那是2018年的圣诞节早晨，凯伦在厨房里试着做墨西哥玉米卷. 墨西哥早餐是她一直为家人做的传统, but this year it wasn't working. Her hands were shaking so badly that she couldn't fry the eggs. After ruining three or four eggs in a row, her daughter-in-law stepped in and asked if she could help. Karen was devastated.
It might seem like a minor thing to not be able to fry eggs, 但对凯伦来说，这是她多年来患的一种神经系统疾病的高潮 essential tremor that kept getting worse. 这就像是地震慢慢夺走的一长串事情中的最后一根稻草：用勺子喝汤, drinking with just one hand, signing her name on her checks, and favorite hobbies like landscape and wildlife photography.
Karen first noticed the tremor in her 30s. 当时还很轻微，但她知道病情会逐渐恶化. 她看到母亲的颤抖随着年龄的增长而逐渐增加, and her brother had it as well.
特发性震颤中的“特发性”一词意味着医生并不真正知道病因. 然而，它确实倾向于在家庭中遗传，这对凯伦来说是真的. 神经科医生开了一些药物来减缓震颤的进展, which worked for many years.
Then Karen was diagnosed with breast cancer in 2018. She needed surgery, chemotherapy, and radiation. 这种治疗对任何人来说都很难，但对她来说，还有一个额外的障碍.
“化疗使我的颤抖明显加重，”凯伦说. “我什么也写不出来，在那之前我从来没有写不出来过. 我以为化疗结束后它就会消失——这只是一个副作用."
But even post-cancer treatment, the extreme tremor persisted.
“大发娱乐不知道为什么化疗使凯伦的震颤恶化，”医生说. 约翰·罗尔斯顿，犹他健康大学功能神经外科前主任. “任何会给你的大脑带来压力的东西，比如睡眠不足或焦虑，都会使原发性震颤恶化。. Chemotherapy causes extreme levels of distress for your body."
Dr. Rolston works with Dr. Matthew Alexander, 她是大发娱乐放射学和成像科学系以及神经外科的神经介入放射科医生, to perform focused ultrasound procedures.
Karen was desperately looking for solutions. 她服用的药物不起作用了，她开始脱离自己的生活. 她很不好意思和朋友出去，或者在公众场合做任何事情，因为人们会看到她的颤抖，看着她挣扎. 她没有参加与工作相关的旅行和培训，因为她不会做笔记. Within just one year, she was becoming increasingly isolated.
她研究了治疗方案，但对更具侵入性的手术不感兴趣 deep brain stimulation. Eventually, she found information about the focused ultrasound procedure available at U of U Health.
利用聚焦超声改变组织的想法在医学领域并不新鲜, 但这种治疗特发性震颤的方法只出现了三年左右. 研究人员了解到，这种方法可以在大脑中用于这种情况. U of U Health很快成为西部山区唯一一家大发娱乐提供这种微创原发性震颤治疗的医院.
During the procedure, an MRI takes pictures of the brain and sends them to doctors in real-time. The patient wears a helmet to keep their head still while about 1,000个聚焦的超声波束击中大脑中一个小而特定的组织区域. The beams destroy a small area of tissue.
凯伦联系了大发娱乐，安排了一个预约. 看看她是否适合做聚焦超声检查. 她不得不接受几项检查，包括核磁共振成像和CAT扫描，以及平衡测试. When they were done, she learned that she was a good candidate.
Not everyone can benefit from a focused ultrasound procedure. Some people have tremors that the ultrasound won't fix, but Karen was likely to see significant improvement. 她很兴奋，并安排了一到2020年3月.
Then COVID-19 hit and procedures like Karen's were put on hold. 她不得不等了三个多月，但最终改到了7月1日.
When she arrived, 医生提醒她，聚焦超声需要剃掉她的整个头——这是手术的一部分，让一些病人三思而行. For Karen, though, it was nothing new.
"One of the nurses reminded me that I had to have my head shaved, 我说没什么大不了的，因为化疗后我的头发又长回来了," Karen said.
At the beginning of the procedure, 医生让凯伦写下自己的名字，并在一张纸上画了一个螺旋. 在手术过程中，这两项测试要重复多次，以实时评估聚焦超声是否击中了患者大脑中的正确位置.
一旦她用螺钉将头盔固定在头上，他们就把她放进核磁共振管. They sent the first dose of ultrasound into her brain, then pulled her out and did the assessments again. 如果他们能看到她写名字或画螺旋的能力有所提高, they would know it was the right spot. 然后他们增加更多的强度来完全破坏一小部分组织.
这是一种微妙的平衡，需要有聚焦超声手术经验的熟练外科医生.
精确很重要，因为大脑既复杂又敏感. Alexander said. “大发娱乐真的需要在毫米精度内找到正确的位置. 如果大发娱乐稍微偏向一侧，大发娱乐可能会导致虚弱、不稳定和平衡问题."
在多次进入核磁共振管后，凯伦对她的写作能力进行了最后一次评估. 她能完美地写下自己的名字，精准地画出螺旋形.
她只能完成一边——她的右手——因为这是她的惯用手. 目前还没有研究表明在大脑两侧都做这种手术是否安全. But that could change in the next few years, 目前正在进行试验，以确定是否可以对大脑的两侧进行治疗.
“当我第一次（在U of U Health）了解聚焦超声手术时，这听起来就像做梦一样," Karen said. "Now that I had a chance to get the procedure done, 我脑海中不断浮现的一个词就是，这真是个奇迹."