ORANGE PARK, Fla. – For more than two years, HCA Florida Orange Park Hospital has been treating patients dealing with essential tremors with a non-invasive procedure.
The movement disorder is the most common one there is.
It can be evident when someone is trying to do a task and a part of their body shakes involuntarily. It keeps getting worse as they try to complete that task.
There are several tests one doctor asks his patients to do throughout the treatment to make sure they get the best results.
Robert Schlag and Aubrey Smith had essential tremors.
For example, their arms would shake while trying to take a drink of water, only for it to get worse the closer the bottles got to their mouths.
Now, both of their tremors are gone after being treated at HCA Florida Orange Park through what’s called a “focused ultrasound.”
“I told everybody I know about this who has tremors, about this procedure,” said Schlag. “So I would definitely spread the word. I love it.”
“I can do more things with both hands, like working with small items,” Smith said. “I like working with wood.”
News4JAX first told you about this procedure more than two years ago.
You might be wondering what happens during that ultrasound?
Dr. Michael Horowitz, who is a neurosurgeon at the hospital, breaks it down.
What is involved is ultrasonic energy being used on the part of the brain called the thalamus.
“The way we do that is by putting someone in an MRI scanner, getting very detailed images of their brain,” Horowitz said. “While they are in the MRI scanner, there is also a device that couples with the MRI scanner that is attached to the patient’s head temporarily. It gives ultrasonic energy, just like an ultrasound, but from about 500 different points. All of those points come down, and all of those energy waves calm down to focus in the same place. We are focusing ultrasonic energy at the point in the brain that we want to damage and heat it up so that it does not work anymore.”
If successful, the tremors either get significantly reduced or go away completely.
Just for clarity, this kind of procedure, right now, can only be done for tremors where a person’s arm is the part of the body that is affected. It does not help with tremor of the mouth, head or legs.
During the entire procedure, a patient is awake.
Over the course of the 90 minutes, Horowitz has each person do simple tests with hopes their performance improves as the right part of the brain is targeted.
“I test people ahead of time with writing, but I also after the procedure when they are out of the room, I test their writing again,” he said. “But when they are in the room, I tested them by giving them a water bottle and asking them to slowly move the water to their mouth as if they are trying to drink. Usually, they will start and [aggressively shake the closer it gets to their mouths]. Then we are ready to treat them. Then they will be very steady or move just a little bit. I also will give them a spoon while they are lying on their back. I give them the spoon like they are eating soup. I will ask them to open their moth really wide and keep it open. Just slowly move the spoon into their mouth, but not let it touch their teeth of their lips.”
Horowitz says HCA Florida Orange Park has treated more than 100 patients with the focused ultrasound.
The FDA approved the procedure to be done on one arm at a time, with a 9-month window between. Horowitz says that specific time frame is to help ensure a patient recovers appropriately.
If someone has tremors in both arms, the nine months give them enough time to decide if they want the other arm treated. That is imperative, especially if they were uncomfortable during the first round of treatment since it is permanent.