Deep Brain Stimulation; an innovative way to deal with Parkinsons disease

That John Maslankowski, who lives north of Wellington, cut his own grass the morning of May 16 was cause for celebration. It was the first time he’d been able to do so for in a year.

A flight engineer by profession and a civilian survivor of the Gulf War, Maslankowski is now retired and these days works as a gunsmith cleaning and repairing firearms with his friend, Roy Frank.

Maslankowski, 67, was diagnosed with Parkinson’s disease eight years ago. He lives alone, treasures his independence and manages thanks to the kindness of friends. Most are buddies he’s come to know through visits to the T-Bar Inn.

“I could not manage with them,” said Maslankowski, who uses a walker to help him get around. “Especially Dwight Johnson who is always willing to drop whatever he is doing to help me.”

But his symptoms were becoming worse when he attended a regularly-scheduled meeting for people with Parkinson’s at the Fort Collins Senior Center and learned about Deep Brain Stimulation therapy. He made the decision to give it a try. An initial procedure in March 2014 on the left side of his body was aimed at improving mobility in his right leg, which was prone to spasms caused by medication he was taking. The hope was that the DEBS therapy would reduce his need for the drug.

While his first encounter with DBS was not completely successful, it did not deter him from trying again. In March, he underwent the procedures necessary to install the device on the right side of his body.

Now, equipped with a set of wires leading from his brain to two transmitters located on either side of his chest, the early results are more than promising. In the course of our visit, he rose from the couch, walked over to a shelf and retrieved a programming device to show me.

“Yesterday, I couldn’t have done that without my walker,” he said. “And my tremors have disappeared.”

DBS has been around for 25 years according to Maslankoski. Denver Neurosurgeon Dr. Kara Beasley explains that there now is reliable evidence that the therapy has been effective for 15 years. While it is not a cure for Parkinson’s, it is a viable treatment option when medicines are not working well and can make routine daily activities easier by treating shaking, stiffness and difficulty moving. It cannot make a difference with such Parkinson’s symptoms as depression and dementia.

She also warned that there is a “window of opportunity” for the therapy. Patients who have progressed too far into the disease cannot be helped, she explained.

A patient must be determined eligible before they are accepted to receive the therapy.

“The psychological examination was the hardest part for me,” Maslankowski said. “I was afraid I’d say the wrong thing.”

The test was extensive is necessary to make sure the patient will tolerate the therapy and that it will provide a benefit. Once approved, the therapy, which can cost as much as $100,000 is covered by insurance and Medicare. Medtronic is the only company currently making the device, which is FDA approved.

Step one requires minimally invasive brain surgery to determine the positioning of the leads so that they reach the exact source of the symptoms. The patient is asleep initially, then awakened and must respond to questions to assist with proper placement. The surgeon will test different areas of the brain in order to maximize effectiveness. This procedure requires a one-night hospital stay.

“The procedure is not painful, Beasley said. “It is demanding, exhausting, and there can be some soreness for a few days.”

Maslankowski verified that there was no pain involved.

A couple of weeks later a transmitter, the size of a pacemaker, is inserted under the skin in the chest and wires from the brain are connected from behind the ear. This phase is usually accomplished in less than an hour on an outpatient basis. A couple of weeks later, the transmitter is programmed and the device becomes active. May 15 was that day for Maslankowski. The adjustment period can take up to three months.

“DBS can be empowering for the patient,” Beasley said. She explained that an important benefit is the reduction of medications and their related side effects.

How will Maslankowski’s life change?

“I’m planning to travel to North Carolina to see my daughter and granddaughter,” he said. He’ll fly and he’ll be able to manage the trip alone.

He still hangs out with friends at the T-Bar but these days he has to watch what he drinks because of the medicine he takes.

His friends don’t care. They’ve got his back. When he needs them, they show up and he couldn’t be more grateful.