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FIRST PERSON | I was wide awake during my brain surgery for Parkinson\’s. Here\’s how it changed my life | CBC News

$\"A$
Before surgery, a metal frame was attached to Harry Forestell’s head to keep it still during an MRI scan. During surgery, the frame was bolted to the surgical table. (Submitted by Harry Forestell)

This First Person article is written by Harry Forestell, host of CBC News New Brunswick at Six, who draws upon his experiences with Parkinson\’s disease.

My latest party trick is a real attention grabber.

It\’s a vivid illustration of the before and after effects of my recent treatment for Parkinson\’s disease. Proof of just how much a little poking around in the brain can achieve.

The treatment is called deep brain stimulation (DBS). It involves implanting thin electrodes into the brain where they emit tiny electrical pulses. Those pulses, applied continuously to just the right section of grey matter, stimulate centres in the brain that control signals sent to your muscles. In the basal ganglia, the engine house of the brain, signals are sent to the body ordering everything from speaking, to swallowing, to walking and touching. When those signals don\’t get through, or when the instructions get scrambled, the body\’s reaction can be cruel. Hands tremble uncontrollably, legs shake, walking becomes increasingly difficult, even swallowing is a challenge.

These are all early symptoms of Parkinson\’s disease and the list is by no means exhaustive.

More than 84,000 Canadians suffer from symptoms of Parkinson\’s disease. From 2011 to 2031, the number of Parkinson\’s cases in Canada is expected to double.

Parkinson\’s is considered a chronic but not fatal disease. As neurologists will often explain, you will die with Parkinson\’s, not from Parkinson\’s. While true, it doesn\’t really capture the creeping, insidious progress of the disease as it deprives victims of the ability to control their own bodies.

Medical stories like this have always been a source of fascination for me. I worked for several years as a medicine and science reporter, covering stories that included the panic over mad cow disease in the U.K. I produced radio features on brain development and decay.

Little did I know that I eventually would be reporting on my own brain malady.

A shock of a diagnosis, and a relief

The day my diagnosis of Parkinson\’s disease was officially confirmed came as much of a relief as a shock.

It was 2015 and for the previous two years, my wife Jenny and I had been careering back and forth between hope and despair. My Fredericton neurologist, Dr. Eva Pniak, a patient and persevering soul, suspected Parkinson\’s, but suggested the problems I experienced walking and with my tremoring hands could also be explained by a modestly more benign condition called essential tremor.

$\"Five$
These are just some of the drugs used to control Parkinson\’s disease. While levodopa is initially the most effective medication, it produces side effects that require other drugs that produce their own side effects. (Harry Forestell/CBC)

She referred me to a specialist in Toronto where the diagnosis was conclusive.

At 53, I had Parkinson\’s.

From leaping out of a tree to dancing the tango, very little happens in the body without first being ordered by the basal ganglia. Those orders are sent at the speed of light through nerve networks with the help of a neurotransmitter called dopamine. It is the as-yet unexplained decline in the brain\’s dopamine-producing cells that leads to movement disorders like Parkinson\’s.

It\’s a simple equation: no dopamine, no movement.

With Parkinson\’s, those dopamine cells start quietly dying off years before symptoms first appear. Scientists aren\’t certain why this happens, or why the process cannot be stopped or slowed.

Doctors can replace some of the lost dopamine with a medication called levodopa, but it causes a side effect known as dyskinesia — sudden uncontrolled muscle movements in the arms and upper body that create a writhing, torquing motion. As doctors increase doses of levodopa to stave off Parkinson\’s tremors, dyskinesia increases.

The payoff is in quality of life for patients

Neurologists have been experimenting with DBS to treat Parkinson\’s and other movement disorders for nearly 40 years. In 1997, the U.S.-based Food and Drug Administration approved DBS to treat Parkinson\’s disease.

The procedure has been available in Canada since 2012. Fewer than 400 patients a year undergo DBS in Canada.

Why not more? The simple reason is that it is a treatment involving intricate brain surgery by highly specialized surgical teams and requiring considerable aftercare.

WATCH | How deep brain stimulation can help overcome debilitating effects of Parkinson\’s:

$\"\"$

See the almost instantaneous effects of deep brain stimulation for Parkinson’s disease treatment

Harry Forestell shows how DBS therapy can work in daily life — and demonstrates what happens when he turns it off.

Dr. Tony Lang leads the Toronto Western Hospital Movement Disorders Clinic, a world-leading centre for deep brain stimulation.

\”The surgical expertise is extremely important,\” he said.

\”You have to have a surgeon that knows how to do the procedure and knows how to put the electrodes in the right spot. But then after the surgery, you need an expertise in doing all of the programming and adjusting the stimulators and also adjusting the medication doses which typically change after the operation,\” he said.

\”So it\’s a very complicated procedure that requires a team and it\’s the neurologist and the nurses after the surgery that are doing a great deal of the work in optimizing the responses.\”

It is a procedure, Lang points out, that requires support from provincial governments. The payoff is a treatment that can offer major improvements in quality of life for Parkinson\’s patients.

\”The Ontario government has appreciated the importance,\” said Lang, adding he feels lucky to have a team of expert neurosurgeons, neurologists, nurses and others to support patients.

\”The government recognized the importance of this technique and have provided what\’s called volume-based funding to allow us to operate on a much larger number than most centres.\”

My own experience is a vivid illustration of the relief DBS can bring to some Parkinson\’s patients.

Holes in my head

I entered Toronto Western Hospital on Sept. 30, 2022 with an idea of what was going to happen, but no real appreciation of what it would feel or sound like.

$\"A$
A metal structure was bolted to Forestell\’s skull prior to surgery at Toronto Western Hospital in September. (Harry Forestell/CBC)

I knew at some point before the end of the day someone was going to drill a hole in my head. At least one hole. Maybe two.

I was forewarned by reliable parties that the sound of that drilling would be akin to an airplane taking off. More like Concorde taking off inside my head!

Before surgery I had a metal structure bolted to my skull, not unlike the square lightshade at the top of a lamppost.

This was meant to hold my head steady during the MRI scan and throughout the more delicate procedure of skewering my brain without damaging the useful bits.

In the surgical suite there was a bustle of activity as half a dozen surgeons and nursing staff prepared for the procedure. My head head frame was bolted to the surgical table, and plastic sheets were draped over me to create an antiseptic site for the skull opening.

The drilling of two nickel-sized holes in my skull was every bit as loud as I had been warned. But no pain, just a feeling of pressure.

$\"A$
\”Somewhere in the middle of all this is me, wide awake,” says Forestell. The clear plastic barrier divides the room into sterile and non-sterile zones. (Submitted by Harry Forestell)

In the back of the suite, a cluster of medical IT specialists sat in front of computer screens ready to track and to provide feedback and directions as to where the probes needed to go in my brain.

I know all of this because I was awake — wide awake — for the duration of the six-hour long surgery. I have spent plenty of time around hospitals, both as a patient and as the c
hild of a hospital worker. I\’ve covered many medical stories as a reporter. So rather than fear, the prospect of this procedure filled me with curiosity. How would it feel? What would it change? Would it work?

A strange experience indeed

The surgical suite hummed with the normal hubbub of a workplace. The surgeons and I kept up an amiable conversation as I asked questions about what was happening. In the background, a steady staccato, like the noise of a Geiger counter, attested to the continuing activity in my brain.

Clicks coming through a loudspeaker amplified the activity of each busy cell.

It was a strange experience to have someone rooting through your brain.

$\"A$
A closer look at how the surgeons implant the sensors on Forestell’s brain that will eventually provide the electrical impulses to help override some of the physical symptoms of Parkinson\’s. (Submitted by Harry Forestell)

There was no feeling to it as the brain has no pain sensors. But as the probes slid into place, there were tell-tale signs that gave away what was happening — most commonly a tingling feeling in an arm or leg — as the surgeons carefully threaded the electrodes through my brain to reach the basal ganglia.

Along the way they asked me whether I could recite the days of the week, the months of the year backwards skipping every second month, and the progression of prime numbers to the fifth integer.

Once the probes were in place, it was time to install the wiring and other hardware. For this part of the surgery, anesthetic was required and I was put soundly to sleep. Both probes are attached to wires that are threaded through the skull and under the skin behind the ear, down the neck, over the clavicle and finally are plugged into a battery-operated pulse generator — similar to a pacemaker — that sits just under the skin of the chest. While the surgery involves all the usual risks of infection, hemorrhage, stroke and heart attack, side effects are rare.

A shocking conclusion

So, does it work?

Well, you can see the party trick I\’ve been boasting about in the video above. You be the judge.

Here is how it works.

Once the electrodes have been implanted in the brain, their ability to deliver the required electrical stimulation is controlled by a pulse transmitter and an adapted cellphone.

$\"A$
Forestell one week post-operation. Aside from what he describes as a terrible haircut, the only sign of surgical intervention is the ‘railway track’ of staples closing the wound. The procedure took less than 48 hours from hospital check-in to discharge. (Harry Forestell/CBC)

The cellphone carries an app that controls the frequency of the electrical stimulation of the basal ganglia. The stimulator is set to discharge regular electrical pulses day and night that miraculously override or disrupt the scrambled neural instructions that are a Parkinson\’s hallmark.

Suddenly I am able to walk normally. There are no tremors. The annoying signs of dyskinesia — those involuntary movements I described above — seem to disappear.

WATCH | In September 2022, before undergoing DBS, Harry Forestell described to his audiences what he was undertaking:

$\"\"$

Harry Forestell opens up about the next stage in his treatment for Parkinson\’s

The host of CBC New Brunswick News at 6 speaks with Rachel Cave about how deep brain stimulation is expected to help him deal with his Parkinson\’s disease diagnosis.

Regaining control of motor functions is nothing short of a miracle, but it will not work for every Parkinson\’s patient. Those with other conditions are not suited for DBS. It alleviates motor symptoms most successfully among those who respond well to levodopa. Where it is successful in those cases, it means a decrease in that drug and its side effects.

I have been able to cut my medication in half and I recently
returned to work after four months away. I sleep soundly and, while I still tire easily, my mood has brightened.

Parkinson\’s disease will continue to dog my life. DBS may allow me another 10 or 15 years without disabling tremors, though they will probably return at some point as they continue to grow in intensity. There are other insidious effects of Parkinson\’s that are not affected by DBS.

But for the time being, it is as though the disease is caged.

On a leash.

I can hear it barking, but for now at least, it can\’t bite me.

Do you have a compelling personal story that can bring understanding or help others? Here\’s more info on how to pitch to us.

Source link

February 20, 2023
FIRST PERSON | I was wide awake during my brain surgery for Parkinson\’s. Here\’s how it changed my life | CBC News

$\"A$
Before surgery, a metal frame was attached to Harry Forestell’s head to keep it still during an MRI scan. During surgery, the frame was bolted to the surgical table. (Submitted by Harry Forestell)

This First Person article is written by Harry Forestell, host of CBC News New Brunswick at Six, who draws upon his experiences with Parkinson\’s disease.

My latest party trick is a real attention grabber.

It\’s a vivid illustration of the before and after effects of my recent treatment for Parkinson\’s disease. Proof of just how much a little poking around in the brain can achieve.

The treatment is called deep brain stimulation (DBS). It involves implanting thin electrodes into the brain where they emit tiny electrical pulses. Those pulses, applied continuously to just the right section of grey matter, stimulate centres in the brain that control signals sent to your muscles. In the basal ganglia, the engine house of the brain, signals are sent to the body ordering everything from speaking, to swallowing, to walking and touching. When those signals don\’t get through, or when the instructions get scrambled, the body\’s reaction can be cruel. Hands tremble uncontrollably, legs shake, walking becomes increasingly difficult, even swallowing is a challenge.

These are all early symptoms of Parkinson\’s disease and the list is by no means exhaustive.

More than 84,000 Canadians suffer from symptoms of Parkinson\’s disease. From 2011 to 2031, the number of Parkinson\’s cases in Canada is expected to double.

Parkinson\’s is considered a chronic but not fatal disease. As neurologists will often explain, you will die with Parkinson\’s, not from Parkinson\’s. While true, it doesn\’t really capture the creeping, insidious progress of the disease as it deprives victims of the ability to control their own bodies.

Medical stories like this have always been a source of fascination for me. I worked for several years as a medicine and science reporter, covering stories that included the panic over mad cow disease in the U.K. I produced radio features on brain development and decay.

Little did I know that I eventually would be reporting on my own brain malady.

A shock of a diagnosis, and a relief

The day my diagnosis of Parkinson\’s disease was officially confirmed came as much of a relief as a shock.

It was 2015 and for the previous two years, my wife Jenny and I had been careering back and forth between hope and despair. My Fredericton neurologist, Dr. Eva Pniak, a patient and persevering soul, suspected Parkinson\’s, but suggested the problems I experienced walking and with my tremoring hands could also be explained by a modestly more benign condition called essential tremor.

$\"Five$
These are just some of the drugs used to control Parkinson\’s disease. While levodopa is initially the most effective medication, it produces side effects that require other drugs that produce their own side effects. (Harry Forestell/CBC)

She referred me to a specialist in Toronto where the diagnosis was conclusive.

At 53, I had Parkinson\’s.

From leaping out of a tree to dancing the tango, very little happens in the body without first being ordered by the basal ganglia. Those orders are sent at the speed of light through nerve networks with the help of a neurotransmitter called dopamine. It is the as-yet unexplained decline in the brain\’s dopamine-producing cells that leads to movement disorders like Parkinson\’s.

It\’s a simple equation: no dopamine, no movement.

With Parkinson\’s, those dopamine cells start quietly dying off years before symptoms first appear. Scientists aren\’t certain why this happens, or why the process cannot be stopped or slowed.

Doctors can replace some of the lost dopamine with a medication called levodopa, but it causes a side effect known as dyskinesia — sudden uncontrolled muscle movements in the arms and upper body that create a writhing, torquing motion. As doctors increase doses of levodopa to stave off Parkinson\’s tremors, dyskinesia increases.

The payoff is in quality of life for patients

Neurologists have been experimenting with DBS to treat Parkinson\’s and other movement disorders for nearly 40 years. In 1997, the U.S.-based Food and Drug Administration approved DBS to treat Parkinson\’s disease.

The procedure has been available in Canada since 2012. Fewer than 400 patients a year undergo DBS in Canada.

Why not more? The simple reason is that it is a treatment involving intricate brain surgery by highly specialized surgical teams and requiring considerable aftercare.

WATCH | How deep brain stimulation can help overcome debilitating effects of Parkinson\’s:

$\"\"$

See the almost instantaneous effects of deep brain stimulation for Parkinson’s disease treatment

Harry Forestell shows how DBS therapy can work in daily life — and demonstrates what happens when he turns it off.

Dr. Tony Lang leads the Toronto Western Hospital Movement Disorders Clinic, a world-leading centre for deep brain stimulation.

\”The surgical expertise is extremely important,\” he said.

\”You have to have a surgeon that knows how to do the procedure and knows how to put the electrodes in the right spot. But then after the surgery, you need an expertise in doing all of the programming and adjusting the stimulators and also adjusting the medication doses which typically change after the operation,\” he said.

\”So it\’s a very complicated procedure that requires a team and it\’s the neurologist and the nurses after the surgery that are doing a great deal of the work in optimizing the responses.\”

It is a procedure, Lang points out, that requires support from provincial governments. The payoff is a treatment that can offer major improvements in quality of life for Parkinson\’s patients.

\”The Ontario government has appreciated the importance,\” said Lang, adding he feels lucky to have a team of expert neurosurgeons, neurologists, nurses and others to support patients.

\”The government recognized the importance of this technique and have provided what\’s called volume-based funding to allow us to operate on a much larger number than most centres.\”

My own experience is a vivid illustration of the relief DBS can bring to some Parkinson\’s patients.

Holes in my head

I entered Toronto Western Hospital on Sept. 30, 2022 with an idea of what was going to happen, but no real appreciation of what it would feel or sound like.

$\"A$
A metal structure was bolted to Forestell\’s skull prior to surgery at Toronto Western Hospital in September. (Harry Forestell/CBC)

I knew at some point before the end of the day someone was going to drill a hole in my head. At least one hole. Maybe two.

I was forewarned by reliable parties that the sound of that drilling would be akin to an airplane taking off. More like Concorde taking off inside my head!

Before surgery I had a metal structure bolted to my skull, not unlike the square lightshade at the top of a lamppost.

This was meant to hold my head steady during the MRI scan and throughout the more delicate procedure of skewering my brain without damaging the useful bits.

In the surgical suite there was a bustle of activity as half a dozen surgeons and nursing staff prepared for the procedure. My head head frame was bolted to the surgical table, and plastic sheets were draped over me to create an antiseptic site for the skull opening.

The drilling of two nickel-sized holes in my skull was every bit as loud as I had been warned. But no pain, just a feeling of pressure.

$\"A$
\”Somewhere in the middle of all this is me, wide awake,” says Forestell. The clear plastic barrier divides the room into sterile and non-sterile zones. (Submitted by Harry Forestell)

In the back of the suite, a cluster of medical IT specialists sat in front of computer screens ready to track and to provide feedback and directions as to where the probes needed to go in my brain.

I know all of this because I was awake — wide awake — for the duration of the six-hour long surgery. I have spent plenty of time around hospitals, both as a patient and as the c
hild of a hospital worker. I\’ve covered many medical stories as a reporter. So rather than fear, the prospect of this procedure filled me with curiosity. How would it feel? What would it change? Would it work?

A strange experience indeed

The surgical suite hummed with the normal hubbub of a workplace. The surgeons and I kept up an amiable conversation as I asked questions about what was happening. In the background, a steady staccato, like the noise of a Geiger counter, attested to the continuing activity in my brain.

Clicks coming through a loudspeaker amplified the activity of each busy cell.

It was a strange experience to have someone rooting through your brain.

$\"A$
A closer look at how the surgeons implant the sensors on Forestell’s brain that will eventually provide the electrical impulses to help override some of the physical symptoms of Parkinson\’s. (Submitted by Harry Forestell)

There was no feeling to it as the brain has no pain sensors. But as the probes slid into place, there were tell-tale signs that gave away what was happening — most commonly a tingling feeling in an arm or leg — as the surgeons carefully threaded the electrodes through my brain to reach the basal ganglia.

Along the way they asked me whether I could recite the days of the week, the months of the year backwards skipping every second month, and the progression of prime numbers to the fifth integer.

Once the probes were in place, it was time to install the wiring and other hardware. For this part of the surgery, anesthetic was required and I was put soundly to sleep. Both probes are attached to wires that are threaded through the skull and under the skin behind the ear, down the neck, over the clavicle and finally are plugged into a battery-operated pulse generator — similar to a pacemaker — that sits just under the skin of the chest. While the surgery involves all the usual risks of infection, hemorrhage, stroke and heart attack, side effects are rare.

A shocking conclusion

So, does it work?

Well, you can see the party trick I\’ve been boasting about in the video above. You be the judge.

Here is how it works.

Once the electrodes have been implanted in the brain, their ability to deliver the required electrical stimulation is controlled by a pulse transmitter and an adapted cellphone.

$\"A$
Forestell one week post-operation. Aside from what he describes as a terrible haircut, the only sign of surgical intervention is the ‘railway track’ of staples closing the wound. The procedure took less than 48 hours from hospital check-in to discharge. (Harry Forestell/CBC)

The cellphone carries an app that controls the frequency of the electrical stimulation of the basal ganglia. The stimulator is set to discharge regular electrical pulses day and night that miraculously override or disrupt the scrambled neural instructions that are a Parkinson\’s hallmark.

Suddenly I am able to walk normally. There are no tremors. The annoying signs of dyskinesia — those involuntary movements I described above — seem to disappear.

WATCH | In September 2022, before undergoing DBS, Harry Forestell described to his audiences what he was undertaking:

$\"\"$

Harry Forestell opens up about the next stage in his treatment for Parkinson\’s

The host of CBC New Brunswick News at 6 speaks with Rachel Cave about how deep brain stimulation is expected to help him deal with his Parkinson\’s disease diagnosis.

Regaining control of motor functions is nothing short of a miracle, but it will not work for every Parkinson\’s patient. Those with other conditions are not suited for DBS. It alleviates motor symptoms most successfully among those who respond well to levodopa. Where it is successful in those cases, it means a decrease in that drug and its side effects.

I have been able to cut my medication in half and I recently
returned to work after four months away. I sleep soundly and, while I still tire easily, my mood has brightened.

Parkinson\’s disease will continue to dog my life. DBS may allow me another 10 or 15 years without disabling tremors, though they will probably return at some point as they continue to grow in intensity. There are other insidious effects of Parkinson\’s that are not affected by DBS.

But for the time being, it is as though the disease is caged.

On a leash.

I can hear it barking, but for now at least, it can\’t bite me.

Do you have a compelling personal story that can bring understanding or help others? Here\’s more info on how to pitch to us.

Source link

February 20, 2023
FIRST PERSON | I was wide awake during my brain surgery for Parkinson\’s. Here\’s how it changed my life | CBC News

$\"A$
Before surgery, a metal frame was attached to Harry Forestell’s head to keep it still during an MRI scan. During surgery, the frame was bolted to the surgical table. (Submitted by Harry Forestell)

This First Person article is written by Harry Forestell, host of CBC News New Brunswick at Six, who draws upon his experiences with Parkinson\’s disease.

My latest party trick is a real attention grabber.

It\’s a vivid illustration of the before and after effects of my recent treatment for Parkinson\’s disease. Proof of just how much a little poking around in the brain can achieve.

The treatment is called deep brain stimulation (DBS). It involves implanting thin electrodes into the brain where they emit tiny electrical pulses. Those pulses, applied continuously to just the right section of grey matter, stimulate centres in the brain that control signals sent to your muscles. In the basal ganglia, the engine house of the brain, signals are sent to the body ordering everything from speaking, to swallowing, to walking and touching. When those signals don\’t get through, or when the instructions get scrambled, the body\’s reaction can be cruel. Hands tremble uncontrollably, legs shake, walking becomes increasingly difficult, even swallowing is a challenge.

These are all early symptoms of Parkinson\’s disease and the list is by no means exhaustive.

More than 84,000 Canadians suffer from symptoms of Parkinson\’s disease. From 2011 to 2031, the number of Parkinson\’s cases in Canada is expected to double.

Parkinson\’s is considered a chronic but not fatal disease. As neurologists will often explain, you will die with Parkinson\’s, not from Parkinson\’s. While true, it doesn\’t really capture the creeping, insidious progress of the disease as it deprives victims of the ability to control their own bodies.

Medical stories like this have always been a source of fascination for me. I worked for several years as a medicine and science reporter, covering stories that included the panic over mad cow disease in the U.K. I produced radio features on brain development and decay.

Little did I know that I eventually would be reporting on my own brain malady.

A shock of a diagnosis, and a relief

The day my diagnosis of Parkinson\’s disease was officially confirmed came as much of a relief as a shock.

It was 2015 and for the previous two years, my wife Jenny and I had been careering back and forth between hope and despair. My Fredericton neurologist, Dr. Eva Pniak, a patient and persevering soul, suspected Parkinson\’s, but suggested the problems I experienced walking and with my tremoring hands could also be explained by a modestly more benign condition called essential tremor.

$\"Five$
These are just some of the drugs used to control Parkinson\’s disease. While levodopa is initially the most effective medication, it produces side effects that require other drugs that produce their own side effects. (Harry Forestell/CBC)

She referred me to a specialist in Toronto where the diagnosis was conclusive.

At 53, I had Parkinson\’s.

From leaping out of a tree to dancing the tango, very little happens in the body without first being ordered by the basal ganglia. Those orders are sent at the speed of light through nerve networks with the help of a neurotransmitter called dopamine. It is the as-yet unexplained decline in the brain\’s dopamine-producing cells that leads to movement disorders like Parkinson\’s.

It\’s a simple equation: no dopamine, no movement.

With Parkinson\’s, those dopamine cells start quietly dying off years before symptoms first appear. Scientists aren\’t certain why this happens, or why the process cannot be stopped or slowed.

Doctors can replace some of the lost dopamine with a medication called levodopa, but it causes a side effect known as dyskinesia — sudden uncontrolled muscle movements in the arms and upper body that create a writhing, torquing motion. As doctors increase doses of levodopa to stave off Parkinson\’s tremors, dyskinesia increases.

The payoff is in quality of life for patients

Neurologists have been experimenting with DBS to treat Parkinson\’s and other movement disorders for nearly 40 years. In 1997, the U.S.-based Food and Drug Administration approved DBS to treat Parkinson\’s disease.

The procedure has been available in Canada since 2012. Fewer than 400 patients a year undergo DBS in Canada.

Why not more? The simple reason is that it is a treatment involving intricate brain surgery by highly specialized surgical teams and requiring considerable aftercare.

WATCH | How deep brain stimulation can help overcome debilitating effects of Parkinson\’s:

$\"\"$

See the almost instantaneous effects of deep brain stimulation for Parkinson’s disease treatment

Harry Forestell shows how DBS therapy can work in daily life — and demonstrates what happens when he turns it off.

Dr. Tony Lang leads the Toronto Western Hospital Movement Disorders Clinic, a world-leading centre for deep brain stimulation.

\”The surgical expertise is extremely important,\” he said.

\”You have to have a surgeon that knows how to do the procedure and knows how to put the electrodes in the right spot. But then after the surgery, you need an expertise in doing all of the programming and adjusting the stimulators and also adjusting the medication doses which typically change after the operation,\” he said.

\”So it\’s a very complicated procedure that requires a team and it\’s the neurologist and the nurses after the surgery that are doing a great deal of the work in optimizing the responses.\”

It is a procedure, Lang points out, that requires support from provincial governments. The payoff is a treatment that can offer major improvements in quality of life for Parkinson\’s patients.

\”The Ontario government has appreciated the importance,\” said Lang, adding he feels lucky to have a team of expert neurosurgeons, neurologists, nurses and others to support patients.

\”The government recognized the importance of this technique and have provided what\’s called volume-based funding to allow us to operate on a much larger number than most centres.\”

My own experience is a vivid illustration of the relief DBS can bring to some Parkinson\’s patients.

Holes in my head

I entered Toronto Western Hospital on Sept. 30, 2022 with an idea of what was going to happen, but no real appreciation of what it would feel or sound like.

$\"A$
A metal structure was bolted to Forestell\’s skull prior to surgery at Toronto Western Hospital in September. (Harry Forestell/CBC)

I knew at some point before the end of the day someone was going to drill a hole in my head. At least one hole. Maybe two.

I was forewarned by reliable parties that the sound of that drilling would be akin to an airplane taking off. More like Concorde taking off inside my head!

Before surgery I had a metal structure bolted to my skull, not unlike the square lightshade at the top of a lamppost.

This was meant to hold my head steady during the MRI scan and throughout the more delicate procedure of skewering my brain without damaging the useful bits.

In the surgical suite there was a bustle of activity as half a dozen surgeons and nursing staff prepared for the procedure. My head head frame was bolted to the surgical table, and plastic sheets were draped over me to create an antiseptic site for the skull opening.

The drilling of two nickel-sized holes in my skull was every bit as loud as I had been warned. But no pain, just a feeling of pressure.

$\"A$
\”Somewhere in the middle of all this is me, wide awake,” says Forestell. The clear plastic barrier divides the room into sterile and non-sterile zones. (Submitted by Harry Forestell)

In the back of the suite, a cluster of medical IT specialists sat in front of computer screens ready to track and to provide feedback and directions as to where the probes needed to go in my brain.

I know all of this because I was awake — wide awake — for the duration of the six-hour long surgery. I have spent plenty of time around hospitals, both as a patient and as the c
hild of a hospital worker. I\’ve covered many medical stories as a reporter. So rather than fear, the prospect of this procedure filled me with curiosity. How would it feel? What would it change? Would it work?

A strange experience indeed

The surgical suite hummed with the normal hubbub of a workplace. The surgeons and I kept up an amiable conversation as I asked questions about what was happening. In the background, a steady staccato, like the noise of a Geiger counter, attested to the continuing activity in my brain.

Clicks coming through a loudspeaker amplified the activity of each busy cell.

It was a strange experience to have someone rooting through your brain.

$\"A$
A closer look at how the surgeons implant the sensors on Forestell’s brain that will eventually provide the electrical impulses to help override some of the physical symptoms of Parkinson\’s. (Submitted by Harry Forestell)

There was no feeling to it as the brain has no pain sensors. But as the probes slid into place, there were tell-tale signs that gave away what was happening — most commonly a tingling feeling in an arm or leg — as the surgeons carefully threaded the electrodes through my brain to reach the basal ganglia.

Along the way they asked me whether I could recite the days of the week, the months of the year backwards skipping every second month, and the progression of prime numbers to the fifth integer.

Once the probes were in place, it was time to install the wiring and other hardware. For this part of the surgery, anesthetic was required and I was put soundly to sleep. Both probes are attached to wires that are threaded through the skull and under the skin behind the ear, down the neck, over the clavicle and finally are plugged into a battery-operated pulse generator — similar to a pacemaker — that sits just under the skin of the chest. While the surgery involves all the usual risks of infection, hemorrhage, stroke and heart attack, side effects are rare.

A shocking conclusion

So, does it work?

Well, you can see the party trick I\’ve been boasting about in the video above. You be the judge.

Here is how it works.

Once the electrodes have been implanted in the brain, their ability to deliver the required electrical stimulation is controlled by a pulse transmitter and an adapted cellphone.

$\"A$
Forestell one week post-operation. Aside from what he describes as a terrible haircut, the only sign of surgical intervention is the ‘railway track’ of staples closing the wound. The procedure took less than 48 hours from hospital check-in to discharge. (Harry Forestell/CBC)

The cellphone carries an app that controls the frequency of the electrical stimulation of the basal ganglia. The stimulator is set to discharge regular electrical pulses day and night that miraculously override or disrupt the scrambled neural instructions that are a Parkinson\’s hallmark.

Suddenly I am able to walk normally. There are no tremors. The annoying signs of dyskinesia — those involuntary movements I described above — seem to disappear.

WATCH | In September 2022, before undergoing DBS, Harry Forestell described to his audiences what he was undertaking:

$\"\"$

Harry Forestell opens up about the next stage in his treatment for Parkinson\’s

The host of CBC New Brunswick News at 6 speaks with Rachel Cave about how deep brain stimulation is expected to help him deal with his Parkinson\’s disease diagnosis.

Regaining control of motor functions is nothing short of a miracle, but it will not work for every Parkinson\’s patient. Those with other conditions are not suited for DBS. It alleviates motor symptoms most successfully among those who respond well to levodopa. Where it is successful in those cases, it means a decrease in that drug and its side effects.

I have been able to cut my medication in half and I recently
returned to work after four months away. I sleep soundly and, while I still tire easily, my mood has brightened.

Parkinson\’s disease will continue to dog my life. DBS may allow me another 10 or 15 years without disabling tremors, though they will probably return at some point as they continue to grow in intensity. There are other insidious effects of Parkinson\’s that are not affected by DBS.

But for the time being, it is as though the disease is caged.

On a leash.

I can hear it barking, but for now at least, it can\’t bite me.

Do you have a compelling personal story that can bring understanding or help others? Here\’s more info on how to pitch to us.

Source link

February 20, 2023
FIRST PERSON | I was wide awake during my brain surgery for Parkinson\’s. Here\’s how it changed my life | CBC News

$\"A$
Before surgery, a metal frame was attached to Harry Forestell’s head to keep it still during an MRI scan. During surgery, the frame was bolted to the surgical table. (Submitted by Harry Forestell)

This First Person article is written by Harry Forestell, host of CBC News New Brunswick at Six, who draws upon his experiences with Parkinson\’s disease.

My latest party trick is a real attention grabber.

It\’s a vivid illustration of the before and after effects of my recent treatment for Parkinson\’s disease. Proof of just how much a little poking around in the brain can achieve.

The treatment is called deep brain stimulation (DBS). It involves implanting thin electrodes into the brain where they emit tiny electrical pulses. Those pulses, applied continuously to just the right section of grey matter, stimulate centres in the brain that control signals sent to your muscles. In the basal ganglia, the engine house of the brain, signals are sent to the body ordering everything from speaking, to swallowing, to walking and touching. When those signals don\’t get through, or when the instructions get scrambled, the body\’s reaction can be cruel. Hands tremble uncontrollably, legs shake, walking becomes increasingly difficult, even swallowing is a challenge.

These are all early symptoms of Parkinson\’s disease and the list is by no means exhaustive.

More than 84,000 Canadians suffer from symptoms of Parkinson\’s disease. From 2011 to 2031, the number of Parkinson\’s cases in Canada is expected to double.

Parkinson\’s is considered a chronic but not fatal disease. As neurologists will often explain, you will die with Parkinson\’s, not from Parkinson\’s. While true, it doesn\’t really capture the creeping, insidious progress of the disease as it deprives victims of the ability to control their own bodies.

Medical stories like this have always been a source of fascination for me. I worked for several years as a medicine and science reporter, covering stories that included the panic over mad cow disease in the U.K. I produced radio features on brain development and decay.

Little did I know that I eventually would be reporting on my own brain malady.

A shock of a diagnosis, and a relief

The day my diagnosis of Parkinson\’s disease was officially confirmed came as much of a relief as a shock.

It was 2015 and for the previous two years, my wife Jenny and I had been careering back and forth between hope and despair. My Fredericton neurologist, Dr. Eva Pniak, a patient and persevering soul, suspected Parkinson\’s, but suggested the problems I experienced walking and with my tremoring hands could also be explained by a modestly more benign condition called essential tremor.

$\"Five$
These are just some of the drugs used to control Parkinson\’s disease. While levodopa is initially the most effective medication, it produces side effects that require other drugs that produce their own side effects. (Harry Forestell/CBC)

She referred me to a specialist in Toronto where the diagnosis was conclusive.

At 53, I had Parkinson\’s.

From leaping out of a tree to dancing the tango, very little happens in the body without first being ordered by the basal ganglia. Those orders are sent at the speed of light through nerve networks with the help of a neurotransmitter called dopamine. It is the as-yet unexplained decline in the brain\’s dopamine-producing cells that leads to movement disorders like Parkinson\’s.

It\’s a simple equation: no dopamine, no movement.

With Parkinson\’s, those dopamine cells start quietly dying off years before symptoms first appear. Scientists aren\’t certain why this happens, or why the process cannot be stopped or slowed.

Doctors can replace some of the lost dopamine with a medication called levodopa, but it causes a side effect known as dyskinesia — sudden uncontrolled muscle movements in the arms and upper body that create a writhing, torquing motion. As doctors increase doses of levodopa to stave off Parkinson\’s tremors, dyskinesia increases.

The payoff is in quality of life for patients

Neurologists have been experimenting with DBS to treat Parkinson\’s and other movement disorders for nearly 40 years. In 1997, the U.S.-based Food and Drug Administration approved DBS to treat Parkinson\’s disease.

The procedure has been available in Canada since 2012. Fewer than 400 patients a year undergo DBS in Canada.

Why not more? The simple reason is that it is a treatment involving intricate brain surgery by highly specialized surgical teams and requiring considerable aftercare.

WATCH | How deep brain stimulation can help overcome debilitating effects of Parkinson\’s:

$\"\"$

See the almost instantaneous effects of deep brain stimulation for Parkinson’s disease treatment

Harry Forestell shows how DBS therapy can work in daily life — and demonstrates what happens when he turns it off.

Dr. Tony Lang leads the Toronto Western Hospital Movement Disorders Clinic, a world-leading centre for deep brain stimulation.

\”The surgical expertise is extremely important,\” he said.

\”You have to have a surgeon that knows how to do the procedure and knows how to put the electrodes in the right spot. But then after the surgery, you need an expertise in doing all of the programming and adjusting the stimulators and also adjusting the medication doses which typically change after the operation,\” he said.

\”So it\’s a very complicated procedure that requires a team and it\’s the neurologist and the nurses after the surgery that are doing a great deal of the work in optimizing the responses.\”

It is a procedure, Lang points out, that requires support from provincial governments. The payoff is a treatment that can offer major improvements in quality of life for Parkinson\’s patients.

\”The Ontario government has appreciated the importance,\” said Lang, adding he feels lucky to have a team of expert neurosurgeons, neurologists, nurses and others to support patients.

\”The government recognized the importance of this technique and have provided what\’s called volume-based funding to allow us to operate on a much larger number than most centres.\”

My own experience is a vivid illustration of the relief DBS can bring to some Parkinson\’s patients.

Holes in my head

I entered Toronto Western Hospital on Sept. 30, 2022 with an idea of what was going to happen, but no real appreciation of what it would feel or sound like.

$\"A$
A metal structure was bolted to Forestell\’s skull prior to surgery at Toronto Western Hospital in September. (Harry Forestell/CBC)

I knew at some point before the end of the day someone was going to drill a hole in my head. At least one hole. Maybe two.

I was forewarned by reliable parties that the sound of that drilling would be akin to an airplane taking off. More like Concorde taking off inside my head!

Before surgery I had a metal structure bolted to my skull, not unlike the square lightshade at the top of a lamppost.

This was meant to hold my head steady during the MRI scan and throughout the more delicate procedure of skewering my brain without damaging the useful bits.

In the surgical suite there was a bustle of activity as half a dozen surgeons and nursing staff prepared for the procedure. My head head frame was bolted to the surgical table, and plastic sheets were draped over me to create an antiseptic site for the skull opening.

The drilling of two nickel-sized holes in my skull was every bit as loud as I had been warned. But no pain, just a feeling of pressure.

$\"A$
\”Somewhere in the middle of all this is me, wide awake,” says Forestell. The clear plastic barrier divides the room into sterile and non-sterile zones. (Submitted by Harry Forestell)

In the back of the suite, a cluster of medical IT specialists sat in front of computer screens ready to track and to provide feedback and directions as to where the probes needed to go in my brain.

I know all of this because I was awake — wide awake — for the duration of the six-hour long surgery. I have spent plenty of time around hospitals, both as a patient and as the c
hild of a hospital worker. I\’ve covered many medical stories as a reporter. So rather than fear, the prospect of this procedure filled me with curiosity. How would it feel? What would it change? Would it work?

A strange experience indeed

The surgical suite hummed with the normal hubbub of a workplace. The surgeons and I kept up an amiable conversation as I asked questions about what was happening. In the background, a steady staccato, like the noise of a Geiger counter, attested to the continuing activity in my brain.

Clicks coming through a loudspeaker amplified the activity of each busy cell.

It was a strange experience to have someone rooting through your brain.

$\"A$
A closer look at how the surgeons implant the sensors on Forestell’s brain that will eventually provide the electrical impulses to help override some of the physical symptoms of Parkinson\’s. (Submitted by Harry Forestell)

There was no feeling to it as the brain has no pain sensors. But as the probes slid into place, there were tell-tale signs that gave away what was happening — most commonly a tingling feeling in an arm or leg — as the surgeons carefully threaded the electrodes through my brain to reach the basal ganglia.

Along the way they asked me whether I could recite the days of the week, the months of the year backwards skipping every second month, and the progression of prime numbers to the fifth integer.

Once the probes were in place, it was time to install the wiring and other hardware. For this part of the surgery, anesthetic was required and I was put soundly to sleep. Both probes are attached to wires that are threaded through the skull and under the skin behind the ear, down the neck, over the clavicle and finally are plugged into a battery-operated pulse generator — similar to a pacemaker — that sits just under the skin of the chest. While the surgery involves all the usual risks of infection, hemorrhage, stroke and heart attack, side effects are rare.

A shocking conclusion

So, does it work?

Well, you can see the party trick I\’ve been boasting about in the video above. You be the judge.

Here is how it works.

Once the electrodes have been implanted in the brain, their ability to deliver the required electrical stimulation is controlled by a pulse transmitter and an adapted cellphone.

$\"A$
Forestell one week post-operation. Aside from what he describes as a terrible haircut, the only sign of surgical intervention is the ‘railway track’ of staples closing the wound. The procedure took less than 48 hours from hospital check-in to discharge. (Harry Forestell/CBC)

The cellphone carries an app that controls the frequency of the electrical stimulation of the basal ganglia. The stimulator is set to discharge regular electrical pulses day and night that miraculously override or disrupt the scrambled neural instructions that are a Parkinson\’s hallmark.

Suddenly I am able to walk normally. There are no tremors. The annoying signs of dyskinesia — those involuntary movements I described above — seem to disappear.

WATCH | In September 2022, before undergoing DBS, Harry Forestell described to his audiences what he was undertaking:

$\"\"$

Harry Forestell opens up about the next stage in his treatment for Parkinson\’s

The host of CBC New Brunswick News at 6 speaks with Rachel Cave about how deep brain stimulation is expected to help him deal with his Parkinson\’s disease diagnosis.

Regaining control of motor functions is nothing short of a miracle, but it will not work for every Parkinson\’s patient. Those with other conditions are not suited for DBS. It alleviates motor symptoms most successfully among those who respond well to levodopa. Where it is successful in those cases, it means a decrease in that drug and its side effects.

I have been able to cut my medication in half and I recently
returned to work after four months away. I sleep soundly and, while I still tire easily, my mood has brightened.

Parkinson\’s disease will continue to dog my life. DBS may allow me another 10 or 15 years without disabling tremors, though they will probably return at some point as they continue to grow in intensity. There are other insidious effects of Parkinson\’s that are not affected by DBS.

But for the time being, it is as though the disease is caged.

On a leash.

I can hear it barking, but for now at least, it can\’t bite me.

Do you have a compelling personal story that can bring understanding or help others? Here\’s more info on how to pitch to us.

Source link

February 20, 2023
FIRST PERSON | My name is Ntwali and it means warrior. It used to embarrass me but now I hope I can live up to it | CBC News

فرد اول کا یہ مضمون ایڈمنٹن میں رہنے والے روانڈا کینیڈین ہپ ہاپ آرٹسٹ Ntwali Kayijaho نے لکھا ہے۔ اس کی کہانی کا حصہ ہے۔ پریریز پر سیاہ، البرٹا، ساسکیچیوان اور مانیٹوبا میں سیاہ فام زندگی کی تلاش کرنے والے مضامین، مضامین، تصاویر اور مزید کا ایک CBC مجموعہ۔ فرسٹ پرسن کی کہانیوں کے بارے میں مزید معلومات کے لیے، دیکھیں اکثر پوچھے گئے سوالات.

ہیلو، میرا نام Ntwali Kaijaho ہے اور میں اپنا تعارف کرانا چاہتا ہوں۔

میں جانتا ہوں، میں جانتا ہوں آپ ابھی کیا سوچ رہے ہیں۔ آپ اسے کیسے تلفظ کرتے ہیں؟ کیا کلک کرنے کی آواز ہے؟ کیا یہ تولی ہے؟ کیا یہ نیت والی ہے؟ یہ کہاں سے ہے؟ کہاں ہیں تم سے؟

البرٹا جانے سے پہلے مجھے اندازہ نہیں تھا کہ میرا نام کتنا منفرد ہے۔ یا لوگوں کے لیے اس کا تلفظ کرنا کتنا مشکل ہوگا۔

میں چار سال کا تھا جب میرا خاندان روانڈا سے مہاجرین کے طور پر کینیڈا چلا گیا۔ تمام اختیارات میں سے — بیلجیئم، کیلیفورنیا، اوریگون، نیویارک، بفیلو جیسی جگہیں — میرے والدین نے فیصلہ کیا کہ ونڈسر، اونٹ، ان کے اور ان کے چار بیٹوں اور راستے میں آنے والے پانچویں بچے کے لیے بہترین موزوں ہوگا۔

آٹھ سال بعد جب ہم ایڈمنٹن چلے گئے تو میرے 12 سالہ خود کو شناخت کے اس مخمصے کے بارے میں کوئی علم نہیں تھا جس کا میں آغاز کرنے والا تھا۔

$\"والد،$
کائیجاہو خاندان روانڈا سے کینیڈا منتقل ہونے کے ایک سال بعد 2001 میں لی گئی تصویر میں۔ نٹوالی، پانچ بیٹوں میں سے چوتھا، دائیں طرف ہے۔ (نطوالی کائیجاہو کے ذریعہ پیش کردہ)

ایک بہادر نام، ایک مشکل وقت

کنیاروانڈا کی میری مادری زبان میں، \”نتوالی\” کا مطلب جنگجو یا بہادر شخص ہے۔ میرے والدین کے مطابق، نٹوالی اس وقت کھڑا ہوا جب وہ مجھے دینے کے لیے ایک نام تلاش کر رہے تھے۔

میں 13 جولائی 1996 کو دنیا کی بدترین نسل کشی کے خاتمے کے دو سال بعد پیدا ہوا۔ 100 روزہ قتل عام جس نے میرے خاندان جیسے توتسی لوگوں کو نشانہ بنایا – روانڈا کی دو اقلیتی آبادیوں میں سے ایک – 15 جولائی 1994 کو ختم ہوا، جس میں ایک اندازے کے مطابق 800,000 سے 10 لاکھ افراد ہلاک ہوئے۔

میرے والدین نے توتسی لوگوں میں رہنے کا انتخاب کیا جنہوں نے ملک کی تعمیر نو کی کوشش کی لیکن مارچ 2000 میں، انہوں نے فیصلہ کیا کہ وہاں رہنا بہت مشکل ہے اور وہ کینیڈا میں بہتر زندگی کی تلاش میں چلے گئے۔

$\"پاجامہ$
ونڈسر سٹار اخبار نے کائیجاہو کی ایک تصویر شائع کی ہے جو جماعت تین کے طالب علم کے طور پر فنڈ ریزنگ ریڈ ای تھون میں حصہ لے رہی ہے۔ (نطوالی کائیجاہو کے ذریعہ پیش کیا گیا)

میرے والدین نے ہمیں ان مشکل وقتوں سے بچایا جن کو وہ جانتے تھے۔

میرے والد، روانڈا میں ایک مشہور معالج, اسے اتنا پڑھا لکھا نہیں سمجھا جاتا تھا جتنا کہ وہ ایک بار جب ہم کینیڈا پہنچے تھے۔ لہذا، وہ ڈیٹرائٹ کی وین اسٹیٹ یونیورسٹی میں صحت عامہ میں ماسٹرز کرنے کے لیے روزانہ سر
حد کے اس پار سفر کرتا تھا۔ وہ ایک ہسپتال میں رضاکارانہ طور پر وہیل چیئرز کو آگے بڑھاتے ہوئے، یونائیٹڈ وے میں کل وقتی کام کرتے ہوئے اور خاندان کی ضروریات پوری کرتے ہوئے اپنی کلاس کے سب سے اوپر گریجویشن کرنے میں کامیاب ہوا۔

میری والدہ، جو روانڈا میں ایک استاد اور ایک کاروباری مالک تھیں، کو پانچ لڑکوں کی پرورش کے لیے اپنی ہوسٹلر روح کو دفن کرنا پڑا۔ اس کے علاوہ، وہ دونوں ابھی تک روانڈا میں خاندان، دوستوں اور جائیداد کو کھونے کے صدمے کا مقابلہ کر رہے تھے۔

میں 17 سال کا تھا جب میرے والدین نے میرے نام کا مطلب سمجھا۔ جس سے وہ گزرے تھے اس کے بعد انہیں اپنی زندگی میں ایک جنگجو کی ضرورت تھی۔

$\"ایک$
کائیجاہو خاندان 2003 میں نٹوالی کے والد کے طور پر مقامی میڈیا کے ذریعہ ونڈسر، اونٹ میں تارکین وطن کی خوشی مناتے ہوئے دیوار کی نقاب کشائی کے لیے انٹرویو لے رہا ہے۔ (نطوالی کائیجاہو کے ذریعہ پیش کردہ)

میرے نام میں بڑھ رہا ہے۔

آج مجھے یہ اعزاز حاصل ہے کہ میرے نام میں اتنی طاقت، ارادہ اور میرے خاندان کی شناخت کی دولت ہے۔ لیکن 12 سال کی عمر میں مجھے معلوم نہیں تھا کہ میرا نام کتنا خوبصورت اور معنی خیز ہے اور مجھے اس پر بالکل الٹا ردعمل ملا۔

شرمندگی اور تذلیل سے بچنے کے لیے، میں نے جونیئر ہائی میں اپنے ساتھیوں سے کہا کہ وہ مجھے ولی کے نام سے پکاریں۔

رول کال ایسی چیز تھی جس سے میں اسکول کے ہر ایک دن خوفزدہ تھا، خاص طور پر جب ہمارے نام ان بڑے سمارٹ بورڈز پر پاپ اپ ہوتے تھے۔ اچھے مطلب کے اساتذہ، خاص طور پر متبادل، پوری تقریر کریں گے کہ وہ کس طرح اس کا قصائی نہیں کرنا چاہتے تھے اور مجھ سے پوچھتے تھے کہ میں کہاں سے ہوں اور کیا نہیں ہے۔

$\"اسٹیج$
Kayjaho نے جولائی 2022 میں Calgary Stampede میں پرفارم کیا۔ (Epitome West Studio)

میرے دوست ہمیشہ مجھے چھیڑتے تھے کیونکہ وہ جانتے تھے کہ صرف میرا نام ہی اساتذہ کو بہت مشکل کا باعث بنے گا۔

جب میں نے 2018 میں اپنے فنکار کا نام تبدیل کر کے Ntwali رکھا تو میں نے بار بار سنا کہ اپنے پیچیدہ نام کے ساتھ خود کو مارکیٹ کرنا کتنا مشکل ہوگا۔ لیکن میرا ورثہ سیکھنے کے بعد – اور اپنے نام کے زندگی کے اسباق کا تجربہ کرنے کے بعد – میں نے قطع نظر آگے بڑھایا۔

اب مجھے اپنی فنکاری کے ذریعے اپنے ورثے کو بانٹنے اور اس ٹھنڈے نام کی تشہیر کرنے کا موقع ملتا ہے جس پر یقین کریں یا نہ کریں، میں ایک بار شرمندہ تھا۔

پورا دائرہ

میں واحد شخص نہیں ہوں جس نے معاشرے میں گھل مل جانے کے لیے خود کو چھوٹا بیچا ہو۔ بہت سے لوگ مجھے اپنے انوکھے اور خوبصورت نام بتاتے ہیں اور پھر جلدی سے مجھے ایک عرفی نام بتاتے ہیں تاکہ دوسروں کو ایڈجسٹ کیا جا سکے۔

لیکن جو پیغام میں حاصل کرنا چاہتا ہوں وہ یہ ہے کہ آپ کے نام کا مطلب ہے۔ آپ کی ثقافت معنی رکھتی ہے۔ اسے چھپانے کے لیے نہ جائیں کہ آپ کوئی نہیں ہیں — مجھ پر بھروسہ کریں، میں تجربے سے کہہ رہا ہوں۔

$\"ایک$
تقریباً 10,000 افراد کی جون 2020 کی ایڈمونٹن بلیک لائیوز میٹر ریلی کے دوران، کائیجاہو نے ایک بولا ہوا لفظ پیش کیا جسے تبدیلی کہتے ہیں۔ (نطوالی کائیجاہو کے ذریعہ پیش کردہ)

یہ 2019 میں میری زندگی کے ایک مکمل دائرے کے لمحے کی طرح محسوس ہوا جب مجھے ایڈمنٹن میں 25 ویں یادگاری برسی کے موقع پر روانڈا کے نسل کشی سے بچ جانے والے سینکڑوں افراد کے سامنے لکھی گئی ایک نظم کا اشتراک کرنے کا موقع ملا۔

میرے والدین اور میرے بھائی دونوں جو اس سے بچ گئے سامعین میں تھے۔ عین اسی لمحے، میں نے اپنے پیاروں، اپنے وقار اور اپنی طاقت کی نمائندگی کرتے ہوئے خود کو اپنے خاندان کے لیے ایک جنگجو پایا۔

اپنی ثقافت کی دولت کے مالک بنیں کیونکہ آپ کبھی نہیں جانتے کہ کب آپ کو اپنے لوگوں کے لیے جنگجو بننے کے لیے بلایا جائے گا۔

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میرے نام کی طاقت: Ntwali Kaijaho

Ntwali Kaijaho کا عرفی نام \’ولی\’ تھا جب تک کہ اس کے والدین نے یہ ظاہر نہیں کیا کہ روانڈا کی مادری زبان کنیاروانڈا میں اس کے نام کا کیا مطلب ہے۔

دی بلیک آن دی پریریز پروجیکٹ کی حمایت حاصل ہے۔ کینیڈا میں سیاہ فام ہونا، سیاہ فام کینیڈین کے تجربات کے بارے میں کہانیاں بانٹنا۔ کیا آپ کے پاس کوئی زبردست ذاتی کہانی ہے جو سمجھ لے سکتی ہے یا دوسروں کی مدد کر سکتی ہے؟ یہ ہے۔ ہمارے پاس جانے کے طریقے کے بارے میں مزید معلومات.

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(سی بی سی)

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February 19, 2023
Islamabad Police file case against unknown person after ‘pet’ leopard runs amok in residential area

اسلام آباد پولیس نے جمعہ کے روز دارالحکومت کے ایک اعلیٰ رہائشی علاقے میں تیندوے کے آزاد ہونے اور متعدد افراد کو زخمی کرنے کے ایک دن بعد، ایک نامعلوم شخص کے خلاف مجرمانہ تحقیقات کا آغاز کیا۔

گزشتہ روز، اسلام آباد کے ڈیفنس ہاؤسنگ اتھارٹی (ڈی ایچ اے) فیز II کے محلے میں دیواروں کو پھلانگنے اور سڑکوں پر گھومنے پھرنے کے ویڈیو کلپس سوشل میڈیا پر وائرل ہوئے، جس کے نتیجے میں گھنٹوں کی کوشش حکام کی طرف سے اسے پکڑنے کے لیے۔

آج، اسلام آباد پولیس نے ٹویٹ کیا کہ اس کے سہالہ پولیس اسٹیشن، جس کے دائرہ اختیار میں ڈی ایچ اے فیز II آتا ہے، نے پاکستان پینل کوڈ کی دفعہ 324 (قتل کی کوشش) اور 289 (جانوروں کے حوالے سے لاپرواہی) کے تحت ایک نامعلوم ملزم کے خلاف مقدمہ درج کیا۔

پولیس نے الزام لگایا کہ تیندوا ایک نامعلوم شخص کے گھر کا پالتو جانور تھا۔ اس نے دوسری ٹویٹ میں کہا، \”مشتبہ شخص نے خطرناک جانور پال کر شہریوں کی زندگیوں کو خطرے میں ڈالا۔\” ملزم کی تلاش جاری ہے، جلد گرفتار کرکے قانونی کارروائی کی جائے گی۔

وزیر موسمیاتی تبدیلی شیری رحمان نے ٹویٹ کیا کہ اسلام آباد کے نجی چڑیا گھر سے گزشتہ رات فرار ہونے والا یہ چیتا پرانے چڑیا گھر میں ہمارے اینیمل ریسکیو سینٹر میں زندہ اور خیریت سے ہے۔

اس نے مزید کہا: \”یہ 6 گھنٹے کی گرفتاری کے آپریشن میں ہمارے وائلڈ لائف کے عملے میں سے ایک کو بری طرح سے زخمی کر دیا گیا۔ کمیونٹی اور جانوروں کے اخراجات اس سے کہیں زیادہ ہو سکتے تھے۔ پرائیویٹ چڑیا گھر بند کرو۔\”

داغدار دن

گزشتہ روز اسلام آباد وائلڈ لائف مینجمنٹ بورڈ (IWMB) اور کیپٹل ڈویلپمنٹ اتھارٹی کو تیندوے کو پکڑنے میں پانچ گھنٹے سے زیادہ کا وقت لگا، جس نے ایک ڈان کی رپورٹ میں کہا گیا ہے کہ ممکنہ طور پر ایک سفاری پارک سے فرار ہوا اور خوف زدہ رہائشیوں کے درمیان پڑوس میں خود کو \”پھنسا\” پایا۔

آئی ڈبلیو ایم بی نے جانور کو پنجرے میں ڈالنے میں ناکامی کے بعد رات 10 بجے کے قریب اس جانور کو سکون بخشنے کے لیے ایک ٹرانکولائزر کا استعمال کرنا پڑا جب اسے موقع پر موجود رضاکاروں اور عملے کی طرف سے بند جگہ میں قید کر دیا گیا۔ وائلڈ لائف بورڈ کی سربراہ رینا سعید خان کے مطابق تیندوے کو ریسکیو سینٹر کے ایک ریسکیو سینٹر میں رکھا جائے گا جو اسلام آباد چڑیا گھر ہوا کرتا تھا۔ جب یہ رپورٹ پریس میں آئی آئی ڈبلیو ایم بی کے سربراہ کمشنر کے ساتھ رابطہ کر رہے تھے۔

شام 4 بجے کے قریب، سوشل میڈیا پر ویڈیوز گردش کرنے لگیں جس میں ہاؤسنگ سوسائٹی میں مرغیوں کو بھاگتے ہوئے دکھایا گیا ہے۔ ان کلپس میں تیندوے کو دکھایا گیا – وہ بھی گھبرا کر – جائے وقوعہ سے بھاگنے کی کوشش کر رہا تھا، لیکن وہ مکانوں اور دیواروں کو پیمائی کرنے میں دوڑتا ہوا ختم ہوا۔

تیندوے کو IWMB کے رضاکار پر دو بار حملہ کرتے ہوئے بھی دیکھا جا سکتا ہے۔ پوری ایپی سوڈ کے دوران IWMB کے دو عملے کے ارکان سمیت تین افراد زخمی ہوئے جس کے نتیجے میں جنگلی بلی پکڑی گئی۔ ایک اور ویڈیو میں، ایک شخص، جو ایک پرائیویٹ سیکیورٹی ممبر کے طور پر سامنے آیا، نے سائٹ پر جمع لوگوں کی حفاظت کا خیال کیے بغیر چیتے کو گولی مار دی۔ تاہم متعلقہ حکام کی جانب سے اس کی تردید کی گئی۔

بلی کو \’ریسکیو سینٹر\’ میں منتقل کیے جانے کا امکان ہے۔ تین افراد زخمی

\’ریسکیو کے لیے کال کریں\’

شام 4:20 پر، ڈی ایچ اے سیکیورٹی نے اسلام آباد وائلڈ لائف مینجمنٹ ڈیپارٹمنٹ کو اطلاع دینے کے لیے فون کیا کہ ایک تیندوے نے ایک سیکیورٹی گارڈ کی پشت پر کاٹا ہے۔ IWMB رینا سعید خان نے کہا کہ جس وقت IWMB ٹیم ہاؤسنگ سکیم پر پہنچی، ریسکیو 1122 پہلے ہی زمین پر موجود تھا لیکن وہ علاقے کو گھیرے میں لینے میں ناکام رہا تھا۔ اس نے دعویٰ کیا کہ سی ڈی اے کے عملے کی طرف سے گھر کے اندر رہنے کی وارننگ کے باوجود بہت سارے ٹک ٹوکر تیندوے کے گرد جمع ہو گئے تھے، خطرناک حد تک اس کے قریب۔ خان نے کہا، \”چیتے نے حملہ کیا کیونکہ اسے محسوس ہوا کہ اسے گھیر لیا گیا ہے۔\”

رینا سعید خان نے کہا کہ عام تیندووں کو پالتو جانور کے طور پر رکھنا غیر قانونی ہے اور اگر یہ ثابت ہوا کہ اس کا کوئی مالک ہے تو کارروائی کی جائے گی۔

ابتدائی طور پر، آئی ڈبلیو ایم بی کا عملہ رضوان محبوب، جو بلی کے حملے سے معمولی زخمی ہوا تھا، نے شبہ ظاہر کیا کہ ایسا لگتا ہے کہ تیندوا قریبی فارم ہاؤس سے فرار ہوا ہے۔ تیندوے نے جنگلی بلی کی طرح حملہ نہیں کیا۔ وہ عام طور پر اپنے شکار کی گردن کو نشانہ بناتے ہیں۔

یہ پہلا موقع نہیں تھا جب عام تیندووں نے بستیوں میں داخل ہو کر زندگی کو درہم برہم کیا ہو – ان کے مسکن میں تجاوزات کا نتیجہ۔

گزشتہ سال نومبر میں تیندوے کئی گھروں میں گھس گئے۔ سید پور ماڈل ولیج مارگلہ ہلز میں خوف و ہراس پھیل گیا۔

جب کہ دیہاتیوں نے کہا کہ انہوں نے چار چیتے دیکھے ہیں، آئی ڈبلیو ایم بی نے کہا کہ تیندوے انتہائی علاقائی تھے، اور شیروں کے فخر کی طرح گروہوں میں نہیں گھومتے تھے۔

جمال شاہد کی اضافی رپورٹنگ

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February 17, 2023
PTI workers ready for ‘jail bharo’ drive, says focal person

اسلام آباد: پاکستان تحریک انصاف (پی ٹی آئی) نے منگل کو دعویٰ کیا ہے کہ پارٹی چیئرمین عمران خان کی راہ ہموار کرنے کی کال پر ملک بھر سے بڑی تعداد میں پارٹی کارکنان جیلیں بھرنے کے لیے عدالتی گرفتاری کے لیے تیار ہیں۔ ملک میں فوری انتخابات کے لیے۔

پریس کانفرنس سے خطاب کرتے ہوئے عمران خان کی جیل بھرو تحریک کے لیے پی ٹی آئی کے فوکل پرسن سینیٹر اعجاز چوہدری نے کہا کہ لاہور میں 4 گھنٹے کے اندر تقریباً 3200 افراد نے تحریک کا حصہ بننے کے لیے رضاکارانہ طور پر جیل جانے کے لیے خود کو رجسٹر کرایا جسے کسی بھی وقت شروع کیا جا سکتا ہے۔ .

انہوں نے کہا کہ پی ٹی آئی ملک کو حقیقی معنوں میں آزاد ریاست بنانے کے لیے آئین کی بالادستی اور قانون کی حکمرانی کو یقینی بنانے کے لیے ہر غیر آئینی اقدام کی مزاحمت کرے گی۔

انہوں نے کہا کہ ہر ضلعی گروپ جس نے خود کو عدالتی گرفتاریوں کے لیے پیش کیا، اس کے ساتھ پانچ ارکان پارلیمنٹ ہوں گے، کیونکہ پارٹی کارکنوں کو تنہا نہیں چھوڑا جائے گا۔

انہوں نے متنبہ کیا کہ طاقتور حلقے کسی بھی غیر آئینی چیز کو استعمال کرنے سے گریز کریں، عمران خان تحریک کی تاریخ کا اعلان جلد کریں گے۔

انہوں نے کہا کہ پارٹی تشدد پر یقین نہیں رکھتی لیکن عوام کو فاشسٹ حکومت سے نجات دلانے کے لیے اپنے پرامن اور آئینی حقوق کو استعمال کرنے سے دریغ نہیں کرے گی۔

چوہدری نے دعویٰ کیا کہ \’امپورٹڈ\’ حکومت نے پی ٹی آئی کے رہنماؤں اور کارکنوں کے خلاف تمام وحشیانہ حربے استعمال کیے جن میں جبر اور تشدد کے علاوہ انہیں برہنہ کرنا بھی شامل ہے۔

انہوں نے کہا کہ پرامن جدوجہد ان لوگوں کے خلاف بھی ہے جنہوں نے کرپٹ حکمرانوں کو مسلط کر کے دنیا کی واحد مسلم ایٹمی ریاست کو گھٹنے ٹیک دیا۔

پی ٹی آئی کے سینیٹر نے مزید کہا کہ پنجاب اور خیبرپختونخوا کی صوبائی اسمبلیوں کی تحلیل کے 30 دن گزر جانے کے باوجود درآمد شدہ حکومت نے ابھی تک انتخابات کی تاریخوں کا اعلان نہیں کیا جو کہ آئین کی کھلم کھلا خلاف ورزی ہے۔

انہوں نے دعویٰ کیا کہ چیف الیکشن کمشنر سکندر سلطان راجہ اور گورنر پنجاب بلیغ الرحمان لاہور ہائی کورٹ کی واضح ہدایات کے باوجود الیکشن شیڈول نہ دے کر توہین عدالت کے مرتکب ہو رہے ہیں۔

انہوں نے کہا کہ صوبائی اسمبلی کے انتخابات میں صرف 59 دن رہ گئے ہیں لیکن درآمد شدہ حکومت اور ای سی پی دونوں الیکشن کی تاریخ کا اعلان کرنے کے بجائے ملاقاتوں کے بعد ملاقاتوں میں مصروف ہیں \’جو کہ غداری ہے\’۔

ساتھ ہی وزیر خارجہ بلاول بھٹو زرداری پر طنز کرتے ہوئے انہوں نے کہا کہ وزیر کو دنیا کے ہر ملک کا دورہ کرتے ہوئے دیکھا جا سکتا ہے لیکن ان میں ہمت نہیں کہ وہ افغانستان میں طالبان حکومت سے مذاکرات کا حل نکالیں۔ دہشت گردی کا مسئلہ.

انہوں نے کہا کہ عمران خان کے دوحہ مذاکرات کے کارنامے سے نہ صرف امن بحال ہوا بلکہ اسلام آباد کے راستے افغانستان سے 55 ہزار سفارت کاروں، این جی اوز اور افسران کا محفوظ انخلاء بھی یقینی بنایا گیا۔

انہوں نے دعویٰ کیا کہ جنرل قمر جاوید باجوہ (ر) نے حکومت کی تبدیلی کے آپریشن میں اپنے کردار کا اعتراف کیا، جو کہ ’’انتہائی شرمناک‘‘ ہے۔

کاپی رائٹ بزنس ریکارڈر، 2023

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February 15, 2023