DBS is more than simply a simple operation. People interested in receiving treatment with DBS should be ready to devote time to the process because it entails a number of assessments, procedures, and consultations before and after the actual operation.
Prospective patients should have reasonable expectations for the outcomes of DBS. Although DBS can significantly enhance the quality of life in carefully chosen patients and reduce movement symptoms of Parkinson’s disease, it is unlikely to restore anyone to perfect health.
Effects Of Deep Brain Stimulation Over Time
People often ask, what can I expect after DBS surgery? The answer is that the tremors, stiffness, slowness, and dyskinesias which are some of the symptoms of Parkinson’s disease can be alleviated with DBS surgery. It may also lower the dosage of medicine required by the patient to control their Parkinson’s disease (PD).
Many patients continue to have improvements in their symptoms for several years after receiving DBS, and they are able to eat, go to the restroom, and take care of themselves, according to researchers who have tracked patients following the treatment. Memory, cognitive, or mood alterations may or may not be experienced by patients receiving DBS for mobility disorders.
Parkinson’s disease is now a progressive condition that cannot be completely reversed. Other symptoms like poor posture, speech difficulty, gait freezing, balance issues, and dementia may still manifest even as DBS continues to treat tremors, stiffness, and slowness.
Precautions Post Deep Brain Stimulation Surgery
- Before passing through the airport detectors, passengers with neurostimulators should inform security personnel. The majority of airport security scanners are okay for pacemakers, but the neurostimulator’s small quantity of metal could cause the alert to go off. Patients who are chosen for additional screening using hand-held detector devices ought to kindly remind the screeners that the detector wand shouldn’t be held over the neurostimulator for more than a few seconds because these devices contain magnets that could affect the neurostimulator’s operation or programming.
- Always have a photo ID with a DBS neurostimulator on you. They might also choose to carry a medical ID bracelet with this information on it.
- Certain MRI treatments may not be performed on patients who have leads or neurostimulators. Prior to any form of MRI, patients should always consult their doctor, even if DBS and MRI can coexist in some situations. They should stay away from locations with strong magnetic fields, such as power plants and auto junk yards that employ powerful magnets.
- Heat should not be applied to muscles during physical therapy for DBS patients.
- Additionally, they ought to stay away from high-voltage or radar equipment like radio or television transmitters, electric arc welders, high-tension lines, radar stations, or melting furnaces.
- Patients should inform their surgeon that they have a neurostimulator well in advance of any scheduled surgery if they have one. Since tools like the electrocautery device, which regulates bleeding, may interfere with the neurostimulator, it is vital to seek guidance on special precautions both before and during the surgery.
- Patients should guard against injury to the neurostimulator area when engaging in physical, recreational, or athletic activities. A trip to the doctor is necessary if the pacemaker is damaged by a hit to the chest that is close to it.
Medication After The DBS Surgery
Unless otherwise directed, continue to take all of your movement disorder medications as you did before surgery.
After the battery insertion procedure, once you have been given the all-clear by neurosurgery, you may resume blood thinners if you were instructed to discontinue them.
Keep taking the drugs your neurologist has prescribed for your movement condition. Following surgery, the DBS generator is turned off, and the neurologist will program it later on.
Each center has a different protocol for postoperative programming. Some centres discharge the patient after one or 2 days, others keep the patient, e.g. Jaslok hospital and research centre, for 7 to 10 days. Depending on the situation you are in, the pacemaker is started in the first week or after 2 to 3 weeks. Once the peacemaker is started it would require programming by an expert clinician to get the maximum benefit of the DBS. This is obtained by titrating the stimulation parameters and selecting the appropriate contact points. In an experienced center this should not take more than 2 or 3 visits. Once you are on a stable programming the medicines can be quickly tapered off and usually, 40% of reduction of medication is achieved after proper programming.
After DBS surgery and after having the DBS leads implanted in their brains, the majority of patients will need to spend one day to ten days (depending on the protocol of your center) in the hospital. Usually, you can return home the same day after surgery to implant the pulse generator.
The best person to give you information about your recovery time and when you will start to notice improvements in your symptoms and how you feel is your healthcare professional. They can estimate how long it will take you to recover, but this will depend on a number of other factors, including your general health, any underlying problems you may have, and your specific situation.
In general, the healing process requires several weeks. Most likely, your healthcare practitioner will instruct you to:
- After each surgery, refrain from any form of activities for around two weeks: This encompasses even the most unimportant activities, like sexual activity or housework. Lifting anything heavier than 5 pounds is not advised (2.25 kilograms).
- For at least four to six weeks, refrain from engaging in any moderate to vigorous exercise: This covers both physical activity and labor. After this, most people can resume their regular activities, such as work.
- Exercise caution when stretching or moving: For a few days following surgery to implant the pulse generator, you should refrain from doing specific motions, such as raising your hands above your head. For how long you must limit your movements, your doctor will advise you.
It might be possible to take fewer medications, depending on the ailment. But when combined with drugs and other treatments, DBS is most beneficial. This is due to the possibility of taking lower drug doses, experiencing fewer side effects, and still receiving the same benefits when used in conjunction with other treatments.