"You have to be ready. You have to be able to accept that it will work — and also that it might not work,” says Maralee Clifton.
Maralee was an active employee in the Stanislaus County Sheriff’s Department when she noticed the first signs. During a work-related fitness test, she had problems gripping anything with her hands.
“I thought it was carpal tunnel,” she says, referring to the weakness and tingling that comes from pressure on the wrist’s median nerve. She had also noticed that she wasn’t writing very well and that her lack of finger dexterity made it difficult to wash her hair.
“The big clue was when my feet started dragging,” says Maralee. That caused her to fall down the stairs in her home. “I’m 6 feet tall, and that’s a long way to fall.”
When the right side of her body became rigid, she sought help. She consulted a local neurologist, who put her through a battery of tests before giving her the diagnosis: Parkinson’s disease. Doctors at the Parkinson’s Disease Clinic and Research Center at the University of California in San Francisco confirmed it.
The diagnosis was a shock to both Maralee and her doctors. She was only 32 years old at the time and had a very young son.
She began a regimen of medications — Levodopa to replace low levels of dopamine in her brain and treat her stiffness, tremors and poor muscle control and, later, Comtan to increase the effectiveness of the Levodopa.
About a year after her diagnosis, Maralee attended a conference sponsored by Doctors Medical Center of Modesto. There, she heard about Deep Brain Stimulation (DBS) surgery. Considered experimental at the time, the surgery involves planting electrodes in certain areas of the brain. The electrodes produce electrical impulses that help regulate the impulses that aren’t normal. Those electrical impulses can help minimize typical Parkinson’s symptoms, such as tremor and sudden movements.
A device that looks much like a pacemaker controls the strength of the electrodes’ stimulation. That device is placed below the skin near the collarbone. A wire that also goes under the skin connects the device to the electrodes in the brain.
Dr. Benjamin Remington at Doctors Medical Center had begun to perform the procedure. At the time, Maralee didn’t know if the surgery was for her.
“I didn’t want to be a guinea pig,” she says. “It was my brain!”
But by the time Dr. Remington had performed hundreds of the surgeries, Maralee had begun to reconsider. Her neurologist urged her to explore it. She discussed it with her Parkinson’s support group, where she was the youngest member.
“It’s an emotional experience,” she says. “You have to be ready. You have to be able to accept that it will work — and also that it might not work.”
Dr. Remington thought she was a good candidate; she was young and didn’t have any other health problems, such as heart disease. In February 2011, she made the decision to go ahead. She was already comfortable with her choice of Doctors Medical Center.
“I’ve never had a bad experience there,” she says. “The staff is great.” And she liked the fact that Dr. Remington would handpick his surgical team.
On the day of the surgery, “stylists” came in to shave her head, which was then numbed with medication and stabilized with a metal halo. While Maralee was still awake, the surgeon drilled holes into her skull and placed the electrodes in various areas of her brain. At the time, she was having tremors in her body.
“Having the opportunity to be awake (during the procedure) would freak most people out,” she says. But “it was the most unique experience I’ve ever had.” And it was an important part of the procedure because she could help the surgeon know that the measures were working.
Then came time for what Maralee calls “party tricks.” She was asked to tap her fingers, and then her knee. At the same time, the surgeon touched certain electrodes. The tremor in that area would stop.
“It brought tears to my eyes,” says Maralee.
She was not conscious for the second surgery, which attached the electrodes to wires implanted in the skin behind her head and then into the stimulator. The stimulator was turned on in the recovery room, where the change “was noticeable right away,” Maralee says.
Today, many of Maralee’s once-noticeable symptoms — such as tremors and facial tics — are in check. The disease is still progressing, but she takes much less medication. She and her husband drive to San Francisco twice each year for monitoring and new batteries for the stimulator.
She also arranges for Dr. Remington to visit her Parkinson’s support group at least once a year.
“I tell them, ‘why go to Stanford (University) or San Francisco’” for the surgery, she says. Doctors Medical Center “is a great resource right here.”