You jumped through all the hoops in getting ready for Deep Brain Stimulation (DBS).
· You have advanced Parkinson’s Disease (PD) and have tried the gamut of PD medications.
· You still respond to Sinemet and have marked differences between “on” and “off” symptoms.
· You are significantly disabled from PD.
· You are in reasonably good overall health except for PD.
· Your cognitive abilities are relatively intact.
· You have no untreated or poorly controlled psychiatric disorder or severe memory problems such as dementia (DBS can worsen these conditions).
· The MRI of your brain shows little or moderate brain shrinkage and no other abnormal areas that could increase the risk of brain surgery.
· You are capable of participating in the programming of the device. This requires you to provide feedback during programming sessions and to attend clinic visits regarding the maintenance of your implant.
· You have a good support network of family and friends.
If you meet the above criteria, theoretically you should qualify for DBS from the DBS medical team’s perspective. However, even if you are medically ready, you might not be emotionally prepared to take the risks of DBS.
You might not be ready for DBS if you experience any of the following:
· You don’t think your PD is “bad enough” to have DBS. You believe that you can withstand PD for awhile longer without DBS.
· You are ambivalent about whether to proceed.
· The thought of having brain surgery makes you extremely anxious.
· You have reservations about DBS that haven’t been addressed by your DBS team.
· You are not confident in the expertise and experience of your DBS team.
· Your family and friends have warned you against brain surgery.
· You are unclear about how you will benefit from DBS and suspect that your expectations may be unrealistic.
· You have observed others who have had DBS, which has made you anxious about having DBS.
· You are not prepared to accept the risks and outcome of having DBS as compared to the possible benefits that you could receive. You believe the risks of DBS outweigh the benefits.
At our DBS support group, we discussed the question as to when DBS is an appropriate option for a patient. We talked about a two part answer to this question.
The first part involves the physical "readiness" of the patient (is this the appropriate stage in the progression of the disease of this particular patient at which DBS presents itself as a reasonable option) which we concluded must be left to the discretion of the medical professionals to determine.
The second part involves the emotional "readiness” of the patient (is the patient truly committed to proceed with DBS and cope with whatever the outcome may be), which we believed is best determined by the patient himself.
Only when both parts can be satisfied is the timing truly right for DBS.
I’m interested in hearing from those who have had DBS and their answers to the following questions:
· How did you overcome any reservations and ambivalence about DBS?
· Are you happy or unhappy about proceeding with DBS?
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