Mr Erlick Pereira 2018-03-29 Person 5 5 0

I am a 57 year old woman with Parkinson's disease who recently had DBS surgery with the DBS neurosurgical team led by Mr Erlick Pereira at St George's hospital, in Tooting, London. As DBS surgery is currently unavailable in Ireland, Irish people like myself must travel abroad to avail of this treatment. As a private patient I could have chosen any of a number of different places to have this elective surgery. I have an excellent neurologist, Professor Mark Edwards, who is professionally acquainted with this team and I was guided in the first instance by his personal connection. But apart from professional reputation and word of mouth recommendation, how do you identify a surgeon in whom you can have confidence? The standard advice is to enquire about the number of DBS surgeries the neurosurgeon has performed and what the infection rate is in his surgical unit. All well and good, but numbers are only meaningful when you know exactly how they have been derived and whether you are comparing like with like. My own preference in deciding to commit to DBS with Mr Pereira, came down to one question in the end - do I trust this person, not just with my life but more importantly, with my quality of life. My first contact with Mr Pereira was when he phoned me himself to inform me he could do bilateral DBS, with minimal head shaving, and the fitting of the stereotactic frame and implanting of the IPG in my chest wall in one four hour surgery, all under general anaesthetic. My first thought was, well we're off to a good start here. The surgeon is actually speaking directly to the person who will have to live with the consequences of his work, and before I've even left my home country. From here on, he addressed every one of my questions immediately, having created an environment where I wasn't afraid to ask them. If he didn't have a ready answer, he said so. If I questioned how or why something was or wasn’t done, he acknowledged it and apologised if necessary. His students as well as his peers clearly like and respect him. He is incredibly proficient at keeping up with the administrative side of things. What used to be called 'paperwork’ is taken care of by him personally by email as you go along and the patient is kept in the loop. As an overseas patient I particularly appreciated this. Aided by his assistant, Dr Shtaya, he installed the most up todate DBS system, Boston Scientific Vercise - my preference - subject to medical suitability. The pain management was excellent. After I awoke after surgery in the High Dependency Unit, it wasn't until I looked down and noticed a white bandage on my chest, that I realised it was all over and I was not just alive but comfortable in my body. I'm sure a large part of this comfort was due to the work of the anaesthetist, Mr Elawushi, who came to my bedside to meet me prior to theatre. I found his calm demeanour very inspiring of my confidence. Anaesthetists are a bit like air traffic controllers. They work largely behind the scenes but carry a greater proportion of responsibility than that for which they are generally credited. The nursing care at St George's was excellent too. I will never forget the kindness of the nursing staff to me, at one of the most vulnerable moments of my life. Overall, I haven't encountered this standard of care in a hospital since my daughter spent five days in an American ICU many years ago, at much greater expense. In the beginning I entered into this whole process absolutely petrified. Yet by the time I walked into theatre I felt completely relaxed and calm. I felt safe. I had made a decision I could live with whatever the outcome, because I was confident that everyone around me was going to do their best for me and you can't ask for more than that really. I'm home now, 16 days post surgery at the time of writing, with no dyskinesia, able to stride down the street. What a transformative experience after a year of being housebound. Lastly, I need to mention the neurologist on the team who did my pre-surgical assessment and who does follow up programming of the DBS device, Dr Dominic Paviour. Assuming good patient selection and a positive surgical outcome, your DBS experience is still only as good in the long run, as the quality of its programming. This is a collaborative process between the programmer and the patient and I am prepared to travel back to the uk on an ongoing basis to achieve optimal programming of the device with Dr Paviour, who is patient, knowledgeable and responsive to my questions. It has been a positive experience from start to finish.