Spinal cord injury can have profound effects on breathing. Some individuals must rely on a mechanical ventilator for the long term, and this need for a ventilator twenty-four hours a day can be a tremendous burden, because the ventilator must be kept available and in working order at all times.Some people have sufficient strength in their breathing muscles to manage without the ventilator for short periods of time, and other devices can sometimes be used to extend this period off the ventilator. One such device is the implantable phrenic nerve stimulator. If the phrenic nerve is undamaged, stimulating the nerve electrically causes the diaphragm to contract. By careful control of the stimulation, the diaphragm can contract with enough strength to fill the lungs with air, as in normal breathing.An electrical stimulator can sometimes be implanted in the body surgically. Its stimulation of the phrenic nerves then produces artificial breathing. This technique has several problems, however. First, it can be used only with certain types of spinal cord injury. Second, it rarely works full-time; rather, it provides part-time relief from the mechanical ventilator. Third, its effectiveness may be only temporary, slowly decreasing over several years as scarring develops around the nerve, making it resistant to stimulation. Fourth, the device may fail unexpectedly, so a mechanical ventilator must be available in case of emergency. This greatly reduces the benefit of the phrenic nerve stimulator: a primary reason for developing this device was to avoid the inconvenience of keeping a mechanical ventilator available at all times. Still, the potential benefits of artificial breathing are great, and several laboratories are working on methods to increase the effectiveness and reliability of the electrical stimulator.An additional problem with breathing after spinal cord injury is weakness of the muscles of expiration (breathing out). The key muscles of expiration are the abdominal and chest muscles, which get their nerve supply from the thoracic levels of the spinal cord. Anyone with a spinal cord lesion above T2 is likely to have some weakness of expiration, even if the diaphragm is working well. Breathing is certainly possible without expiratory muscles, but we need these muscles to exhale forcefully, to shout, and most importantly, to cough. Coughing is essential for keeping the lungs clear and preventing infection, especially pneumonia. Patients with cervical spinal cord injury are highly vulnerable to respiratory tract infections because they cannot cough.”Quad coughing” is a very effective method of clearing the lungs, but it requires another individual’s assistance. Although no method is yet available for a person with quadriplegia to cough effectively without assistance, researchers are working on several methods for independent artificial coughing. The first is a mechanical method, such as a specially made body jacket that squeezes the abdomen and chest to help generate a cough. The second method is electrical stimulation of the expiratory muscles, causing muscle contraction and forcing air out of the chest. These methods for independent artificial coughing are not yet available for clinical use.Another method for artificial coughing uses a mechanical device that has air pumps for exsufflation and insufflation. The device first blows air into the lungs (exsufflation), and then forcefully sucks it out of the lungs (insufflation) at high velocity. Some patients can learn to use this device for independent artificial coughing. Further research is needed to determine whether this is more effective at clearing the lungs than routine quad coughing.
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It’s important for you to decide what is really most important for your child. Maybe it is the seizures. But maybe it isn’t. For some children the problems of mental retardation are far more important than the seizures themselves. For some children with cerebral palsy, mobility may be the principal problem. For parents of these children, UCP or the local ARC may provide the most important resources. If seizures are the central problem you may need to educate these organizations about epilepsy and about the special needs of children who have recurring seizures.For children whose seizures are the dominant disability and mental retardation, for example, is of lower priority, at least for now, parents have often had difficulty finding help. There has been a gap in support services for the multiple handicapped child who also has seizures. Fortunately, the Epilepsy Foundation of America has recognized this need and, as part of its recommitment to serving all families, is in the process of developing new programs to meet this need.The medical community also has failed to serve this population well. Developmental pediatricians trained to help manage the multiple problems of the disabled child and to help families find needed services frequently havs less expertise in epilepsy than other conditions. Further, neurologists or epileptologists who do specialize in treating children’s seizures often have inadequate expertise in managing family problems and in finding services. We need to develop better one-stop shopping for this comprehensive care. But until we do parents of a multi-handicapped child must continue to advocate and seek services with persistence and determination.*208\208\8*
Diabetes mellitusThe normal levels of blood sugar in a fasting person are between 80-120 mg %. If the fasting level of blood sugar is more than 110 mg%, or after meals more than 160 mg%, it is called diabetes or high blood sugar. In diabetic patients, sugar can be detected in the urine also. Diabetic patients have a higher chance of developing coronary blockages. They are also prone to several other diseases like kidney damage, as well as damage to the nerves and eyes. Patients with diabetes are usually obese, have high blood pressure and high blood cholesterol levels, all responsible for blockages. Heart attacks may occur at a younger age in severe diabetics. The symptoms of diabetes are increased thirst, increased urination and weight loss, but in some cases there may be no symptoms at all. It is important for heart patients to control diabetes.
Obesity or overweightIf the weight of a person is more than the upper limit of weight for that age and sex, he is called obese or a fat person. People who eat excess fat and do not do exercise put on weight. There are standard charts available from which one can find out whether one is overweight or obese. Obese individuals have greater chances of getting heart diseases. They have increased chances of having high blood pressure and diabetes and thereby blockages. Obesity can be prevented by eating low caloric food, avoiding fats, avoiding excess sugar, and doing physical exercise regularly. Fat people remain inactive and are also made fun of sometimes. Therefore, they tend to develop excessive mental tensions resulting in hypertension and heart attacks. The chances of getting a heart attack increases by 15 times for obese people as compared to lean and thin individuals. *15/283/5*