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16th Sept 2009.

Life after DBS surgery

On the same day I visited Ms. Khoo Siew Lay in Port Dickson (please refer to “The long wait for DBS surgery”), I also went to Seremban to meet Mr. Hamzah Abdul Rahman, another Parkinson’s patient whom I have known for a long time.

Whenever I think about Mr. Hamzah, 53, it always reminds me of the DBS surgery that he underwent in 2004 – he was one of the most successful cases of DBS surgery which was carried out by Professor Tipu Aziz at Kuala Lumpur. The video recording of Mr. Hamzah’s DBS surgery is shown below.

I was still working at University Malaya Medical Centre, Kuala Lumpur then. It was the very first time the DBS surgery was performed at my hospital. Professor Aziz had come all the way from Oxford, UK, to help set up our first DBS surgery centre. Mr. Hamzah was one of the first few patients who were selected for the DBS surgery.

Prior to the DBS surgery, Mr. Hamzah’s physical condition was quite bad. Being a young-onset Parkinson’s patient (who started having the illness since the age 37), he was taking quite a high dose of Parkinson’s medications prior to the surgery. “Each dose of medications worked for just about three hours. When I was “on”, I had severe dyskinesia. It was quite tiring to go through the involuntary body swinging movements. Despite being “on”, I was quite dependent on my wife. She had to help me to eat meals, take shower, etc. When I was “off”, it was even worse. I could not do anything because my whole body was so stiff,” recalled Mr. Hamzah.

He worked as a clerk at the Malaysian Agricultural Research and Development Institute. Even though his work was quite simple, he was struggling to use the computer due to the severe dyskinesia. As a result, he was forced to take medical leave quite frequently.

In 2003, he was driving to work when he lost control of the steering due to severe dyskinesia. His car crashed into the fence. Fortunately, he was not seriously injured. Since then, he has stopped driving, even till today.

On the morning when he underwent his DBS surgery, I was with him in the operation theatre. Right after the electrodes were inserted into his brain, the tremor of his hands disappeared almost instantaneously. His surgery went smoothly without any complication. I can always remember that by evening, Mr. Hamzah was walking around the ward, visiting several other Parkinson’s patients who had been operated upon. He was obviously very happy to “show off” his rapid recovery following the surgery.

He was one of the best responders to the DBS surgery. Following the surgery, he could reduce the total daily dose of Parkinson’s medications by almost 50-70%. His dyskinesia was markedly reduced and no longer affected his daily activities. He was “on” most of the time. Most importantly, he regained his independence. He could carry out daily activities without needing any assistance. After the DBS surgery, he managed to resume work for a few years, till he retired.

 

“I am very grateful that my DBS surgery was successful. The surgery has really helped in improving my body movement and daily functioning. I can even ride motorcycle and bicycle to go to the shop and market . I can never imagine what would have happened to me if I had not gone for the surgery αΎ’ my physical condition would certainly be worse,” commented Mr. Hamzah.

“The DBS surgery is an effective treatment for advanced stage Parkinson’s. I hope that the DBS surgery will be further established in Malaysia so that many more Parkinson’s patients will benefit from the procedure. Parkinson’s patients do not have to suffer so much if the DBS surgery is easily available in this country,” concluded Mr. Hamzah.