It's a Boy, It's a Girl, NO it's ......

We get back to our hotel and I call the hospital and ask for the Pathology department. A woman answers and I ask about getting the IPG they removed from me earlier. She says this is the lab and I don't know what you are talking about. I thought about saying 'Chocolate or Yellow Lab', but I just ask if she can transfer me to Pathology. She says yes.

"Pathology, this in Ingrid." 

Hi, Ingrid. I'm Beverly Ribaudo, I just had surgery and I'd like to have the IPG they removed from me. I have my medical record number, if you need it.

"Okay?? You want what?"

It's a small chunk of metal, similar to a pacemaker. The surgeon, Dr. Norton said it's okay if I take it home with me.

"Okay, let me see if we have it. What's your date of birth? I found it. When are you leaving the hospital?"

It was outpatient surgery, I'm already back at the hotel. We go back to Yuma tomorrow.

"Let me see how quickly we can process it. It might be tomorrow morning before I can get one of our Pathology Doctors to sign off on it. May I have your phone number?"

Thank you Ingrid.

I am hungry. There's a McDonald's across the street from the hotel, so Wonderful Hubby walks over and gets us burgers and fries. After we eat, we decide to take a nap. I have no pain, but take a Tylenol tablet just in case. I am just dozing off when...

The phone rings, it's Ingrid. My 'specimen' is ready to be picked up. She says I'm to go to the Maternity, Labor & Delivery entrance and then call her. She says she's there until 5:30pm. I tell her I will be there in an hour or so (I really NEED that nap.)

After my nap, we drive back to the hospital and find the Maternity entrance. We are the only people who aren't carrying balloons, gifts or flowers. Once inside, I call Ingrid and she comes to meet us. We follow her down hallways and through an unmarked door and she goes and gets a form for me to sign and hands me a brown paper bag.

My IPG baby 

I asked how she managed to get it done so quickly. She said she just asked the Doctor if he could rush it and he said yes. Then she says she was almost born in Yuma. Her Dad was military and he was stationed in Yuma, but her Mom decided to drive to San Diego to have her baby.  

Ingrid asked me what I was going to do with it?

With as serious a face as I could manage, I said 
"Sell it on eBay, of course." Then I started giggling.

I took a peek inside my paper bag and she walked us back out to Maternity. I felt silly carrying a paper bag when everyone else was holding babies. 

YumaBev's specimen in sealed container

It's a boy, it's a girl, no it's.............an IPG! 

Yes, this is the actual IPG that has been inside me since October 25, 2012. That's a LONG gestation period. I think I will refer to "it" as a she. Why? Because a he would have quit working years ago!

Activa PC "Pretty Cute"

Oh my, these Parkinson's Humor blog stories are almost writing themselves.

We stopped at Subway and picked up some sandwiches on the way back to the hotel. 

I'm still in no pain. Tonight we watched Grumpier Old Men on TV and laughed some more. 

June 13th, Surgery Day

Warning: Graphic surgical photo included. 

We arrive at the Tucson Medical Center at 8:30am and get in the Valet Parking line. The attendant arrives and we head inside. We go up to the outpatient surgery floor, I get checked in and pay my co-pay. The hospital wants their money before surgery. I no sooner get done and my name is being called, so we head back to pre-op.

Nurse Esther gives me the designer one-size-fits-absolutely-no-one gown and says take off everything and put it in the bag, EVERYTHING. She pulls the privacy curtain and I comply.

YumaBev ready for surgery

A few minutes later, a fellow comes in and says "I'm the lab guy."

Without missing a beat, Wonderful Hubby says "Chocolate or Yellow Lab?" 

The labs guy starts laughing, says he's never heard that one before.


A few minutes later, Joey the Medtronic Rep comes in. He checks my current settings and will make sure the new IPG is set the exact same way. He says he'll see me in the OR (operating room) and leaves.


Dr. Norton pokes his head around the curtain. He's wearing multiple surgical masks and gives Hubby a fist bump and me a thumbs up. I ask how he's feeling. He says the cold came on quickly, but he took some Nyquil last night and is feeling well enough to do my battery change but cancelled the brain drill and generator placement surgeries scheduled prior to me. I thanked him. He said it's okay, I can't see you having to drive all the way over here again. He marked an X on my right shoulder (hospital rules, he mumbled) and listened to my heart and lungs. 

I asked him if I can have the old IPG that they are removing? He said he'd ask, but he didn't see why not, after all, you paid for it. 

He said Dr. Robin Kloth, the anesthesiologist who did my original surgeries will be in to see me soon. I'm glad. I like Dr. Kloth, she's nice and wears colorful shoes. Dr. Norton leaves. 


A few minutes later, a man comes in. "I'm Dr. Offerdahl, anesthesiologist. Dr. Kloth is in another surgery, so I will be filling in. Is that okay?" 

Do you have colorful shoes?

He looks down and says just boring brown.

How about colorful socks?

Looks down again and says no, but at least they match today. I've been known to wear one white and one dark. 

I like this guy's sense of humor but I find it funny that he had to look to see what color shoes he had on. 

I tell Dr. Offerdahl about my adhesive allergies and ask him to get the EKG pads off me as soon as possible. I also tell him that I want to be as wide awake as possible so I can blog about it. He says how about I give you just a bit of Propofol when Norton is doing the painful numbing shots? Then I will wake you right up again. I say okay.


I kiss Wonderful Hubby goodbye and Nurse Esther takes him out to the waiting area. 

YumaBev ready to go

Dr. Offerdahl says "I'll give you a shot of whiskey when we get in the OR." 

I say I prefer tequila. 

"Tequila?" he says.

Jose Cuervo Light Peach Tequila, please.

"Wow, you're exact aren't you!" 

And off we go. As he is wheeling me down hallways and around corners, he keeps bumping the gurney into the walls.

Turkey or Jack? I say.

"What?"

Wild Turkey or Jack Daniels? I say. Which did you have for breakfast, because you're driving like you are drunk! 

He laughs. "This surgery should be interesting."

We get to the OR, they slide me over on the surgical table, tuck my arms in, give me a warm blanket and an oxygen mask.

Dr. Norton says "Dr. Kloth, your voice is much lower and you've gained weight." I pipe in and say "and you have boring shoes." We are all laughing. 

Poor Dr. Offerdahl, he must think we're all nuts.

As Dr. Norton is doing his thing, he tells the OR nurse to figure out how to get me the IPG he removes. He's telling them about my blog and how I kept the drill bit he used on me during my DBS brain surgery six years ago. I say "I wish we could Live Stream this on Facebook. I want to see what you are doing." 

YumaBev's actual surgical site

I ask Dr. Norton if he ever plans to retire? (he's 79) His reply:

"No, I will just keel over during surgery.
Dr. Offerdahl will try to revive me.
He will be unsuccessful.
My estate will then sue him.
And he will end up living in his car."

Dr. Offerdahl says, "I'm not filling in for Dr. Kloth anymore."

I'm laughing so hard that it's difficult to stay still. 

I can feel the sensation of Dr. Norton suturing me. There's no pain at all. He says he's done and going to find my hubby. I ask Joey to take a picture of Dr. Norton and me. Two other male voices chime in and say "We want to be in the picture, too!"

(L-R) OR nurse Chris, YumaBev, Dr Offerdahl, Dr Norton

And we were done. They slid me back on the gurney, wheeled me to recovery, Dr. Offerdahl said this was the silliest surgery he had done and he disappeared. Wonderful Hubby came in. A nurse went over the post-op care sheet with us. Another person said I should call pathology later because they have the IPG in their possession.

Joey came in to make sure my new device was working properly. A nurse sent Hubby down to get the car from Valet and another nurse helped me get dressed. They wheeled me down to the car and Hubby drove us back to the hotel. It wasn't even Noon. 

Looks like the 13th wasn't a bad day for surgery after all.

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The Energeezer Parkie Will Need a New Battery...Soon

Several years ago, I wrote a story where I used rechargeable batteries as a way to describe what life is like with Parkinson's disease. Using my warped sense of humor, I changed the famous Energizer Bunny to the Energeezer Parkie. It thought it was a pretty good analogy. Once I had DBS surgery, my 'Parkie' battery was pretty close to 100% every day. 

I knew my Medtronic Activa-PC DBS generator battery would need to be replaced some day. The average lifespan is 3 to 5 years. Mine was six years old in October 2018. 

At the beginning of 2016, my battery level was 2.97v. At the beginning of 2017, my battery level was at 2.91v. At the beginning of 2018 it was 2.85v. It was averaging a drop of .06v a year, so I figured I'd have several more years until it reached the ERI (Elective Replacement Indicated) warning you get when it drops to 2.61v, I was wrong.

I had been in the habit of checking my battery level using my patient programmer about every three months. April was 2.83v and July was 2.81v, right on target. So you can imagine my surprise when I checked it at the end of October 2018 and saw that it was down to 2.76v.  

I started checking it monthly, then weekly and now daily and I wasn't liking what I was seeing. The amount of time between voltage drops was decreasing. 

As of today, January 21, 2019, it's now at 2.69v. That's a drop of .07v in less than three months. If the voltage drop continues to accelerate, I will get the ERI warning in a few months!!!

Jan 2019, battery at 2.69v

My neurosurgeon, Dr. Norton is in the same office as Dr. Bradley, my Movement Disorder Specialist and I have an appointment with her in mid-March. I have already contacted Norton's assistant because I didn't want to wait until March and then find out that he's going to be on vacation or something else that would make him unavailable. Norton's assistant said they could get me on his surgery schedule within two weeks, but I should call if I get the ERI warning before my March appointment. 

Looks like the Energeezer Parkie will soon be getting  a brand new generator. 

The generator won't stop working when the ERI warning appears. There's a built in cushion of time, it doesn't stop working until it gets to 2.20v.

If you have a Medtronic Activa DBS generator and don't know how to check it, click on the link above. You don't want it to suddenly stop working.

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DBS Update: Six Years Later

It has now been SIX years since I joined the DBS "Holes in My Head Club" for Parkinson's disease and I bet you are curious as to how am I doing?

There isn't much change from last year. My DBS device settings are exactly the same as they were last year (1.30 left, 1.90 right) and my generator battery level is 2.76V which is lower than I expected, but still a long way from the 2.59V replacement (ERI) warning. 

I have reduced my intake of carbi/levodopa to one half of a 25/100 pill per day. Yes! You read that correctly, I have LOWERED the amount of Parkie meds I take daily. 

My sense of humor is still there and I try to find things to laugh about every day. My slowness of movement and rigidity are well controlled. I have almost no visible tremor, except first thing in the morning. 

Settings: 1.30 left side, 1.90 right side

I am happy that I have had such amazing results from my DBS experience and am thankful to Medtronic for making this therapy a reality. 

If you want more details, read last year's update: DBS Year Five.

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DBS Update: Five Years Later

Well, it has been FIVE years since I joined the DBS "Holes in My Head Club" for Parkinson's disease and the thing people want to know most is...how am I REALLY doing?

I am still doing fairly well. There isn't much change from last year. My DBS settings are slightly higher; up .1 on my left side and .3 on the right. However, they are still much lower than the average DBS recipient.  

current DBS settings

My battery is reading 2.85V, so I still have a ways to go before it hits 2.59V, and will need to be replaced. 
Dr. Norton, my neurosurgeon, promises not to retire before then. Dr. Norton is 77, still working full time, and one of the best. 

Battery level

I now take one half of a carbi/levodopa pill on odd days and two halves on even days. I tried taking two halves every day, but it was too much.

Daily pills: Allergy, Sinemet, Thyroid 

I'm still a Happy Parkie and I try to find some humor every single day. I feel better when I laugh, so I laugh at cartoons, stories, neighbors telling jokes, funny TV shows, etc. But if you want all the details, please keep reading. 

Tremors: My intention (action) tremor is almost non-existent, except early in the morning before I take my first carbi/levodopa pill or if I am under duress. Resting tremor was never a problem for me. I still get bouts of internal tremor occasionally, but I am so used to them, I don't even notice. 

My rigidity is also well controlled, unless I stay seated too long, then it takes considerable effort to get to a standing position. Getting out of the passenger (right) side of the car is becoming more difficult, but the drivers side presents no problems. I also noticed that I have been hooking my foot off the side of the mattress to help me turn over in the past few months. Straightening up when first getting out of bed takes more effort than it used to, but then again, I'm another year older.     

My gait is becoming more shuffling. I also notice my right foot hits toe-first whereas the left rolls easily heel-toe. I can force the right foot to roll and take bigger steps, but I must concentrate totally just on that. As soon as I'm distracted, the shuffling returns.

If I grab a cart when I am shopping, pushing the cart seems to help with my gait. I don't know if it's the actual pushing, the way I'm holding my arms/hands or a mental thing, but it works. Look closely at my feet in this video.   

Adjustments of DBS settings help somewhat, but then cause other problems that are worse. Adding an extra dose of carbi/levodopa causes my right foot to kick out sideways and more dyskinesia, so I just live with it and am thankful I'm not worse.  

Bradykinesia (slowness of movement) varies during the day, but overall, my right side is considerably slower that my left. This is very noticeable during the finger touches, open/close hands and foot tap tests performed by my Neurologist. Not that I actually use any of those movements in real life! Does anyone?

My Wonderful Husband notices this mostly when I am trying to scratch an itch or use a knife to cut meat. It's as if my right hand refuses to move back and forth quickly. I have never noticed this, but I'm glad he does. 

That takes care of the Motor symptoms designed to be helped by the DBS. The Medtronic DBS is doing its job!

As far as the non-motor symptoms, I see some advancement of my Parkinson's disease:

I drool. It's embarrassing. I try to keep my mouth shut, but it re-opens and combined with a typical Parkinson's head down posture, saliva sneaks out. I tried chewing gum, but I have always swallowed the gum after a few chews, and I still do the same. I suck on mints, regular or sugar-free, and this helps. If possible, I sit with my hand under my chin, to keep my mouth closed. My Neurologist said we could try Botox, but I declined. I'll figure out a non-medical way to deal with it.

YumaBev with hand under chin

Constipation: If I eat my regular diet and drink plenty of water, I have no problems. If not, well, you know.

Speech: My voice is getting softer in volume. I use the speaker option when making phone calls and this helps me with the volume. My upper lip doesn't move correctly, and this causes some words to sound slurred. When I preview voicemail recordings I leave, no matter how hard I try to speak clearly and with inflection, I sound like a monotone drunk.   

I used to be excellent at reading out loud, and I enjoyed it, but now find I stumble on the words. 

When I speak, the words seem to have a difficult time getting from my brain to my mouth, even though they are both in my head. It's as if the words travel all the way down to my big toe first, then some take a detour to my other big toe, and then a few of the words stop and visit my pinkie finger. Well, you get the picture. 

Doing all the speaking at our monthly Parkinson's Support Group meeting, even with a microphone, is exhausting. 

I will be participating in a speech related clinical trial in early 2018, so I hope it helps.

Cognition: I can sit here and easily type out my thoughts. And by easily, I mean, the words flow easy; getting my fingers to type them requires using the backspace and delete keys often. 

If you ask me to subtract 7 from a starting number and continue, I can do it easily. (I wonder how the "new math" students would do with this?) But if you ask me to say as many words that begin with the letter "N" in 30 seconds, I probably won't name as many as I could last year. 

Multi-tasking: I used to be able to do many things at the same time. On a scale of 1 to 10, I was a 16. Now I have trouble answering a question while I am pouring milk on my cereal. It is frustrating. My neurologist dismisses this as age related, but I think it's a Parkie thing. My Wonderful Husband and most of my friends are all 20+ years older and none of them have this problem.

Driving: My built in GPS still works good though, and I am still the primary driver in our house. I know what exit to take, which lane to be in and where to turn when we travel to Tucson to see my Parkinson specialist. It's easier for me to just drive than for me to try to give the directions to my Wonderful Husband, especially with my speech delay. 

Sleep and fatigue: I sleep about 8 hours a night, but still seem to run out of energy every afternoon, so I take a nap. If I skip the nap, I find it difficult to stay awake while watching TV in the evening. 


Miscellaneous: I seem to have a constant stuffy nose and congestion in my throat, and my primary doctor recommended an OTC 24-hour allergy pill, which seems to help. 

The two smaller toes on my right foot randomly decide to curl under. I've tried to see if it's an on/off medication timing thing, but it never happens at the same time of day. It is not too painful, but it has caused the nails on those two toes to become thick and ugly. (This is my excuse for a pedicure!)  

All and all, year number FIVE with DBS has been very good and that keeps me a HAPPY PARKIE indeed!

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