The visual image I chose is a photo of the Als/ Lou Gherigs Disease. These comprises of three photographs put together in a collage. The first photograph is of a man and his two children, who are happy together as a family. The second photograph is of the children separated from their father with a poster that reads that they are missing their father. This could be probably due to the effects of the Als/ Lou Gherigs Disease. The third photograph is of a man, who is supposedly the father of the lonely children, and he is walking around in the streets. This could then denote the advanced state of the disease, which is well known to have no cure.
The topic of the collage photograph reads as “ALS, more than physical”. This could be interpreted to mean that the effects of the disorder are all encompassing; in that, they go beyond the physical consequences they could have on an individual. This, therefore, made me think of this disorder as of an important issue to be discussed.
The Amyotrophic lateral sclerosis, abbreviated as ALS, is the most popular deteriorating disease of the system of the motor neuron. It was first explained in 1869 by neurologist Jean-Martin Charcot, who was French, and thus, it is also termed as the Charcot disease. It gained famous recognition and it is currently named after Lou Gehrig, a baseball player who made known his diagnosis with the disorder in 1939. The disease affects nerve cells of the brain as well as the spinal cord. The Motor neurons, which are in charge of the movement of the voluntary muscles, are destroyed and finally they die. At the death of the motor neurons, the brain fails to begin and manage the movement of the muscles. And because muscles cannot further get the messages they require operating, they slowly become weak and deteriorate (Mitsumoto and Munsat 5).
The first signs of ALS may differ. The symptoms entail stiffness and an increase in the weakness of the muscles, particularly of those of the hands and the feet. The disorder then affects one's speech, swallowing as well as breathing. Walking or even running up and down stairs may be problematic. Those affected adversely may drop things, laugh and even cry without any control, fall, and even get muscle cramps. The arms and legs often feel particularly tired and if the disease affects the hands, the patient may have challenges picking up tiny objects or even opening things using keys. As the signs become worse progressively, twitching may happen in the tongue as well as in the affected limbs. Other patients encounter more problems in swallowing saliva and liquids rather than in solid food. Too much salivation and problematic swallowing may lead to drooling. The patient may need a ventilator in the case of the weakening of the muscles of the respiratory system (Mitsumoto and Munsat 6)
The patient's senses as well as the mind are not affected, since the disorder only affects the motor neurons. Estimates show that 14 cases of the disease are diagnosed daily across nations. The most affected population who develops the illness is aged between 40 and 70 years. The approximated time for survival of the ALS patients ranges between three to five years. At any given time, close to thirty thousand individuals in the United States are continuously diagnosed with the disorder. This is one of the reasons the photograph drew my attention, as the disease has not been given the attention it deserves, and yet it affects a large population.
The derivation of the disease is not fully understood. Several researchers and physicians think of viruses, neurotoxins, and heavy metals, defects of the DNA, abnormalities of the immune system, and abnormalities of the enzymes as the possible causes. The most popular accepted theory on the cause of ALS holds that relationships between the genetic, environmental as well as the age-dependent risk factors generate the onset of the disorder. The risk factors of the disorder entail a deficiency in the inheritable genetic material, which is responsible for the 5–10 per cent of the cases of familial ALS,abbreviated as FALS, in the United States. FALS is associated with a genetic imperfection on chromosome number twenty one. This gene codes for an enzyme, known as super oxide dismutase that is an antioxidant that shields the motor neurons from any radical destruction. Over 60 different mutations that result into loss of the antioxidant qualities have been identified. Close to 40 per cent of FALS cases are associated with the super oxide dismutase mutations, and thus, there could be other genetic defects involved that are unknown (Mitsumoto and Munsat 9). The man in the photograph is seen walking in the streets that are full of the environmental risks mentioned here, and thus the burden of the disease will be further felt since no precautions of slowing down of the disease have been employed.
Smoking of cigarettes is the exceptional external factor that may be taken to be as a reputable risk factor for the disease. Some concerns of the results show that smoking may be involved directly as the causative agent of the disease. Serial smokers have an estimated double risk of being affected by ALS as compared to the non smokers. Those who are former smokers experience an intermediate risk. The putative risk factors gaining current attention also entail the service in the US military in the period of the Second World War, the Korean War, the Persian Gulf War in 1991 and the Vietnam War. However, related scrutiny brings doubts on the quality of the evidence subsidiary to the duty of the factors mentioned in causing the disorder.
To determine the possible pathways of the disease involving TDP-43 and FUS/TLS in the pathology of the disease, before any substantial research, much of the data had been obtained from research on transgenic mice that has the human super oxide dismutase mutation, which puts its effect via the gain of function. Oxidative damage, glial cell pathology, dysfunction of the mitochondria, expression of the growth factor, apoptosis, axonal transport defects and glutamate excitotoxicity all come between as the pathways, resulting into cell death in the disease (Mitsumoto and Munsat 9).
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However, the disorder is known to be incurable. The treatment pays attention only to relieving of the symptoms and enhancing an ideal quality of life. It is founded on individual therapy as well as on the ongoing adaptation of proper medications. Such include Riluzole, Baclofen, tizanadine ibuprofen and Tramadol, as the only few drugs that are so far known to be efficient against the disease. They may prevent further development of the disease and help in prolonging life for a couple of months, among other functions (Mitsumoto and Munsat 9). Physical therapy is one of the essential aspects of treatment that aids in relieving muscle cramps and pain. In addition, passive stretching aids in avoiding of permanent muscles contraction that may result into joint complications (Mitsumoto and Munsat 10). These treatments are many and the patient has to use a combination of them for the effect to be realized. The family in the photograph, therefore, has to bear the economic burden of buying all drugs, and yet it is a small family of children who cannot help their father.
Other kinds of therapy, such as speech therapy and occupational therapy, may also be utilized in the treatment procedures. Patients of the disease need a diet that is high-energy and may offer comfort in swallowing; and thus, they may need consultation of a nutritionist for this purpose. If the ailing individual is unable to sustain a proper nutrition, a feeding tube may be put in their digestive system. This is portrayed as a life prolonging tool for the patients of ALS, who are losing their weight very fast. Other ALS diagnosed may require pulmonary consultants as well as therapists of the respiratory system to help them breathing. Less than 5 per cent of patients make use of long-term ventilation assistance. The photograph shows the man and the small children, who may lack the nutritional skills required for their sick father; therefore, the man may continue suffering the burden of the disease that is beyond the physical burden.
Other noninvasive types of breathing aids such as continuous as well as bi level positive airway pressure may be employed to better the quality of life of the patients. Besides, since depression is a very rampant condition in the ALS diagnosed, antidepressant medication as well counseling should be employed to enable the patients and their families to cope (Mitsumoto and Munsat 10). Such kinds of treatments could be employed in the case of the families that are suffering from the consequences of the disease, such as in the photograph where the children have been abandoned by their father. The various other therapies could also be used in the same case. Therefore, it is true from the photograph that the effects of the disease go beyond the physical problems they cause.
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