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| Charles F. Bryan Jr. |
The human brain is an amazing organ. It accounts for only 2 percent of the body’s weight, but it consumes 20 percent of the body’s energy. Every physical move we make, every word we utter, every problem we solve originates in the brain.
When the brain comes under attack, those functions can be affected seriously. More than a decade ago, I began to suspect there was an assault on my brain when I started to show signs of Parkinson’s disease. My wife and I were devastated when our family doctor confirmed that our fears were justified.
Parkinson’s is an incurable neuromuscular illness that strikes the substantia nigra section of the brain, ruthlessly mounting a slow and deliberate siege on the mind and body. Little by little, it ages and slows you down. It makes you feel awkward in public. It makes you chronically tired. Simple actions such as buttoning a shirt, keyboarding, tying shoes, rolling over in bed, or getting in and out of a car turn into major, time-consuming chores.
Balance becomes a cause for concern, with many Parkinson’s patients experiencing serious falls and resulting injuries. Although people do not die of the disease, they often succumb to other causes that it has exacerbated.
This catastrophic illness was named for English surgeon and apothecary James Parkinson, who officially identified the ailment when he published “An Essay on the Shaking Palsy” in 1817. Parkinson classified the disease, and for the next century and a half, doctors and scientists looked for a cure and ways to treat it.
Finally in the 1960s, with the introduction of the drug Levodopa, doctors had the first weapon available to them that actually worked in fighting Parkinson’s. Most patients receiving Levodopa experienced significant improvement in their condition.
Over the years other drugs were introduced to slow the progress of the disease and to further minimize symptoms. These medications brought about a revolution in the management of the disease.
But diagnosing and treating Parkinson’s is a tricky business, usually requiring the skills of well-trained and experienced specialists. As an Army veteran, I was fortunate to qualify for comprehensive treatment at the Parkinson’s Disease Center at McGuire VA Medical Center. McGuire is one of seven VA hospitals nationwide to have such programs.
The team of specialists there was able to prescribe just the right combination of drugs to treat me. Almost as soon as my neurologist put me on them, I felt better and my Parkinson’s symptoms were reduced significantly for more than a decade.
People often expressed surprise when I told them that I had Parkinson’s. Having a positive attitude and adhering to a rigorous exercise schedule contributed to my overall well-being.
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Nevertheless, Parkinson’s proved to be a relentless demon that can be slowed but not stopped.
Gradually, the symptoms I had experienced when I was first diagnosed began to subtly reappear — a slight tremor in my right hand, an unsteadiness while on my feet, occasional falls, and increasing difficulty in performing simple tasks that require some degree of manual dexterity.
Realizing that more drugs would no longer provide the help I needed, early this spring my neurologist and I began to discuss the next option — Deep Brain Stimulation surgery (DBS). DBS is a major surgery that if successful could diminish my Parkinson’s symptoms.
I am fortunate that one of the country’s most experienced and accomplished neurosurgeons specializing in DBS is located in Richmond. Dr. Kathryn Holloway, director of the DBS program at VCU Medical Center, has performed more than 500 (I was number 510) of these complex surgeries.
My wife and I met with her in early April, and Dr. Holloway explained that during the six-hour surgery she and her team would insert two thin, insulated wires through two openings in my skull and implant them in a pre-determined portion of my brain.
The wires would then be slipped under the skin on my head, neck, and shoulder and be connected to a neurostimulator they would implant under my skin near my collarbone. When they turned it on, she explained, this device would send out a steady stream of electrical impulses that would block the electrical signals that caused my Parkinson’s symptoms.
If the surgery was successful, I could limit the amount of drugs I was taking, while enjoying a reduction in my symptoms. Dr. Holloway warned, however, that the operation was not risk-free.
Anytime brain surgery is performed, the patient runs the risk of a stroke, infection, and excess bleeding in the skull, or having a bad reaction to anesthesia. Given the alternative, I decided to take those risks.
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To qualify for the surgery, I had to pass a series of tests to determine that I responded well to my medications, that I did not have other ailments not related to Parkinson’s, and that I was not suffering from depression. I passed easily, and was given a date for my surgery — July 26 — more than three months in the future.
I had to wait in line for my turn for the DBS, and the next three months seemed excruciatingly long. The closer it got, time seemed to slow to a crawl. It reminded me of those few days before Christmas when I was a child and the hands on the clock never seemed to move.
Finally the big day came. A small contingent of family and friends took me to McGuire Hospital for my 6 a.m. surgery appointment.
In many ways the rest of the day is a blur, but here are some impressions: an exceptionally friendly and welcoming medical staff who helped ease any worries I had; endlessly repeating my full name and social security number; being told to count backwards from ten and not quite reaching five before the anesthesia kicked in; waking up to the voice of Dr. Holloway and some of her team members and realizing that they were in the middle of my surgery; hearing a strange, fluctuating noise in the background that I was told — after asking — was the sound of my brain as Dr. Holloway guided a probe to find a “sweet spot” to place my implants.
I remember my neurologist commanding me to move my arms and legs at intervals to ensure that the implants had been properly placed — and waking up in the recovery room, my head still foggy from the surgery and the affects of the anesthesia.
The total time for the surgery was a little more than six hours. I was then kept in the hospital for five days, including one for Dr. Holloway to place the stimulator device in my chest. Once she did, to ensure there was no infection or other complications, I had to wait two weeks for the stimulator to be activated.
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My wife and I went back for my appointment on Aug. 12 to have me “turned on.” As we made the 21-mile drive to McGuire, I thought again of Christmas during my childhood. What would be under the tree? A bright, new, shiny toy, or a pair of pajamas and some socks?
Fortunately my device was the new toy. After they turned it on, I soon felt like a new person. No more shaky hands. No more freezing when I came to a doorway. No more falls. No longer having people stare at me as I stutter-stepped my way through the grocery store.
I know that the DBS has its limitations and that a time will come when it, too, will no longer be as effective as it is now. But if I can have another 10 years, even five years, of the way I feel now, it was well worth the effort, despite the risks involved. Thanks to a gifted surgeon and her team, I have been given back a way of life I thought I had lost forever. They have truly turned me on.
Charles F. Bryan Jr. is president emeritus of the Virginia Historical Society and the author of “Imperfect Past: History in a New Light, “ which is a compilation of many of his Times-Dispatch essays. Contact him at cbryan69@verizon.net.
http://www.richmond.com/opinion/their-opinion/charles-f-bryan-jr/article_a89b10fe-3bad-5f23-9e57-61508e547afd.html
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