San Francisco VA Medical Center

Did you know that Parkinson’s disease affects 1.5 million Americans, and the VA treats 40,000 Veterans with Parkinson’s disease each year?

The Mayo Clinic describes Parkinson’s disease as a steady, progressive disorder of the nervous system that affects movement. Patients and family members may notice hand tremors. Walking becomes short and shuffling, muscle stiffness may occur, speech can become challenging, and facial expressions gradually diminish. Parkinson’s disease usually spans 7-20 years and varies dramatically from patient to patient.

What causes Parkinson’s disease? No one knows exactly. Although there is no cure at present, there are effective palliative treatments. The San Francisco VA Medical Center (SFVAMC) provides state-of-the-art technology, medicine, deep brain stimulation, physical therapy and support groups, all with a focus on enhancing each patient’s quality of life.

“We provide world-class care for Parkinson’s disease,” said PADRECC Director Graham (Alec) Glass, MD. “In 2001 the VA decided to create Parkinson’s Centers of Excellence at six sites. The goal was to make this a center where Parkinson’s patients could come and get state-of-the-art care, and to become the highest-quality deep brain stimulation (DBS) center in the country.”

PADRECC team members include expert neurologists, neurosurgeons, nurses and researchers as well as consulting clinicians from various health care fields. The Center provides a comprehensive approach to caring for patients, per Glass. Patients have access to world-class surgeons and to nurses who focus on the whole patient and who have training in Parkinson’s disease. “It’s a more integrated system.”

What’s palliative care? “Palliative care, in Parkinson’s could be started fairly early; it literally means palliation or relief of suffering,” said Nicholas Galifianakis, MD, PADRECC Associate Director of Education. Besides the use of medicines and DBS, the PADRECC also considers home situations, financial stressors, psychological issues, sleep disorders, and spiritual matters.

What is DBS? “Deep brain stimulation is a surgical method for patients in the more advanced stages. The easiest way to describe it is, it’s like a Pacemaker for the brain,” said Galifianakis. “DBS is given to promote a more ‘even-keel’ response to medicines, ‘round the clock instead of the couple of hours of relief the medicine provides.” The center also uses Botox, therapeutically, to relax overactivity of muscles, such as in dystonia where a patient feels he has a constant muscle cramp.

Anyone needing some support may attend a community-based Parkinson’s Disease and Caregivers Support Group which meets the 3rd Tuesday of each month from 4 – 5:30 p.m., in Bldg. 200, Room 1A-122 (Teak Room). “The purpose of this group is to provide ongoing support for caregivers, patients, and spouses,” said PADRECC Associate Director for Clinical Care Susan Heath, RN, MS.

An Advanced Parkinson’s Care Support Clinic for advanced patients meets at the PADRECC, Bldg. 203, Room 1B31, the first Tuesday of each month from 1 – 3 p.m. “The purpose of this group is to provide support for caregivers and to decrease emergency department visits and admissions,” said Heath. “In one visit you have a nurse, a social worker, and a chaplain all focusing on your needs and coordinating your loved one’s care.”

Future plans? “We recently completed filming eight video vignettes to be posted on YouTube on eight topics,” said Heath. “We have eight more planned for the upcoming year and we’d like to develop a video library. We would like to host a Parkinson’s Disease Boot Camp for SFVAMC and UCSF, which would be a patient event with yoga and exercise, and invite all our patients and support group members.”

“Our nurses are an integral part of the Parkinson’s Center of Excellence team,” said PADRECC Clinical Research Manager Elaine Lanier, RN, MS. “We’re doing a nursing research study with patients undergoing DBS and their caregivers. We’re also offering a visiting nurse scholarship program, the Edmond J. Safra Visiting Nurse Faculty Program.”

Along with conducting ongoing research, the Center also hosts monthly educational presentations for Neurologists. “Part of our goal is to educate others to be able to provide our same level of care,” said Glass.

“Of all the VA centers in the country, we do the most DBS, we publish the most research on DBS, we have the highest enrollment of any cooperative study, we’re the lead recruitment site, and we are respected around the country as having absolutely top-notch DBS surgeons,” said Glass. “The bottom line is, there’s no place better to get your care than here at SFVAMC if you have Parkinson’s disease.”

For more information about the PADRECC or Parkinson’s support groups, call (415) 379-5530.