My World of Parkinsonian Delights

Three Years Ago Today — Surgery 1 of 3

It was three years ago today, June 5, 2007, that I had the first of the three surgical procedures that make up the deep brain stimulation protocol at Vanderbilt University Medical Center.

See, most hospitals that do DBS surgery take the patient to the CT Lab first thing in the morning and install this huge metal superstructure, fastening it to the skull.  It looks like this. 

Then, as soon as the frame is attached, the patient is wheeled into the OR for the probe implantation.  The patient must remain absolutely still, and it’s a tiresome, uncomfortable situation.

At Vanderbilt, they developed an epoxy resin frame, individually made for each patient.  During the first surgical procedure, they put you under anesthesia and get a good CT scan of your skull and brain and decide just where they want to install the bone markers that they will use to attach the frame.  They take measurements and decide what dimensions the frame should be, send them off to the manufacturer and in no time, they’ve crafted a frame just for you.  It allows a more comfortable procedure… and it shortens the operative day for the patient because you get the bone markers installed, go home the next day, then come back for surgery and don’t need to go through the whole “attaching the superstructure” thing.

Here’s the frame Vanderbilt had made for me.  I still have it.

The little screws you see protruding from the bottom of the frame are inserted into the skull — in my case, about 8 days before the actual DBS surgery.  They take you to the CT room, and when you wake up you have four little scars on your bald noggin.  Then, on the surgery day, they pull out the staples, open the little holes, position the frame, screw it into place, and there ya go!  You have a steady, stereotactic frame from which to perform this very sensitive brain surgery.

Here’s what the whole thing looks like in practice.  You can barely see the frame because the probe drivers are in place and are moving the probes, millimeter by millimeter, to the proper part of my brain.

Yes, my neurosurgeon took this picture during the surgery.  That’s the top of my head, the frame attached, the drivers in place, and me on the other end of the plastic sheeting wide awake and participating fully in the procedure.

But, as I said, first things first.  The little golden screws get implanted in your skull, they stitch you up, do a follow up MRI, let you rest for the night, and send you home.

As I mentioned in my book, “Deep Brain Diary: My Life as a Guy with Parkinson’s Disease and Brain Surgery Volunteer”, when the anesthesia wore off, there was a bit of discomfort involved.

After lunch, I relaxed and waited for the local anesthetic in my head to begin wearing off.  It did.  And that’s when I noticed how much the entire scalp is involved in something as routine as the movement of an eyebrow.  Each motion of expression was met with pain.  It wasn’t so much a “headache” as it was a feeling of getting the crap beaten out of you by someone with brass knuckles.  My eyes felt swollen.  My sinuses ached.  Tylenol took the edge off.  But there was no way to lie comfortably.  I was able to sleep that night, but woke up frequently – every time I moved my head.

By the next morning it felt a little better.  By the time I got on the plane to come home, it was even better.  I had the same seat on the flight home as I did on the flight to Nashville – but now I was paranoid about passengers swinging their carry-on luggage and smacking me on the head with it.  When Gail met me at the airport, I was paranoid about banging my head on the car door as I sat down.  It’s amazing how much you think about and care about a previously ignored body part when it aches and throbs with each and every movement.

My sense of humor, however, was not affected.  Gail and I stopped at a grocery store on the way home and I noticed an elderly woman pushing a cart towards her car.  “Howzabout I take off my hat and stagger towards that lady – Frankenstein-like – and demand that she give me my brain back?” I asked.  Gail shook her head.

“Yes, that’s a good idea.  Why don’t you do that?  I’ll wait here.”

I was a pretty sight to behold!  But the real head-scarring, brain piercing action would happen eight days later.

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