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Jacob - We're happy you have the opportunity for some surgical relief. In a message dated 97-03-04 14:57:11 EST, you write: >My first question is: Has anyone on the list had a thalamotomy or a deep >brain stimulation, and if so, how much did it cost ($)? Also what were the >results? Would there be anyway to get medicaid to pay for at least some of >the cost? Finally, would having this operation rule me out of a fetal tissue >implant? I'll do my best to answer your questions based on our experience. First, Dick's pallidal stimulations averaged $20,000 each, and that was with the neurosurgeon donating his time because the operation was "investigational." Dick still had private insurance, both his and mine, and both insurance companies paid, although we had to go into both surgeries not knowing whether they would or not. They generally go by what Medicare covers, and we do know that others of the first five who had pallidal stimulation had their surgeries covered by Medicare. We understand that they have now said they won't cover any more until it receives FDA approval. We were told that Medicare had just stopped covering Thalamic stimulation, based, according to our neurologist, on totally erroneous information. He was actively corresponding with them to get that situation corrected. That was about a year ago. I suggest you look in the phone book for the 800 number for Medicare and call. You'll be on hold forever, but eventually you'll speak to a real person who can tell you the current status. Dick chose pallidal stimulation rather than pallidotomy because of the potential of having the electrodes removed if something better came along, such as fetal transplant, nerve growth factor, or whatever. We asked if, once the electrodes came out, there would be scar tissue or other effects from the surgery that would rule out other procedures later. That question can't really be answered with any certainty, but according to Dr. Koller of KU Med, they had one patient with a thalamic stimulator who died of a non-PD-related cause 3 1/2 years after implantation. On autopsy, they found no scarring whatsoever - I think they'd expected to see some. You'd have to ask your doctor, but my guess is that if you have deep brain stimulation now (or any brain surgery), that would rule you out of having fetal tissue implants as long as it remains experimental. They wouldn't want any other factors to cloud their results. However, if the procedure should become routine and accepted (many, many years down the road), you would probably be a candidate if you have deep brain stimulation, but not if you have thalamotomy or pallidotomy. Just my non-medical opinion. I'm a bit unclear as to whether you are a candidate for thalamic stimulation or pallidal stimulation - they're pretty much the same surgery except for where the tip of the electrode is placed. We have seen good results from both surgeries. Dick has had good relief of his major symptoms from the pallidal stimulation, but it's not a cure. If you'll write to us directly, we'd be happy to answer any questions you might have. Sincerely, Margie Swindler (cg for Dick, 52/15) [log in to unmask]