TORONTO -- A pioneering patient with extreme obsessive-compulsive disorder (OCD) is championing a new treatment which uses targeted ultrasound on the brain to treat the condition.
鈥淚t saved my life,鈥� Jeffrey Kotas said in an exclusive TV interview with CTV National News.
The 32 year old from Toronto had over time become imprisoned by anxious and repetitive thoughts about perfection and cleanliness.
鈥淎ny surface, whether a bit of dirt or sweat got on it I鈥檇 feel overwhelmingly guilty, I would feel like I鈥檇 damaged the world,鈥� said Kotas.
He dropped out of university because he became worried his textbookswere contaminated and was throwing them out, replacing them weekly. Writing assignments was torturous because everything had to be perfect.
鈥淚 was constantly writing the page over and over. The same page I would write and attempt to write hundreds of times and so I would be up all night and I still wasn鈥檛 satisfied with the way it was.鈥�
He barely slept and rarely went out on his own
An estimated one in 40 Canadians will display symptoms of obsessive-compulsive disorder in their lifetime -- intrusive repetitive thoughts that cause anxiety and stop them from living a normal life. Obsessions can be mild, and are often accompanied by 鈥渞ituals鈥� that need to be performed, such as obsessive handwashing or repetitive behaviours like checking that doors are locked.
Counselling and medications help some people but there are cases where the condition becomes so severe, the person鈥檚 life is in danger.
THE TREATMENT
That鈥檚 what happened In Kotas鈥檚 case 鈥� therapy and more than 30 medications didn鈥檛 help, leaving him depressed and suicidal.
鈥淭he entire day I would feel just in so much pain. It felt like it would never stop and I knew that my fears or concerns were irrational but that didn't help the suffering,鈥� he said.
But things changed when he became the first OCD patient in North America treated with focused ultrasound as part of a 10-person study
Doctors at Toronto鈥檚 Sunnybrook Health Sciences Centre targeted a small part of the brain thought to trigger the unrelenting worry at the root of many cases of OCD, using ultrasound energy to kill the tissue.
The treatment is not invasive and it鈥檚 done while the patient is laying down in an MRI unit, allowing doctors to see images of the brain and provide precise delivery of the ultrasound.
The pilot study is designed to find out if this new treatment is safe 鈥� with doctors saying so far, it is. They add there are signs that it works too.
鈥淚n some of our patients, at one year when we follow them, there is significant reduction in their anxiety surrounding their OCD,鈥� said Dr. Nir Lipsman, the neurosurgeon at Sunnybook who treated Kotas.
Doctors stress the treatment doesn鈥檛 cure obsessive compulsive disorder. But with a patient鈥檚 anxiety reduced, they can return to counselling and treatment.
鈥淲e鈥檝e seen quite a number of individuals report really meaningful improvements, given how bad their illness was,鈥� said Dr. Peggy Richter, who heads the Frederick W. Thompson Anxiety Disorders Centre at Sunnybrook.
鈥淚 think focused ultrasound for OCD is an exciting option because it gives us a new way to target illness for people with severe disability,鈥� Richter added.
鈥淧eople who have been suffering for years, if not decades, and who have not responded, this offers them big promise. Not infallible but it helps.鈥�
After the ultrasound treatment, Kotas enrolled in a nine-week intensive residential program at the anxiety disorders centre, where Richter noticed a change.
鈥淔ollowing the focused ultrasound Jeffrey was now able to sit with disturbing thoughts, and challenge things in a way that wasn鈥檛 possible before,鈥� she said. 鈥淎fter the focused ultrasound he was just different.鈥�
'FIRST PIECES OF A NORMAL LIFE'
Now, nearly three years since starting the ultrasound treatment, Kotas said his life has changed for the better.
鈥淚t gave me the first pieces of a normal life,鈥� Kotas said.
Normal for him means walking his dog, going shopping and no longer obsessively cleaning. He is making plans to return to university full time.
鈥淚t felt like it would never stop and I knew that my fears or concerns were irrational but that didn't help the suffering,鈥� Kotas explained.
鈥淓ven though I was very determined to get better, with so many false attempts to get better I did start losing all hope and each time it didn鈥檛 work it was so much more painful.This has been extremely important to me.鈥�
Psychosurgery has been used to treat OCD since the 1960s, when doctorsphysically removed part of the brain during surgery. There were significant risks involved.
Some patients experienced permanent complications including paralysis on one side of the body and cognitive impairment.
Focused ultrasound is non-invasive with fewer complications. But doctors stress it is a last ditch option only for patients who have failed everything else.
Kotas told 麻豆影视 he wasn鈥檛 scared to be the first person to receive this new treatment.
鈥淏ecause I studied science and math in university I had always hoped to be on the cutting edge of scientific research, this had just fallen into my lap and I felt it was my purpose," he said.
