Eight years into his battle with Parkinson’s disease, Jim wasn’t doing well. The medications he was taking no longer kept the tremors at bay, and sometimes, while walking, he would freeze in place, unable to take another step. Jim could no longer mow his lawn, a task he had always enjoyed, and he no longer was able to refinish old furniture, another of his hobbies. He was exhausted by the time dinner rolled around. “It was to the point where if I wasn’t showered and ready for bed by 6:30 or 7 in the evening, I probably wasn’t going to be showered,’ he said.
Jim was 52 years old when he first saw Dr. Fredy Revilla, a Parkinson’s specialist at The Neuroscience Institute at the University of Cincinnati and University Hospital. The Institute’s Center for Parkinson’s Disease and Movement Disorders is a multi-disciplinary center with expertise in all areas of Parkinson’s disease. Dr. Revilla told Jim about deep brain stimulation (DBS), a procedure that involves implanting a device that acts like a pacemaker for the brain. The device provides chronic electrical stimulation to targeted areas deep within the brain, blocking or overriding signal disturbances that cause the disabling symptoms of Parkinson’s.
Dr. Revilla and Dr. George Mandybur, a neurosurgeon with the Mayfield Clinic and The Neuroscience Institute, recommended that Jim undergo the procedure. After receiving counseling about what the surgery entailed, Jim decided to go forward. As a result of the operation, which Dr. Mandybur performed at University Hospital, Jim is once again enjoying his life. “Everything changed with the surgery,” Jim said. “If it weren’t for that operation, I absolutely wouldn’t be working full-time.”
Jim was 44 when he was diagnosed with Parkinson’s disease. The first sign was his penmanship. “I would start out writing my name, and it would get smaller and smaller and smaller as I got to the end of my long last name,” he recalled. “I also had some shakiness, so I went to my family doctor. You hear about people who struggle to figure out what they have, but my doctor hit it on the head, first guess. He said, you’re not going to like this news, but you have Parkinson’s disease. I’ll send you to a neurologist and he will verify my diagnosis.”
Indeed, the neurologist verified the Parkinson’s diagnosis, and Jim began taking a small dose of standard medication, Sinemet.
“It was an uphill climb from there,” he said.
Parkinson’s disease is a degenerative neurological disorder involving the death of dopamine-producing nerve cells deep within the brain. There is no cure for Parkinson’s at this time, and scientists do not yet know how to slow or halt its progression. As a result of the disease’s progressive nature, treatments for individual patients typically change over time.
Jim was open to having deep brain stimulation surgery because his medications were no longer enabling him to live a normal life and because he was an ideal candidate for the DBS procedure.
“He was a good candidate for the surgery because he had developed intolerable side effects from dopaminergic medications (mainly dyskinesias) and short duration of benefit,” Dr. Revilla said. “In other words, when a Parkinson’s patient develops wide motor fluctuations, requiring frequent doses of medications, along with intolerable side effects, it is time for DBS surgery. But it is still a requirement that the patient experience some benefit from the medications, even if it is short-lived. The lack of cognitive problems and overall good general health also made Mr. Arlinghaus an ideal candidate for surgery.”
The DBS procedure was performed in two stages. During the first stage, Dr. Mandybur made an opening in Jim’s skull and implanted two electrodes (in the subthalamic nucleus) deep inside his brain. “I was awake during the operation,” Jim recalled. “It’s a very eerie feeling to hear and feel this Black & Decker coming at your head. But I didn’t have so much as a headache afterwards.”
A week later, Dr. Mandybur implanted the battery pack, which is connected to the electrodes, under the skin near Jim’s collarbone. “After that operation I felt like they’d beat the tar out of me,” Jim said. “I’m 6-foot-5 and as skinny as a rail. I was black and blue from armpit to armpit.”
But the benefits were enormous. Jim, a quality control coordinator who inventories half a million square feet of product daily, was back at work within three months. Outside of work, his life improved enough that he could start mowing his lawn again. He also regained his energy. “I’m no longer collapsing at 7 o’clock every evening,” he said. “We’ve been to wedding receptions, and I’m out until 11:30 at night, still moving. Since my surgery, my life has been nothing but pleasure compared to what it was.”
UPDATE FROM JIM, February 2009:
“I am still working full-time at the 3½-year mark since my surgery. I’m still enjoying life to the fullest, helping my son, a head baseball coach at Conner High School, coach and instruct young men.”
