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KOLKATA: Homemaker Chandra Sanyal's world came crashing down a few years ago after doctors diagnosed her slowness of movement, tremors and stiffness/rigidity of limbs as the first stages of Idiopathic Parkinson's Disease. Would she be reduced from a healthy human being to a bedridden wreck, depending on medicines and physical support for even basic needs?
While the news put Chandra into depression, Sk Salauddin, Zafar Ahmed and Chandra Sekhar Bhowmick started considering premature retirement after being diagnosed with Parkinson's.
But the disease failed to get the better of them. Chandra has gone back to her household chores, while the remaining three have put their retirement plans on hold - courtesy a surgical intervention that is now available in Kolkata.
If you thought that pacemakers were used only for hearts requiring electrical impulses, think again. Neurosurgeons in Kolkata have started using pacemakers on Parkinson's patients. The gadget not only reduces the patient's dependence on medication, it also allows him or her spend more time in a day without the tremors and stiffness associated with the disease.
"I thought that my normal life had come to an end till I met neurosurgeon Sujoy K Sanyal at the Rabindranath Tagore Hospital. Today, I lead a normal life and no longer have to depend on others for every need," Chandra said.
Sanyal is the one who pioneered in brain pacemakers in Kolkata several years ago. A couple of years ago, Medica Superspecialty Hospital in the city started annual workshops with neurosurgeons from abroad. It was during these workshops in 2010 and 2011 that Parkinson's patients got the pacemakers fitted.
The pacemaker has worked like magic for Bhowmick. The bank employee from Panskura in East Midnapore, who had been bedridden for nearly two months before the surgery, is now planning to rejoin office.
"Initially, the symptoms are mild and the patients respond to medicine. In fact, initial response to medicine is almost a diagnostic hallmark of Idiopathic Parkinson's Disease. When Chandra and the others came to me, I suggested that they undergo Deep Brain Stimulation (DBS) surgery. In this procedure, electrodes connected to electrical leads are inserted into the 'subthalamic nucleus' of the brain. These are then connected to a pacemaker that sends controlled impulses to the brain. After DBS, Parkinson's patients need to take fewer medicines. Their drug-induced abnormal movement (Dyskinesias) also goes down significantly. There is a complete change in the quality of life," Sanyal said.
DBS is an expensive procedure. According to surgeons, the major chunk of the cost goes towards the pacemaker. Neurosurgeon L N Tripathy of Medica spoke of lesional surgery which is cheaper (nearly a third of the cost involved in DBS). In this procedure, the thalamus inside the brain is actually 'burnt' by inserting electrodes. "Surgeons need to be extremely careful as this is a non-reversible process," Tripathy added.
Sanyal, too, is not in favour of lesional surgeries. According to him, the good effects last barely a few months and the patients can't go in for DBS after that. The neurosurgeon is now making efforts to raise a corpus for poor patients who may require DBS.
Patients who undergo DBS require post-operative pacemaker programming and medicine adjustment. The voltage, pulse width and frequency of simulation of the pulses from the pacemaker has to be monitored and controlled frequently immediately after the surgery and this is why patients need to be close to their doctors.
"The pacemakers nowadays are rechargeable and don't need to be changed every four to five years. The batteries inside can be recharged just by placing an antenna on the surface of the skin below which the pacemaker is implanted and connecting them to a power source while the patient watches television or relaxes," Sanyal said.
File photo of Smriti Irani. (Raj K Raj/HT Photo)