How do Nerve Cells Work?
Nerve anatomy creates the physiology or functions which nerves carry out. The inner part of the cell is the nucleus that is endowed with coding that is its program to perform the work of your nervous system. The outer layer of the cell is the myelin sheath, which helps carry the signals. Nerves help deliver feeling hot, cold, pain, and pressure messages to the brain. Nerves also carry the message of how the body responds to these signals. Your nervous system also balances the awareness of your body in relation to space. This is known as proprioception. Which entails understanding that the perception of whether you are sitting or standing or suspended upside down.
How do muscle fibers work?
Just like the shape and structure of nerve cells help them work as such, muscle fibers are formed in such a way to perform the way muscles are supposed to.
This diagram shows the connection of muscle with nerve, that anatomy combined performs the function or neuromuscular physiology.
The electrical signals from energy made by mitochondria in cells carries along the nerve to your muscles and creates contractions that perform movement. Some movement is intentional, that is your somatic system, and the unintended movement is your autonomic system performing brainless operations.
When there is a problem
Whether it is a rare or common complication with the nerve and muscle functions, it often results in similar outcomes, restrictions and sequelae. Neuromuscular Anomolies can reak havoc on patients and familes, as well as health care community in missions to help out.
- Myasthenia Gravis, when the nerve signal gets interrupted between the muscle and nerve.
- Multiple Sclerosis
- CIDP and variants POEM Syndrome, MADSAM Disease
- CMT Charcae Marie Tooth Syndrome and variants
- Cerebral Palsy
- Traumatic Brain Injuries
- strokes, the brain attack
- Quadriplegia and other paralysis
- Alzheimers is a disease of the brain and central nervous system.
- Multiple sclerosis
- Congenital complications
- Audiology and nerve dysfunction of the ear
- Botulinum toxin
This list only includes firsthand patient experience. There are many other types of nerve and muscle problems not listed here. All the anomalies interrupt the normal flow of energy from nerves to parts of the body and affect some or all ability to perform sensory. They impede some or all ability to create movement.
Role of therapies
Skilled needs include home bound wound care, medication management, pain control, tracheostomy and ventilator, Parenteral nutrition, infusion teaching and administration, medical and surgical rehabilitation, coordination of ancillary disciplines:
Physical therapy-work outs and physical training
Occupational therapy-use of adaptive products, equipment and techniques to adapt to health impairments
Speech therapy- Did you know the hidden super power of speech therapy? They do not just help people practice talking with mashed potatoes in their mouth. For example, they are heroes when modifying diet to someone who is unable to swallow properly after a stroke. This prevents them from choking or silently aspirating stomach contents into the lungs.
Medical social work- assists in adapting to loss of function requiring therapies. They provide social, spiritual and emotional resources and coordinate living will, power of attorney, as well as advocacy.
Home Health is certified for 2 month periods if the interdisciplinary team can progress on planned objectives by meeting measurable milestones.
In-Home Care has a separate niche, they provide care in the home in specific time increments through the day or night and if needed, 24 hour care.
Hospice 101: Many families and individuals have a very tough time when making a decision whether to use hospice care at the end of life for comfort measures. Sometimes families disagree or are in denial that the loved one is knockin on heaven’s door. Denial is a stage of grief! Grief is complicated when someone is frozen in one stage with ongoing depression. Hospice combats complicated death with support, and the support continues after the loss of a loved one. During the process of death, the medical team helps prioritize comfort and provides hospital beds, medication, wound care and many other skilled needs. The treatment plan shifts, to focus on quality of life and prevention of complicated recovery from a death of someone you love.
Immunoglobulins are liquid medicine made from blood plasma. The intravenous route has its disadvantages, leading to new subcutaneous immunoglobulins that can be given in the skin instead of veins.
Ports can also help to alleviate venous access difficulty, less frequently a PICC line can be used.
“peripheral” =(arms usually)
IV (into the vein, hopefully!)
Methods for the PIV (peripheral intravenous) therapy have improved over time, and the use of this method for people with neuromuscular anomalies can pose challenges. For better access to get an IV started, plenty of drinking fluid over time and not a lot all at once prior to starting an IV can help dilate the vein. A “springy” vein is best because the surface tension of the blood vessel needs to accommodate the needle. I am terribly sorry for those patients with the fear of needles as we discuss this part. Other ways to have a better start are a warm pack, with hot hands or a baggy filled with warm water to apply to a springy vein. New products are fascinating and helpful in different ways. The Turemo butterfly is great for small volume infusions, and there is now a butterfly cannula, that is the start which is easier to keep hold of with a flexible little plastic straw to add comfort and easier access into the vein. The cannulas, or small straws that give veins the drink from the bag of fluid.
To be safe each cannula can only be attempted ONE time.
Not only for infection prevention, but also for the purpose of preventing a small piece of the plastic from breaking off into the vein to create health hazards. There is a small risk of this adverse incidence. The way to prevent this is to have a trained professional or professional training. Do NOT try any of these things without one of these:
Proper training is obtained by a practitioner with knowledge and experience in this area!
Damages are sought in court cases regarding toxic torts. An example is when a chemical has caused personal injury toward people that was preventable or undisclosed. An example is asbestos or Agent Orange. Round Up Weed Killer is another chemical, which was settled as the cause of many cases of Non-Hodgkin’s Lymphoma. (Cancer). Others include exposure to carcinogens, such as the ‘sartan’ blood pressure medications that are recalled.
Some toxic torts will cause irreparable harm to nerve and muscle cells.
Regardless of the etiology, any neuromuscular impairment requires attention to preventing injury related to falls. Standards are changing to incorporate a universal fall prevention approach that considers every person a fall risk. The over use of fall alarms is debated due to the risk of pressure ulcers or restraint of the patient. As well as alarm fatigue of caregivers. Using a standard precaution approach is developed to avoid missing a fall risk. This prevents failing to acknowledge all who require medical attention will have diagnosis or treatment that inherently increases risk of falls.
One very highly litigated topic is falls. This results in constant pressure for the health care team to do everything in their power to prevent falls. Still, falls occur regardless of every prevention and precaution known to man. Some people will require 1 to 1 care for prevention of falls. This will greatly decrease the incidence and severity of injuries.
Changes of Technology
The evolution of technology makes it possible for reversing paralysis. Treatment or reversal of once incurable ailments are emerging. A few elite patients of mine have gone from completely paralyzed to walking each day. I could hardly believe seeing someone go from needing a hoyer lift to driving a car after infusions to help the nerve cells.
Current studies progress about paralysis reversal involving non differentiated cells that are given a special treatment to become a nerve cell and then re infused in increments after pooling the precursor cells. These are autologous infusions, that means the product comes from the patient. It is very sci-fi idea to imagine. The fat is extracted from stomach, then the undeveloped cells are extracted from this to be used in the experiment- I mean treatment. It is still in stages of development, but there has been reversal of diaphragm paralysis. The diaphragm is a muscle that is needed in order to breathe. People with diaphragm paralysis often require a ventilator, but it is possible to treat with discoveries recently made.
Technology can revolutionize the way medications are prescribed. Now you can get a buccal swab to identify the set of enzymes that tells you which medications your body can tolerate. The results are nearly 100% accurate, and consist of composites for psychotropics, anesthesia, antibiotics, opioids, and this technology will continue to grow. It seems natural that the if you can check for anaphylaxis (certain risk of sudden death), this will soon be a common diagnostic. The price of this is expensive, but some insurances do pay for it, and the good news is that you should only need to get the swab one time. That would eliminate many unnecessary and dangerous medications.
Studies continue to reverse paralysis, and products related to all the medical needs of people with paralysis. Studies continue involving genetics in medicine and results will entail new standards of care.
Point blank: our health system needs to involve nurses who actively practice at the bedside in making the policies.
Goals for care planning can be revised to reflect new products, standards and individual needs that are ever-changing. Nurses are required for this process.
Nurses are natural innovators, and can collaborate in many respects to help achieve the best outcomes for patients and the greater communities they serve. An ongoing investigation of new requirements, standards and best practice is needed for patient safety and quality of life.
A cornerstone of integration is for health care consumers to report needs to providers, this reciprocates the plan of action to incorporate diverse needs within the community.
The community can impact care, and has an integral role to adapt to changing health systems, products and standards.
When the community plays primary role of shaping our health care with communication, we have the ability to make changes to benefit all and adapt for ensuring better outcomes.