16
Deep Brain Stimulation and Parkinson’ s
Personal and Professional Considerations
When thinking about DBS, you’ ll have many questions and considerations, not only about the procedure, but also about possible effects on your personal and professional life.
+ Does insurance cover DBS? DBS is almost always covered by health insurance, including Medicare. Sometimes, especially with private, non-Medicare, insurance, your doctor’ s office may have to seek approval before the surgery or provide additional information to secure approval. The DBS team and your insurer will determine if surgery is covered and what your out-of-pocket costs might be.
+ Where’ s the best place for DBS? There are many centers across the world that perform DBS. That includes most major academic medical centers, which often have a medical school and / or research institution. Your Parkinson’ s doctor may be part of a DBS center or team. If not, they can refer you to trusted partners and sites. You also can get recommendations from others with Parkinson’ s who’ ve undergone DBS.
Some people need or want to get DBS farther from home. This could be because there isn’ t a center nearby or because they wish to work with a specific physician or surgeon. If you consider this, think about the time required to travel back and forth, how often you might need to make the trip, where you will stay, and other logistics. Also ask whether a provider near your home or at the DBS center will program your device and what to do in case of a complication or urgent need. Make sure to maintain a relationship with your local Parkinson’ s doctor, who can help with ongoing care and issues that may arise.
Living with Parkinson’ s for more than 20 years, Kevin Younger, MD, seated, with neurosurgeon Ajmal Zemmar, MD, PhD, experienced the successful controlling of dyskinesia after DBS. Photo courtesy of the National Parkinsons Institute.
+ Will my Parkinson’ s doctor change? Not necessarily. But it’ s important to discuss this. Your doctor may not program DBS. In that case, you see an expert programmer who is either part of your doctor’ s practice or the DBS team. Make sure you know who you’ ll see for what and how often. Who will program? How will the programmer work with your doctor and surgeon, if needed? Who will adjust medication? Who should you call with concerns? Who can you contact if you’ re unsure who to call?
+ Will my DBS go“ out of date”? DBS research is active and promising. Researchers are working toward smarter devices, which deliver stimulation“ on demand” when you have symptoms rather than constantly, as they do now. These devices might have a longer battery life and less potential side effects.