Surgery for Parkinson's Gives Farmer His Life Back

Ray Bricker is a 72-year-old farmer whose livelihood depends on his mobility. So nine years ago when he started to carry his arm funny, he immediately went to the doctor.

After various tests, a local neurologist determined that he was in the beginning stages of Parkinson's disease. Soon after that he started taking medication to control the tremor.

Eventually Bricker, who lives near Chambersburg, Penn., visited a doctor in Austin, Texas, on the advice of a friend. That's where he learned that excellent care was much closer to home at Cleveland Clinic's Center for Neurological Restoration. He underwent a multidisciplinary evaluation and confirmed the Parkinson's diagnosis.

Like so many Parkinson's patients, Bricker's symptoms worsened over a period of time, and he proceeded to the next treatment option – deep brain stimulation (DBS) surgery with Dr. Andre Machado, Director of the Center for Neurological Restoration. DBS uses a surgically implanted medical device to deliver controlled electrical pulses to targeted areas of the brain. The electrical pulses are generated by a battery-powered device that is implanted in the chest, like a pacemaker. That device is programmed externally to fine tune the electrical stimulation as needed. Bricker had surgery for the tremor in his right arm during the summer of 2012. The brain lead was implanted in the left side of his brain.

"Without the surgery, I would probably be in a wheelchair."

"Treatment for Parkinson's disease involves replacing dopamine, a lost chemical that helps to fine tune a section of the brain for movement," says Joseph Rudolph, MD, of Cleveland Clinic’s Department of Regional Neurosciences, who now treats Bricker. "This dopamine then triggers the next group of cells to behave appropriately." After a patient has been on medication for many years, he may opt for surgery to replace the lost signal with electricity rather than a chemical.

DBS for Parkinson's disease is not experimental and has been in use for many years, but there are still not many places that perform this complex procedure. "This is very benign brain surgery," Dr. Rudolph says. "Half of the surgery is typically done while the patient is awake." Like any surgery, there are risks, but the odds are quite low, so people should not shy away from it. However, to ensure optimal results, a team of multidisciplinary Cleveland Clinic professionals meets to determine if a patient is an appropriate candidate for the surgery.

For Bricker, the surgery was a success and he is happy to continue leading a fairly active life. "We left the hospital, and I felt good," he says. "Without the surgery, I would probably be in a wheelchair." Instead, Bricker is able to help his son with the farm – even driving the tractor.