Wednesday, March 18, 2009

How I Became Bionic

Deep Brain Stimulation (DBS) is a surgical “therapy” that has been FDA- approved in the U.S. since 2002, but used world-wide for nearly 20 years. Its use is intended for patients for whom medications no longer work effectively. Nearly 80,000 of us in the world are walking around with neurotransmitter implants that allow us to function nearly normally. The surgery is done in two stages: the first stage, implanting the electrodes into the brain, takes about 5 hours during which the patient must be awake. The second surgery involves connecting wires from the anchored brain electrodes from the scalp down through the neck and into two battery packs in the chest
Below is a picture from Wikipedia during the actual first stage of the implanting of the electrodes into the brain:

As you can see, there is a “halo” that is actually bolted into your head at six places with screws. This halo prevents your head from moving at all, during surgery or the MRI and CAT scan that the neurosurgeon uses to guide his tools to the specific magical “sweet spot” in your brain: the subthalmic region.
Now you can perhaps see my fear. It is not a fun morning and the surgery is intense. Even though you have to be awake for a good part of it, at other times, the anesthesiologist puts you into a state of “twilight sedation” which helps you to forget much of the surgery.
What do I remember? I remember the sound of the drill making holes in my skull. I remember watching the computer screen and hearing the sounds of my brain's neurons firing during the hushed and critical episode where the neurosurgeon had to find my “sweet spot.” I remember the look on my neurologist's face and hearing her “oh my god” exclamation as the head nurse turned on and up the electrical current. The tremor in my left arm, flopping like a fish with no medication, and my jaw instantly ceased. My left side completely…relaxed, for the first time in years. I felt my body stop fighting itself. I remember when they turned it up too far, I felt literally like I was on fire. “HOT” I yelled, and nurse Peggy immediately turned the current down. To test my right side, which had few symptoms, they made me write the sentence,”Today is a sunny day in Seattle.” I remember thinking, who could even care about the weather??
But my micrographia, or cramped handwriting was gone, replaced with large, loopy cursive on a legal pad somewhere left in a Seattle surgery suite. I remember my neurosurgeon telling me before closing me up what a good and brave patient I was. “Brave?” I thought…it must be worse than it feels. And indeed, I could not look at the Wikipedia photo for a long long time. This surgery was traumatic, emotionally. It required all of my faith and all of my prayers to the healing angels around me. I felt every one of them during the course of that five hours.
I fell in love with my anesthesiologist, who performed his job as though it were a well-rehearsed, perfectly choreographed ballet. He knew when to turn up the sedative and when to clear my head, just from his close watching of my face. Under sedation, I think I told him I loved him and owed him a few kisses. Smiling, his Asian eyes crinkling, gave me reason to believe he had heard this before.
I tell you all this now because it was not easy to undergo. I was in so much pain post both surgeries that at times I just got through each minute, each hour, and considered it progress. My partner Steve became my caretaker, making sure my environment was as clean as possible to prevent brain infection (a fairly common danger) and gently showering me each evening. I felt much worse before I got better.
But, here I am, today, sitting in bed on a Saturday morning in October, 2008, six years post diagnosis. My typing speed is nearly as fast as it was seven years ago, with much less medication. I am back to work full time long time. I feel so lucky for my job, my profession, and being able to work and get back my feeling of purpose.at a very mentally and emotionally challenging job after being at home on disability for over a year. And I am happier than I have been in a long, long time.
And so I look different. I have two huge bumps on my chest, too big because they impinge on each other when I lie down and one rides up uncomfortably on my neck. I am easily fatigued, and spend a good deal of time after work horizontally, too tired to make dinner. My hair is short and I bleached it a platinum blonde. I have gained 15 pounds, in part due to Steve, who insists I take my vitamins and eat three meals a day.
Would I do it again? I am not sure. Would I recommend this procedure? I am not sure. My neurologist looks at me in awe now and says I am a text-book perfect example of a patient this DBS is designed for. This means little to me. But what does mean something is that I can work and make an income again. I can move without feeling self conscious about people watching me tremor. My pain is slowly easing, and I can breathe a bit easier. Does DBS work? It did for me. And when the next and improved gene therapy or stem cell procedure joins the treatment options for Parkinsons, I will be one of the first in line. This bionic wiring is completely reversible.
So there, you have it. More research is being done on DBS for untreatable depression, obsessive-compulsive disorders, and a few other conditions. I am bionic because I chose to be. The license plate on my brand new shiny red VW Rabbit reads:

BIONIC1

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