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Dear Ida: Dennis has given such a great explanation of the acronym soup! My husband, Don, has recently been facing the decision of WHAT PD surgery to get to achieve optimum relief from his PD symptoms and dyskinesia and WHERE to go to get it. We have decided to go to a Movement Disorder Clinic where all the surgeries currently available, including the DBS of the Palladus and Thalamus have been done frequently and successfully on PD patients and where the neuros are already trained to do the DBS of the STN when it is approved by the FDA. It is our understanding that all DBS surgeries are the same except for the brain "site" where the electrodes are placed. (It was also good for us be reminded that experience by basic neurosurgeons in these surgeries does not mean they are necessarily specialists in such PD surgeries, or in fact, have even done them on PD patients. So keep in mind when choosing a neurosurgeon that "Experience" in these surgeries DOES NOT necessarily mean on PD patients.) Only four places in the US are doing the DBS of the STN at this time until the "imminent" FDA approval for this surgery comes through and their waiting lists are into late 1999 or even into 2000 (we checked). So we have decided to go ahead this month with an appointment for Don to be evaluated at a Movement Disorder Clinic with neurosurgeons specializing that are experienced in Pallidotomy and DBS surgeries and have been trained, and are waiting, to do the DBS of the STN upon approval. Our rationale for this decision is that they can help us make the decision which surgery would help Don's particular case the most after they do a thorough evaluation. (We also inquired about whether Don would still be eligible for STN surgery after Pallidotomy or other DBS surgery. The answer was always "yes".) This is all so tough, isn't it? Good luck to you, Ida, in your decision. Thank God for all the info that was given to us on this PD Info Exchange. I don't know what we would have done without it. This is all so tough, isn't it? Good luck to you, Ida, in your decision. With you, glenna (for Don 72/9) Dennis Greene wrote: > Hi Ida, > > > Did the neuro's give any explanation why this is so, what they expect > > to happen if a PWP who had a pallidotomy in the past, would get > > nevertheless a STN DBS be it one- or two-sided? > > My understanding of the situation is that for those of us who have already > had a palidotomy: > > 1. there is no reason to assume that a DBS/STN will be unsuccessful, > > but > > 2. "at this time" they are not being done because no-one actually > knows what results they will get simply because so few (if any) > have been done that there is no evidence available. > > 3. In other words anyone who can find a doctor who will perform the > surgery on them, should be aware that they are breaking new > ground. > > > and what about a one side DBS in he Globus Pallidus. > > In what respect are the results expected to be inferior to STN DBS? > > The procedure I am scheduled to have in September is a DBS of the Globus > Palidus. This is to compliment the palidotomy I had 2 1/2 years ago and > control the dyskinesia I experience on the right hand side of my body. My > understanding of the difference between DBS/STN and DBS/GP is that > > 1. DBS/ GP is used to control dyskinesia ( thereby allowing the > subject to combat the symptoms of PD by increasing their > medications without paying the penalty), whilst, > > 2. DBS/STN is affective against the symptoms of PD as such. > > It is my understanding that DBS?STN is considered the superior procedure as > it addresses the symptoms of PD per se and the subject can expect a > reduction of symptoms AND a reduction in the amount and frequency of their > medications. As it is not available to me now, because of my previous > palidotomy, and as I am not the stuff that heroes are made of, I will go > ahead with the DBS/GP in the hope that the positive expectations of the > doctors prove to be correct and that a DBS/ STN will be available to me in > the future, should I need it. > > Dennis > +++++++++++++++++++++++++++ > Dennis Greene 49/dx 37/ onset 32 > There's nothing wrong with me that a cure for PD won't fix! > [log in to unmask] > http://members.networx.net.au/~dennisg/ > +++++++++++++++++++++++++++