Sky Ridge Surgeon Offers DBS Candidates Alternative Option

By Colorado Health & Wellness Magazine

Try keeping a steady hand while training a shotgun on a flushing pheasant that just made a startling jump at your feet. Or try putting a golf ball into a distant hole with Tiger Woods’ precision. Now, try doing it with Parkinson’s disease.

For Curtis Vogel, experiencing the joy of his favorite sports grew harder each year, as the tremor in his hand and the stiffness in his body from the disabling disease intensified. Only in his 50s, the Englewood resident wasn’t ready to hang up the shotgun and throw in the golf towel.

So, like 100,000 patients before him, Vogel underwent Deep Brain Stimulation, a surgery that has steadied the hands of people with movement disorders for more than a decade. But unlike those people, Vogel had the potentially life-altering procedure asleep.

Breaking barriers

Although Vogel, 59, says he would have done the surgery in the traditional awake fashion if he had no choice, that procedure requires more time and more steps. “I’m glad I didn’t have to go through that process.” And his surgeon, who is one of only about five in the country using the advanced technology that allows for slumbering patients, suspects many more people will opt for DBS as the new approach proliferates.

“The number of patients who qualify for DBS versus the number who actually get it is very low (below 10 percent), so there have to be barriers,” says Dr. David VanSickle of Sky Ridge Medical Center. “Some people just don’t know about it, but it’s clear that it’s scary to be awake during surgery. It doesn’t take a brain surgeon to know that.”

DBS involves placing electrodes deep into the brain to electrically inhibit the signals that cause a patient’s movement-disorder symptoms, such as tremors, rigidity and slowness of movement for Parkinson’s patients. A transmitter, programmed and used to control the impulses, is implanted in the chest.

With the traditional approach, surgeons use brain imaging coupled with patient feedback during surgery to precisely place the electrodes, meaning the patient must be awake for that step. With the asleep version, VanSickle uses miniature CT scanners and advanced technology offering direct imaging verification for lead placement instead.

“My question was: Which is safer? Which is better?” Vogel says. And while VanSickle tells all patients the new approach hasn’t been studied long enough for a definitive answer, his experience with 200-plus surgeries is that it’s just as good. “And it’s done in about half the time,” he says. “You wake up, and you’re done,” adding that the shorter duration can also provide a societal benefit, with doctors spending less time in hospital operating rooms and more time treating more patients.

Vogel, whose father had successful awake DBS for Parkinson’s, was prepared to be awake, as are most of his patients, VanSickle says. “This is a very patient-driven surgery,” VanSickle says, meaning patients meet other patients, see the results, and seek out treatment.  “But, I am finding a whole new population that wouldn’t even consider seeing a doctor about it because the surgery was done awake,” VanSickle says.

Life Changer

For Parkinson’s disease, studies have shown DBS works better than drug therapy alone. “Often, this is the best treatment patients with Parkinson’s can get,” VanSickle says. Vogel would agree, saying he’s been able to dramatically reduce his reliance on his rigid, daily drug regimen.

Although DBS is not a cure for Parkinson’s, VanSickle says, “It’s a great Band-Aid. In my opinion, the average patient is backed up about seven years. It’s not going to take away your Parkinson’s disease; it’s just going to make you a lot better.”

Vogel, back to his active lifestyle, would agree. “It was like night and day after surgery. Now, if I turn the transmitter off, I’m shaking like crazy. With it, I can play golf again without my hand shaking at all. It’s really a life-changing experience.”