New pump helps man battle Parkinson's

AMHERST – Eight-month-old Audrey Hurda smiled and grabbed the bill of her dad’s Caterpillar hat as he bent to give her a kiss.

Her dad, Tim, 38, has lived with Parkinson’s disease for eight years and late this summer started a recently-approved treatment, Duopa, aimed at helping control the symptoms of the degenerative disease.

Hurda did it for Audrey and his wife, Holly.

He underwent surgery in August to implant a tube in his digestive tract connected to a small external pump. The treatment is designed to provide patients with a more consistent flow of medications intended to help control disease symptoms including difficulty walking, stiffness, shaking, and slow movements.

“That’s the main reason I did it, because of Audrey,” Hurda said. “Holly can’t do everything herself, and I want to be functional enough to be able to play with her, raise her, pick her up from daycare, and feed her. That’s pretty much exactly what I got with this pump.”

The pump, a square device about the size of a small paperback book, delivers medication (carbidopa and levodopa) directly to Hurda’s small intestine via a tube implanted in his abdomen. The treatment, sold by AbbVie, was approved by the Federal Drug Administration in January.

While there’s treatment for Parkinson’s, there is no cure.

Hurda is one of two people in Wisconsin using the pump – the other recipient was involved in clinical trials of the device – according to AbbVie. The pump is manufactured in Minnesota by Smiths Medical.

“I can function a lot better, my balance is better, my speech is better,” he said. “With the Duopa pump, it’s like a constant drip of medication going directly into my small intestine… and I couldn’t be happier.”

Hurda is being cared for by Froedtert and the Medical College of Wisconsin, which participated in the FDA approval process for Duopa.

“When I was taking oral medications there was a point where it would just wear off, and by the time I took another oral medication it would take an hour or two to kick back in,” he said. “Throughout the whole day, I’d bet I was (effectively medicated), maybe five to six hours.”

The National Parkinson’s Foundation says about 1 million Americans live with the disease, a number that is expected to “increase substantially” in the coming years as the nation’s population ages.

Hurda says Duopa keeps him medicated through his waking hours. What he eats, sleep pattern, and his stress level can affect some of the times during the day where the medication is less effective, but he’s largely happy with the treatment.

Froedtert is one of three healthcare providers in the state that have completed Duopa training so far, according to AbbVie. The Marshfield Clinic and Neenah-based Neuroscience Group are the other two.

Medical staff at Froedtert are working with additional patients who are candidates for the treatment.

Dr. Bradley Hiner, Neurologist at Froedtert and the Medical College of Wisconsin, said the treatment isn’t intended for people who are doing well on oral medications, but rather those with more advanced cases of Parkinson’s where pills aren’t as effective.

Delivering the medicine directly into the small intestine helps find a middle ground between too little medication and too much, which can cause twitching and shaking in the patient.

“One of the battles we wage with Parkinson’s is that while the initial year, or couple of years, go smoothly and treatment is fairly straightforward… at a certain point we start to see fluctuations where the pills may not kick in in a consistent manner or last for a consistent duration,” Hiner said. “We’re very optimistic that for the right patient it’s going to provide a good improvement in quality of life.”

Dr. Lisa Kokontis, a neurologist with Neuroscience Group, said development of other Parkinson treatments is ongoing, as is research into the cause of the disease.

“We still don’t know what causes Parkinson ’s disease and that’s where a lot of research is driven: What is going wrong?’” Kokontis said.

She said it’s unlikely a cure will be found in the next five years, but she anticipates more products for managing the disease -- and improving the quality of life for patients – will be introduced to the market.

Both Hiner and Kokontis said only a certain percentage of patients will be candidates for Duopa.

“If patients aren’t doing well with oral therapy, that’s where Duopa has a role,” Kokontis said. “It’s not something for everyone. There’s a small population patients who will benefit from this.””

Holly said the couple had little apprehension about trying the recently approved treatment, pointing out it has been used in Europe for years and provided the family another medical option. Tim and Holly -- who married in December 2010 -- have been through Parkinson-related surgery before with a number of procedures tied to deep brain stimulation.

“There really wasn’t a better alternative,” she said. “I wasn’t nervous about, even though it was new, because of the mechanism of it. Worst case, they could take it out if it didn’t work. I really wanted it to work, and it does.”

nphelps@gannett.com and follow him on Twitter @nathanphelpsPG or Facebook at Nathan-Phelps-Gannett-Media-Wisconsin