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Novel Parkinson’s Treatment Gives Patients Their Lives Back

Mike and Mary Kilfoy were prom dates at Mater Dei High School in Santa Ana. Now, after almost 50 years of marriage, Mike’s Parkinson’s disease has slowed his dancing, but their ability to enjoy life together remains as strong as ever.

That’s why when the Parkinson’s and Movement Disorders Program at the Pickup Family Neurosciences Institute at Hoag offered a unique option to keep Mike’s motor fluctuations under control, he decided to go for it.

“I didn’t want to be immobilized. That was the main thing,” said Mike, 71, whose Parkinson’s has advanced in the 11 years since his diagnosis. “The mechanics of everybody in the department at Hoag working together is what I had confidence in. We said we might as well try it.”

The “it” that Mike underwent is a surgical procedure in which a gastric tube is inserted directly into his small intestine to deliver DuopaTM, a gel suspension of two medications that treat motor fluctuations in patients with advanced Parkinson's disease. By bypassing the stomach, the procedure ensures a continuous delivery of the medications carbidopa and levodopa for 16 hours daily. The Pickup Family Neurosciences Institute at Hoag, recently renamed thanks to a generous donation from the Pickup Family Foundation, performs more of these procedures than any hospital in Orange County.

When he took medication orally, Mike said he often experienced “peaks and valleys” as medicine was absorbed throughout the day. If he missed a pill or if he got the timing wrong, the results were awful. Over time, involuntary muscle contractions began to twist Mike’s foot inward, a disorder known as dystonia.

Movement Disorder Specialist Sandeep Thakkar, D.O., told Mike and Mary about Duopa a few years ago, but at first the couple declined.

“It looks a lot like a feeding tube, and when people think of feeding tubes, they think of end-of-life care. That is why it is not utilized a lot,” said Dr. Thakkar. “But of the 33 people we have on it, not one person wants to give it up. It gives them their life back.”

Seven years ago, Mike underwent Deep Brain Stimulation surgery at Hoag, in which a wire lead with electrodes was implanted through a small incision in the skull to send targeted electrical impulses to the brain to block his symptoms. Over time, however, the disease progressed, and the pulses alone were not enough to keep his foot from twisting.

“I went to see some of the top foot specialists, and they said that I could have a surgical procedure done to the foot that would have immobilized me for three months. Well, at 71, you flash forward and three months is a big chunk of time,” Mike said.

Instead, the flow of medications allows Mike to “tool around town,” as Mary puts it, in one of his restored classic cars. He wears a pump on a sling across his shoulder that is attached to a tube above his navel. He plugs into it at 7 a.m. and unplugs at 8 p.m. every day, allowing the pump to deliver the medication he needs to keep his motor fluctuations under control. Thanks to the medication, Mike’s foot has “untwisted” to the point that he can walk on it with a brace and a cane.

Surfing is a thing of the past. As is international travel.

“But a lot of our friends can’t do those things either anymore, and they don’t have Parkinson’s,” Mary says. “Hoag has been our hospital for 41 years. We’ve always received great treatment here, and that made the decision easier. We can’t say enough nice things about Hoag.”