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Living with ALS: How a former marathon enthusiast is coping with a terminal, degenerative disease

Johnrambo

Alfrescian
Loyal
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Former engineer and running enthusiast Ooi Lin Kah is stricken with amyotrophic lateral sclerosis (ALS)
He used to jog 5km daily in the morning and 10km on weekends, and had run in 13 marathons
Now he is completely dependent on his family, domestic worker and machines to sustain his life
Some studies suggest that people with athletic propensity or have served in the military have a higher risk of the disease
However, the causal relationships of these factors with ALS remain to be established, a doctor said

SINGAPORE — In the last seven years, amyotrophic lateral sclerosis (ALS) has taken so much away from Mr Ooi Lin Kah.

That includes his love for running and hiking, of getting outdoors and doing simple activities such as having his favourite hawker foods and clearing a scratchy throat.

Diagnosed with the same crippling neurodegenerative disorder that killed British scientist Stephen Hawking, the 62-year-old former engineer is now trapped inside a rapidly deteriorating body that once conquered 13 marathons even as his mind remains sharp.

The neurodegenerative disease of the motor neurons leads to progressive weakness of the muscles that control movements of the body including swallowing, speech and breathing.

Since his diagnosis in 2013, Mr Ooi no longer has voluntary muscle function and control from the neck down. He is now completely dependent on his family, domestic worker and machines to sustain his life.

A ventilator pumps air round the clock into his lungs, a cough-assist machine helps sucks out phlegm and saliva from the mouth, windpipe and lungs, and a feeding tube delivers specialised milk feeds and water directly into his stomach.

Yet, Mr Ooi, who once harboured thoughts of suicide, has found the courage to live a meaningful life.

Using an eye-gaze device that allows him to type on a computer, Mr Ooi talked to TODAY via an email interview.

Through his experience, he hopes to raise awareness of the illness and encourage people battling motor neuron diseases to find peace while living out their remaining years.

THE DIAGNOSIS

There is no cure for ALS, which affects an estimated 300 people in Singapore. This staggering fact, and that most patients survive only an average of up to five years, had hit Mr Ooi hard when he first learnt of his illness.

“My greatest fears then were death and suffering. I was most fearful of the discomfort to my weakening body, the emotional and financial stress to my family. I did not want to burden my family,” he said.

A former avid runner, Mr Ooi first noticed subtle early signs of limb weakness in his early 50s, especially while jogging or hiking.


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He was diagnosed only two to three years later when weakness in his left arm became more pronounced.

At first, he thought the subtle signs were due to him being tired though they were more obvious when he was hiking. His legs would tremble slightly as he made his way down.

Another sign was how his arm froze while he was brushing his teeth. He might also miss a step while walking and talking.

As the illness progressed, he could not grip things tightly or lift things.

At the time, he was leading an active lifestyle, enjoying daily jogs, travelling and working on engineering projects.

Besides jogging 5km every day in the morning before work and 10km on weekends, Mr Ooi also completed 13 marathons and had gone on various hiking trips overseas.

His three children, now aged 27, 28 and 31, were still studying then.

Read more at https://www.todayonline.com/singapo...thusiast-coping-terminal-degenerative-disease
 

blackmondy

Alfrescian (Inf)
Asset
I feel most marathoners are too skinny and unhealthy looking. They are eating too little to replenish their strength and other body loss.
 

countryman

Alfrescian
Loyal
Being fit doesn't mean u are healthy.....
Apparently, our local mediacock actor Chew Chor Meng recovered from his illness which was quite similar to this!
 

sweetiepie

Alfrescian
Loyal
Being fit doesn't mean u are healthy.....
Apparently, our local mediacock actor Chew Chor Meng recovered from his illness which was quite similar to this!
KNN apparently many people have the thoughts that exercise and keeping fit means stay healthy KNN
 

syed putra

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Loyal
Some people already know something is wrong thats why they train like hell to maintain fitness hoping it will go away.
 

UltimaOnline

Alfrescian (InfP)
Generous Asset
The sadistic irony. Welcome to physical incarnation.



People who engage in intense physical activities, such as professional athletes and people in the military, are more likely to be affected by ALS. In some, the disease seems to start after an injury -- muscle weakness at the site of the injury slowly spreads to new areas until weakness in the muscles responsible for breathing causes suffocation.

Now, researchers at the University of Illinois at Chicago are the first to demonstrate that a peripheral nerve injury can trigger the onset and spread of the disease in an animal model of ALS. Their findings, published in the journal Neurobiology of Disease, show that rats genetically engineered to develop ALS-like symptoms have an abnormal inflammatory response in the region of the spinal cord associated with an injured peripheral neuron. As the spinal cord inflammation and other damaging processes spread, they cause progressive muscle weakness throughout the body.

"We know that in some patients with ALS the weakness starts in a hand or leg, and the disease spreads. Coincidentally, the patient will describe a recent or remote injury to that same hand or leg that matches the location of their disease onset. We wanted to study how environmental contributions, such as a focal nerve injury, affects how the ALS starts and spreads," said Dr. Jeffery Loeb, the John S. Garvin Endowed Chair in Neurology and Rehabilitation in the UIC College of Medicine and corresponding author of the paper.

"Our results show that a single nerve injury, which is small enough that it only causes temporary weakness in normal animals, can start a cascade of inflammation in the spinal cord that initiates and causes the disease to spread in genetically-susceptible animals," said Loeb. "The ability to precipitate the disease through injury gives us a new animal model we can use to identify treatments for ALS that focus on stopping the spread of the disease after it first starts. The medical community has no therapies that significantly slow or stop the progression of the disease and we are currently putting all of our efforts on developing a drug to do this."

While a growing number of genes have been associated with the development of ALS, only about 10 percent of ALS patients have one or more of these gene mutations and none can explain why the disease presents with localized weakness or how it spreads. Ninety percent of ALS patients develop the disease for unknown reasons.

"This raises an important question of the relative contributions of environment versus genes or nature versus nurture," Loeb said.

One of the most highly-studied gene mutations in ALS is in a gene called SOD1. In their study, Loeb and colleagues used rats with mutated forms of the SOD1 gene, which causes the animals to have higher levels of the SOD1 enzyme and to develop ALS-like symptoms, including progressive muscle weakness, starting at 15 weeks of age.

The researchers surgically injured a single nerve in the leg of both SOD1 and wild-type rats at 10 weeks of age. While all rats had reduced strength in the injured leg post-surgery, the wild-type rats recovered almost completely within a few weeks. The SOD1 rats never returned to normal and also experienced weakness in their other leg.

They also found that surgically-injured rats had elevated and prolonged inflammation, and higher numbers of microglia and astrocyte cells in areas of the spinal cord associated with the injured neuron, and the inflammation and presence of these other cells spread to adjacent neurons.

"This spread of inflammation could potentially explain how the disease spreads once it first starts from the site of injury," Loeb said. "Microglia have many roles, but one role is to prune or eliminate synapses that connect one nerve cell to another. These connections are critical for normal functioning and for survival of neurons during development. Where there was increased inflammation and microglia in the spinal cord, we saw up to a two-fold reduction in the number of synapses."

Loeb explained that once a nerve loses connections with its neighbors, the neighboring cells tend to die off.

"This chain reaction of cell death could be what causes the progressive spread of muscle weakness we see in ALS," Loeb said.


https://www.sciencedaily.com/releases/2019/02/190220112208.htm
 
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