Thursday, June 26, 2008
I went to have an MRI of my brain as a basic mapping image for the Neurosurgeon. Now for most of you this would not be any type of adventure but for a claustrophobic wimp like my self it was very stressful.
I do not like small places and even in a crowded elevator I begin to break a sweat, so imagine me in an MRI tube "NOT". I spent several hours searching for an alternative to the standard MRI and cam across Upright MRI in Deer field, IL. This is an open MRI unit that you actually sit upright in like your in a chair. The radiology purists state the image quality from these are not as high quality as those from a standard unit, but for my purposes of a baseline scan it was acceptable. Though I was still a bit cramped between the magnets I was comfortable enough to clam myself to be still for the 40 minute exam.
I am told that the pre-operative MRI I can be sedated for the day day of the surgery. I find it humorous that I am not truly concerned about them drilling holes in my head and inserting wires while I am awake but I have to be put to sleep to have an MRI. I guess we all have our stranger phobias.
My next entry will deal with the emotional experience of having your affairs in order.
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.
Tuesday, June 17, 2008
Today I went to the Neurologist at Rush University in Chicago to have my first consultation and discussion about Deep Brain Stimulation surgery (DBS).
Ann (my beautiful bride) accompanied me as she typically does for my Neurology appointments, this way I do not forget to tell her something important (I forgot lots lately). We entered the waiting room to grab an seat and as usual I am the youngest person there, which typically draws some stares and looks of pity from the older patients.
Leo Verhagen, MD, PhD Medical Director at the Rush Movement disorders clinic came down the hall to greet us, and so it begins. We sat and things began as usual with introductions and a review of my chart and the massive list of medications I take daily.
My Parkinson's medications (I take many more for other issues)
- Sinimet 25/100mg x2 tid
- Mirapex .25mg x1.5 tid
- Amantadine 100mg x1 tid
Dr. Verhagen is a very pleasant professorial looking gentleman with a great sarcastic sense of humor, one that i appreciate. Most of the appointment was the usual neuro tests of stomping you heels, opening and closing you thumb to fore finger ect... Then he went on to explain the procedure of evaluation and pre, intra and post op for DBS (I will cover in later posts.
After about an hour appointment he told us he felt I was a good candidate and should see many benefits from having DBS. It was at that moment it hit me "I am going to have brain surgery!" As i had hoped Ann was strong and supportive and I only was in shock for a few moment's before I decided it was the right thing to do. I had originally thought I might document this on film but on the way home after some thought I felt this was the best way to share the experience with others. Blogging allows me to reflect a bit more and describe what I experienced in a clearer manner than having someone just watch and try to interpret my feelings.
Next appointment is Friday with the psychiatrist and the Surgical PA.