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Chris... With all due respect, my own pallidotomy was performed at Loma Linda University Medical Center, by Dr. Gary Heit of Stanford University Medical Center and Dr. Robert Iacnono of Loma Linda University Medical Center. Prior to my surgery, which was performed on Oct. 24, 1994, one of the dozens of questions (actually, that might have been HUNDREDS of questions!) <smile> I asked the surgeons was the feasibility of "correcting" an older pallidotomy should the patient finds the original no longer working effectively. BOTH physicians had SUCCESSFULLY perfomed a number of "corrective" pallidotomies, I.e., on persons who had ALREADY had at least one, and sometimes TWO previous pallidotomies in the past performed by a couple of contemporary pioneers in the field of neurosurgery, and more specifically, pallidotomy. Dr .Heit has returned to Stanford (he was at Loma Linda as a Fellow for 4 months and I was his 40th, and last palidotomy before his return to Stanford). However, Dr. Iacono is still successfully repairing earlier pallidotomies and giving those he operates on a new chance at a better, more comfortable quality of living and in many cases, a near-normal existence. I cannot speak for any other neurosurgeons, but when it comes to Dr. Iacono, and Dr. Heit, well, they're absolutely the TOPS in MY book. By the way, Dr, Iacono is considered a bit of a "medical renegade" by some of his peers, because he's out there on the cutting edge (no pun intended) of legitimate surgical, pharmacology, and alternative medicine. He's absolutely DETERMINED to make Parkinson's Disease a thing of the past! FYI - Dr. Robert Iacono will be the featured guest speaker at Encino Tri-Valley Parkinson's Support Group on Jan. 15, 2000, from 1 to 3:00 p.m. We meet at Encino Hospital (in L.A.), and I'll be posting more about this meeting at a later date. Barb Mallut [log in to unmask] -----Original Message----- From: Chris van der Linden <[log in to unmask]> To: [log in to unmask] <[log in to unmask]> Date: Sunday, October 03, 1999 1:27 AM Subject: Fw: PD-Pallidotomy vs biSTN >Dear fellow listservers, > >The following was send by one of the listmembers to explain in lay-person's >terms the difference between the two surgical options; I thought to share >this with you all. > >Regards, > >Chris > >> For those studying the two options, pallidotomy and >> bilateral STN, consider the >> following: >> >> >> 1. Pallidotomy is a relatively old procedure first used >> about 50 years ago. The advent of Sinemet and other >> drugs that were effective on PD made pallidotomy >> unecessary. When the drugs began to fail -- the known >> effective surgical treatment was pallidotomy. Therefore >> that is what was used. >> >> 2. Like everything about PD, no two people are alike. >> Many pallidotomies gradually become ineffective after 4 >> to 5 years --- but there are patients who have excellent >> effects for a longer period. Same as with medications. >> Many of the pallidotomies were done before the newer >> technology was even developed or was in the research >> stages. >> >> 3. In layman's terms ---- a pallidotomy is kind of like >> fixing a defective transmission in a car by welding the >> gears into a position that works the best under most >> driving conditions. If the engine becomes weaker or you >> come to a big hill (ie. your PD deteriorates) you can >> not undo the "repair" --- it is permanent. You can no >> longer change gears in that part of the drive train. >> >> 4. Bilateral STN --- is like buying a computer and >> printer cable. The subthalamic nucleus is the >> "printer" The "printer cable" is connected to the >> subthalamic nucleus and the internal pulse generator >> (IPG), the computer, is connected to the cable. The IPG >> sends the signal to the STN telling it what to "print" >> or what "not to print". If you do not like the message >> sent to the printer (your STN) you change it. You send >> it a new "email". >> If the computer fails -- you connect a new one to >> the cable (a simple outpatient procedure). >> If a newer computer and program comes along you can >> plug a new computer to the cable and use the newer >> technology. >> AND --- if in the future a completely new technology >> develops that does not require this computer or printer >> cable you can remove them and install the new equipment >> OR use the new medical treatment because you have not >> damaged the printer (the STN). >> >> 5. With either procedure there is a risk of >> complications as there is with any surgical procedure to >> the brain. The historical results show that the risk, >> though real, is very very low. >> >> I hope this explanation puts the choice in >> understandable, layman's terms. >> >>