4 YEAR POST-Pallidotomy REPORT (Surgery date 12/1/93)
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 simultaneo=
us
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 interna=
l
capsule and the optic nerve.
The results have been nothing short of outstanding as the followi=
ng
report will seek to communicate on paper what has and continues to be a
life-transforming experience.
COLUMN CODES
1. SYMPTOM BEFORE SURGERY =
2. 6 mos. AFTER SURGERY =
3. 1 YR. POST-OPT =
4. 1 1/2 YR. POST- OPT
5. 2 YR. POST-OPT
6. 3 YR. POST-OPT
7. 4 YR. POST-OP
SYMPTOM COLUMNS
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 Back Back Back Back Back
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 Enhancd
STRESS Severely No No No No No
Affected Effect Effect Effect Effect Effect
DROOLING NONE Slight Slight Seldom Seldom Seldom
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 5
Sinemet 25-100 1
Sinemet 10-100 .5 .5 .5 .5 2 1
Eldepryl 2 1 1 1 0 0 0
Amantadine 3 1 1 1 1 1 1
Permax 5mg 4 1.5 1.5 1.5 1.5 1.5 2
Zoloft 50 mg 1 1 1 1 1 =
Paxil 1 1
Hydergine 0 0 4 4 4 0 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 regim=
e
One Coenzyme Q10 (60 mg) and 0ne DHEA (50mg).
Since last December 1995, I have been using magnetic therapy in t=
he
form of insoles for my shoes, chair pads, and sleeping on a magnetic slee=
p
pad. All of which I believe have benefited me in sleeping sounder and
feeling more energized.
OTHER PATIENT RESULTS
Although I no longer go out to Loma Linda to work with Dr. Iacono since I=
have moved to Pittsburgh over the years I have seen literally hundreds of=
patients who 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, an=
d
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 pool.
FURTHER REFLECTIONS ON PALLIDOTOMY.
In further reflecting on my Pallidotomy I believe that after four=
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 wi=
th
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 activ=
e
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 slightl=
y
slowed down in the late evening. There has been some deterioration in
speech quality over the last year and a half. You will notice from the
chart above that I have increased my Sinemet intake which has presented n=
o
problems.
Concerning the stimulator implants, that may be a way to go if yo=
ur
surgeon has not had much experience or very good results with
Pallidotomies.
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 fr=
om
God.
FOR MORE INFO SEE WEB PAGE- WWW.PALLIDOTOMY.COM
Dr. Don Berns
110 Delano Dr.
Pittsburgh, PA 15236
412-650-6812
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