Paralysis Resource Guide - (Page 5) CONDITIONS effective by quad coughing (assisting a cough by applying a sort of Heimlich-like maneuver as the patient coughs), supplying fuller breaths with an ambu-bag to improve the cough, or using a devise such as a “cofflator” or “In-Exsufflator” (delivers deep breaths through a mask and then quickly reverses to negative pressure to simulate a cough). Drooling: While people with ALS do not overproduce saliva, their swallowing problems can create sialorrhea, the term for excess salivation and drooling. Sialorrhea can be under-treated—it may take trials of several medications until one provides relief without undesirable side effects. Muscle problems: Spasticity is present in some people with ALS. It causes a tightening of muscles and a stiffening of the arms, legs, back, abdomen or neck. It can be triggered by a simple touch and can be painful especially if it sets off muscle cramps, common in ALS because of muscle fatigue. Cramps can be very painful but become less severe with time—weakening muscles can’t tighten into a cramp anymore. Fasciculation (muscle twitching) is common, too, though they aren’t painful so much as annoying. Loss of communication: While the loss of the ability to communicate is not life-threatening or painful, being “lockedin” is a devastating, extremely frustrating aspect of ALS. Although assistive technology offers many solutions, it may be underutilized because people lack information about what is available. Equipment is available to magnify a weak whisper into audible speech. As long as a person can move nearly any body part there is potential for some basic communication. Numerous communication devices are on the market and can be found in many home health dealers or at Internet shopping sites. See www.ALSA.org for a list of products and vendors. These devices range from simple call buttons and sensitive switches to small communication boards that speak pre-recorded words and messages. In experiments using brain waves, people who are locked in due to ALS have learned to communicate by way of a computer using only their thoughts. Using a headband sensor, Brainfingers is a brain-actuated hands-free mouse that enables 5 http://www.ALSA.org
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