Chuck Laing, a 76-year old veteran from Toms River, New Jersey, first noticed uncontrollable shakes in both hands about five years ago. What started as an inconvenience that made his signature messy and kept him from enjoying a bowl of soup gradually worsened and impacted nearly every area of his life.
Laing has spent most of his career in construction; he ran his own company for more than two decades, used his extensive trade knowledge as a home inspector, and even became a professional witness for construction litigation cases. More recently, he dabbled in managing rental properties, but going up and down a ladder every time he dropped a screw became increasingly frustrating. Though the shaking of his right hand was more severe, his left hand trembled as well, making every job more difficult. “Imagine working in a live electrical panel with a wiggle in one hand and a shaky screwdriver in the other. Not too safe, right?” he said. “I forced myself to be patient, and I adjusted as much as I could, but it was tough.”
In his search for answers, Laing discovered he was one of approximately 10 million Americans living with essential tremor, a movement disorder that causes parts of the body to shake involuntarily. This neurological condition isn’t life-threatening, but it can transform simple tasks like drinking from a cup or applying makeup into time-consuming challenges.
Until recently, the only treatment for essential tremor was deep brain stimulation, an invasive surgery that involves implanting electrodes in areas of the brain and connecting them to an implanted pacemaker-like device in the chest. But earlier this year, Laing learned from an employee at his local bank that there was actually a newer, non-invasive intervention that he could pursue — MR-guided focused ultrasound.
“MR-guided focused ultrasound is a non-surgical procedure that doesn’t involve incisions or hardware,” said Gordon H. Baltuch, MD, PhD, a neurosurgeon at Pennsylvania Hospital and director of the Center for Functional and Restorative Neurosurgery. “We focus beams of ultrasound energy on a single point deep in the brain and make a small thermal lesion [‘zapping’ the tissue with heat]. Real-time MRI imaging measures temperature changes in the skull and ensures we destroy the targeted point without damaging surrounding areas. The effect is immediate.”
After about three years of using this technology for essential tremor patients, Baltuch and his colleagues at PAH are looking to extend it to other movement disorders like Parkinson’s disease.
Laing’s neurologist referred him to PAH, one of only 22 institutions in the United States and the only hospital in the state that offers this groundbreaking therapy. Baltuch and his team have performed this procedure on patients from around the world, and even during the pandemic, they’ve continued providing telemedicine consults to prospective patients across the nation. In Laing’s case, he clicked with the PAH team immediately, but his insurance refused to cover MR-guided focused ultrasound for his right hand in Pennsylvania. He reluctantly decided to pursue treatment in New York instead, but then COVID-19 hit, and all elective procedures were paused. However, this setback ended up working out; this past summer, MR-guided focused ultrasound for essential tremor was approved for Medicare coverage across all 50 states, and Laing received a call from the PAH team sharing the news.
On October 1, he became the 100th patient to undergo MR-guided focused ultrasound at PAH — an exciting milestone for the hospital and “an honor” for Laing. Throughout the procedure, he was sedated, but awake, and an exceptional interdisciplinary team regularly tested his right hand to ensure the tremor was being suppressed.
“This procedure brought many departments together. Neurology, neurosurgery, radiology, nursing, anesthesiology, physical therapy, occupational therapy…. For all of us to be able to come together and change someone’s life in just a couple hours is just fantastic,” said Hanane Chaibainou, CRNP, ACNP-BC, a nurse practitioner in Neurosurgery.
Indeed, just a few hours after Laing had arrived at the hospital, his right hand was completely steady for the first time in years. He hopes to return to PAH in a few years’ time to stabilize his left hand too, but for now, he is focused on getting back to the dream that inspired him to pursue help in the first place: flying. Just one month after discharge, he had already taken his first post-tremor flying lesson.
“I had to stop learning to fly years ago because the tremor made it impossible to do anything I needed to do as a pilot. Now, I’m getting better every day. My fine motor skills, my coordination, my positive attitude — everything!” Laing said. “I want to retire soon, and I always imagined that my retirement would involve traveling and playing with planes, cars, trucks, and boats. The tremor was just a bump in the road, and now, I can do it all.”