Though risky, elderly should not be denied surgery, say docs
If Mohammed Walji (71) had not come to Mumbai, he would have had to live with tremors and other difficulties associated with Parkinson’s disease.mumbai Updated: Mar 10, 2010 01:00 IST
If Mohammed Walji (71) had not come to Mumbai, he would have had to live with tremors and other difficulties associated with Parkinson’s disease.
In the US and UK, deep brain stimulation (DBS) surgery is not offered to those over 65-70 years because of the risks involved, among other reasons.
Dr Paresh Doshi, who operated on Walji, admitted that the “risk of brain haemorrhage during surgery is a little higher in elderly patients”.
Hinduja Hospital’s neurosurgeon, Dr Milind Sankhe, said the elderly are more “fragile”. “The stress caused by the surgery can precipitate heart attacks in rare cases. I have done the surgery successfully on many elderly patients. In one case, a 74-year-old woman died of a heart attack 10 days after the surgery,” he said.
But the doctors felt that the “slight increase in risk” was not reason enough to deny surgery.
“The surgery not only improves the patient’s quality of life but also of the care giver. Besides, these days, even 70-somethings want to work and lead active lives,” said Doshi.
Thirty-nine of the 165 Parkinson’s patients Doshi has operated upon, were over 65 years at the time of surgery. “The results were equally good in the elderly as compared to younger patients,” he said, adding that 17 of the elderly patients lived for more than two years.
“There was a 60 per cent improvement in disability and drug requirement reduced by 20 per cent in the elderly patients,” he said.
To avoid surgical complications in elderly patients, Doshi said they perform more pre-operation tests to identify
target areas in the brain more precisely.
“We also try to complete the surgery within three hours instead of the usual four to six hours so the patient is put under less stress,” he said.