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ardziv7

DBS Programming / Configuration

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Hi, 

I wanted to ask if it is possible for a DBS operation to give bad results? or it is just the programming part which is not well done?

My father has done DBS surgery and the programming is still not so good, and he does not feel well. He needs to go every week or so to reprogram. (it a Medtronic device)

Also, I wonder if anyone here uses the personal programmer for his/her DBS ? any opinions about it?

 

Thank you

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Could be both. Did the reduce his medication post DBS? If so that may be partly to blame. Body needs levadopa even after DBS. If the leads are not placed properly, no amount of programming will give intended results. If the leads are placed properly, then it can take couple years of programming to optimize settings. If he doesn’t improve, go for DBS troubleshooting clinic. Sierra Farris have one in Denver and UF Florida Dr Okuns group have one too. They will do a MRI scan and check for lead placement and reprogram if settings are suboptimal.

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21 hours ago, waruna01 said:

Did the reduce his medication post DBS?

Actually he has stopped medication completely as it is making him more uncomfortable. 

Couple of years?

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Big mistake. If medication, especially levadopa is making him uncomfortable, his DBS settings are way off or to high. Which country he had DBS? In USA, medication is slowly reduced over the years but not completely eliminated. Most patients can expect a 50% reduction of levodopa. Other Parkinson’s medication can be stopped but levadopa is essential to the body it must be taken even after DBS. Any levadopa reduction over 50% after DBS can adversely affect the body. DBS need levadopa to function properly.

Read this book entirely, especially the section about medication after DBS.

http://www.parkinson.org/sites/default/files/Guide_to_DBS_Stimulation_Therapy.pdf

what are his DBS settings? Voltage? Frequency?

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On 4/29/2018 at 12:14 PM, ardziv7 said:

Hi, 

I wanted to ask if it is possible for a DBS operation to give bad results? or it is just the programming part which is not well done?

My father has done DBS surgery and the programming is still not so good, and he does not feel well. He needs to go every week or so to reprogram. (it a Medtronic device)

Also, I wonder if anyone here uses the personal programmer for his/her DBS ? any opinions about it?

 

Thank you

 

Many variables involved... Bilateral or unilateral DBS? STN or GPi target? Age of patient, severity of disease, medications, infection.

Could be lead placement or programming. How long ago was it? Most people with a successful outcome report a brief "honeymoon" period right after the procedure, where they feel very good, even without meds.

I have a Medtronic programmer with two different settings, one for normal activity and one for higher activity levels. It's worked very well so far ( two years). I was told to turn off the programmer if I suspected any problems. 

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Some questions please? Firstly is there a separate programmer specialised in for example St Jude brio or any other IPG? Do these programmers always do the work and not the neurosurgeon. Does he just superwise or is he not there at all. What is the step by step procedure. 

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Neurosurgeon is out of the loop after surgery. Programmers do most work after surgery. Most programmers are familiar with Medtronic. They may learn other systems as they become popular. They all follow same concept 

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16 hours ago, waruna01 said:

Neurosurgeon is out of the loop after surgery. Programmers do most work after surgery. Most programmers are familiar with Medtronic. They may learn other systems as they become popular. They all follow same concept 

How long is such a session and who organises it.  How many sessions are required  and  is the producer representative present in the session.

Thanks

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6 hours ago, janvier said:

How long is such a session and who organises it.  How many sessions are required  and  is the producer representative present in the session.

Thanks

A neurologist or a movement disorders specialist will usually do the programming. Often a manufacturer representative may be there also, but usually not all that often in our experience. The number of sessions depends on how well you respond, how good of job they do programming, and how the disease progresses.

Hope that helps,

Coach

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