Communications Director, Connecticut Hospital Association
110 Barnes Road, Wallingford, CT
rall@chime.org, 203-265-7611
Hartford Courant – Monday, November 4, 2024
By Pamela McLoughlin
John Goekler’s hands started shaking 30 years ago and it progressed to the point where he couldn’t write a legible check, hold a can of soda or easily put toothpaste on his toothbrush.
Goekler, 75, was diagnosed with an “essential tremor” and endured all the stigma and practical hurdles that come along with it.
According to Johns Hopkins Health System, essential tremor is a “neurological disorder” and can cause hands, head, trunk, voice or legs to “shake rhythmically.” It can be confused with Parkinson’s disease and while most often seen in people older than 65, can occur at any age, according to Johns Hopkins. It can be disabling.
With the shaking, it took Goekler, of Enfield, 15 minutes to put an earing in his pierced ear and in an embarrassing restaurant mishap, three peas on his fork went catapulting into a woman’s hair-sprayed hair and stuck there.
“I was mortified,” he said of the pea incident, not telling the woman who was eating at a neighboring table.
Now Goekler’s life has been forever changed for the better through a cutting edge, high tech procedure at Hartford Hospital.
His left hand shakes no more and doctors will do the procedure for his right hand soon.
“I’ll sing this from the rooftops,” he said of the procedure. “It was life changing to me.”
He likes to say the neurosurgeon did the surgery by, “zapping my brain.”
But more technically what happened is that neurosurgeon Dr. Patrick Senatus treated Goekler at Hartford Hospital with High Intensity Focused Ultrasound.
It was the first time in Connecticut the procedure was used for this purpose, as Hartford Hospital was the first in the state to acquire the technology and the fourth in New England to do so.
Dr. Patrick Senatus, a neurosurgeon, of Ayer Neuroscience Institute uses the new technique to perform brain surgery from a computer while the patient is awake.
The non-invasive procedure uses sound waves to precisely ablate deep brain targets with no surgical incisions. The “very high-intensity and highly focused sound waves interact with targeted tissues in your body to modify or destroy them,” according to the Cleveland Clinic.
The “very high-intensity and highly focused sound waves interact with targeted tissues in your body to modify or destroy them,” according to Cleveland Clinic,
At Hartford Hospital, each treatment is performed in a single session under Magnetic Resonance Imaging, or MRI, guidance for high resolution “visualization” of the patient’s anatomy, permitting precise targeting, real-time temperature monitoring and “immediate confirmation of treatment outcomes,” according to the hospital.
The result was immediate for Goekler, happening right before everyone’s eyes in the MRI suite.
“I was in tears,” said Dr. Toni de Marcaida, medical director, Chase Family Movement Disorders Center. “This is someone I’ve been trying to to help for years.”
She held Goekler’s hand throughout the procedure.
De Marcaida said they had tried medication, external stimulators, even Botox, but nothing had worked on Goekler’s essential tremors.
She said there are 10 million people in America with essential tremors and while people often think of Parkinson’s, “not all that shakes is Parkinson’s.”
Essential tremors can occur in any part of the body, but the hands are most common.
Doctors said the current understanding of tremor is related to abnormal activity in certain parts of the brain responsible for movement.
De Marcaida said many people who get essential tremors assume the condition runs in their family.
The two peak ages for tremors are in the twenties and sixties, she said.
Goekler, an adjunct professor at University of Hartford, said he thinks surgeon Senatus was “excited as I was. ”
Senatus said it “felt great” to see the progress happen at the same time as the procedure.
Goekler said he was tested between “passes” to his brain and each time he came out he was tested and the stability of his left hand improved every time.
“Before when I went into tremor I couldn’t even keep a marker in paper,” the patient said. ” Each time I came out just watching the tremors disappear was unbelievable to me.”
Goekler said he often worried he would “end up like actress Katharine Hepburn” who had an essential tremor that made her head shake.
One test had Goekler holding a can in his left hand.
“I haven’t been able to hold a can of soda in 20 years,” Goekler said. “The day after I wrote a check. I haven’t been able to write a check in 20 years. ”
Just getting keys in the car ignition was once a problem and he can control his food now too.
“I can pick up a fork full of corn now,” Goekler said.