Deep Brain Stimulation and wellbeing

What is normal?

Being nervous or anxious is understandable. Patient’s who have been through this process recall that their symptoms felt worse at different points as medications are stopped or changed. They found it helpful to remind themselves that these times are temporary and a normal part of the process.

There will not be an immediate change in symptoms after DBS and this is normal. The DBS device cannot be programmed until approximately 6 weeks after surgery to allow the brain to heal. Some patients may at this stage worry that DBS has not worked or struggle with symptom management so using strategies below may be helpful.

Practical advice

Keep a routine

If you do need to come in to hospital, please discuss your admission time with the Ward. Coming in too early can lead to a build-up of anxiety and it may be more helpful to try and keep your day as normal as you can beforehand.

For example, it is possible for patients attending for the L-DOPA challenge and who need an overnight stay, to leave the ward after admission and go off site before returning by 19.30pm. Please discuss this with your Neurologist or Charge Nurse.

This will not be possible when you come in for DBS surgery.

Home comforts

Bringing in some home comforts can make hospital stays a bit easier. This can include items such as:

• Your own pillows and duvets if you feel these would be more comfortable for you than what is provided on the ward.
• Pyjamas
• Heat pads
• Books, magazines and other reading materials
• Tablets, phones, headphones and mobile computer devices to keep you occupied

You can make a note of your pin code or passwords for your electronic devices so nursing staff can help you access them if required. Staff will keep this safe and it will not be shared with anyone else.

There is also access to TV’s and radios on the ward as well as stands and holders for tablets and phones which can be provided by asking the ward staff. These can be helpful if you are unable to hold your device.

We encourage you to engage in activities that you enjoy in your own home life and daily routine as these can help you through your time in hospital. Making a note of favourite shows, podcasts etc. can let family and staff know what to put on for you should you need assistance in doing so.

It is always helpful to understand the different stressors and demands you have in your life as well as the impact this can have on you. Stress does not always have to be negative. There can be positive stress in our lives as well. There can be times where stress and demands can feel over whelming so taking time to consider what stress you have and how you are dealing with it can be helpful. It may be there are ways to reduce demands and responsibilities around you, or it may be more necessary to build on coping strategies to keep things balanced.

It can be helpful to think about stress like water that can fill up a bucket. The more stress we have, the more our bucket fills with water and our buckets can over flow if we do not manage it.

Trying to balance your bucket before, during and after DBS surgery can be helpful.

Please scan the QR below or visit the website below to see a short animation on the “Stress Bucket Model” to help you understand this process better and take time to consider your own “bucket”.

The strategies below can offer ways to help keep your “bucket” balanced.

   NHSGGC - The Stress Vulnerability Bucket Model (youtube.com)

Distraction and focusing on more pleasant thoughts and sensations can be helpful to reduce stress and worry. You can use them at any point in the DBS journey or for general stress management.  We would encourage you to try these strategies in advance so you know which ones work best for you.

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This exercise relies on senses to ground yourself to the here and now and also serve as a distraction. In as much detail as you can……..

Other sensory grounding

• Touch something that has a noticeable texture or temperature like a cool face cloth, hair brush etc. and focus on how each part feels.
• Listen to music e.g. try listening to your favourite song but pick one instrument to focus on the whole way through
• Carry a scent with you that you find relaxing, pleasant or is associated with positive memories (lavender, or a favourite perfume) 

Safe place Imagery

Shift your attention away from worrying thoughts or emotions to a positive image that you choose:

• Imagine a place in your mind that is associated with safety and positive emotions and thoughts
• Think about this place in as much detail as you can
• What might you hear, see, smell, touch and taste in this place
• Imagine you are taking a walk through this place, allowing yourself to just be in this place.

Scan the QR code or view the YouTube video  below to see a guided safe place imagery exercise.  

Balloon Breathing

Breathing exercises are simple but effective.  When we are anxious or stressed, our breathing can quicken and become shallow.  When we do balloon breathing, we slow breathing down and send a message to the emotion centre of the brain to relax.

1. Let your attention focus on your breathing
2. Imagine you have a big balloon in your stomach

1. Imagine the balloon inflating with your in breath and hold for 2 seconds
2. Imagine the balloon deflating with your out breath.
3. Repeat this at least 5 times or for a period of time e.g. 5 to 10 minutes.

Scan the QR code or view the YouTube video  below to see a guided Balloon Breathing exercise

There are also many resources and apps that can help alleviate stress and anxiety.

  Breathing and relaxation exercises for stress | NHS inform | NHS inform

  Relaxation | Wellbeing Services (wellbeing-glasgow.org.uk)

These are NHS resources that contain a range of information, tips and exercises similar to those above to help you cope with stress, anxiety and low mood.

  Smiling Mind

Smiling Mind is a free web and app-based program developed by psychologists with different relaxation and mindfulness exercise

   Calm

Calm offers a range of activities such as mindfulness and meditation, relaxation, visualisation and help with sleep issues.

There are also helplines to call if you are struggling with your mental health:

Samaritans – 116 123

Breathing Space – 0800 838587