最近這三天晚上, 左腿似乎又開始不太安分起來, 開始強直性抽筋, 不知道是否是最近下肢力氣有點恢復的關係而 嘗試著使用自身力氣小步行走所致, 後來問了醫生, 知道這仍是屬於症狀的部分, 所以要增加要的劑量, 所以在睡前在癲通的劑量由半顆增為一顆試試, 若能有效改善, 則採用此一方式.
在這裡要針對急性類固醇治療後復建後所產生的抽筋, 肌肉緊繃, 或強直性抽筋(經孿)這些症狀 所代表的意義給一個參考註解 : 當以上的症狀程度嚴重到已經讓你覺得不舒服或影響到你的日常生活的時候, 那就不是所謂的(神經修復), 那是原本受損的神經所表現出來的現象. 若要紓緩這些症狀, 其中的方法就是用藥物來控制.
2008年9月30日 星期二
2008年9月24日 星期三
服用新的藥
2008年9月22日 星期一
坐輪椅撞牆自殺?
一點一滴的復健
2008年9月19日 星期五
後遺症---無法完全復原
2008年9月13日 星期六
2008年9月12日 星期五
2008年9月6日 星期六
重新復建計畫
為了避免舊事重演, 再加上病友的協助, 參考了領導護理刊物的資訊, 決定利用EDSS量表做為復健的依據, 使用全關節運動為起始, 輔助以水療方式, 慢慢的復健, 已達到不累為原則, 進行緩和的復健.
全關節運動是指一特定關節在正常活動範圍內運動,而每一個關節能活動的角度大小不一樣,而活動每一個可動關節,就叫全關節運動(ROM)。可藉由此運動活動到每一個可動關節,增加關節活動度及增加肌力。
http://stonestarstar.blogspot.com/2007/12/blog-post_25.html
全關節運動是指一特定關節在正常活動範圍內運動,而每一個關節能活動的角度大小不一樣,而活動每一個可動關節,就叫全關節運動(ROM)。可藉由此運動活動到每一個可動關節,增加關節活動度及增加肌力。
http://stonestarstar.blogspot.com/2007/12/blog-post_25.html
重新復建計畫
預防再次復發~~
行為能力(殘缺)量表 EDSS
最近閱讀了病友寄來的資料, 知道了以下所列的量表, 可以知道目前自己的行為能力有幾分, 也可以觀察在治療過程是否有進步, 依照我目前的狀況, 只有6.5分左右, 在3星期之前, 是比較好的4分.
所以目前狀況比較差
供大家參考: EDSS
Kurtzke Expanded Disability Status Scale
0.0
Normal neurological examination
1.0
No disability, minimal signs in one FS
1.5
No disability, minimal signs in more than one FS
2.0
Minimal disability in one FS
2.5
Mild disability in one FS or minimal disability in two FS
3.0
Moderate disability in one FS, or mild disability in three or four FS. Fully ambulatory
3.5
Fully ambulatory but with moderate disability in one FS and more than minimal disability in several others
4.0
Fully ambulatory without aid, self-sufficient, up and about some 12 hours a day despite relatively severe disability; able to walk without aid or rest some 500 meters
4.5
Fully ambulatory without aid, up and about much of the day, able to work a full day, may otherwise have some limitation of full activity or require minimal assistance; characterized by relatively severe disability; able to walk without aid or rest some 300 meters.
5.0
Ambulatory without aid or rest for about 200 meters; disability severe enough to impair full daily activities (work a full day without special provisions)
5.5
Ambulatory without aid or rest for about 100 meters; disability severe enough to preclude full daily activities
6.0
Intermittent or unilateral constant assistance (cane, crutch, brace) required to walk about 100 meters with or without resting
6.5
Constant bilateral assistance (canes, crutches, braces) required to walk about 20 meters without resting
7.0
Unable to walk beyond approximately five meters even with aid, essentially restricted to wheelchair; wheels self in standard wheelchair and transfers alone; up and about in wheelchair some 12 hours a day
7.5
Unable to take more than a few steps; restricted to wheelchair; may need aid in transfer; wheels self but cannot carry on in standard wheelchair a full day; May require motorized wheelchair
8.0
Essentially restricted to bed or chair or perambulated in wheelchair, but may be out of bed itself much of the day; retains many self-care functions; generally has effective use of arms
8.5
Essentially restricted to bed much of day; has some effective use of arms retains some self care functions
9.0
Confined to bed; can still communicate and eat.
9.5
Totally helpless bed patient; unable to communicate effectively or eat/swallow
10.0
Death due to MS
所以目前狀況比較差
供大家參考: EDSS
Kurtzke Expanded Disability Status Scale
0.0
Normal neurological examination
1.0
No disability, minimal signs in one FS
1.5
No disability, minimal signs in more than one FS
2.0
Minimal disability in one FS
2.5
Mild disability in one FS or minimal disability in two FS
3.0
Moderate disability in one FS, or mild disability in three or four FS. Fully ambulatory
3.5
Fully ambulatory but with moderate disability in one FS and more than minimal disability in several others
4.0
Fully ambulatory without aid, self-sufficient, up and about some 12 hours a day despite relatively severe disability; able to walk without aid or rest some 500 meters
4.5
Fully ambulatory without aid, up and about much of the day, able to work a full day, may otherwise have some limitation of full activity or require minimal assistance; characterized by relatively severe disability; able to walk without aid or rest some 300 meters.
5.0
Ambulatory without aid or rest for about 200 meters; disability severe enough to impair full daily activities (work a full day without special provisions)
5.5
Ambulatory without aid or rest for about 100 meters; disability severe enough to preclude full daily activities
6.0
Intermittent or unilateral constant assistance (cane, crutch, brace) required to walk about 100 meters with or without resting
6.5
Constant bilateral assistance (canes, crutches, braces) required to walk about 20 meters without resting
7.0
Unable to walk beyond approximately five meters even with aid, essentially restricted to wheelchair; wheels self in standard wheelchair and transfers alone; up and about in wheelchair some 12 hours a day
7.5
Unable to take more than a few steps; restricted to wheelchair; may need aid in transfer; wheels self but cannot carry on in standard wheelchair a full day; May require motorized wheelchair
8.0
Essentially restricted to bed or chair or perambulated in wheelchair, but may be out of bed itself much of the day; retains many self-care functions; generally has effective use of arms
8.5
Essentially restricted to bed much of day; has some effective use of arms retains some self care functions
9.0
Confined to bed; can still communicate and eat.
9.5
Totally helpless bed patient; unable to communicate effectively or eat/swallow
10.0
Death due to MS
行為能力(殘缺)量表 EDSS
2008年9月1日 星期一
好多了
再度進入急診室
這個星期, 天天堅強著忍受著雙腿帶來的僵硬感覺, 和行動不便, 夜晚忍受著規律的間歇性潛在電流從腿內部深處流過~ 伴隨著間歇性不自主的抽蓄, 肌肉經鑾, 還有晚上至少起床4次的頻尿. 讓我的睡眠品質再度低到了一定的水準....(黑眼圈)
眼睛閉起來左耳就會出現嗡嗡聲...似乎是告訴自己 應該小心了.... 自動增加了類固醇的量, 由10mg/day增加到30mg/day 直到前天, 但是還是沒有明顯的改善. 再回顧之前我的長官寄給我的一本電子書"Managing_the_symptoms_of_multiple_sclerosis" 第4章---Spacticity 當中提到:
"Spasticity means stiffness. It often occurs when demyelination occurs in the nerves that regulate muscle tone. Because many of the nerves in the brain and spinal cord regulate movement and any ofthem may be affected by demyelination,"
以上就清楚的說明隨鞘質依然被攻擊當中.....(復發) 決定昨天的早上進入榮總急診室.
經過了和醫師討論的結果, 100mg類固醇和2mg類似Diazepam(Valium)(我建議)的Lorazepam注射.
因為Diazepam特別是針對夜晚肌肉經鑾的藥物, 也同時會幫助睡眠,有鎮定的效果. 應該能夠改善這種症狀, 幫助我回覆!!
果真有效, 之前問了並要求許多醫生開立鎮定安眠的藥, 他們都不開, 不知道是不敢開還是不願意(怕糾紛)
對於我們服用類固醇的人而言, 睡眠問題一直是副作用之一, 如何解決這個副作用讓神經好好的休息才是王道!! 不然類固醇服用得再多, 也只是枉然.....
最近一睡覺就會做夢或夜間盜汗, 就必須藉由類似Diazepam(Valium)的藥物來輔助
另外還有一種可以搭配Baclofen的藥物是Tizanidine(Zanaflex)也可以幫助達到類似的效果
眼睛閉起來左耳就會出現嗡嗡聲...似乎是告訴自己 應該小心了.... 自動增加了類固醇的量, 由10mg/day增加到30mg/day 直到前天, 但是還是沒有明顯的改善. 再回顧之前我的長官寄給我的一本電子書"Managing_the_symptoms_of_multiple_sclerosis" 第4章---Spacticity 當中提到:
"Spasticity means stiffness. It often occurs when demyelination occurs in the nerves that regulate muscle tone. Because many of the nerves in the brain and spinal cord regulate movement and any ofthem may be affected by demyelination,"
以上就清楚的說明隨鞘質依然被攻擊當中.....(復發) 決定昨天的早上進入榮總急診室.
經過了和醫師討論的結果, 100mg類固醇和2mg類似Diazepam(Valium)(我建議)的Lorazepam注射.
因為Diazepam特別是針對夜晚肌肉經鑾的藥物, 也同時會幫助睡眠,有鎮定的效果. 應該能夠改善這種症狀, 幫助我回覆!!
果真有效, 之前問了並要求許多醫生開立鎮定安眠的藥, 他們都不開, 不知道是不敢開還是不願意(怕糾紛)
對於我們服用類固醇的人而言, 睡眠問題一直是副作用之一, 如何解決這個副作用讓神經好好的休息才是王道!! 不然類固醇服用得再多, 也只是枉然.....
最近一睡覺就會做夢或夜間盜汗, 就必須藉由類似Diazepam(Valium)的藥物來輔助
另外還有一種可以搭配Baclofen的藥物是Tizanidine(Zanaflex)也可以幫助達到類似的效果
再度進入急診室
訂閱:
文章 (Atom)