On March 3, gastroenterologist Dr. Rajeev Vasudeva performed a new procedure to evolve medical treatment for Parkinson’s disease at Providence Health.
It was the second time Dr. Vasudeva has performed this rare procedure. The first time was at Providence Health in 2016, and the patient showed remarkable results.
“He was a new man,” says Dr. Vasudeva. “Prior to the procedure, he was immobile. He was in bed all day and needed a wheel chair to move. After the treatment, he was out walking around and moving on his own on a regular basis.”
The procedure works by changing the way a patient’s medication is delivered and absorbed.
People with Parkinson’s disease have to take medication three to four times a day. As it gets absorbed, the levels of medication in the body fluctuate, appearing in peaks and troughs and creating what is known as Parkinson’s “on-off” phenomenon. “When the medicine is at a peak level, the patient is highly functioning. They are active, experiencing less tremors, and are up and walking,” says Dr. Vasudeva. “When the medicine is at a trough level, the patients become rigid and the tremors increase.”
Some patients experience more flex than others due to the way their bodies absorb the drug. Because Parkinson’s disease can affect a person’s ability to empty stomach contents, the absorption of medication passing through the stomach can be a significant concern. Patients with too much fluctuation in their drug levels feel miserable.
Research has shown when medication is infused directly to the small bowel in a continuous 24-hour delivery, drug levels remain stable throughout the day and night and patients maintain their mobility. Their bodies function well, and they feel better.
The procedure performed by Dr. Vasudeva helps to facilitate that type of delivery by inserting a tube, first into the stomach, and then inserting a second tube through the first, directly into the small bowel. A special pump then infuses the medicine directly into the patient’s small bowel at a stable and predictable level.
This stable absorption allows the patient’s condition to remain, not only more mobile and active, but also more predictable, which enhances the overall quality of life for patients, caretakers, and loved ones.
Dr. Vasudeva works closely with Dr. Priyantha Herath, Professor of Neurology at the USC School of Medicine, who treats patients with Parkinson’s disease and identifies the appropriate patients for the procedure.