Our services include individualized comprehensive evaluations for individuals considering deep brain stimulation (DBS) and comprehensive care for individuals who already have deep brain stimulation. We consider DBS a process that requires a patient-centered interdisciplinary team approach to maximize outcomes. All patients are evaluated by Dr. Monique Giroux, a neurologist specialized in DBS and may include physical therapy, occupational therapy, neuropsychology, and speech therapy. Sierra Farris PA-C, specializes in DBS evaluation and management and provides care coordination for the short-term and long-term experience with DBS. We coordinate care with multiple neurosurgeons with personalized referrals depending on patient preference, insurance, skill and outcomes.
Read personal stories from patients that underwent a DBS programming second opinion that led to restored function, enhanced quality of life and hope.
Expert DBS Team
Our cohesive team work, extensive experience and empathic care offers patients the most comprehensive DBS care in Colorado. Our team includes movement disorder specialist Monique Giroux, MD, (DBS since 1996), DBS programming expert Sierra Farris, PA-C, (DBS since 2000). This team has worked together since 2007. Sierra has extensive experience adjusting stimulation for routine and very complex cases for Parkinson’s, Tremor and Dystonia with ages ranging from 9 to 92.
“Our team is uniquely qualified to provide DBS care due to our understanding of the science, technology and numerous medical applications for DBS and most importantly, our experience in how DBS impacts disease and symptoms over the long-term. We have cared for many patients that have lived with DBS for more than a decade. Our collective experience and outcomes for DBS therapy is exceptional. Combining technological expertise with an empathic approach sets our team apart from many other centers that specialize in DBS.” Sierra Farris
The pre-surgical evaluation provides information to determine if DBS surgery is a reasonable next step in your treatment. The evaluation is typically covered by major insurance carriers. Read about some important topics to discuss with your insurance company. Our evaluation is based on current DBS expert consensus guidelines. Additional appointments with Sierra Farris or Dr. Giroux includes a detailed surgery overview to include risks and benefits, review expectations, goals and limitations of surgery, discuss long-term care requirements and medical follow-ups, aspects of living with an implanted device, environmental and medical safety considerations. The team approach continues throughout your DBS experience to optimize your ongoing care.
Surgery – New DBS Implants, Revisions and Battery Replacements
Dr. Giroux and Sierra Farris PA-C evaluate and educate patients fully before proceeding with DBS surgery. Watch the video for a short video highlighting DBS surgery. Sierra attends surgery to assess symptoms and test stimulation during surgery.
Comprehensive Personalized Care
We offer patients with DBS ongoing long-term care by our specialist DBS medical team. Custom appointments for a second opinion for programming are available for patients with dissatisfaction, unusual problems or side effects from DBS. Typical long-term care services will include:
- Battery check-ups and optimization of battery longevity
- Establish the most effective DBS stimulation settings and eliminate stimulation side effects
- Investigate device problems or unusual symptoms associated with the device
- Referral to our rehabilitation specialists to optimize function
- Optimize medical therapies
- Coordinate referral to our DBS surgical center for wire or battery replacement
- Brain MRI and CT imaging for lead localization to optimize stimulation settings
Outcomes research is an important component of our deep brain stimulation program and is essential in order to meet or exceed the benchmarks established by best medical practices. Outcomes also serve to inform the community about our DBS program and long-term expectations of living with an implanted neurological device. Outcome reports will include the quality measures we have found to be crucial for best practices in DBS care. We are one of 16 center nationwide involved in a new DBS device research study, learn more.
DBS Troubleshooting Clinic for patients in Colorado, Nebraska, New Mexico and Wyoming
The DBS Troubleshooting Clinic is a unique comprehensive troubleshooting clinic for second opinions about their stimulation settings, worsening symptoms after surgery, investigate problems from stimulation side effects or hardware concerns. Typically 3 to 4 visits with our team may be required to complete the assessment and are tailored to investigate the cause(s) of problems, dissatisfaction or ineffectiveness of DBS. Specialized evaluations are conducted to assess whether DBS is working as well as can be expected. Troubleshooting includes a medical consultation with Dr. Giroux, brain MRI or CT and DBS programming sessions with Sierra Farris to optimize benefit and avoid or eliminate stimulation side effects. Surgical consultation is coordinated if additional surgery is indicated.
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