THE 411

BY THE TIME A PERSON IS DIAGNOSED WITH PARKINSON'S DISEASE, THEY'VE ALREADY LOST UP TO 80 PERCENT OF A CRUCIAL BRAIN STRUCTURE. The substantia nigra is a brain structure located in the mesencephalon (midbrain) that plays an important role in reward, addiction, and movement,WIKIPEDIA STATES.

ACCORDING TO MEDTRONICSDBS.COM, WHICH I ASSUME MAKES EQUIPMENT USED FOR DEEP BRAIN STIMULATION SURGERIES:

Why Consider DBS Therapy Now?

The medicines used to treat Parkinson's disease are normally very effective for treating symptoms at first. Over time, many people find that these medicines do not work as well as they used to. When this happens, their doctors make changes to their therapy. At the time medicines stop working as well, one option is DBS Therapy.

How DBS Helps

DBS Therapy for Parkinson's has been approved by the FDA to treat shaking, stiffness, or difficulty moving. DBS Therapy has helped people continue working, care for their families, return to favorite activities, and experience the joy of doing the simplest things in life again.

The Right Time for DBS

The symptoms of Parkinson's get worse over time. During the course of the disease, there is a period when DBS Therapy can do the most good to help control your symptoms. The right time for DBS is when your body stops responding to medication as well as it used to, but before your medicine stops working completely. If you wait too long, DBS Therapy will not be an option.

THAT'S STRIKE TWO IN MY WIFE'S ARGUMENT ABOUT HAVING DBS. STRIKE ONE IS EVEN SIMPLE SURGERIES.

So don't think of DBS as something for later, but as something to explore now.

Signs Levodopa Is Losing Effectiveness

You are probably taking levodopa to control your movement symptoms. Brand names include Parcopa, Sinemet, and Stalevo.

After 2 to 5 years, many people find that levodopa is becoming less effective at controlling their symptoms. Signs to watch for include:

• More hours a day with symptoms.
• Longer waits for relief to kick in after taking a dose.
• Wearing off of the medication between doses.
• Needing to take it more often, including at night.
• Drug-induced side effects like uncontrolled movements.

DBS OR THE dB's?

IT'S A NO-BRAINER, REALLY.

ACTUALLY, IT'S AN ALL-BRAINER FOR A TINY SLIVER OF THE POPULATION.

THE QUESTION: WOULD YOU RATHER LISTEN TO AN OLD BAND CALLED THE dBs OR HAVE DEEP BRAIN STIMULATION SURGERY TO RELIEVE PARKINSON'S DISEASE SYMPTOMS?

DBS OR dBs?

DUH. CRANK UP THAT OLD CASSETTE PLAYER AND I'LL PLAY SOME JANGLY TUNES FROM THE GROUP WHOSE NAME IS BASED ON "STANDS FOR DeciBels."

OR I CAN HAVE A NEUROSURGEON CRANK UP WHAT I CAN ONLY IMAGINE IS A LOUD SAW - OR WHATEVER THEY USE TO LITERALLY GET INTO THE TOP OF MY HEAD - TO PERFORM DEEP BRAIN STIMULATION SURGERY.

THERE'S SKULL THEY HAVE TO GET THROUGH TO REACH THE PART OF THE BRAIN THEY NEED TO WORK ON. CAN'T IMAGINE THAT'S THE EASIEST THING TO GET INTO.

NOW THE BEST PART: I AM WIDE AWAKE DURING THIS PROCEDURE, AS THERE AREN'T ANY NERVE ENDINGS UP THERE, HENCE I CAN'T FEEL A THING.

SURE.

BUT I CAN IMAGINE I FEEL STUFF AS THEY DIG AROUND UP THERE LIKE A TODDLER REACHING INSIDE HIS TOY BIN TO GRAB A FEW BRIGHTLY-COLORED BLOCKS.

TO BE HONEST, I DON'T REALLY KNOW WHAT DBS WILL DO FOR ME, SO I WILL THROW SOME STUFF FROM THE INTERNET AT YOU IN THE NEXT COLUMN.

BUT FIRST A BIT OF BACKGROUND. ON DEC, 8, IT WAS MY 11th YEAR SINCE BEING DIAGNOSED WITH EARLY-ONSET PARKINSON'S DISEASE. (YOU CAN FIND OUT ABOUT "MY STORY" AT THE BOTTOM OF www.pdproject2020.blogspot.com).

I WAS 38 WHEN DIAGNOSED, AFTER A FEW SCARY MONTHS OF MEDICAL TESTS AND MY NEUROLOGIST UNABLE TO PINPOINT WHAT WAS GOING ON.

NOW, 11 YEARS LATER, I SPEND SOME OF THE DAY IN A WHEELCHAIR. I HAVE FALLEN TOO MUCH IN THE LAST TWO YEARS NOT TO DO THIS.

OUR NEIGHBOR'S FATHER HAD PARKINSON'S AS WELL. WHEN I SAW GARY AND HIS WIFE AT ROBERT TINO'S FALL FESTIVAL A FEW MONTHS AGO, I TOLD THEM I WAS READY TO HAVE THE SURGERY, BASICALLY BECAUSE I WANT SOME SEMBLANCE OF QUALITY OF LIFE BACK.

GARY SAID HIS DAD HAD THE SURGERY IN 1965 - AND WHEN SURGEONS FROZE PART OF HIS BRAIN, HIS DAD'S TREMORS IMMEDIATELY CEASED AND THAT THE SURGERY HELPED HIM.

MY WIFE ANGIE IS IN THE MEDICAL FIELD - SHE KNOWS EVEN SIMPLE SURGERIES KILL. WE SAW A DOCTOR AT VANDERBILT A FEW MONTHS AGO AND HE TOLD US WE SHOULD CONSIDER THE SURGERY NOW.

I AM PRETTY SURE ANGIE HAS ALWAYS LOOKED AT DBS AS A "LAST RESORT," WHICH IS EXACTLY WHAT THE VANDY DOC TOLD US NOT TO DO.

HE WANTS ME TO HAVE THE SURGERY ASAP, SO I CAN SLOW DOWN THE SYMPTOMS AND BETTER ENJOY LIFE - WHILE I CAN.

THAT'S BECOME MY VOTE, TOO, AFTER GOING THROUGH WHAT I HAVE THE PAST 24 MONTHS. TO ME, THE CIRCLES OF PARKINSON'S ARE MOVING FROM ONE AREA TO ANOTHER, CONSTANTLY SEARCHING FOR A PIECE OF FURNITURE, A PILE OF PILLOWS, A COUNTERTOP TO LEAN AGAINST, ALL IN THE SEARCH OF COMFORT.

IT'S NOT POSSIBLE FOR ME TO FIND IT - IF I HAVE TO GO THROUGH THE MENTAL DISTRESS OF THE WAIT FOR THE SURGERY, THEN I WILL.

STOP THIS RIDE, I WANNA GET OFF

"NEXT YEAR, IF ALL GOES WELL, HE'LL BE BARKING FOR THE 'YAK WOMAN.'"
-------------COUSIN EDDIE IN NATIONAL LAMPOON'S "VACATION."

"DRIVER 8, TAKE A BREAK, YOU'VE BEEN ON THIS ROAD TOO LONG."
---------------------------------------- R.E.M.




THIS MORNING, ABOUT 1:30 IN THE a.m., I HAD ONE SIMPLE THING TO DO BEFORE I COULD GET BACK ON THE COUCH AND SNOOZE.

GOD GIVES ME 20 MINUTES TO PEE - AFTER THAT IT'S A WHOLE NEW BALLGAME - ANYTHING GOES.

I NEEDED TO SIMPLY WORK MY WAY OFF THE COUCH AND HIT THE PEE JUG STATIONED ON A TABLE ABOUT 10 FEET AWAY. NOT LITERALLY, BUT TO STAND AND PLACE IT BELOW ME.

PROBLEM IS, SHORTLY AFTER MY WIFE ANGIE WENT TO BED, ABOUT 11:30, I NEEDED TO GET OUT OF THE WHEELCHAIR - I COULDN'T GET COMFORTABLE TO WATCH THE SAINTS-FALCONS GAME.

SO I WHEELED NEAR THE COUCH - AND SINCE I WAS MOVING PRETTY WELL, PUSHED A FOOTSTOOL TO THE BASE OF THE COUCH, FIXED THE COUCH PILLOW I WOULD LEAN BACK AGAINST AND CONSOLIDATED OTHER ITEMS I MIGHT NEED: LAPTOP, BLANKET, PLAYSTATION3 CONTROLLER AND TV PUNCHER.

NOW, I HAD TO JUST FINISH THE LANDING. STRADDLING THE FOOTSTOOL, I EASED MY BUTT ONTO THE COUCH, TRYING TO GET IN THE MIDDLE OF WHERE THE LEFT AND MIDDLE CUSHIONS MEET. MY GOAL IS TO SIT EVENLY SO MIGHT RIGHT CHEEK CAN STAY FLAT AND EVEN.

IF I HIT IT RIGHT, EVEN THE COMMUNIST JUDGES WILL GRUDGINGLY SCORE IT A 9.5. BUT THIS TIME I LAND A BIT OFF, TOO MUCH BUTT LEANS TO THE RIGHT, MEANING I WILL EVENTUALLY WORK MYSELF TOO FAR TO THE RIGHT.

WELL, FIRST, I CAN FINISH WATCHING FOOTBALL, THEN PLAY SOME VIDEO BASEBALL. I AM SLEEPY, AND NOTHING PUSHES ME OVER THE EDGE LIKE BASEBALL.

THE EDGE OF SLEEPINESS TO SLEEP, THAT IS. PLAYING THE GAME IS INFINITELY MORE FUN THAN WATCHING A GAME, WHICH BRINGS ON A COMA-LIKE DEEP SLEEP. I MEAN REALLY, IS THERE ANYTHING MORE BORING THAN BASEBALL ON TV?

OF COURSE THERE IS. GOLF, BOWLING, SOCCER, FISHING, MOST ANY REALITY SHOW (FROM THE MORONIC AMISH TO THE REDNECKS THAT LIVE IN SWAMPS, ALASKA, RIVERS, TRASH-FILLED HOMES AND UNDER BRIDGES). MY WIFE WATCHES THEM ALL, SWITCHING CHANNELS AT THE HINT OF A COMMERCIAL.

"I HATE COMMERCIALS," SHE TELLS ME.

"I CAN'T STAND PEOPLE WITH TV REMOTES THAT CAN'T CONTROL THEIR VIEWING HABITS TO TWO OR THREE SHOWS, NOT 20," I THINK TO MYSELF. A FEW DEEP SIGHS LATER, I'LL READ A BOOK OR OPEN UP THE LAPTOP. THE KIDS ARE ASLEEP - OR ON THEIR WAY THERE - IN THEIR ROOMS, SO I CAN'T GO WAKE THEM UP TO PLAY.

BUT I DIGRESS. WE WERE ABOUT TO WORK OUR WAY OFF THE COUCH. EXCEPT I HAVE BEEN TRYING THE WHOLE TIME WHILE MY MIND RUNS THROUGH A THOUSAND-AND-ONE THINGS.

PROGRESS REPORT: I HAVE SAT BACK TOO FAR IN THE COUCH AND IT'S OBVIOUSLY GONNA BE A STRUGGLE TO GET OFF IT. I KNOW WHAT I HAVE TO DO - PUSH THE NEED TO PEE BEYOND CONSTANT THOUGHT - CHECK, I'VE DONE THAT, THINKING ABOUT THE TIDBITS YOU READ ABOUT ABOVE.

I'VE TRIED ROCKING MYSELF FORWARD - NO GO, MY RIGHT HAND CAN'T GET A GOOD GRIP ON THE SHEET COVERING THE OUCH AND MY LEFT FIST IS USELESS IN THAT ENDEAVOR. EVENTUALLY, I HAVE TO GET MYSELF OVER MY RIGHT LEG (AND THE QUAD THAT'S BEEN GIVING ME SO MUCH TROUBLE.)

AGAIN, I HAVE TO LAND PRETTY WELL, ON MY KNEES SO I CAN STRAIGHTEN MY BACK AND, HOPEFULLY, PULL MYSELF TO MY FEET. I LAND OK, AND START "WALKING" HAND-KNEE, HAND-KNEE TOWARD THE WHEELCHAIR, WHERE THERE'S ANY NUMBER OF THINGS TO GRAB AND PULL MYSELF UP.

SUDDENLY, PROGRESS GRINDS TO A HALT.

UH-OH.

THE FIRST RULE OF FIGHTING GRAVITY IS TO NEVER - EVER - GET TO FLOOR LEVEL.

THAT'S OUT THE WINDOW.

THE NEXT LAW IS TOO NEVER STOP ONCE YOU GET GOING.

WHOOPSIE. I MAY BE SCREWED. WHILE I AM STILL IN A NAVIGABLE POSITION, I HAVE ALSO FROZEN UP - NEVER A GOOD SIGN.

SO I WAIT. AND I WAIT. AND I WAIT SOME MORE, UNTIL MY ARMS FEEL A BIT RESTED, EVEN THOUGH A LOT OF MY WEIGHT HAS BEEN RESTING ON THEM - AND THIS IS THE FOURTH TIME IN TWO DAYS I HAVE PUT MYSELF IN A BAD POSITION - EVEN A LITTLE REST CAN OFTEN HELP ME MAKE A FINAL SHOT AT REACHING SOMETHING TO HOLD ON TO.

NO GO.

SHOULDERS ULTRA-FATIGUED, I AM SLOWLY SLIDING INTO NO-MAN'S LAND - FACE DOWN ON THE CARPET. MY LEFT ARM GETS PINNED UNDER MY CHEST (LAST COUPLE OF TIMES I BELIEVE IT WAS MY RIGHT ARM). NO MATTER, I STILL GOTTA PULL IT OUTTA THERE, WHICH EXTENDS MORE ENERGY.

(FYI, THIS IS A GREAT FREAKING WORKOUT FOR YOUR UPPER BODY. I'VE LOST 15 POUNDS BETWEEN PULLING MYSELF OFF THE GROUND SO MUCH AND NOT DRINKING MUCH BEER AT ALL, AS IT SLOWS ME DOWN EVEN MORE.)

BUT I WOULDN'T TRY IT AT HOME. OR EVEN TRY IT AT ALL.

ANYWAY, I GET THE LEFT ARM OUT, SO BOTH ARE NEXT TO ME, READY TO PUSH UP ON MY FISTS, WHILE BRINGING ONE KNEE FORWARD AT A TIME. I AM HOPING TO GET EVENLY BALANCED ON BOTH MY KNEES SO I CAN LEAN BACK AGAIN AND STRAIGHTEN MYSELF FOR BETTER BALANCE.

THE FIRST ATTEMPT IS POSITIVE AND I GET VERY CLOSE, UNTIL I FREEZE AGAIN AND HAVE TO GO BACK TO MY BELLY. LONG STORY SHORT - AND SINCE I'M TIRED OF TYPING - SIX MORE ATTEMPTS OVER THE NEXT HOUR-PLUS PROVE POINTLESS.

YEAH, I'VE STILL GOT TO PEE.

I HEAR MY WIFE STIRRING IN THE BEDROOM.

"ANG?"

"YEAH?"

"CAN I GET A LITTLE HELP?" (AND BY A LITTLE, I MEAN A LOT).

SHE'S A PHYSICAL THERAPIST AND DOES THIS STUFF ALL DAY - I TRY NOT TO WAKE HER AS MUCH AS POSSIBLE.

SHE SAVES THE DAY (NIGHT) YET AGAIN. I AM BACK INN THE WHEELCHAIR - WIDE AWAKE NOW - SHE'S BACK IN BED. I PLAY A BIT OF BASEBALL, THEN TRY AND WRITE WITH THE LAPTOP IN MY WHEELCHAIR (THE SECOND COLUMN OF THE BLOG).

IT SUCKS.

NOT ENOUGH ROOM AND IT HURTS MY SHOULDER TO PECK AWAY LEFT-HANDED (NORMALLY, I HAVE NO PROBLEM USING BOTH ARMS TO DO SO, BUT CAN'T DO THAT NOW.)

TWO MINUTES AFTER I SHUT THE LAPTOP DOWN, HER ALARM STARTS GOING OFF. SOME TIME LATER, SHE FINDS ME ASLEEP, WITH THE BASEBALL GAME SCROLLING FROM PAGE TO PAGE AS I HAVE FALLEN ASLEEP WITH THE CONTROLLER UNDER MY HAND.

NORMALLY, I WOULD JUST GET UP AND GO AND MAKE THE KIDS' LUNCHES FOR SCHOOL, BUT THE LAST 36 HOURS HAVE TAKEN ITS TOLL. I GET TO THE COUCH A QUICK AS I CAN.

MY DAUGHTER ADDIE GRACE LIKES SITTING IN THE BATHROOM WRAPPED IN BLANKETS WHILE MOMMY TAKES A BATH. I HEAR HER SNEAKING ABOUT AND ASK HER TO GIVE ME A HAND.

SHE COVERS ME WITH A BLANKET, ADDS A PILLOW UNDER MY HEAD AND KISSES ME ON A CHEEK, THE MOST BEAUTIFUL 7-YEAR-OLD IN THE WORLD. I GO TO SLEEP, WORN OUT, BUT HAPPY.

CHEERS.

CIRCLES OF CONFUSION

LET'S BEGIN FROM THE BEGIN
                                             --------michael stipe

GOOD ENOUGH PLACE TO START AS ANY.

THE BLOG IS NAMED AFTER MY NIGHTLY QUEST FOR COMFORT, STARTING ABOUT 11 p.m. AND RUNNING TO 4:30 OR 5 IN THE MORNING. IF I DO FALL ASLEEP,  I THEN WAKE A FEW MINUTES BEFORE MY WIFE'S ALARM STARTS SPOUTING OFF.

SO, MY NIGHTLY SOJOURN FROM PLACE TO PLACE AROUND THE LIVING ROOM IS REALLY MORE ABOUT FINDING A SAFE PLACE TO RIDE OUT THE DISCOMFORT RATHER THAN BEING COMFORTABLE.

PARKINSON'S DISEASE HAS TAKEN THAT AWAY FROM ME - IT WON'T GIVE IT BACK. WELL, THIS FIRST ATTEMPT TO TYPE FROM MY WHEELCHAIR IS AN ABJECT FAILURE, SO MORE LATER.

CHEERS.

DEFINITION OF CHARACTER

TACO BELL WANTS US TO "THINK OUTSIDE THE BOX."

BY WHICH, OF COURSE, THEY REALLY MEAN "THINK OUTSIDE THE CIRCLE."

THINK ABOUT IT.

GO AHEAD, FURROW YOUR BROW AND DIG YOUR BRAIN INTO THE TACO KING'S AD LOGO. I GOT TIME - PLUS I'M PATIENT.

FIRST OF ALL, NO SUPER NERD EVER COINED THE PHRASE "THINK OUTSIDE THE CIRCLE."

NOT COOL LINGO.

WE GET OUR STUFF IN BOXES. NOBODY EVER SAYS, "I'M GONNA RUN DOWN TO THE MAIL CIRCLE" AND SEE IF THAT LETTER HAS GOTTEN HERE YET.

STILL WAITING, BUT I AM TRULY BLESSED ALMOST EVERY DAY WITH AN IRRATIONALLY LONG TIME TO THINK ABOUT THESE THINGS. IT'S EASY - I SIMPLY PUT MYSELF IN AN AWKWARD POSITION AND LET GRAVITY THROW ITSELF ON TOP OF MY PARKINSON'S SYMPTOMS.

IT CAN START HAPPENING WHEN TRYING TO DO SEEMINGLY SIMPLE THINGS LIKE GET UP OUT OF A CHAIR OR COUCH. NOW WHEN MY MEDS ARE WORKING, I RARELY RUN INTO ANY PROBLEMS - MY LEGS DON'T FEEL SUPER HEAVY, I CAN WALK FINE AND MY LEFT HAND ISN'T CLAWED INTO A FIST.

BUT OBVIOUSLY MY MEDS AREN'T "ON" ALL THE TIME - OR I HAVE BEEN STANDING OR SITTING TOO LONG IN ONE POSITION AND MY BODY TIGHTENS UP.

WHEN THIS STARTS, I CAN'T EVEN THINK MY WAY OUT OF A WET PAPER BAG LET ALONE A BOX. BUT NO MATTER HOW IT STARTS, 90 PERCENT OF MY PROBLEMS END UP UP WITH MOST OF MY WEIGHT ON MY RIGHT LEG OR ARM.

FROM THERE IT'S A SLOW SLIDE - DOWN, DOWN, DOWN. I LOOK AROUND TO SEE IF THERE'S ANYTHING DANGEROUS BELOW WHERE I WILL EVENTUALLY LAND AND SEE IF I CAN SHOVE THEM OUT OF THE WAY.

NOT EXACTLY THINKING OUT OF THE BOX, BUT SAFETY FIRST, BECAUSE EVENTUALLY THE MUSCLES IN MY LEG, ARM OR SHOULDER ARE GOING TO REVOLT AND I WILL END UP ON THE FLOOR.

IT HAPPENED THREE TIMES FROM AROUND NOON WEDNESDAY TO NOON THURSDAY. THE AVERAGE TIME I FIGHT TO KEEP UPRIGHT UNTIL I END UP ON THE GROUND AND THEN AM ABLE MAKE IT SAFELY BACK UPRIGHT IS ABOUT 90 MINUTES.

THAT'S A LOT OF TIME TO THINK ABOUT ANYTHING, EVEN TACO BELL'S MARKETING STRATEGY. IF I HAD MY DRUTHERS, I'D WISH MY MEDS WERE MORE CONSISTENT AND TELL TACO BELL TO BRING BACK THE CHIHUAHUA.

BUT MY PARKINSON'S ISN'T LEAVING ANY TIME SOON AND THAT TINY DOG ISN'T GOING TO SELL BURRITOS ANY TIME SOON EITHER.

SO, MY ANSWER IS: TACO BELL WANTS YOU TO THINK OUT OF THE BOX ALRIGHT - THE BOX YOUR ROUND BIG MAC OR WHOPPER COMES IN. THEY REALLY WANT YOU THINKING OUT OF THE BURGER CIRCLE TO THE TACO BELL SHAPES, EVEN ROUND.

ROUND IS EVEN GOOD - TOSTADAS AND MEXICAN PIZZAS ARE ROUND, AND IRONICALLY, THE PIZZA COMES IN A SQUARE BOX. RECTANGLES ARE ANY NUMBER OF TACO BELL ITEMS - BURRITOS, ENCHILADAS ... ETC.

THEIR MOST FAMOUS SHAPE IS THE SEMI-CIRCLE: YOUR BASIC TACO AND ALL ITS VARIATIONS.

OH, BY THE WAY, THE $5 BOX IS STILL AVAILABLE AT TACO BELL - IT'S NOT ON THE MENU, YOU JUST HAVE TO ASK FOR IT.

MUCH LIKE I ASK FOR A SOFT LANDING AND AN EASY WAY BACK TO MY FEET.

FOOD FOR THOUGHT: A LOCAL TV NEWS BROADCAST WEDNESDAY NIGHT SHOWED A MARKET THAT POSTED THE NAMES OF THOSE WHO HAD PASSED BAD CHECKS AT THE STORE.

QUICK INTERVIEWS WITH MARKET PATRONS SHOWED ABOUT HALF WERE IN FAVOR OF THE NAMES BEING POSTED ON THE MARQUEE. ONE DISSENTER SAID IT WAS DEFINITELY A "DEFINITION OF CHARACTER" TO POST THE NAMES - AND WHEN YOU THINK OUT OF THE BOX, SHE WAS RIGHT.

WRONG WORD, BUT CORRECT IN THE USAGE - OF COURSE YOU HAVE TO THINK OUT OF THE BOX TO REALIZE IT.

CHEERS.