A Dreaded Opponent: The Impact of Lou Gehrig’s Disease

by Wellness Editor – MH

It is easy to think that chronic diseases only tend to afflict those who are exceptionally unhealthy or are of an advanced age. In fact, serious medical conditions can strike people who are in otherwise excellent health. Steve Gleason, a former professional football player for the NFL’s New Orleans Saints, announced in 2011 that he was locked in a terminal struggle with amyotrophic lateral sclerosis (ALS), known commonly as Lou Gehrig’s Disease. Decades after it initially grabbed the public’s attention, medical science has yet to find a cure for ALS. Though ALS is a terminal disease, a patient’s remaining years can be made less onerous through proper medical care.

A Mysterious Illness

The many problems caused by ALS occur after the body’s motor neurons start to weaken, becoming increasingly feeble before being destroyed entirely. Despite years of research, doctors still do not have a concrete answer as to why these motor neurons start to die off. To explain this phenomenon, a number of theories have been proposed, some of which are detailed below:

  • The body’s own immune system mistakes its own motor neurons as enemy invaders, and proceeds to launch a prolonged assault on them until they are destroyed
  • Toxic chemicals or certain viruses enter the patient’s body
  • A lack of nutrition from the patient’s diet
  • Doctors have noticed that some ALS patients have elevated levels of glutamate in their spinal fluid, which acts as insulation for both the spine and brain. Research has found that excessive amounts of glutamate can be very damaging to nerve cells.
  • In about 10 percent of diagnoses, the patient inherits ALS from his or her parents. In these patients, ALS symptoms occur after certain genes mutate. Because hereditary ALS closely mimics non-hereditary ALS, some researchers have speculated that ALS might be attributed to genetic mutations.

The Progression of ALS Symptoms

The destruction of the motor neurons has severe consequences for the body, as these cells are responsible for all of your voluntary movements. In other words, you could not consciously move your arms, legs, head or any other body parts without functioning muscle neurons. The development of ALS symptoms depends on which type of motor neurons is first affected by the disease. Damaged lower motor neurons, which link the brainstem and spinal cord to muscle fibers, lead to problems in specific parts of the body, such as the hands and feet. If the upper motor neurons bear the initial burnt of the ALS onslaught, a patient must usually contend with clumsy movements, difficulty swallowing and a tendency to slur words.

As the disease takes hold and increases in severity, the patient loses more and more control of his or her motor skills. In addition to growing problems with swallowing, talking and awkward movements, ALS sufferers are also stricken with muscle twitches, cramps, arm and leg fatigue and uncontrollable fits of laughing and crying. With the patient unable to exercise or even move normally, the body’s muscles slip into a permanent state of decline, and the patient’s bodyweight plunges precipitously. The loss of motor neurons also impacts the body’s reflexes, which begin act in an unpredictable and exaggerated manner.

As the body approaches a state of total paralysis, the patient loses the ability to breathe without the aid of a ventilator. In its advanced stages, ALS effectively cripples the muscles of the cardiovascular system, rendering the body highly vulnerable to lung failure, heart failure and blockages in the lung’s arteries known as pulmonary embolisms. Many ALS patients, unable to properly swallow, contract pneumonia after food and fluids accumulate inside their lungs. It is the development of these complications that cause the bulk of ALS-related deaths.

Treatment

ALS sufferers face an exceedingly grim prognosis; only 5% of patients live longer than 10 years after being diagnosed with this debilitating malady. Most people live about 3 to 5 years before succumbing to ALS. Though there is no cure for ALS and premature death is all but guaranteed, doctors can slow the progression of the disease with certain treatment methods.

Riluzole – To date, the only medication approved by the US Food and Drug Administration for ALS is riluzole, which is sold under the brand name Rilutek. Riluzole is taken in tablet form. While this drug does appear to offer some relief to ALS patients, doctors are still not sure how it actually does so. Side effects include muscle cramps, constipation, fatigue and excessive saliva and phlegm.

Physical Therapy – Physical therapy for ALS involves performing a number of low-impact exercises, which helps patients maintain their muscle strength, cardiovascular system and overall range of motion for a longer period of time.

Occupational TherapyWith the loss of motor skills and bodily strength, ALS patients must rely on braces, walkers and wheelchairs in order to navigate their homes. Occupational therapy helps patients adjust to using such devices.

Speech Therapy – People with ALS are often unable to speak without slurring noticeably. Speech therapy enables patients to learn new techniques for talking coherently. If the patient is no longer able to speak, a speech therapist can teach the patient how to use alternative forms of communication, including alphabet boards and speech synthesizers.

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