DBS On My Mind

The road leading to deep brain surgery for tremor of Parkinson's and other movement disorders is a long and arduous one. It includes several tests prior to even talking with a surgeon. However, enough is known about who might benefit from this surgery and who might not, that the preliminary screening process is essential.

"Blue hole" over Whidbey Island 

On the Road
Carolyn, Bella and I wait for the 10:15 ferry to Port Townsend. A road trip to St Helens, Oregon lies ahead where we intend to spend some time with our son Jay and his wife Luka in their new place of residence. 

This morning the weather is moderate and there are breaks in the persistent Northwest cloud cover.  Patches of blue sky appear among the clouds and brighten my spirit.  Such a sky is a hallmark of central Whidbey Island. Geographically we live in the shadow of the Olympic mountains, a shadow that reduces our rainfall to 20-22 inches annually.  Mountaineer, author and former pharmacy customer of mine, Harvey Manning, called it the blue hole over Whidbey in his book "Walking The Beach to Bellingham."  However matters of weather often change rapidly and as we crossed the sound to Port Townsend the heavy clouds closed rank, the blue hole vanished and the once glowing Olympics were obscured by layers of gray, misty clouds.

This blog may be about a road trip but I find it difficult to put the events of the previous week aside and not think about them.  After all it has only been a few days since I was treated to a Skype style live computer conference to review the results of my recent cognitive and memory testing. This testing is required for those considering deep brain surgery or DBS.  If memory loss or the presence of dementia is detected during this process they are considered ito be reason enough to disqualify the patient from DBS surgery.

The video format proved to be an amazingly personal way to get the results of a medical procedure recently completed in Seattle.  Carolyn and I were able to make a much shorter trek to a satellite clinic to be given the results personally via the miracle of television.  We just got seated in front of a large screen television when the doctor, a Phd psychiatrist, dialed in and her live image, direct from her desk jumped to life.

After stating that I did all right in the cognitive testing. She went on to explain that I had scored below expectations on two areas of testing and above expectations in two others.  Below expectations included situations in which I would be slow to react on information given and difficulty functioning in situations where processing information from multiple sources(multi tasking). She emphasized that these changes were consistent with Parkinson's.  The condition described, that of slow response to a variety of stimuli and difficulty processing multiple inputs is called neuro-cognitive disorder. In my case it is mild neuro-cognitive disorder. The psychiatrist, went on to explain that in a ten year period one with mild neuro-cognitve disorder might expect that among similar patients 30% would remain the same, 30% would get better and 30% would get worse.  Mild neuro-cognitive disorder is not a deal breaker with DBS.

I was in charge Bella's needs but the duties were shared .

My cognitive and memory test results would be compatible with surgery.  The next stop in this process will be Swedish hospital in Seattle for physical assessment both on and off of medications.  Before the computer conference was complete the Psychiatrist, inserted what I took to be a warning. She cautioned that mild neuro-cognitive poblems may worsen with DBS surgery. She quickly added that many considered that to be a fair trade for the physical improvement. Is it? How could any deterioration of cognitive function represent a fair trade for something else? She inserted this warning into the conversation more than once.

The ferry had rocked and rolled just a bit this morning, with a light chop on the water but no whitecaps. After putting ashore in Port Townsend Carolyn pointed our Toyota away from town and about 8 miles later we turned South on highway101.  101 is a beautiful highway which runs quite a few miles along a natural fiord known as Hood canal which demarcates the large peninsula on the West side of our state.  I was not worthless on this trip and had a well defined role and a purpose: support man for Carolyn.  Under this title I was official road trip copilot, which included: GPS monitor, lunch server, and disc jockey.  Informally I was also in charge of Bella's needs.  Things like when where to stop for water and other basic dog needs.

We passed the turn off to the small town of Chimicum, the location of Bettty Macdonald's wonderful, humorous book, "The Egg and I." Her memoirs of life in the 1930's with her young husband on a chicken farm. A delightful book that made old fashioned hillbillies Ma and Pa Kettle household names in America during the 40's and 50's. More than 80 years later Chimicum is still rural and sparsely populated.

We passed through the Columbia river town of Longview

Later as we approached our destination we passed through the Columbia river town of Longview.  A dreary and industrial looking city and even more on this day we had begun with the uplifting sight of the blue hole over Whidbey. We approached the end of our journey in the dismal contrast flattening gray fog of Longview. Here we drove by acres and acres of fir and hemlock logs which lay trimmed and ready for loading onto, ocean going transport ships for export to Japan. Some will be milled to lumber and sent to California or other places for home building.

We crossed the bridge over the Columbia river and entered Oregon and then it is only a short stretch to St Helens. Soon we would be spending time with our son and his new wife in their new home. The matters of weather and other concerns fade when Thinking of this.

The road home

Shaky in Coupevillle