Here are answers to questions that people often ask about DBS Therapy. What do you want to know?
Is DBS what Michael J. Fox had?
No. The popular actor, who has had Parkinson’s for over 20 years, had a different kind of brain surgery years ago. The Michael J. Fox Foundation is an important source of information about Parkinson’s and a major supporter of research toward a cure.
Would DBS keep me from using future treatments or cures that may come along?
No. DBS Therapy will not reduce your future therapy options. DBS Therapy is reversible and the system can be removed.
Is DBS just for tremor?
No, DBS also treats stiffness and slow or absent movement.
Is DBS something to put off as a last resort?
No! The window of opportunity for DBS Therapy opens when your body isn't responding to medication as well as it used to... but before your medicine stops working completely. If you wait too long, the window will close and DBS Therapy will not be able to help you as much as it could have had you asked about it sooner.
How long will it take for the DBS Therapy to work after the implant procedure?
Typically, a Medtronic DBS Therapy system is not activated until you've healed from the surgery. Your symptoms may decrease at that time. Optimal results are usually achieved after the doctor or nurse who programs your device has gone through multiple programming sessions with you. This process may take several months.
What does the stimulation feel like?
Most people don't feel the stimulation at all as it reduces their symptoms. However, some people may feel a brief tingling sensation when the stimulation is first turned on.
Higher levels of stimulation have been described as uncomfortable, jolting, or shocking. If the stimulation changes or becomes uncomfortable, contact your doctor immediately.
Does the brain stimulation system make any noise?
Will I be able to resume my normal daily activities?
For the first few weeks after surgery, you should avoid strenuous activity, arm movements over your shoulder, and excessive stretching of your neck. You may gradually want to try activities that were difficult before your surgery. Talk about this with your doctor first, and be sure to follow all of your doctor's instructions.
Will the neurostimulator show through my clothes?
Depending on your body build, the neurostimulator may be noticeable as a small bulge under the skin. However, your doctor will try to place the neurostimulator in a place that is most comfortable and cosmetically acceptable.
Will I be able to increase or decrease the strength of stimulation?
In most cases, only your doctor can change the strength of stimulation. Depending on the type of neurostimulator you have, you may be able to choose from a range of stimulation settings that your doctor has programmed for you.
Will my insurance cover DBS Therapy?
The current national policy provides coverage for Medicare beneficiaries who qualify as candidates for DBS. (Medicare does not require prior approval before an implant, although you must meet Medicare's criteria in order for the procedure to be covered.) You will still pay deductibles, coinsurance, and copayments.
Typically, your doctor will work with private insurance companies to obtain prior approval. This process normally requires that your doctor send a letter of medical necessity to the insurance company. This letter explains why DBS is appropriate for you. It also describes the other treatments that have been attempted and failed.
It is not uncommon for an insurance company to deny a request for prior approval if they are unfamiliar with the treatment. If you receive a denial and wish to appeal, we're here to guide you and your doctor through this process.
Is it safe to have medical tests with the system implanted?
Consult your doctor before engaging in any medical treatment or diagnostic test (for example, MRI, mammograms, electrocautery, or heart defibrillation). Diathermy (deep heat treatment) should not be permitted under any circumstances.
Will I be able to have an MRI scan with a DBS system?
Someday you may need a magnetic resonance image (MRI) head scan to diagnose the cause of a common condition, such as hearing loss, headache, vision problems, seizures, tumors, or stroke. When you have an implanted electronic device, however, you have to be careful about MRI scans. The good news is that all Medtronic DBS systems are designed so that an MRI head scan is possible with proper safeguards. In fact, only Medtronic offers deep brain stimulation systems that are FDA-approved for MRI head scans, under specific conditions of use. Talk to your doctor if an MRI scan is prescribed for you.
Can stimulation be used during pregnancy?
The safety and effectiveness of this therapy have not been established for patients who are pregnant.
What are the risks associated with this type of treatment?
DBS Therapy requires brain surgery. Risks of brain surgery may include serious complications such as coma, bleeding inside the brain, seizures and infection. Some of these may be fatal. Once implanted, the system may become infected, parts may wear through your skin, and the lead or lead/extension connector may move. Medtronic DBS Therapy could stop suddenly because of mechanical or electrical problems. Any of these situations may require additional surgery or cause your symptoms to return.
Medtronic DBS Therapy may cause worsening of some motor symptoms associated with your movement disorder, and may cause speech and language impairments. Stimulation parameters may be adjusted to minimize side effects and attain maximum symptom control. In patients receiving Medtronic DBS Therapy, depression, suicidal thoughts and suicide have been reported. Occurence of falls has also been reported in patients with Parkinson's disease.
Talk with your doctor about the risks that may be applicable to your specific situation.
Is this a permanent procedure?
Medtronic DBS Therapy is a reversible procedure. It is also adjustable, which means that the stimulation can be adjusted to match changes in your symptoms. The system can also be deactivated or even removed. Removal would require additional surgery.
What happens if the neurostimulator stops working?
Your symptoms will return. If you can't determine the possible cause and correct the problem, contact your doctor.
How long will the neurostimulator battery last?
On average, and depending on programmed settings, an Activa SC or Activa PC neurostimulator battery lasts 3 to 5 years. The rechargeable neurostimulator lasts for 9 years.
What happens when my neurostimulator is ready to be replaced?
Before your battery runs out, you'll need to replace the neurostimulator through a surgical procedure. The DBS Therapy leads and extensions can typically stay in place and be reconnected to the new neurostimulator.