One of the "unpublished" guidelines for my insurance was "Medication no longer controlling symptoms after taking it for four years". If less than four years and Sinemet & Comtan (aka Stalevo) is not working.

If you do NOT respond to Levodopa (sinemet) you are not a candidate for DBS. If you have poor balance, not a candidate.

Obese. If you are overweight, higher risk so often insurance may deny DBS. I had dropped from 300# to 235# prior to surgery, so not an issue. Irony is after DBS, I'd gained weight and back up to 245# in part from not exercising post DBS.

I did go through a six hour Neuropsychological assessment. That was good, so I was considered an excellent candidate!

In years past it was considered a "last chance effort", now my MDS recommends it when medication wears off too soon. Amazingly, knock on wood, I have not fallen size surgery. My tremors are coming back after the "honeymoon period" post surgery, but on just a little medication.

There is always a risk during the surgery, not everyone has improvements. If you are healthy and active, and it keeps you moving then it worth while.

For me the decision to have surgery done is when I had lost luggage at the airport and couldn't use my voice nor write a note about what I needed. Clerk assumed I had been drinking all night, but it was just my meds were off after being diverted to another airport and a 24 hour delay getting home. Thankfully my daughter was their to assist me, but damn that was a horrible feeling.