Amyotrophic lateral sclerosis, or ALS, is a progressive disease that affects the nerve cells responsible for muscle movement. A small percentage of ALS cases are inherited, but at least 90 percent of the time no cause is identified, explains MayoClinic.com. Initial symptoms are mild, including muscular weakness or twitching, or a minor change in speech. Late stage symptoms of this terminal illness are more severe.
Muscular Paralysis
The voluntary muscles progressively weaken during ALS, also called Lou Gehrig's disease. This occurs because the motor nerves can no longer correctly send messages to the muscles to move; they begin to weaken due to lack of use, and waste away, eventually becoming paralyzed as the messages stop altogether. Typically, the muscles in the feet or hands are initially affected, with the legs and arms progressively affected over time. An assistive device such as a cane or walker may help the patient remain independent for as long as possible. A physical therapist can help the patient maintain his muscular strength longer. Eventually, a wheelchair and full assistance is needed for movement.
Loss of Speech
Early in the disease process, ALS sufferers may slur words as they speak. This is due to the nerve impulses failing to control the muscles of speech. The problem may progressively worsen until it is difficult for others to understand what the patient is trying to say. MayoClinic.com indicates that a speech therapist can help by teaching the patient new speaking techniques. As the disease progresses, a computer or speech synthesizer may be needed for communication. Eventually, the sufferer may become unable to speak at all.
Chewing and Swallowing Difficulties
Late-stage ALS affects the nerves that direct the muscles responsible for chewing food. Swallowing also becomes difficult and, eventually, impossible. These problems can lead to malnutrition and dehydration. Food, fluid or saliva can also be aspirated into the lungs, causing pneumonia and other lung problems. A speech therapist may be able to help promote chewing and swallowing for as long as possible by teaching caregivers the appropriate foods and beverages to serve, and safer ways to feed the patient. A feeding tube is eventually needed to maintain nutrition.
Difficulty Breathing
Late-stage Lou Gehrig's disease affects the nerves controlling the muscles of the chest wall and diaphragm that affect breathing. This causes the patient to feel short of breath due to his inability to take full breaths. As the muscles become progressively paralyzed, the assistance of a ventilator is needed, relates the National Institute of Neurological Disorders and Stroke. Medical personnel usually monitor ventilator use, but family members can also be trained to use the equipment. Ventilator patients may be hospitalized, admitted into a skilled nursing facility, or allowed to remain at home.
References
- "Medical-Surgical Nursing"; Donna Ignatavicius, M.S., R.N. and Linda Workman, Ph.D., R.N.; 2002
- ALS Association: Initial Symptoms of the Disease
- National Institute of Neurological Disorders and Stroke: Amyotrophic Lateral Sclerosis Information Page
- MayoClinic.com: Amyotrophic Lateral Sclerosis
- University of California at San Fransisco Medical Center: Lou Gehrig's Disease
