- Tina Pascual
- Jul 27, 2020
- 4 min read
Updated: Aug 31, 2020
*from the story of the red tin bucket (see link below)
PREFACE/PROLOGUE
The plant from the red tin bucket had passed away. Perhaps, the earth is not its ideal environment. But of course I refuse to believe that. Now, the red tin bucket still refreshes my memory of that life we once experienced in Mars where its altered gravity needing no muscles to work.
Repurposing the red tin bucket full of iced water reminds me of the famous Ice Bucket Challenge that went viral some time around 2014. Although it was done half for fun by many, the ALS Association in the U.S. had started it all to raise awareness and funds for advance research.
Being an Asian nurse, I never encountered patients with ALS as it is more common with Caucasians. But because it is uncommon for us doesn't mean we are spared. Thus, we cannot take this condition for granted. Mostly, many have fewer understanding about the case. Since it is more wiser to be aware, here’s a background of ALS:
ALS or Amyotrophic Lateral Sclerosis, is also known as Lou Gehrig Disease (named after the famous American baseball player from New York Yankees who died because of it in 1941).
ALS is defined as a progressive, degenerative diseases of the nervous system. It affects the nerve cells, specifically, the motor neurons which innervate the skeletal muscles. Therefore, making us unable to move or control our body.
The cause of motor neurons destruction is unknown but to a very few cases, it was inherited. The average risky age is 55 and is more common in men. People who will acquire this disease is 5 in 100,000 around the world*.
The first manifestation of the disease is having excessive cramps, stiffness, twitching and weakness of the muscles which are experienced first in the hand. It may usually be painless and felt on one side of the body.
As the disease progress to other voluntary muscles, there will be atrophy (muscle wasting or loss of muscles). Thus, contributing to severe tiredness, weight loss and paralysis.
The weakening of facial and throat muscles may cause difficulty in swallowing, speaking and drooling. Eventually, the breathing muscles will get affected, leading to difficulty of breathing.
People with ALS may also exhibit inappropriate reactions such as crying or laughing since they may lose the ability to control their emotions.
Fortunately, the cognitive process such as logical thinking and intelligence, the senses such as smell and touch and the involuntary muscles activity of the heart, bladder, etc. remains normal.
ALS may spread rapidly. About 50% die within 3 years from the onset of first symptoms and averagely10 years for the others. Few, lived up to 30 years**. Usually, respiratory failure or pulmonary infection is the cause of death.
Since muscle weakness had many causes, it is always advisable to consult the doctor. Signs and symptoms are generally analysed by the doctor according to how and when it started and as well as the changes. Also, they may order MRI (Magnetic Resonance Imaging) of the brain and sometimes including the spinal cord. They will as well do a nerve conduction study and perform electromyography (stimulating the muscles and recording their electrical activity) to determine wether the problem is caused by the nerve or the muscle. It measures how fast the nerves transmit impulses. Blood test are also ordered to confirm if it is just caused by other diseases.
Sadly, there is no specific treatment or cure for ALS. That is why a massive campaign for awareness to fund in-depth research and studies are pushed through. Hoping to at least effectively manage - if not to exterminate the disease.
As of this date, to try to extend the progress ALS, the doctor may give Riluzole drug. It will protect and prolong the life of the nerve cells. Other medicines include Baclofen to help with the spasm and Phenytoin or Quinine to decrease cramps. To decrease saliva, anticholinergics are given.
Multidisciplinary care should be provided. Family is also encouraged to give support to help our patient cope with the disease. Physical therapy may also help to maintain muscle and prevent it from shortening. Assistance is also required in movement such as when sitting, dressing up, walking, etc. to avoid fall and accidents. Aid must also be provided while they eat as they are prone to choking. Some fed through NGT (naso-gastric tube) which is inserted from the nose to the stomach.
*data is as of 2010 in the book of
Family Guide to Health. Kindly refer
below. Also check ALS.org for latest
findings.
**data from Home Health Handbook.
Kindly refer below.
SOURCES:
1. Harvard Medical School Family Health Guide, by President and Fellow of Harvard College with Anthony L. Komaroff, M.D. as Editor-in-Chief, United States of America 1999, p363
2. Family Guide to Health, Created and Produced by QA International Montreal with Martine Podesto as the Editorial Director, Quebec Canada 2010, p163
3. The Merck Manual, Robert S. Porter, M.D. as Editor-in-Chief, New Jersey USA 2009, p815-17
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