Restoring people to a fuller life

Divina was 51 years old when it all started. She was living in a two-bedroom condominium with her husband of 27 years. Her two children were all grown-up and had families of their own.

She had a fairly active life then: making the rounds of the wet market early in the morning and haggling with her "suki," taking leisurely afternoon walks in the mall and playing with her grandchildren on weekends. But all this changed gradually.

It was eight years ago when Divina first noticed a shake in her right hand. Though hardly noticeable, the shake became worse when she was not doing anything. Deciding that it would be better if she got busier, she took up needlepoint and kept up her daily routine and playing with her grandchildren. Life went on.

But after a year or so, the shake became more noticeable. It was a rhythmic shake that she just could not control. Her hand seemed to have a life of its own. Divina could no longer do needlepoint.

The shake became even more prominent after another year. Embarrassed by her condition, she retreated to her home and ventured out only when it was absolutely necessary. She no longer did her rounds of the market, she shortened her mall walks, and her grandchildren would ask her about her shakes.

She finally consulted the family physician. Parkinson’s disease was the diagnosis and she was put on medication. Her tremors improved and she was at last able to do her regular activities again.

But as time went on, she needed to take more medication more frequently and in larger doses to control the tremors. She became a walking drug store. Her Parkinson’s disease now needed to be managed by a neurologist.

In the last four months, her arm began to develop involuntary writhing and snakelike movements as well – a side effect of her medications. Stopping the medicine helped end this but then the tremors returned with a vengeance. Her life was definitely coming to a halt.

It is patients like Divina who can be helped by deep brain stimulation (DBS), which has been proven to significantly suppress Parkinson’s symptoms like tremor, rigidity, slowness or lack of movement, and poor balance.

The occurrence of these symptoms is attributed to abnormalities in structures deep within the brain. One of these structures is the substantia nigra.

In Parkinson’s, cells in this structure die and stop producing dopamine, a chemical essential for controlling normal movement and muscle function. Two brain structures affected by the loss of dopamine are the subthalmic nucleus (STN) and the globus pallidus (GP).

Without normal amounts of dopamine, these two structures affect the motor circuit by virtually slowing it down – and this is when the symptoms of Parkinson’s disease appear.

When nerve signals in either the STN or GP are modulated by DBS such as that offered by the Activa Parkinson’s Control Therapy, the abnormal brain signals are essentially blocked and more normal movement and function return.

The Activa Parkinson’s Control Therapy works by delivering mild electrical stimulation to an area of the brain called the subthalamic nucleus (STN). Two surgically implanted medical devices similar to cardiac pacemakers are implanted near the collarbone to control Parkinson’s symptoms on both sides of the body.

These devices deliver carefully controlled electrical pulses to the STN or GP through electrodes attached to a thin wire.

Thousands of people throughout the world have already benefited from Activa Parkinson’s Control Therapy. It has been available in Europe, Canada, and Australia since 1995 and in the United States since 1997.

In the Philippines, the Activa Parkinson’s Control Therapy is pioneered by PhilMove, a team of medical experts in the fields of neurology and neurosurgery, with offices at the Cardinal Santos Memorial Hospital in San Juan.

Patients who have benefited from the therapy swear by its life-changing effects. Michael Placeman, an American, for instance, says he can now do all the normal things that make life a joy for him. "I was an invalid before, but now I can use my computer, go shopping, and exercise," he says.

The same thing goes for Jose Miguel del Olmo, who had to quit his job and stopped participating in sports activities. "Nowadays, I can be a father again to my children. I play with them and share their activities. I walk much better. I do things by myself. No one has to be taking care of me all the time," he says.

Like them, Divina can lead a normal life once again – do her usual rounds at the market, take leisurely afternoon walks, and most importantly, play with her grandchildren.

To learn more about DBS and the Activa Parkinson’s Control Therapy, contact the Philippine Movement Disorder Surgery Center at 726-0776 or 727-7653.