Neurosciences Patient Story: Janice Blazich

Janice Blazich likes to move. But the 63-year-old swing-dancing aficionado likes to control her movements; she doesn’t like her movements to control her. So when Parkinson’s disease began to interfere with her dancing, Blazich knew something had to change.

Blazich was diagnosed with Parkinson’s disease, a brain disorder that causes tremors, stiffness and difficulties with balance, at the relatively young age of 44. For years, she controlled her symptoms with medication.

“Unfortunately, after several years of the medication, I starting having side effects from it, dyskinesia,” Blazich said. “I couldn’t do some of the activities my husband and I like to do. Some nights I’d have to tell him I couldn’t dance.” Ironically, the very medications that initially ease the tremors and stiffness associated with Parkinson’s disease can eventually cause involuntary movements, called dyskinesia. A dosage adjustment will sometimes lessen the involuntary movement, but often at the expense of symptom control. Patients often feel caught in a catch-22: treat the disease and suffer life-affecting side effects, or decrease the side effects and experience more disease-related symptoms.

Blazich was discouraged. “My outlook wasn’t very good,” she admitted.

A relatively new procedure, called deep brain stimulation (DBS), seemed to offer some hope. Introduced in the 1990s, DBS is a surgical procedure that implants an electrode into the brain. Electrically stimulating the electrode can improve the symptoms of movement disorders such as Parkinson’s.

“We’d been keeping track of deep brain stimulation for a number of years,” said Blazich, who first read about the procedure in the Milwaukee Journal Sentinel. “Every time I saw my neurologist, I would ask him about it, but most of the time, he’d either say ‘I don’t think you’re ready for it,’ or ‘It’s not ready for you.’”

By 2005, though, Blazich’s dyskinesia had advanced to the point that her neurologist referred her to the Froedtert & the Medical College of Wisconsin Parkinson's and Movement Disorders Program. The experts at the Movement Disorders Program told Blazich she was an excellent candidate for DBS.

According to Bradley C. Hiner, MD, a Medical College of Wisconsin Movement Disorders Neurologist, “any patient with a movement disorder who is not responding adequately to medications may be considered. DBS is an especially effective option for patients with moderate severity Parkinson’s disease who are becoming less and less responsive to medication.”

Blazich had her DBS surgery in June of 2006. She went in on a Sunday night, had the three-and-a-half hour surgery on Monday morning and returned home on Wednesday.

Almost immediately, she noticed improvement. “I just felt so much better,” Blazich said. “I didn’t have as much of a tremor.”

Not all patients experience immediate results, in part because of how the procedure is performed. During the actual surgery, an electrode about the thickness of a strand of spaghetti is implanted in the brain. Then a stimulator is implanted under the skin of the collarbone. When activated, the stimulator sends electrical impulses from the stimulator to the electrode; these impulses suppress the abnormal movements.

Once Blazich’s stimulator was fully activated, she was able to substantially decrease her medication. She returns to Froedtert & the Medical College of Wisconsin every six months, to have her stimulator and medication adjusted. Currently, she takes just 1/3 of her original dose of medication and her symptoms are much improved.

“I don’t have to plan my life around my medication anymore,” Blazich said. “Before, in between doses, I would always have a period of a half an hour where my medicine wasn’t working and my tremors would show. Since the stimulator has been in there, I don’t have that situation. It makes it so much easier to plan my day.”

New research underscores the benefits of DBS. A study published in the Journal of the American Medical Association found that patients who had DBS surgery had 4.6 more hours each day of good symptom control than patients who received the best drug therapy.

Unfortunately, while up to 15 percent of Parkinson’s patients are good candidates for DBS, only about 2 percent of them actually have the surgery.

Blazich, a Thiensville resident, knows how lucky she was. DBS is a complex surgery requiring a lot of expertise, but the specialists at Froedtert & the Medical College have performed over 300 DBS surgeries since 2005.

“They gave me my life back,” Blazich said. “Now, I don’t have those evenings where I have to tell my husband I can’t dance. I’m back out on the dance floor.”