside the USA and familiar with DBS hold some invaluable information and I [and others] would be grateful to hear from you.Geert from Belgium has been kind enough to share his eexperience with me. And those of you who reside in the states but had DBS surgery in another country could give me a most interesting slant. Joanne and Don of Berkeley were most kind in sharing their experience with DBS surgery in France I'm leaning toward doing the 2nd side Pallidotomy because it is familiar.I would like to have more information available although my decision will be based on what feels right to me. Thank you kindly for reading this posting but I must warn you there is more serious stuff to follow. My very best, George Lussier [[log in to unmask]] [log in to unmask]