Phil, Have you considered moving to another small town somewhat south and west?... Maybe in Pennsylvania. ....Maybe Puxatawney. Seriously, surgery is not to be taken lightly...Any surgery.. Pallidotomies are becoming less popular. Many of the best candidates have already been 'done.' In the town I live in there have been three cases. One was a disaster. I was a temporary success. One is still a success. I am taking a COMT inhibitor ...Ectacapone [to be marked in the USA as Comtess] I have been on this for five years this month and have no side effects yet. It is not so potent as Tasmar. IF Tasmar gives her good control of her symptoms AND IF frequent liver functions tests reveal no adverse effects, I would recommend the Tasmar route. The pallidotomy is not reversable. Will Will Johnnston A.P.D.A. DelMarVA Chapter Pres. 4049 Oakland School Road Salisbury MD 21804 USA 410-543-0110 ---------- From: Philip Connors <[log in to unmask]> To: [log in to unmask] Subject: Pallidotomy or Tasmar ???? Date: Saturday, June 26, 1999 12:03 PM Carol, my wife of almost 40 years, faces a very difficult decission and I sollict your input. I have been mostly, but not exclusively, lurking from the inception of this List. I have learned more about PD than I ever wanted to know, but also many useful things also as my wife, Carol's PD progressed. Again I ask for some timely input. (ASAP as u will c below.) Quick Background: Carol is 62, basically good health, X-cpt for... She is a young onset, symptoms mid to late 40's. Always a very active, driven person. We live in rural New England town, 3,500 popul. near Worcester, but with no public transportation. She has her driver's license, but has stopped driving. Her main problems are Freezing, OFF periods, and dyskinesia. We live in a 125 year old Victorian 3 story house in the center of the town. The most serious thing facing us is that Carol's neurologists suggested that she see the MGH surgeon, Dr. Reese Cosgrove, and he strongly suggests a pallidotomy. (It would be done in the Fall.) It will be her decision and it is not clear or easy. (I ask that anyone who feels that they can contribute or constructively kibitz to do so as we prepare for next TUESDAY's app't with her neuro at Fallon HP.) An interesting spin occurred when Carol & I visited my sleep apnea doctor, a neuro, and when we were discussing things in my life that could cause stress - Carol's situation, including the potential pallidotomy, came up. He asked if we had considered Tasmar and when we said that we had and Carol had used it, but her neuro had taken her off it when the liver damage fatalities had come up. He said fine compared to another drug, but now we were comparing the Tasmar risk (which has apparently not continued with many patients using it under close liver function monitoring) to BRAIN SURGERY. He then backed off and said that he did not want too interfere in some other DR's area, but suggested that we rethink it and discuss it (the possibility of restarting Tasmar) with Carol's local (15 years) neuro who we are seeing next week.