Tuesday, May 5, 2009

Health Care and Paralysis

According to the Center for Disease Control (CDC) as reported by ThirdAge.com, roughly one in 50 Americans has some degree of paralysis, and five times more people than doctors thought are living with a spinal-cord injury -- nearly 1.3 million -- says a startling new study. It's a largely hidden population that neither the government nor medical organizations had ever attempted to fully count, and the findings promise to help health authorities understand the scope of need. The report found that overall, almost 5.6 million people have some degree of paralysis due to a variety of neurologic problems. Stroke and spinal-cord injury are the leading causes, but they also include multiple sclerosis, brain injuries, birth defects, surgical complications and a list of other ailments. That's about 30% higher than previous estimates. But for spinal-cord injury alone, previous estimates were woeful -- suggesting just a quarter million people were living with the trauma, a count that mostly included people like the late actor Christopher Reeve, who wound up at specialty treatment centers.

According to the National Institute of Health (NIH), paralysis is the loss of muscle function in part of your body. It happens when something goes wrong with the way messages pass between your brain and muscles. Paralysis can be complete or partial. It can occur on one or both sides of your body. It can also occur in just one area, or it can be widespread. Paralysis of the lower half of your body, including both legs, is called paraplegia. Paralysis of the arms and legs is quadriplegia. Most paralysis is due to strokes or injuries such as spinal cord injury or a broken neck. Other causes of paralysis include:
--Nerve diseases such as amyotrophic lateral sclerosis.
--Autoimmune diseases such as Guillain-Barre syndrome.
--Bell's palsy, which affects muscles in the face.

Sudden loss of muscle function is a medical emergency, according to the NIH. Seek immediate medical help. After you have received medical treatment, your doctor may recommend some of the following measures:
--Follow your prescribed therapy.
--If the nerves to your face or head are damaged, you may have difficulty chewing and swallowing or closing your eyes. In these cases, a soft diet may be recommended. You will also need some form of eye protection, such as a patch over the eye while you are asleep.
--Long-term immobility can cause serious complications. Change positions often and take care of your skin. Range-of-motion exercises may help to maintain some muscle tone.
--Splints may help prevent muscle contractures, a condition in which a muscle becomes permanently shortened.

The chain of nerve cells that runs from the brain through the spinal cord out to the muscle is called the motor pathway, according to Answers.com. Normal muscle function requires intact connections all along this motor pathway. Damage at any point reduces the brain's ability to control the muscle's movements. This reduced efficiency causes weakness, also called paresis. Complete loss of communication prevents any willed movement at all. This lack of control is called paralysis. Certain inherited abnormalities in muscle cause periodic paralysis, in which the weakness comes and goes. The line between weakness and paralysis is not absolute. A condition causing weakness may progress to paralysis. On the other hand, strength may be restored to a paralyzed limb. Nerve regeneration or regrowth is one way in which strength can return to a paralyzed muscle. Paralysis almost always causes a change in muscle tone. Paralyzed muscle may be flaccid, flabby, and without appreciable tone, or it may be spastic, tight, and with abnormally high tone that increases when the muscle is moved. Paralysis may affect an individual muscle, but it usually affects an entire body region. The distribution of weakness is an important clue to the location of the nerve damage that is causing the paralysis. Words describing the distribution of paralysis use the suffix "-plegia," from the Greek word for "stroke."

Until recently spinal cord injuries were thought to be incurable, according to the Bryon Reisch Paralysis Foundation. Now the question is no longer is a cure probable, but when is it possible. Scientists and researchers alike have made great strides in the past years. However, for the hundreds of thousands of people suffering from paralysis a cure cannot come soon enough. While costs of taking care of these individuals continue to spiral upwards, research continues to be hard to establish. The current annual cost of injuries are close to $10 billion while the current research investment is less than $100 million from all sources - federal industry, foundations and private donations. Today, advances are happening faster than ever from therapeutic vaccines to axonal regeneration, stem cell transplantation to exercise and treadmill studies. All of these move the scientific community closer to finding a cure for paralysis.

According to MedicalNewsToday.com, researchers found in the recent survey, sponsored by the CDC and the Christopher and Dana Reeve Foundation, that 29% of affected Americans became paralyzed or partly paralyzed after a stroke, and 23% as a result of spinal cord injuries. About 50% of the respondents who were subsequently included in the paralysis group reported having a lot of difficulty moving or were completely paralyzed. While the leading cause of spinal cord injuries appeared to be due to motor vehicle accidents, about 7% of respondents who reported that they became paralyzed from an accident or injury said it happened while they were serving in the armed forces. Another surprising result was the estimate of people living with multiple sclerosis is estimated to be around 939,000 Americans. The annual household income of most of the respondents in the paralysis group was less than 30,000 dollars, while for a quarter of them it was under 10,000 dollars, a figure which compares with only 7% of the US population as a whole. Paralysis often leads to job loss; and because often the spouses become the main caregiver, they may also lose their job and any associated health insurance, while treatment that might improve movement and independence is costly. It is also estimated that the average number of years people have been living with their paralysis is about 16, a figure that believe is rising as patients are living longer.

How much of the body is affected depends on the site of the neurological damage, according to MedicineNet.com. Strokes, brain tumors, etc. classically cause such extensive loss of function. In instances of inflammation of nervous tissue such as occurs in polio, specific nerve cells are damaged leading to paralysis and muscle wasting. Various diseases that affect muscle tissue are encountered much less often that those that affect nervous tissue. These are often hereditary, and due to a disturbance of muscle metabolism. Most cases of paralysis of muscular origin, therefore, usually begin early in life. However, other diseases can occur at any time of life, such as myasthenia gravis. Toxins such as alcohol can also affect muscle tissue, as well as abnormalities of hormonal production. The diagnosis of the cause of neuromuscular paralysis is made by careful evaluation of the nervous system, and the use of ancillary tests.

The evaluation of muscle loss given by a primary care doctor may prove to be invaluable if you can get a diagnosis quickly after experiencing symptoms causing paralysis. If the medical trauma happens suddenly, getting to a critical care facility or a hospital emergency room is imperative after dialing 911 to seek immediate treatment. Paralysis may be caused by a variety of reasons, but it is up to you to get help right away if you have any problems caused by a sudden loss of muscle control. Getting to a medical provider should be a priority if you experience any signs of paralysis, regardless of the severity.

Until next time. Let me know what you think.

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