Dr. Chal Nunn, Post-Op

Local doctor uses deep brain stimulator as treatment for Parkinson’s

By Shannon Kelly

Since Chalmers Nunn was diagnosed with Parkinson’s Disease in 2017, the doctor, former hospital administrator, and leadership coach has undergone multiple surgeries, medical consultations, medication, and other therapies targeted toward alleviating at least some of the symptoms as he learns to navigate life with the condition.

Last May, we shared the story of Dr. Chalmers "Chal" Nunn—his life, his dedication to the Greater Lynchburg community, and his recognition with a Humanitarian Award from the Virginia Center for Inclusive Communities. At the time, he noted that while it was not a sure thing, he was a likely candidate for deep brain stimulation therapy, a procedure he hoped would help manage the challenges of Parkinson’s disease. Sure enough, he was chosen for the surgery. Now, months after undergoing the procedure, Nunn continues to adjust to life with the device, remaining committed to sharing his journey with others.

Last autumn, Nunn underwent procedures for deep brain stimulation, a surgery which implants electrodes in the brain through which electrical impulses are sent to provide targeted treatment to mitigate, if not cure, symptoms of certain conditions, including some cases of Parkinson’s.

The diagnosis of Parkinson’s changed Nunn’s life in many ways and presented many challenges. Although he is not one to give up, Nunn never pretended the journey had not been difficult. He has openly shared his story, in hopes that it might help others.

After thorough evaluation, Nunn was thought of as a candidate for deep brain stimulation.

Prior to the surgery in August of last year, Nunn said he was losing too much weight, mostly due to a restricted diet - he cannot have too much protein, or it plunges him to a severe low with the Parkinson’s, he said - and he experienced involuntary shaking, as well as voice issues, and chronic pain, along with severe highs and lows wrought by the disease. The side effects of his medication, which was not incredibly effective to begin with, also diminished quality of life in certain ways. Cognitively, Nunn said he has continually tested well; the physical challenges associated with Parkinson’s are the big issue.

After years of seeing specialists and enduring several surgeries - most related to Parkinson's and associated pain - a more intensive treatment was looked for.

On Aug. 28 of 2024, the day before his wife’s birthday, Nunn underwent surgery to get the deep brain stimulator implanted. A team of 12 conducted the procedure, using both their own hands, and robotic instruments.

“I was most impressed with the commitment to one patient all the people had. It just was heartwarming to me,” he said.

The deep brain stimulation device has wires that run from a generator in his chest, deep into Nunn’s brain. Constant electrical pulses are sent through these wires, signaling to the brain. Like a pacemaker, the device must be fine-tuned over time to suit the individual patient. Nunn is still tweaking the deep brain stimulator to better meet his needs. He can control and check the device through a smartphone. 

“I have an electric current running through me at all times,” Nunn said. 

The entire process was not completed in one surgery. After having the wires implanted deep in his brain, Nunn had to recover sufficiently from that procedure before the next step. He spent a sleepless night in the Intensive Care Unit, suffering from a headache, hyperness, and acute awareness of the noise in the hospital following the first surgery.

“You go back a week later, they put in this chest thing, and that hurts like the devil. Then you have to wait six to eight weeks before they turn it on,” he said. “I feel like the finish line kept being pushed further ahead. You have to wait for it to heal.” 

Although Nunn said he had hoped for a better outcome - perfection is always the hope - the surgery was successful in some ways. Chiefly, the device stopped his dyskinesia - the uncontrollable “wiggling,” as he described it, that resulted from Parkinson’s. If the device is on and firing those electrical signals, Nunn does not shake. Nunn said he also feels deep brain stimulation has blunted the highs and lows characteristic of Parkinson’s, though he still must watch for diet triggers.

At the same time, the procedure was not without its side effects. The stimulation to the brain caused Nunn to speak too fast, and not clearly enough to be well understood, he said. 

“My voice is already bad, but it really screwed that up,” Nunn said.

He has been working with a speech therapist and reads poetry and other passages aloud to practice cadence and volume. 

The challenges from Parkinson’s lead to frustration in socializing, work, and everyday function, particularly in terms of communication. 

“The pace of what I do, it screws up my pace. So, my cognitive function is good. My ability to communicate is not good,” Nunn said. 

This contributes to a sense of isolation, and even loss of identity. One of Nunn’s passions and long-time area of work is teaching, specifically teaching leadership skills and practices. He said he was always good at engaging with people and was always one to speak up even to the point of being a “contrarian,” but now it is getting harder to connect effectively with others - something Nunn never struggled with before. 

“All the connection skills I had are being challenged,” he said.

Nunn’s biggest concern now is that Parkinson’s is causing him to lose his presence. A hovering sense of disconnect is wont to plague him, thanks to the condition. 

“I can’t connect with people. They can’t hear my voice, they can’t understand what I’m saying. And the more I get engaged, the more exciting the topic, the faster I get,” he said. Sometimes, Nunn said he feels like he is yelling, which leads to weariness. 

Communication can be particularly challenging with peers who are getting hard of hearing.

“People my age can’t hear. They can’t hear, and I can’t speak. Put two of us together, we’ve got a problem,” Nunn said.

Another side effect of deep brain stimulation can be crying spells. Nunn experienced some of these as well. In addition to Parkinson’s medication, Nunn was prescribed an antidepressant to help manage chronic pain. He said he is not certain whether this also helps the crying spells.

Overall, Nunn said he believes the effectiveness of deep brain stimulation lies in the art of the programmer who adjusts the device. He is still tweaking it, hoping to hit on the right settings to get the best possible outcomes.

Throughout his journey with Parkinson’s, Nunn, who was a practicing gastroenterologist earlier in his career, said he has learned what it is like to be a patient, as well as the importance - and sometimes frustration - of advocating for oneself with medical professionals. 

“I’ve learned a lot about being a patient. And aging, and chronic disease,” he said.

Nunn’s wife is his biggest support, he said. He is not alone in the journey, not the only one affected by Parkinson’s. 

Despite the challenges, Nunn said he is nowhere near giving up, and he is always looking for treatment options.

“I just don’t give up,” he said. I had a friend of mine who just gave up. He just sat in his chair, and he died within a few years. I’m just not going to let that happen.”