Question: What questions should you ask before deciding on a team of doctors?
Rev. 03/03
Answer: 1. What is the surgeon's training and how long has he/she been performing DBS?
2. Who is on the surgical team?
3. How long has the team worked together?
4. Do the doctors have back-ups? If one is on vacation or leaves the practice, what provisions have they made?
5. How do they select patients?
6. What diagnostic evaluations do they use to make sure you are a good candidate? MRI, full physical exam, EKG, chest x-ray, cardiologist work-up, PET scan, neuropsychological evaluation, cognition evaluation?
7. Does the team do stereotactic procedures? If so, how many have they done?
8. Can they tell you specifically what happens during surgery? And after?
9. What type of surgery does the team specialize in? STN, VIM or Gpi?
10. What are the statistics of the team? Have they encountered problems with hardware failure, incorrect placement of electrode, bleeding, infections, stroke or seizures?
11. How does the team describe the satisfaction level of patients with implants? Would it be possible to speak with a variety of STN patients?
12. Where do you need to go for adjustments?
13. Who will do the adjustments?
14. Are there provisions for "immediately needed" appointments?
15. How often can adjustments be expected?
16. What is the follow-up protocol? How often are evaluations scheduled?
17. Who supervises the medications? Who coordinates the meds with stimulator adjustments? Who prescribes additional/different meds if needed?
18. How comfortable are you with the physician?
19. Do you feel your questions and concerns are addressed?
The second most important aspect of your search is to make sure you have a first-rate neurophysiologist and extremely well trained nurse practitioner to make adjustments to your pulse generator. It may take an extended period of time to find a setting that will give you the best balance between your medications and the stimulator and thus offer optimum benefit of the surgery.
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