3 YEAR POST-Pallidotomy REPORT
By Dr. Don Berns
After having suffered through the ravages of Parkinson's Disease for 12
1/2 years I was privileged to become Dr. Iacono s first simultaneous Pallidotomy
patient. In just three and a half hours Dr. Iacono performed a Postero-Ventral
Pallidotomy creating two perfectly placed lesions in the interior portion of the
globus pallidus nestled right down by the internal capsule and the optic nerve.
The results have been nothing short of outstanding as the following
report will seek to communicate on paper what has and continues to be a
life-transforming experience.
COLUMN CODES
1. SYMPTOM BEFORE SURGERY 4. 1 YR. POST- OPT
2. AFTER SURGERY 5. 2 YR. POST-OPT
3. ? YR. POST-OPT 6. 2 ? YR. POST-OPT
7. 3 YR. POST-OP
SYMPTOM
1 2 3 4 6 7
TREMOR Severe GONE GONE GONE GONE GONE
DYSKINESIA Excessive GONE GONE GONE GONE GONE
SWEATING Excessive GONE GONE GONE GONE GONE
SLEEP
DISTURBANCE Definite GONE GONE GONE GONE GONE
EYELIDS Slightly
DURING SLEEP Open Closed Closed Closed Closed Closed
SHUFFLE Definite GONE GONE GONE GONE GONE
GAIT FREEZE Definite GONE GONE GONE GONE GONE
SENSE SMELL GONE Restored Restored Restored RestoredRestored
ACHING
MUSCLES Definite NONE NONE NONE Rarely Rarely
BACK PROBLEMS Definite GONE GONE GONE GONE GONE
AKINESIA Definite GONE GONE GONE GONE GONE
BRADYKINESIA Definite GONE GONE Slight Slight Slight
SEXUAL STAYING
POWER DiminishedEnhancd Enhancd Enhancd Enhancd Enhanced
STRESS Severely NoEffect NoEffect NoEffect NoEffectNoEffect
Affected
DROOLING NONE Slight Slight Slight Occas nlOccas nl
URGENCY TO
URINATE Yes No No Slight Slight Slight
DYSTONIA NONE NONE NONE NONE NONE NONE
VOICE Weak Improved Improved Improved Varies Varies
SPEECH Affected Improved Improved Improved Varies Varies
SHORTNESS OF
BREATH Affected NONE NONE NONE NONE NONE
HANDWRITING Very Bad Normal Normal Normal Normal Normal
ON-OFF Definite GONE GONE GONE GONE GONE
APPETITE Very Poor Normal Normal Normal Normal Normal
MEDICINE SCHEDULE
1 2 3 4 5 6 7
Sinemet CR
50-200 3.5 3.5 3.5 4 4 4 4
Sinemet 25-100 1
Sinemet 10-100 .5 .5 .5 .5 1 2
Eldepryl 2 1 1 1
Amantadine 3 1 1 1 1 1 1
Permax 5mg 4 1.5 1.5 1.5 1.5 1.5 1.5
Zoloft 50 mg 1 1 1 1 1 1 1
Hydergine 0 0 4 4 4 5 0
VITAMINS etc.
In addition to the above meds I take the following on a daily basis: 800
I.U. of Vitamin E, 1000 mg of vitamin C, 750 mg of Chewable Calcium, and one
Ginseng tablet. Since Aug. 96 I have added to my regime One Coenzyme 10 (60
mg) and 0ne DHEA (50mg).
Since last December 1995, I have been using magnetic therapy in the form
of insoles for my shoes, chair pads, and sleeping on a magnetic sleep pad. All
of which I believe have benefited me in sleeping sounder and feeling more
energized.
OTHER PATIENT RESULTS
I have continued going out to Loma Linda every Tuesday to assist
Dr. Iacono in whatever way possible. 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
results are based on a very broad patient selection basis.
Further reflections on Pallidotomy.
In further reflecting on my Pallidotomy I believe that after three years
I can make the following statements:
The Pallidotomy intervened into my Parkinson's Disease and re-balanced
the brain taking into account the dopamine and seratonin depletion that existed
and given the medicine schedule I was on at the time. This in a sense reset my
Parkinson's Disease time clock back to zero.
Since the surgery meanwhile the underlying disease has continued to
progress with the dying off of more dopamine producing cells in the substantia
nigra. Yet because the brain was brought back into balance with so few of the
dopamine producing cells active (let's say 10 % in my case), the fact that I now
only have say 9% of my dopamine producing cells active does not make that great
a difference.
Plus I now have the luxury of taking a little more medicine when needed
without facing those dreaded dyskinesias. The greatest deficits I face are
occasional drooling, getting sleepy mid-morning or mid-afternoon, some slurred
speech when I am tired or low on medicine, and being slightly slowed down in the
late evening. There has been some deterioration in speech quality over the last
six months.
I continue to feel my life was given back to me through the Pallidotomy
and tend to view every day as a bonus day, a gracious gift from God.
By the way on 12/27/96 I had bi-lateral arthroscopic knee surgery. After
all I am a bi-lateral man. <grin>
