Thursday, June 26, 2008

ALS & Reflexology

Amyotrophic lateral sclerosis (ALS), often referred to as "Lou Gehrig's disease," is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. Motor neurons reach from the brain to the spinal cord and from the spinal cord to the muscles throughout the body. The progressive degeneration of the motor neurons in ALS eventually lead to their death. When the motor neurons die, the ability of the brain to initiate and control muscle movement is lost. With voluntary muscle action progressively affected, patients in the later stages of the disease may become totally paralyzed. Yet, through it all, for the vast majority of people, their minds remain unaffected.
A-myo-trophic comes from the Greek language. "A" means no or negative. "Myo" refers to muscle, and "Trophic" means nourishment---"No muscle nourishment." When a muscle has no nourishment, it "atrophies" or wastes away. "Lateral" identifies the areas in a person's spinal cord where portions of the nerve cells that signal and control the muscles are located. As this area degenerates it leads to scarring or hardening ("sclerosis") in the region.
As motor neurons degenerate, they can no longer send impulses to the muscle fibers that normally result in muscle movement. Early symptoms of ALS often include increasing muscle weakness, especially involving the arms and legs, speech, swallowing or breathing. When muscles no longer receive the messages from the motor neurons that they require to function, the muscles begin to atrophy (become smaller). Limbs begin to look "thinner" as muscle tissue atrophies.
What Types of Nerves Make Your Body Work Properly?
The body has many kinds of nerves. There are those involved in the process of thinking, memory, and of detecting sensations (such as hot/cold, sharp/dull), and others for vision, hearing, and other bodily functions. The nerves that are affected when you have ALS are the motor neurons that provide voluntary movements and muscle power. Examples of voluntary movements are your making the effort to reach for the phone or step off a curb; these actions are controlled by the muscles in the arms and legs.
The heart and the digestive system are also made of muscle but a different kind, and their movements are not under voluntary control. When your heart beats or a meal is digested, it all happens automatically. Therefore, the heart and digestive system are not involved in ALS. Breathing also may seem to be involuntary. Remember, though, while you cannot stop your heart, you can hold your breath - so be aware that ALS may eventually have an impact on breathing.
Although the cause of ALS is not completely understood, the recent years have brought a wealth of new scientific understanding regarding the physiology of this disease.
While there is not a cure or treatment today that halts or reverses ALS, there is one FDA approved drug, Rilutek®, that modestly slows the progression of ALS as well as several other drugs in clinical trials that hold promise. Importantly, there are significant devise and therapies that can manage the symptoms of ALS that help people maintain as much independence as possible and prolong survival. It is important to remember that ALS is a quite variable disease; no two people will have the same journey or experiences. There are medically documented cases of people in whom ALS ‘burns out,’ stops progressing or progresses at a very slow rate.
No matter what your individual course or situation may be, The ALS Association is here to help.
I and another ARCB certified colleague, Lynda Byrne, worked with Barbara, in her early 60's, with ALS for a total of 4 years. She initially came to me with the symptom of foot drop -- weakness in one foot. The cause was a puzzle to the neurologist for more than a year, when she developed weakness in one hand. At that point ALS was suspected and finally diagnosed.
ALS, amyotrophic lateral sclerosis, or Lou Gehrig's Disease, is a degenerative disease of the nervous system with no known cause or treatment. It affects the motor neurons, beginning with weakness and atrophy of the hands, forearms, legs and feet, and then the face, muscles of respiration and the rest of the body. It is the disease written about in the book, Tuesdays with Morrie.
Reflexology did not restore use of Barbara's foot, but she felt energized and uplifted by it. With the hope that it might slow the progression of this degenerative neurological disease and help her to maintain, we continued weekly sessions. The symptoms progressed to include weakness and eventually loss of use of both feet and legs, and weakness in first one hand, then the other.
I began with foot reflexology once a week, then increased to twice a week hand and foot sessions when her hands began to show weakness and the diagnosis of ALS was made. At this point, Lynda treated her while I was away on vacation. When I returned, we each continued seeing her once a week. We work differently -- I use the Laura Norman method and Lynda does the Ingham method, and we both included energy work -- and I think that was helpful for Barbara. I work with affirmations, and always included a heartfelt prayer for trust that there was meaning and purpose in this experience for all of us.
I think it was helpful for each of us to see her only once a week -- it is intense emotionally to work with someone you have come to love, and see her slowly losing ground. I'm grateful that Lynda was available and interested in working with this client.
Barbara also received acupuncture twice a week and "as needed" psychotherapy for 3 years with my husband Jim, who is both a licensed acupuncturist and clinical psychologist. She had retirement income, and the good fortune to be able to pay for all of it, as well as physical therapy, and most recently, water therapy. She passed on last week, surprisingly quickly and easily. She never reached the dreaded stage of struggling for breath and being incontinent. She was blessed with a strong support system -- her loving, dedicated (and exhausted) husband and many, many friends, an active social life, and strong faith. Her mood was almost always cheerful, and we all agreed that it was as good as it could have been.
We believe that our work with Barbara made a huge difference for her, and she and her husband fully agreed.

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