It DOES take a brain Surgeon (Part 2)

In our last thrilling installment, the armchair expert parried the question "How does DBS work?" by referring to a helpful diagram, which you can find a couple of posts down. We now resume where we left off...

Q: You call that helpful?

A: Hey, I'm doing my best here. I'd like to give you a better answer, but nobody knows why it works. Here's one theory: As one part of the neural communication network in our brain sends out fewer, fainter signals that say "MOVE" other parts of the brain that specialize in "STOP!" interpret the absence of "GO!" messages as a signal that "Stop!" is the agenda, and steps on the metaphorical brake pedal.

This dutiful but misguided part of the brain is the part targeted by the surgeon when the leads are implanted. The leads, in a sort of tiny replication of the Milgram experiment, zap the offending part of the brain with a jolt of electricity to discourage the hyperactivity. This enables freer movement, and subtly perfumes the air with the delicate odor of fried brain cells, which remind some people of bacon browning.

Q: EW!

A: OK, I made that last part up.

Q: Right. How about another theory?

A: Here's a simpler one from my friend Alec, broadly paraphrased. "The electrical charger creates noise in an overzealous section of the brain, impeding its operation" I think of this as similar to the "Beseiging-The-Bad-Guy-With-rock music-at-Painful-Volume" strategy our military used to force Gen. Noriega out of his diplomatically protected sanctuary back in the previous century.

Q: Are you sure PD is your only problem?

A: I'll overlook that and offer one more explanation in diagram C. (BELOW)


(To be continued.)

DIAGRAM C

The "Still Kicking File" Revisited

My Parkinson's motto is "I can do more than I think I can." This may not seem particularly inspiring... "All together now, let's hear it: PETer, PEter, He's OUR MAN! He can can do MORE than he thinks he can!" whoopee. Nonetheless, it is important to hold this belief, for two reasons. First, because it is probably true, which means you can keep doing things you enjoy and even try new ones. Second, I'll bet this straining against the surly bonds of Parkinson's Disease will help you to prolong your vitality.

If I must be on a downward spiral, I want those loops to be as wide and slow as I can make them. Which was how I found myself flailing on a mandolin for five and a half hours last Saturday night in a bar as a member of a Pogues-meet-the-Clancy-Brothers-on-Bill-Monroe's-Porch band we call Whiskeyjacks.

Was I afraid that I would freeze up and be unable to keep time? Yes I was. Was I spent and sore the next day? You bet. Was it laughable for me to pass myself off as a mandolin player on an instrument borrowed from my wife, on which I knew only three chords just a month ago? Apparently not. We caught fire during the last set and ended playing maybe an extra hour, and had the audience plying us with twenty dollar bills to give just a couple more songs.

Which we did. It was much more than we thought we'd do, and way more fun.

Coming up, a return visit from Seattle Neurologist Dr. Susie Ro

Hello friends, The Washington Chapter of the American Parkinson's Disease Association is bringing back Dr. Susie Ro for another patient care program. Don't miss this chance to ask questions of an expert! See you there,

Pete

Please be our guest on Tuesday November 18th,2008 at Alaska Regional Hospital for an Educational Patient Program with

DR SUSIE RO
MOVEMENT DISORDER SPECIALIST
SWEDISH NEUROSCIENCE INSTITUTE,
SWEDISH HOSPITAL
SEATTLE WA

11 am - 1.30 pm

Lunch will be provided and there is no charge for this event

Reservations required
Please RSVP to;
evedavis@gmail.com or 425-443-8269

Sincerely,

Evie
Evelynne Davis
Parkinson Educational Patient Program

Registration - 11am



Event Info
Alaska Regional Hospital
2801 DeBarr Road
Anchorage AK 99508
Alaska Regional Classroom, Medical Plaza, Mezz Level

Diagrams for post below. Click to enlarge.

It DOES take a brain surgeon ( Part One)

Armchair authority fearlessly takes on questions about DBS

Q: "DBS"? WTF?

A: DBS is the acronym for Deep Brain Stimulation, a surgical procedure that lessens some symptoms of Parkinson's Disease in some patients.

Q: Wouldn't "Shallow Brain Stimulation" be called for with your particular brain?

A: Cheap shot. In this case, "Deep Brain" refers to anatomy, as the target area of the operation lies far inside the the brain. (See diagram A)

Q: "Some symptoms"?

A: An abbreviated list of symptoms that DBS works well for include tremor, rigidity, and slow movement. Among things the surgery does not seem to help with are balance, speech problems (which may increase,) and Parkinson's related dementia.

Q: Well that sucks

A: Tell me about it. As more experience accumulates, some of the early problems are now understood to be related to placement of the apparatus in the brain. Others, such as cognitive impairment may not be as consequential as previously believed. But is not a panacea or a cure for PD.

Q:"Some Patients"?

A: One has to be carefully evaluated by a neurologist to determine whether this expensive and somewhat risky operation will actually benefit the patient or just the surgeon.

Q: Now YOU'RE making with the cheap shots.

A: Sorry, I'll try to behave.

Q: How does DBS work?

A: See diagram B.

This ends part one.