I'm Gayle Granat
and I've been living with essential tremors for 18 years.
I've been shaking and I can't use the fork and the knife.
I was a left-hander
and I taught myself to write right-handed.
Now my right hand is not doing so good.
My dad had the shaking problem too.
My grandmother had it also.
It's been a struggle for 18 years.
My grandson can write better than I can.
And I just wanna, I just wanna, you know,
play with him and build with him and just be in control.
- My name is Shauna Krstevska,
I'm movement Disorder Specialist.
I'm also Director for Integrative Neurology.
Gayle is my patient and she has essential tremor.
Initially, her tremor was mild involving her left hand,
and over the years an increase
in intensity and now it's involving her right hand.
Throughout the course of her treatment,
she has tried the standard medications
to control the intensity such as Propranolol,
Primidone, and Topiramate.
Some of these medications cause side effects,
and there is a limit
to the benefits or the tolerability of the medication.
It is estimated that less than 60%
of people with essential tremor are helped by medications.
Fortunately, we have deep brain stimulation,
which can greatly improve the quality of the patient's life.
[Narrator] Gayle will undergo a procedure
known as Deep Brain Stimulation.
Tiny electrodes are inserted into the brain and wired
to a pulse generator implanted near the collarbone.
Electrical impulses are emitted when the generator
is activated, resulting in altered neural functioning.
- I'm Jason Schwalb.
I'm a Neurosurgeon here at Henry Ford Health.
I'm the Surgical Director of the Movement Disorder Center
and I've been performing Deep Brain Stimulation
implants for 25 years.
In terms of how we do this surgery,
we put this frame on the patient's head.
We take the patient for a head CT and that gives me X, Y,
and Z coordinates for every point in the brain.
Based on the coordinates, we will make an incision,
drill a hole about the size of a nickel,
open up the membranes that surround the brain,
and then place a very, very small electrode,
less than 600th of a millimeter
into the brain and listen to the individual neurons
as we progress.
If I think I'm in good position, at that point,
we'll take out the very small micro electrode
and then put in the large DBS electrode,
which is 1.3 millimeters in diameter.
And then with the patient awake,
we run electricity through that electrode
and can see do we get tremor suppression?
Are we getting side effects
that indicate that we're not in the right place?
Yes, a little more picture.
Okay, so now I want you go.
Look at this. Holy cow.
Unbelievable.
[Jason] And then we do that on the other side
and then sedate the patient and bury the leads
underneath the skin with caps that I can find later
and take the patient out of the frame.
[Narrator] Gayle will return
as an outpatient to have the pulse generator inserted
through an incision in her chest.
The capped electrodes will be exposed
and then extension cords will be tunneled
between the two incisions.
The connections are verified
and the incisions are closed up.
And when they go and see their neurologist,
their neurologist has a programming device similar
to Bluetooth where they can adjust
how the electricity is delivered to make sure
that we get as much suppression
of the tremor as possible without side effects.
(gentle music)
I wanted to feel comfortable with myself again.
I was so glad that I did the surgery and I'm overwhelmed.
Hello. Good morning.
[Gayle] Good morning.
-How are you?
I'm doing okay.
So before the surgery I could not write my name at all,
and after they programed me, I was able to write my name.
I was able to do the spiral.
They showed before and after.
What a difference.
I can now hold a cup, eat like a normal person.
I can do everything now that I want to do.
We've been doing it a long time.
It's very safe and patients do well,
and it's really life-changing.
Dr. Schwalb
and the nursing staff that took care of me,
thank you from the bottom of my heart.
Now I can go out and have a life
and be what I wanna be and do what I wanna do.
I'll forever be grateful for that.