Parkinson’s patient gets more “on” time

For people with Parkinson's disease, feeling "on" refers to the periods when their medication is working effectively to control their symptoms. During these "on" times, patients experience improved mobility, reduced tremors and better overall motor function. They may feel more like their normal selves, with increased energy and the ability to perform daily tasks with greater ease.

Feeling “on” has become more and more challenging over the years for Bruce High, who was recently forced by his struggles with Parkinson’s to retire. He feels and acts just about as normal as anyone when his medicine is working. However, his medication comes with many side effects, such as dyskinesia (aka, involuntary movements). He also must eat whenever he takes his medication, creating many complications with life because he has to take 15 tablets throughout the day—a maximum dose for his type of medication.

“My life revolves around taking these tablets,” says High.

He has been searching for a way to improve his quality of life. One option for him is Deep Brain Stimulation (DBS)—a treatment that involves implanting electrodes into specific areas of the brain, which are then connected to a small pulse generator implanted in the chest. A DBS device sends continuous electrical impulses to the targeted brain regions, effectively interrupting the irregular signals that cause movement symptoms. DBS has shown significant success in reducing tremors, stiffness and slowness of movement, as well as decreasing the need for medication in many patients.

DBS does not, however, help with balance issues, which High experiences frequently, having fell and broke his wrist last fall. DBS also a permanent implant that is not guaranteed to work, giving High reservations.

An advanced therapy now offered at Indiana University Health Arnett has given High a different option. The therapy, a gel formulation that is delivered directly into the small intestine through a surgically placed tube, provides continuous delivery of medication, significantly improving a patient's “on” time.

The treatment is administered via a small, portable pump that connects to a tube surgically inserted into the patient's abdomen. The pump delivers the medication directly into the small intestine over a 16-hour period, typically covering the patient's waking hours. This method of delivery bypasses the stomach, which can be affected by Parkinson's and may slow the absorption of oral medications. It allows for more precise and individualized dosing, potentially reducing the dyskinesia that can occur with oral medications.

High opted to try this option and underwent the procedure to install the device in early August. So far, he is happy with the lifestyle improvements offered by this advanced therapy.

“I followed up with [High] and he is very happy with the device,” says IU Health Arnett neurologist Husain Shaath, MD. “He is especially happy that he does not have to put on a timer for every three hours to take his medication.”