"It's Been Life Changing": Angel Ortiz's Journey with Focused Ultrasound for Essential Tremor Treatment

Angel Ortiz was always passionate about fitness and staying active and healthy, but his life took an unexpected turn when he began experiencing shakiness in his right hand.

Ortiz had no idea what was happening beyond that he couldn't control the involuntary shaking. He'd particularly notice it while reaching to push a button in the car or at the dinner table with his family. They noticed it too, figured it was nerves.

"My kids were saying, Dad, you're shaking again, Dad, you're nervous," says Ortiz, who lives in Houston with his wife and two daughters. "No, I'm not nervous," he'd reply.

Ortiz did some hand exercises, trying to manage the shaking on his own. But they didn't help.

All the while, Ortiz's condition got progressively worse. Frustrated, he eventually took action, resolving to find out what was happening and whether there's a treatment option.

That search led him to Houston Methodist, where he met Dr. Amir Faraji, a neurosurgeon who diagnosed him with essential tremor, a nervous system disorder that's eight times more common than Parkinson's disease.

"Essential tremors are a widely prevalent condition," Dr. Faraji explains. "Millions of people in the United States have this disorder."

The condition can be treated with medication, but these drugs sometimes fail the patient, either causing intolerable side effects or not providing sufficient relief.

In such patients, there are surgical options, says Dr. Faraji.

Faraji offered Ortiz a less invasive option: a new treatment known as focused ultrasound. Houston Methodist is among the first in the country — and the first in the Houston area — to offer the treatment.

Ortiz was intrigued. "They're essentially doing surgery through ultrasound on a specific part of your thalamus that's responsible for the tremors. I liked the idea that nothing had to be cut, and nothing had to be put in my brain."

Dr. Faraji describes the process: "With focused ultrasound, patients come into the procedure suite, into the MRI scanner. Their head is shaved completely. We place a water bath on the head. And through different sound elements, we can transmit sound waves into the brain through the skull to a precise target. The patient is awake through the entire procedure."

The real-time feedback during the procedure is key. "We are able to get real time feedback in terms of their tremor benefit, whether there are side effects, if they have any speech slurring, or tingling sensations," Dr. Faraji says. "We do whatever we can to minimize those effects during the procedure so that when they leave the MRI suite, they're left with just optimal tremor control."

For Ortiz, the results were immediate. "I had a little headache from the procedure and everything, but overall I was in shock that my essential tremors were gone. You know, when I'm doing work, I click on what I want once, not multiple times. I can again eat with a fork or chopsticks or have soup. It's huge."

The treatment offers a new option for patients who may not be candidates for traditional surgery.

"Focused ultrasound can be applied to patients that can't undergo an open procedure, such as deep brain stimulation, or they do not want to have an implanted device, such as electrodes, in the brain, or a battery under the skin," says Dr. Faraji. "By having this program in place, we're able to increase access to patients that would otherwise not pursue treatment for their essential tremor, or tremor-dominant Parkinson's disease."

For Ortiz, the impact has been profound.

"It's amazing," he says. "It's done in a couple of hours, and the results are life changing. It's been life changing to me."