How long will it take for my symptoms to improve?
Some patients note improvement after the first programming session, while others may require several sessions for improvement. DBS requires patience and an understanding that we may need to try several settings to find the one that works best for you.
Why was I better right after surgery before the stimulator was even turned on?
This is not unusual — the placement of the leads often quiets symptoms for one to two weeks following surgery. Most patients' symptoms have returned to baseline by the time of initial programming. Do not be disappointed that your symptoms have returned.
How many programming appointments will I need?
This varies from patient to patient, but as a general guideline you can expect monthly appointments for several months following the initial programming and then quarterly appointments. Once the stimulation is optimized, patients will need minor adjustments and battery checks two or three times per year.
How do I know whether to call Neurology or Neurosurgery if I have a question?
If you are experiencing problems or have questions in the time period between the surgery and initial programming, you should call Neurosurgery. Once your programming has occurred, you should call Neurology.
When can I cut back my medicine?
Taking less medicine is not a primary goal of DBS, but often occurs after the right stimulator setting is found. Do not decrease your medications unless you have been instructed to do so.
Deep brain stimulation (DBS) has its own unique vocabulary. Following are a few terms you will hear during your initial programming session:
- Lead: This is the small wire in your brain kept in place with a small cap (the bump you feel below your scalp).
- IPG (Internal pulse generator): This contains the power source and electronics and is located in your chest (or abdomen in some patients.)
- Patient controller: This is a plastic device that looks like a remote control. It allows you to turn the DBS on or off, after it has been programmed.
Four parameters that can be adjusted for stimulation:
- Contacts: Four places in the wire in your brain which can be chosen for stimulation
- Frequency: The number of times in a second that the stimulation pulses
- Pulse width: The duration in microseconds of each stimulation pulse
- Voltage: The main parameter used to control the intensity of the stimulation
Reminder: No MRI now that you have DBS (X-rays and CT scans are OK).
Patient Instructions and Surgery Precautions
Additional information is available at the Medtronic website.