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Battling Parkinsonís Disease
Electronic therapy helps stop tremors

By Howard Lestrud
ECM Online Managing Editor
Jim Johnson is maybe the only one of ECM Publishersís 475 employees who can kick back in his easy chair in mid-afternoon of his regular work day, take a short nap and get away with it.
You see, Johnson, 57, of Anoka, works at his desk with a computer during most of his work day and completes his duties as director of financial analysis and special projects for ECM Publishers, a printing and publishing company.
Itís not his job that gives him special napping privileges, however. It is the surgery that he underwent last June 3 to alleviate the severe tremors he was experiencing with Parkinsonís Disease. He was back at work about two months later.
Talking from his office at the ECM Center in Coon Rapids, Johnson is proud to put out his right hand and demonstrate that he no longer has the tremors that were very noticeable and physically debilitating for him.
Johnson has not been cured of Parkinsonís Disease but he is fighting it more effectively with the help of tremor control therapy, a generic name for a medical treatment developed by Medtronic in collaboration with medical researchers for both the treatment of unilateral Essential and Parkinsonian tremor. The therapy uses an implantable medical device to deliver mild electrical stimulation to the thalamus of the brain.

Diagnosis made in 1998
A diagnosis of PD was made by medical specialists in February of 1998. Johnson said he and wife Sharon were suspicious of a physical problem as early as three years before.
ìI had trouble writing checks due to my shaking,î Johnson said.
He then visited a family doctor and was referred to a neurologist. He actually obtained two opinions and was then placed on medications and found suitable relief. His neurological doctor also ìbrought up the idea of the brain stimulation programî at the University of Minnesota, Johnson said.
His condition gradually worsened and it was monitored carefully by his wife who is a licensed practical nurse at the Riverway Clinic in Anoka and by the Minneapolis Clinic of Neurology during his monthly checkups.
In December of 2001 it was recommended to the Johnsons that they take a serious look at the stimulation therapy.
Johnson used a fast track for information on the therapy after talking to fellow worker Barb Eggert who said her husband Brian, a Medtronic employee, could possibly put Jim in contact with someone who could explain the therapy.
That happened with the Johnsons meeting Lynn Otten of Medtronic. She headed up the engineering team that designed the therapy project.
Jim recalls: ìWe spent about an hour and a half with her; she was very blunt and matter of fact about the procedure and about what the equipment does. She also explained in detail what would happen in surgery.î
University evaluation
Johnson then went through the University of Minnesota evaluation program for the therapy. ìIt looked like I was going to be turned down early on because my condition wasnít bad enough,î he said.
A series of physical tests and other tests ensued, including visits with a psychiatrist and a program of adjusting his existing medications.
With not much fondness, Johnson recalls twice being taken off his medication for as long as 24 hours and then returned to his medical treatment. He said he experienced withdrawal and the tremors and cramping became nearly unbearable.
He said he passed those hurdles and only because of his supportive wife and family including his children, his parents and siblings.
The actual surgery involved two procedures. First, two electrodes were placed in the brain and in another surgical procedure, the actual neurostimulators were implanted in his chest connected by leads to the electrodes.
In visiting with Johnson, the average person can not visibly detect that any surgery has been done.
Surgical entry three inches
Pointing to his receding hairline, Johnson said, ìCanít you see the two little bulges?î Those bulges are where Dr. Robert Maxwell surgically entered delicately and went down three inches to the thalamus of the brain. Dr. Maxwell has done more than 75 of these surgeries.
Johnson said early in the development of this therapy, the surgery was done, one side of the brain at a time. Now, both are done during the same surgical procedure.
Prior to surgery, a metal halo was attached to Johnsonís head. It contained all of the equipment to be used for the surgery. ìThat was tough on my family,î Johnson said. Johnson added that he remembers the doctor tightening the halo just before he went into surgery.
He went into surgery at 7 a.m. Surgery was completed at 4 p.m. Amazingly, Johnson was released from the hospital within 24 hours of the surgery.
Three weeks later, the neurostimulators were implanted. This procedure took only three hours. Johnson was again out of the hospital within 24 hours.
All of his equipment was now installed but it was not activated. ìYou get this false feeling of instant physical improvement,î said Johnson. ìI was ready to conquer the world but a few days later I was brought back to reality,î he said.
In a few weeks his surgeries were fully healed and it was time to turn on the equipment. The multiprogrammable system then delivers electrical stimulation to the thalamus of the brain. The electrical pulses to the brain control the tremors.
Shaking stopped
ìIt was amazing,î Johnson said. ìWhen they turned on the stimulators, my right hand was shaking like gangbusters; it stopped immediately.î
He says he recovered quickly and went about his daily life maybe a bit too aggressively at first. ìI remember walking really fast,î he says, a sharp contrast to his slower gait previously. Johnson is still experiencing some problems created by the disease, cramping in his legs, shoulders and arms. ìThe disease keeps progressing,î he pointed out.
Family and his faith have had a lot to do with his sudden turnaround in enjoying a better quality of life. But Johnson said some big challenges remain, ìlike keeping my sanity.î He said constant bouts with pain can be very disturbing. He said he is glad he underwent the surgery and therapy but said he wouldnít want to put his family through it again.
Last fall Johnson and his wife were contacted by Medtronics and asked to testify before a Federal Drug Administration (FDA) panel in Minneapolis.
By sharing his story about battling Parkinsonís, Johnson said if it can help others and give them hope . . . ìfantastic.î

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