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I am reposting this because the formatting was not right before. I hope = I have corrrected the problem. If not does anybody have suggestions. ALL PALLIDOTOMIES ARE NOT CREATED EQUAL. I just returned from the The 2nd Pallidotomy Accord held at Princeton Uni= v. where I heard neurosurgeons report their results. I want to tell you folk= s that there is a huge difference between the results of 30% success rate reported by most of the neurosurgeons well known to many of you on this list and the 90% success rate reported by Dr. Iacono. = Furthermore it was disheartening and demoralizing to see the way Dr. Iaco= no was disenfranchised by his peers. Seemingly unable to cope with his positive results, repeated potshots were taken toward the man whose knowledge and surgical expertise are clearly head and shoulders above the= other well known doctors from around the country and Canada. Why is it this group of neurosurgeons cannot put aside their huge egos an= d engage in cooperative learning? As patients we need to be concerned abou= t this. After all we are the consumers. When it comes to putting that whic= h is so valuable to us, our brains, we must insist on the best from our doctors. Many of these doctors are opting for the less precise deep brain stimulat= or implants (citing a variety of reasons to the patient, such as reversibili= ty of the technique) when in reality patients are paying an extra $10-15,000= for the hardware. Overlooking incentives from the hardware manufacturer,= the question must be asked, Why would a person want a foreign device implanted in the body when an *on target* pallidotomy works so much bette= r? The one exception is if a stimulator were needed on a second side thalamotomy. To listen to these neurosurgeons discount bi-lateral pallidotomy because = of cognitive deficits and frontal lobe damage is to discount more than 150 simultaneous bi-lateral pallidotomies done by Dr. Iacono with no cognitiv= e deficits. In fact, in most cases there is improvement in frontal lobe functions such as reasoning and feeling of over all well-being. = The pallidotomy operation if done well is as much an art form as it is a science. I believe this is what scares so many of these neurosurgeons an= d makes them want to hide behind stimulator implants, or micro-electrode recordings, because they don't know how to get down within a millimeter o= f the optic nerve and internal capsule which is what is necessary to get th= e optimum result. Most of the neurosurgeons reporting at this conference were not trying to get any closer than 3mm. Given their current skill level this is understandable and even acceptable so as not to permanently= damage the patient, but it is a lot easier to see why they are not gettin= g the results Dr. Iacono is getting. = Dr. Iacono has spent a lifetime learning and perfecting the functional stereotactic procedure of a pallidotomy. He trained under Nashold at Duk= e, Shimi (sp?) in Japan, and Laitinen in Sweden. He has performed over 1100= pallidotomies and thalamotomies as compared with 50-75-150 done by the other neursurgeons in attendance. = Therefore, it is really not so surprising that he would be getting so muc= h better results. HOWEVER, what was surprising was to see the attitudes demonstrated that remained a barrier to any sense of collegiality publicl= y with a man who has given his life to helping the Parkinson's Disease patient. Although I did observe some doctors approach Dr. Iacono private= ly to ask more about his technique right after publicly castigating him fo= r being too anecdotal when he sought to respond to a question about no one having records of patients more than two years out from surgery. He was prevented from showing a video of a patient 4 1/2 years out from surgery.= Why do I write this? Because I believe it is time that patients, who suffer from this hideous disease, rise up and demand better from the neurosurgeons across the country and in Canada than a 30% success rate wh= en 90% is obtainable, if some people could put aside prideful egos and begin= to cooperate. My hope and prayer is that next year this group of pallidotomy experts could come together with the purpose of discovering from one another how they can more effectively perform pallidotomies on you, the sufferers with Parkinson's Disease. = Don Berns D.Min 50/17 110 Delano Dr. Pittsburgh, PA 15236 412-650-6812 [log in to unmask] p.s. = WESTMINISTER PRESBY. CHURCH 2040 WASHINGTON ROAD (RT 19) UPPER ST. CLAIR, PA. WEDNESDAY APRIL 29,1998 4:30PMM - 6:15PM DINNER AT 6:15 PM- COST $4.00 CALL FOR RESERVATIONS 412-835-6630