A No-Brainer: Grandfather Finds Deep Brain Stimulation Right Answer for Parkinson’s disease
If you ask Tim Devine what he missed most when his uncontrollable tremors from Parkinson’s disease became severe last year, his answer is simple: holding hands. Whether it was holding his grandchildren’s hands on long walks, clasping his daughter’s hand at her mother’s memorial service or joining hands with other church members as they celebrated their faith, that small act was a huge loss for the 72-year-old widower and Sky Ridge Medical Center volunteer.
But today, Tim has his grip back, once again holding hands, hoisting his dumbbells at the gym, and grasping the handlebars of the wheelchairs he uses to escort patients around the hospital, all with greater ease. In fact, thanks to the Deep Brain Stimulation procedure, it’s hard to tell Parkinson’s afflicts Tim, as he bustles about the Sky Ridge Cardiac and Pulmonary Center of Excellence, joking with patients and co-workers.
DBS Gains Attention
An increasing number of patients with movement disorders are turning to DBS to take back life’s stolen pleasures. “Part of it is just awareness,” Dr. Daniel Kitei, Tim’s Sky Ridge neurologist, says of the increase in DBS surgeries, with more than 100,000 performed today. Despite being a surgical option for more than 20 years, many patients and even physicians have not heard of DBS, Dr. Kitei says. Now that research keeps rolling in, with some long-term studies finding patients still enjoying reduced symptoms 10 years post-surgery, interest is climbing.
“The data are just blowing ‘best medical therapy’ data away,” Dr. Kitei says, referring to randomized studies that found impact on quality of life significantly better with DBS than with traditional, non-surgical Parkinson’s treatment. Advanced technology has also led to better outcomes, shorter surgeries and increased safety, he says. “We have better imaging techniques, and we’re better at determining which patients are likely to have good outcomes.”
With DBS, surgeons thread spaghetti-thin leads into the brain to the precise locations responsible for patients’ symptoms, essentially short-circuiting the abnormal electrical messages. The leads are controlled by a small, pacemaker-like device, which is implanted near the collarbone, just under the skin. The lead targets vary for each patient, and DBS traditionally has been performed with patients awake, so that they can help surgeons pinpoint the correct spots.
But now, with medical advancements and the pioneering efforts of physicians, including those at Sky Ridge Medical Center, patients have the option of having DBS asleep. “I just didn’t want to be awake,” Tim says, adding that he trusted his neurosurgeon, whom he had come across during a Sky Ridge presentation on DBS and other treatments last year. Devine says being asleep was simply easier. “The only thing I remember after waking up is my head itched.”
Teamwork Proves Critical
Tim, who moved to Colorado two years ago (after losing his wife of 44 years to cancer) to be close to his daughter in Lone Tree, heard about the DBS presentation last year from another Sky Ridge volunteer. He was growing weary of his symptoms, which included dragging his leg, sometimes causing him to stumble and fall, and his uncontrollable tremors. He also had the words of his grandkids ringing in his head. “They would say: ‘When I grow up, I don’t want to be like Grandpa.’ That kind of encouraged me to pursue it the most that I could.”
At Sky Ridge, Tim received his first official diagnosis of Parkinson’s disease and was put on a comprehensive treatment plan, including physical, pharmaceutical and speech therapy, as DBS is recommended only when non-surgical treatment fails or is, itself, causing life-altering side effects. Eventually, when doctors found the medications were not working for him, he underwent more tests and was offered DBS as an option.
A team approach at Sky Ridge accounts for the program’s effectiveness and efficiency, which is particularly beneficial for the many patients who travel miles for the hospital’s expert care, Dr. Kitei says. “And with all of the neurological experts and speech and physical therapists working together, patients are treated appropriately and chosen only if they are good candidates, which ultimately means better results.”
Results are Notable
“If the patients are selected appropriately, the localization (lead placement) is done well, and the programming is done correctly, we will pretty much always see some improvement,” Dr. Kitei says. “The question is how much. From my experience, it ranges from people being happy they’ve done it to life-changing. I haven’t had any patients who weren’t happy they’d done it.”
Programming the stimulator device can take repeated visits to fine-tune, and the electrical impulses can be adjusted if patients have problems arise. At a programming appointment after his surgery, the technician told Tim that she was going to show him what happened if she shut the device off. “All of a sudden, my arms are going every which way,” he says, flailing wildly to demonstrate. “And I said: Turn it back on; turn it back on,” he recalls, chuckling.
Tim says he might start to shake a little after a particularly hard weight workout, or if he gets a little wound up at his 13-year-old grandson’s basketball game. But for the most part, he’s happy and generally steady. “And I can hold hands at church again,” he says, triumphantly throwing his head back and stretching both arms out to each side, palms up. After holding still for a quiet few seconds, he says: “As far as I’m concerned, having it done was a no-brainer. I just went for it, and I’m glad I did.”