The meeting with the Physician assistant

Well now it was Friday and I had some time to absorb the idea of having brain surgery. I was not feeling apprehensive but I was a bit uneasy just because I have read a great deal on this and I thought I knew what to expect.

As I looked down the hallway I saw Peggie coming to greet me. She is a pleasant young lady who is very personable and not overly clinical in her approach. I was put at ease very quickly by her demeanor. She began by explaining the procedure I would follow in the coming months to prepare for the surgery.

Now normally it would not take several months but I have so many travel commitments for work through the end of August and then a vacation in early September. So with all that I have decided not to have the surgery until I return from vacation in mid September. Some do not agree with my decision but after all this is somewhat of an elective procedure and my Parkinson;s will still be there in September (unfortunately).

So as we began o discuss the pre-operative procedure I realized she was speaking to me in very laymen terminology which sometimes for me is harder to understand. I explained to her my experience in the medical field and my current position that deals with clinical procedures and research daily. This made the conversation more comfortable, at least from my side. so here is what I was told was the testing I had to go through prior to the actual surgery.

1) You will be seen in the morning, before you have taken any Parkinson medication. In fact, the last dose of Parkinson medications should be taken at least 12 hours before the evaluation takes place; hence, you are scheduled to be seen at 8:00 AM, so your last dose of Parkinson medications should be no later than 8:00 PM July 30th. Of course, you should continue to take your medications for other diseases, such as high blood pressure, diabetes and so on. It may be difficult for you to come in before taking any Parkinson medications, but please understand this is essential for a proper evaluation. As you may be aware, transportation from your car to the clinic by wheelchair is available. As we discussed, it may be worthwhile to stay in a hotel close to the hospital for the night prior to the evaluation.

2) The first part of the evaluation will take about 1 hour. Thereafter you will be given an appropriate dose of Sinemet, and about 1 hour later, after the medication has become effective (‘kicked-in’) the same evaluation will be performed once again. The off/on evaluation takes approximately three hours.

3) You will then see the psychologist for an evaluation that could take as long as three hours.

Following these appointments, Dr. Verhagen will make the final determination if you are an appropriate candidate for DBS surgery (Dr. Verhagen has already told me I am a good candidate). If that is the case you will also need to make an appointment to be evaluated by Dr. Bakay, the neurosurgeon, and discuss any pre-operative testing you might need (such as a chest x-ray, EKG, and lab work.).

I was then to schedule an MRI of my brain for a pre-operative map for the doctor. I will discuss this experience in the next blog. Just a teaser I am VERY VERY Claustrophobic so just imagine how that test went.

Stay Focused,

Ken