Need ALS/Para Help W/ Family Member

[Just Plain Ruff]

It means that the cord is not fully severed, but the lesion is at a level that effects all four limbs. He may have various combinations of sensation and motor control, most often there is limited ROM in the upper extremities, usually controlled by the chest muscles and very diminished sensation. Most people don't realize that the majority of "quads" aren't anything like Christopher Reeve, rather they push themselves around in wheelchairs.

Akinesia is a loss of normal motor function resulting in impaired muscle movement. ER doc last night described it as freezing in place.

Hypokinesis is just diminished or slow movement.

All this information that has been given to the OP is what this forum is all about. Sharing knowledge and insight as to life issues that we all face.

It sort of overpowers the negativity of many posts.

Even though this situation is not my own, I've learned somethings today.

[uglyEMT]

maverick56 thanks for the info on those two definitions. As far as Christopher Reeves goes, he was my fathers roommate at Kessler when he was there. He was a very brave man and taught me alot about the human spirit and the human condition. In my fathers case it actually was never severed (the spinal cord) he had a blood clot between C3,C4,C5 due to a low speed MVA. When I say low speed I mean he backed into another car in a parking lot!!! One reason I am a PITA at MVAs with getting everyone checked even though there is no significant MOI. The clot put pressure on the cord and apparently the cord never recovered. As far as the limited upper extremity ROM its so true. He always said he would give up his legs over his arms.

Ruff you are so right I also learned alot from the posts. It does help get through some of it. I know it seemed like basic stuff that I was asking for but for some reason I drew blanks. I picked up the event and got the wheels in motion but since then I have been like a space cadet. About the only things that are up there are my ABCs and BSI LOL

FYI for anyone that was wondering, I was on the phone with him when he asked a very general question and it set the bells off for me.... What do you do for heartburn thats lasted all day? My question was have you been sweating? Yes. Difficulty breathing? NO Arm pain? NO Chest Presssure? NO Jaw pain? Yes now that you mention it. Dad get off the phone and put Mom on... Mom give him an asprin and get 911 there NOW. EMS came, he never had LOC, never needed the AED, basically just had the heartburn, sweating and jaw pain. I know we got lucky and there is issues ahead for us but at least we know what to look for as far as the heart goes. I am sure his regular cardiologist will give a complete rundown of what needs to be done and what can be done to prevent future episodes.

Edited June 22, 2010 by UGLyEMT

[DartmouthDave]

Hello,

I can not think of adding anything in reference to the NSTEMI. It has been covered quite well by the previous posters. I suspose, that the normal standard of care for a NSTMI is an angiogram at some other point.

From what you have written about the 'partial quadriplegic'(poor arm ROM and sensation changes)and the MOI (playing hockey)it sounds like a 'incomplete' or 'partial' cord injury. The spinal corad in fact is made up of numerous tracts. One for motor control. One for pain. One for deep sesation (i.e. the pressure one feels on their feet when standing).

There are many types of partial cord injuries. This one sounds like Cental Cord Syndrome (CCS). I have added a couple of wik links about the various cord syndromes.

CCS

ACS (Anterior Cord Syndrome)

Brown-Sequard Syndrome

Best of luck to you and your family.

Cheers...

PS....Pardon any typo. I am firing this off while at work.

[Richard B the EMT]

Did the Doctor in Florida advise your father either way on his safety on a plane flight?

As for a description of what that diagnosis said, I have access, off duty, to our OLMC Doctors. As long as I advise them it is not an active call within our system, and if they are not actively handling an assignment, usually they have been helpful to me. I have even told them I'd be quoting them here, and they said, "No Problem". Hopefully, you have a good relationship with your OLMC Doctors.

(PS: If they are working a call, I just say that I'll try to call back at a less active moment.)

[DwayneEMTP]

[br]Non Q Wave <b>clot </b>is usually <b>non occlusive ...<br>

Sounds like an oxymoron to me, but perhaps I'm misunderstanding the terms 'clot' or 'non occlusive.

Dwayne

fuck it. Tired of trying to figure out the formatting. I've bolded 'clot' and 'non occlusive' but the editor has buggered it up. No other changes made.

Edited June 23, 2010 by DwayneEMTP

[HERBIE1]

Tough to do this long distance. You need a face to face with the doc so he/she cannot brush you off. Get a list of questions, treatment plans, prognosis, efficacy of each, etc. Be armed with as much information as you can. Ask tons of questions, and if you are not satisfied with your answers move up the food chain at the hospital and start asking to speak with supervisors and administrators. No doctor should be ignoring you, and trust me, if you make noise, higher ups WILL pay attention. Just be respectful, objective in your questions, and as tough as it may be try to stay away from name calling and/or personal attacks. Explain your concerns. I promise you will get answers.

Even if you are across country, you can still get answers via the phone. Many hospitals now have patient advocates who's job includes things like this.

Good luck.

[uglyEMT]

Thanks guys.

Well by tonight my Father will be home up here in NJ. They fly out at 5:30 so at least he will be close and his normal cardiologist will be assuming treatment. He is also my cardio so he will actually talk to me. Just keeping the fingers crossed that the flight is uneventful and Dad comes home, tired, but well and we get ontop of this.

I will keep everyone posted...

[Just Plain Ruff]

Thanks guys.

Well by tonight my Father will be home up here in NJ. They fly out at 5:30 so at least he will be close and his normal cardiologist will be assuming treatment. He is also my cardio so he will actually talk to me. Just keeping the fingers crossed that the flight is uneventful and Dad comes home, tired, but well and we get ontop of this.

I will keep everyone posted...

Make sure your father signs a medical release stating that you can be talked to about his condition. Most clinics and doctors offices have that.

Have your father tell the physician and his nurses that you are to be included in the medical talks about him. Once you have that done, you should be good.

If you don't get that done then they can refuse to talk to you about his condition and treatement plans.

[uglyEMT]

He has always included me with my Father so that shouldn't be a problem. Its funny actually, he knows I am an EMT so he rattles off all the medical jargon and I understand most of it, then explains to my Mother and Father in lay terms Hes a great cardiologist, one of the best in the country and has been part of our family for close to 20 years and been my cardiologist for 9 years. We have that nice report going.

Just glad to be getting Dad home right now. Cant wait to see him come out the airport doors

Thanks everyone for your support and comments it means alot to me and my family

[uglyEMT]

Well thankfully Dad is home now They got in late last night do to delays but he looks good. Was clowning around, joking with me, and honestly if I didnt already know what happened I wouldnt have been able to tell. He will be seeing his cardio on Monday (earliest he's available) so I will know more then. For right now though, he is home, looks good, and is in good spirits.

I want to thank you all for everything and I will keep you all informed.