Paralysis Resource Guide - (Page 4) CONDITIONS damage already done to motor neurons, and people taking the drug must be monitored for liver damage and other possible side effects. Because of its expense and limited efficacy, riluzole is not always considered by people who could benefit by using it. Aventis Pharmaceuticals offers a patient assistance program that helps qualified patients receive the drug without charge. Many private health plans cover the cost of Riluzole. ALS experts have identified at least 20 compounds that show promise for treating the disease. Several drugs are currently being tested in patients. See www.clinicaltrials.gov. Physical or occupational therapy and special equipment can enhance independence and safety throughout the course of ALS. Low-impact aerobic exercise such as walking, swimming and stationary bicycling can strengthen unaffected muscles, prevent deconditioning, improve cardiovascular health, and help patients fight fatigue and depression. Range-of-motion and stretching exercises can help prevent painful spasticity and muscle contractures. Occupational therapists can suggest devices such as ramps, braces, walkers and wheelchairs that help people conserve energy and remain mobile, while making it easier to perform activities of daily living. Respiratory weakness: People with ALS are at risk for pneumonia and pulmonary embolism. Indicators of deteriorating respiratory status can include difficulty breathing, especially when lying down or after meals; lethargy; drowsiness; confusion; anxiety; irritability; loss of appetite; fatigue; morning headaches and depression. When the muscles that assist in breathing weaken, use of ventilatory assistance (intermittent positive pressure ventilation, IPPV; or bi-level positive airway pressure, BiPAP) may be used to aid breathing during sleep. When muscles are no longer able to maintain oxygen and carbon dioxide levels, these devices may be used full-time. Another problem common to many people with ALS is the inability to cough strongly enough to clear away even normal amounts of mucus. People are advised to make sure their fluid intake is sufficient to keep the secretions thin; some take an over-the-counter cough medicine containing the expectorant guaifenesin, a mucus thinner. A weak cough can be made more 4 http://www.clinicaltrials.gov
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