Received a call from my neurosurgeon today that he is switching to the new machine for the Deep Brain Stimulation leads insertion surgery on 9/27.
You may recall from previous posts that the neurosurgeon had told me that the hospital was getting in a relatively new DBS machine that would not require the fiducial rods that they would normally put in on a "standard" frameless DBS procedure.
The usual way DBS is done is through screwing in rods around the parameter of the skull (these are actually screwed into the skull using holes they drill into the bone). These rods are then attached to a stationary frame so that the patient cannot move their head. This creates a singular reference point for the computer to help guide the lead into the brain and ensure it gets to the right spot.
The frameless DBS, which is relatively new, has five rods screwed into the top part of the skull bone. These fiducial rods provide the reference points for the computer to accurately track the brain despite any movements of the patient's head. Then a wire lead feeder is screwed onto the skull over the hole the surgeon will create to gain access to the brain. The surgeon can use the motorized feed attached to the head to feed the lead into the brain, which moves with the patient's head. This procedure does away with needing to immobilize the patient's head, so is more comfortable, and requires fewer rods being implanted into the skull. My neurosurgeon is one of six certified to teach this method to other surgeons, and is the type of DBS surgery I was scheduled to have in less than two weeks.
This new machine the surgeon has available--he received it the week of our initial consultation toward the end of August--he told me at the time, he might use it on me if he was satisfied with its accuracy. Apparently he is satisfied with it, because his office called me today to tell me they were going to do the surgery with this new, fancy piece of equipment.
I don't fully understand how it operates, but it does away with needing the fiduciary rods screwed into the skull. I believe it has something to do with imaging the head like an MRI does, to track the head's movements and relay that to the computer so it has a steady image of the brain for the surgeon's guide in placing the leads.
How do I feel about it?
Well, on one hand, it means there are five less holes in my skull: only the two entry points (both at the top of the head about an inch or two from the center as I understand it) for the lead wires, and the three screws to secure the lead-feeder to my head for each entry hole. So now it will be down to 2 entry holes and six screws penetrating my skull bone, and my head will still be able to move around during the procedure. So fewer things screwed into my head is a good thing.
There is also sort of an excitement of being one of the first, if not the first, to have this new technology used on me, at least by this doctor. I got the impression from him that there are only two or three other places in the world using this technology. So it is a kind of privilege to be able to use the most up-to-date technology. I'm also hoping he'll tell me that he's found it even more accurate in hitting their targets than the previous methods. That would be a definite plus.
That said, I have two main concerns. This one isn't big, more psychological than anything. As I stated in my title, I'm sort of a guinea pig for him. That means he may not be totally comfortable in using the machine, or there may be unforeseen issues arise related to it that he wouldn't have with a procedure he's intimately familiar with from having done it hundreds of times on a wide variety of patients. I'm sure he would not use it on me if he was at all unsure of the results. He seemed particularly proud of his success record and I know he doesn't want to mess that up. So I don't think this is a big issue or concern, but I feel it does raise the risk level up a bit, as a result. It's the nature of guinea pig status, I guess.
The other concern is whether insurance will still cover this. I believe it is an approved procedure, and it is not radically different from the process of the other procedure, just different in how it gets done. I'm sure they've filed for pre-approval and all. I just have this nightmare scenario after it is done getting a $20,000 bill that insurance wouldn't cover. So it makes me a little nervous.
Other than that, this is good news, I believe. I feel real confident about the skill of my neurosurgeon and my neurologist. I believe I'm in good hands. I'll be glad to get through this, and really happy if it provides the benefits everyone says it does.
I will still be going in on 9/26 to get a CT scan done, but it is all in the afternoon so I won't have to go in as early as originally planned.
That's it for now.
No comments:
Post a Comment