 In September 2021, I have undergone a so called sleep DBS operation to enter tremor in my hands and head. Where the DBS procedure until recently was performed while the patient was awake during the first part, recently it became possible to do it asleep where the patient is under anesthetics during the entire operation. I have had this operation and would like to tell the world about it since it increased the quality of life for me drastically while the operation for me was not traumatic at all. I want you to realise that I have no medical training. This video is nothing more or less than a report on the quest to get rid of the tremor in my hands and head. It ends in how I underwent the operation to have the electrodes and the deep brain stimulator installed. Please also note that my knowledge of medical terms in English is limited. As with all my videos I give my own opinion and was not paid by any personal organisation. If after this video you seek more information, there are many sources on the internet. Do realise that there is a difference between DBS for essential tremor patients and DBS for Parkinson's patients or patients that suffer from dystonia, a disorder in which the patient's muscles contract involuntarily. So if you suffer from essential tremor, query for essential tremor, ampersand, sleep DBS. As with all information on the web, carefully judge the source on its status and interests. Universities or scientific publications can be trusted but their info might be a difficult read. Often YouTube videos published by university hospitals are easier to understand but might not contain enough information. Personal enterprises, like private clinics or manufacturers of medical equipment, might be more optimistic than institutes that work in a scientific environment. I am not saying that private clinics offer inferior services. I only notice that the language used sometimes is more like a sales speech. Nothing wrong with that as long as you do realise it. I started my quest by visiting my GP who sent me to a neurology staff at my local hospital. I was told there is no medication developed for essential tremor but there are half a dozen medicines that are known to reduce tremor, like some beta blockers. I had to try each of them for six weeks to see if that helped. None of them did. One made me very sick, two others made me very tired and the others didn't do anything. It took me a good part of a year to get that behind me. Which left one option, the brain stimulation, DBS for short in Amsterdam. To send me to the Amsterdam University Medical Center I should have an MRI scan in the local hospital first. I was asked if I suffered from claustrophobia, which I didn't. But as soon as the scan was started my body started to shake like I had an epileptic attack. The scan was aborted, a second scan was planned a few weeks later, this time after an injection in my leg would keep me calm. And that went great. Thinking back I concluded that the panic was due to the fixation of my head, which of course is necessary to get a sharp image. I was invited to a consultation at the Amsterdam UMC a few weeks later. After an interview, a number of tests and a video made of my hands and me walking my case would be discussed by a team of specialists. It was concluded that I was eligible to a deep brain stimulation procedure. A specialized nurse introduced me to this procedure and showed me the electrodes that would be inserted in my brain. Again a scan needed to be made. I warned the nurse that I had panicked before in the MRI machine, so the nurse arranged me a pill that should keep me relaxed during the scan. Unfortunately that pill didn't do its job so I had to fight the panic for 20 minutes while the radiologist on the headset told me I was doing great, if only. I wondered if DBS was the solution for me since I realized that having my head fixated would be a paramount importance during the operation. I didn't know what to do so I did what most people do in such cases. Nothing. Then a video call with the neurosurgeon was announced. I wondered if he could do his work while I was under the influence of anti-panic medication and wondered if not what to do. For I have read about the operation and seen videos on YouTube on the procedure and know that I had to be conscious during the first part of the operation. But the neurosurgeon, Dr. van der Munkhoff, could easily take away my fear. The operation would take place under General Anastasia. He would later tell me that they frequently performed the operation for Parkinson patients under Anastasia and recently did so for essential tremor tool, if the patient was concerned about being conscious. I was the 14th essential tremor patient to be operated asleep. The problem was solved and I was put on the waiting list. Covid-19 would postpone it for half a year but then the call came in. It was my turn. I needed to check in on Wednesday, September 29, 2021, at 2.30pm, the day prior to the operation. So they could take blood samples, apply intravenous drip, measure things like heartbeat, oxygen saturation, blood pressure and so on. I was lucky to have a room for myself so I could watch my favorite TV programs that night without needing headphones or in ears. The next day I was planned as first in the OR which was great since I had to remain sober from midnight on. At 7 I was given the opportunity to take a shower and to dress according to the OR dress code. We had to be at the recovery room downstairs at 8 o'clock where I was wired up to have heartbeat and blood saturation measured. I had done sufficient research on the procedure so I had no anxiety at all. I know that surgery always has some risk to it but so has driving a car or taking a hike in Manhattan without a bulletproof vest. At 9 my bed was driven into the OR, next to the operating table and I was asked to move to it from my bed. An intravenous drip was connected for the anesthetics, an oxygen mask was put over my mouth and nose, the anesthetics drip was opened and it was 19 height. When I woke up my head was full of plasters and on my chest, left just below the collarbone, there was another one. I had no pain at all. All vital signs appear to be fine and I was rolled back to my room. It's a bit of a surrealistic experience to be driven through the hospital in a bed, at least for me. For the first few hours simple tests were done every hour, like shining in my eyes with a pen light and comparing the strength left and right of my feet and hands. During the night the frequency was brought back to every two hours. The next morning the neurosurgeon visited me like he had done the afternoon after the operation but this time we had an interesting talk about the procedure. The DBS for essential tremor procedure is performed 300 times a year in if I remember well seven hospitals in my country. Amsterdam UMC does 140 of them. He told me the MRI imaging technology has proved enormously over the last seven years, making it possible to do an operation on the general anesthesia, also called a sleep DBS. It was already done for Parkinson patients where a different part of the brain needs stimulation and as said I was the 14th essential tremor patient that had the sleep DBS procedure. He was fascinating to see him talk passionately about his profession. At the same time he remained realistic. When I remarked that I was glad my operation went well he simply said that we will know when the stimulator got activated. For that I had to wait 18 days. A nurse then came to remove the plasters from my head and clean it up a bit. The plaster on my chest was packed in Tegaderm film so I could take a shower without the stitches getting wet since they were of the dissolving type. When that was done I was ready to leave for home. After five days I could remove the film. Having undergone anesthesia I needed around two weeks to fully recover. During that period I was tired, I had trouble reading anything more complex than Donald Duck and, as announced, I had a black eye for a couple of days. I was not able to work and needed to sleep a lot. Again I was never in real pain but I did enjoy paracetamol. After a week I went downtown in Utrecht and had a beer on a terrace along the old canal. I wore a cap not to scare of people on the terrace and to prevent the Indians summer sun to slow down the curing of my wounds. No stitches on my head had to be removed by the GP assistant after ten days. Just in time to prevent confusion on Halloween. I had to wait another week to have the stimulator measured and switched on. The adjustments on the stimulator were made by a specialist nurse, Ms. or Mrs. Marijs Houlten. One of those healthcare wonders that give you the feeling that there is all the time in the world to go through the adjustment procedure and answer any question you have. She started to explain that the electrodes have several contact areas, the tip and four rings. The first and second ring have three sectors and the third and the fourth ring were omnidirectional. The fourth ring functions as the minus. She started by switching on her voltage on the tip of the right-handed electrode. This initially gave me an annoying tingle in my right arm that reduced somewhat over time. It reduced the tremor unsatisfactory so the voltage and thus the current was increased until she concluded that the tremor was not gone while the tingle was annoyingly high. Therefore the tip was reached off and the first ring was tried. Again no satisfactory result so the second ring was tried and did give a more satisfactory result. It was decided to keep this setting for now. The same procedure was followed for the left arm. When that was taken care of, the right arm electron was switched on too and we took a 30 minute break in which I should walk around to see how that felt and drink a coffee to test the tremor in my hands. After the break we concluded that this was a satisfactory solution for the coming weeks and that we would call after two weeks or if necessary earlier. We also set an appointment for two months later to further tweak the settings. Once at home I was surprised I could drink from a glass using just one hand. At first I didn't trust my hands and was very carefully but within 24 hours I was used to my hands functioning like they should. From time to time I feel a right tingle in my arms, for instance when I have to cough. Since I haven't read about this with other patients I am sure that we will go away after time or after a more precise adjustment or stimulator. I made this video for all that suffer from essential tremor, where medication didn't work and that are scared for a brain surgery. I can only speak about my own experiences and for me the process of testing the medicines gave more stress than the operation. The sleep DBS procedure is internationally used for as far as I can see. A publication in the Journal of Neurosurgery stated that surgery under general anesthesia is a viable option. Based on that publication and others, plus the information given to me by my neurosurgeon, I am under the impression that it surely is successful and a great option for those that, for whatever reason, are afraid for the awake operation. What had brought me up till now? I got the functional use of my hands back. It will need some more tweaking to get the optimum result, but even if this is what it will be, I am so happy I did the operation. There is nothing to fear but fear itself. I had informed myself and was completely relaxed. I had hoped someone would ask me prior to the operation if I was nervous for then I could have replied that I suffered from essential tremor and therefore my hands always shake. But old jokes aside, the entire procedure was without any real pain and the result is mind blowing. Please feel free to ask me anything below this video in Youtube. If I know the answer and have some time left, I will surely answer.