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Deep Brain Stimulation and Parkinson ’ s
Once out of the hospital , you take some time to let your body and brain recover . Then you start the process of programming and adjusting to daily life with DBS .
Recovery
In the days and weeks following surgery many people feel significant relief from Parkinson ’ s symptoms . Some don ’ t , and that ’ s normal too . Any benefit is thanks to mild , expected brain swelling around the ends of the brain leads . As the brain heals and swelling lessens , symptom benefit lessens too . But benefit returns when the device is turned on and programmed .
It can be tricky to manage medication during this time . At first , you might feel like you need less medication . As your brain heals , you might feel you need more , even what you were taking before surgery . Talk with your doctor about how to adjust medication during this time .
During this time , incisions heal and shaved hair begins to grow back . You might wish , like some , to wear head scarves or hats when going out . Make sure these are clean to prevent infection . The skin on the scalp may feel numb or itchy for a few months as small nerves regrow . Resist the urge to scratch or rub incisions to avoid infection . About two weeks after battery placement , you see your surgeon who will inspect the incisions .
You may gradually resume gentle movement , sometimes with the guidance of a physical therapist . But you probably won ’ t restart many other activities , like work or exercise . Doctors may also limit driving and alcohol intake for at least two weeks while the brain recovers .
In the months following DBS , some people put on weight , often because they have less dyskinesia , tremor and other symptoms that required a lot of calories . For those who are underweight prior to surgery , these pounds may be welcome . But for others , weight gain is unwanted and frustrating . During your DBS evaluation , talk with your team about this possibility and what you can do to limit or avoid weight gain . Meet with a dietitian , if possible , who can monitor your weight , calculate calorie needs and help you plan an eating pattern to meet those needs .
Programming
A few weeks after battery placement , you have the initial DBS programming visit . At this appointment , your clinician will :
+ Turn on and program DBS Just as with lead placement surgery , you won ’ t take Parkinson ’ s and tremor medication the morning of this visit . But bring medications along so you can take a “ test ” dose after programming . Have a loved one drive and join you .
Using a computer tablet , the clinician programs one lead at a time . They slowly increase electrical stimulation and test different combinations of electricity . Most people don ’ t feel the stimulation ; it ’ s not like a “ jolt ” or “ zap .” With each setting , the clinician watches you tap your fingers and toes , open and close your hands , or walk down the hall to check for benefit . They also ask whether you have side effects , like tingling or numbness in the arms or legs , which are easily fixable with programming adjustment .
Initial programming can take an hour or more . Once you find good settings , you take a low dose of medication to see how the medicine and DBS work together . This directs further DBS adjustments and medication changes .
+ Prescribe medication adjustments The clinician may tell you to decrease or discontinue certain medications following the initial programming . This begins the process