5 YEAR POST-Pallidotomy REPORT
(Surgery date 12/1/93)
By Dr. Don Berns
UPDRS On Off
3 11
=
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. NOW AT MY FIVE YEAR ANNIVERSARY I MUST SAY TO ALL T=
HE
NAYSAYERS WHO SAID THAT A Pallidotomy WOULD ONLY LAST A YEAR OR TWO AT TH=
E
MOST.
AT FIVE YEARS I AM STILL GOING STRONG AND CONSIDER THE results to=
be nothing short of MIRACULOUS.
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-OPT
8. 5 YR. POST-OPT
SYMPTOM COLUMNS
1 2 3 4 6 7 =
8
TREMOR Severe GONE GONE GONE GONE GONE =
GONE
DYSKINESIA Excessive GONE GONE GONE GONE GONE =
GONE
SWEATING Excessive GONE GONE GONE GONE GONE =
GONE
SLEEP
DISTURBANCE Definite GONE GONE GONE GONE GONE =
GONE
EYELIDS Slightly
During Sleep Open Closed Closed Closed Closed Closed =
CLOSED
SHUFFLE Definite GONE GONE GONE GONE GONE =
GONE
GAIT FREEZE Definite GONE GONE GONE GONE GONE =
GONE
SENSE SMELL GONE Back Back Back Back Back =
BACK
ACHING =
MUSCLES Definite NONE NONE NONE Rarely Rarely =
Rarely
BACK PROBLEMS Definite GONE GONE GONE GONE GONE =
GONE
AKINESIA Definite GONE GONE GONE GONE GONE =
GONE
BRADYKINESIA Definite GONE GONE Slight Slight Slight =
Slight
SEXUAL STAYING
POWER Lessened Enhancd Enhancd Enhancd Enhancd Enhancd =
Enhanced
STRESS Severely No No No No No N=
o
Affected Effect Effect Effect Effect Effect =
Effect
DROOLING NONE Slight Slight Seldom Seldom Seldom =
Seldom
URGENCY TO URINATE Yes No No Slight Slight =
Slight
DYSTONIA NONE NONE NONE NONE NONE NONE =
None
VOICE Weak Improved Improved Improved Varies Varies =
Varies
SPEECH Affected Improved Improved Improved Varies Varies =
Varies
SHORTNESS OF =
BREATH Affected NONE NONE NONE NONE NONE =
None
HANDWRITING Very Bad Normal Normal Normal Normal Normal =
Normal
ON-OFF Definite GONE GONE GONE GONE GONE =
GONE
APPETITE Very Poor Normal Normal Normal Normal Normal =
Normal
MEDICINE SCHEDULE
1 2 3 4 5 6 7 8
___________________________________________________________________
Sinemet CR =
50-200 3.5 3.5 3.5 4 4 4 5 5
Sinemet 25-100 1
Sinemet 10-100 .5 .5 .5 .5 2 1 6
Eldepryl 2 1 1 1 0 0 0 0
Amantadine 3 1 1 1 1 1 1 1
Permax 5mg 4 1.5 1.5 1.5 1.5 1.5 2 2
Zoloft 50 mg 1 1 1 1 1 =
Paxil 1 1 1
Hydergine 0 0 4 4 4 0 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 two Ginkoba tablets. Since December 1995, I have been
using magnetic therapy in the form of insoles for my shoes, chair pads, a=
nd
sleeping on a magnetic sleep 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 o=
f
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 five=
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. =
I now have the luxury of taking a little more medicine when neede=
d
without facing those dreaded dyskinesias. The greatest deficits I face a=
re
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 year and a half. You will notice from the
chart above that I have increased my Sinemet intake which has presented n=
o
problems. AT 4 1/2 YEARS I MADE A SUBSTANTIAL INCREASE IN MY SINEMET FRO=
M
1200 TO 1600 mg/day of LEVADOPA WITH VERY GOOD RESULTS.
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 SITES
Website for Dr. Iacono and pallidotomies:
www.pallidotomy.com 909-792-8188
Website for Don Berns story:
www.parkinsonalliance.net/medical/palberns.htm
Dr. Don Berns
110 Delano Dr.
Pittsburgh, PA 15236
412-650-6812
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