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VETERAN SEES IMPROVEMENT AFTER PARKINSON'S DISEASE

SURGERY AT SF VA -- Deep brain stimulation is a procedure

in which thin wires are inserted into the brain.

Andrew Klepper, with a surgery scar stretching across the top of his head, shows off the scar on his chest where doctors placed a device that stimulates deep brain activity to ward off the effects of Parkinson´s disease. (photo: Doug Allen / The Enquirer)

For more about Parkinson's Disease, use the VA Watchdog search engine...click here...
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Story here... http://www.battlecreek
enquirer.com/apps/pbcs.dll/article?
AID=/20071012/NEWS01/7101
20316/1002/NEWS01

Story below:

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Parkinson's patient sees improvement after surgery

Elizabeth Huff
The Enquirer

Andrew Klepper has a long scar over the top of his head that is still visible beneath his recently shaved head, but things couldn't be better for the Parkinson's patient.

He demonstrated that by holding his hand perfectly level this week.

The Battle Creek resident underwent surgery last month to correct his steadily worsening rigidity and tremors. Without medication, Klepper's muscles lock up. On medication, his hands, head, arms and legs move uncontrollably, a side effect that disrupts his balance and speech.

"I was getting to a point where I couldn't walk anywhere by myself anymore," the 60-year-old said on Tuesday. "I was tripping and falling everywhere."

Parkinson's disease is the second most-common neurodegenerative disease after Alzheimer's disease, the Miami-based National Parkinson Foundation reports. It affects one in 100 individuals age 60 and older. Five to 10 percent of patients begin showing symptoms at age 40 or younger.

Klepper first noticed trembling in his pinkie finger and mouth in his late 40s. It is not clear what causes Parkinson's, but most researchers believe it is a combination of genetic and environmental factors, according to the foundation.

A veteran, Klepper went under the knife for deep brain stimulation on Sept. 18 at the Center for Parkinson's Disease and Movement Disorders at the San Francisco Veterans Affairs Medical Center. Klepper was scheduled to have surgery in April, but was delayed beacuse of a bladder infection.

Deep brain stimulation is a procedure in which thin wires are inserted into the subthalamic nucleus, a place the size of a black-eyed pea at the center of the brain, where doctors believe Parkinson's begins.

For patients like Klepper who have advanced idiopathic Parkinson's — a form of the disease that has no clear cause — and have maxed out on medication, surgery is a good option, said Susan Heath, a clinical nurse specialist who coordinated Klepper's surgery at the VA Medical Center in California.

With deep brain stimulation, the wires attach to a pacemaker-like device beneath the chest skin that delivers electrical pulses to that part of the brain. Medical professionals can reprogram the voltage and frequency for optimal effectiveness down the road, Heath said.

"The beauty of it is, it is reversible and adjustable," she said.

The technology became available in the United States in 2002. About 35,000 people worldwide have undergone the procedure, Heath said.

"In the old days, we would burn a hole in the brain," said Dr. Nicolaas Bohnen, one of Klepper's neurologists specializing in movement disorders at University of Michigan Health System and Veterans Affairs Ann Arbor Healthcare System.

"The problem with that is you go in, you take your best shot, you burn a hole, and you hope the patient gets better."

A year later, the symptoms may return, and then the only option is to burn a bigger hole, he said.

During a portion of the four-hour surgery, Klepper said he was awake.

He said he thought he was having a nightmare.

Doctors kept asking him to perform simple tasks, such as repeating the question, "Is it raining in San Francisco?" he said.

The surgery can dramatically improve symptoms for some Parkinson's patients. At this point, Klepper has an uncomfortable bulge under his chest skin the size of a pack of cards. He still moves uncontrollably and will use a wheelchair until he can get his medication and electrical pulses balanced.

"He still needs adjustment, but that sometimes takes three or four more months to work out," Heath said. "You see he's not perfect, but he's way better and he is going to continue to get better."

Klepper said he knows others with movement disorders who qualify for surgery, but fear it. He said he encourages them to reconsider.

"There's nothing to be afraid of," he said. "A whole new body — that's what it feels like."

Elizabeth Huff can be reached at 966-0684 or ehuff@battlecr.gannett.com.

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Larry Scott  --

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