Wednesday, June 28, 2006 at 1:07 PM
This week in Boston a group of Cleveland patients are telling doctors at a medical conference their stories about how a bio-medical technology has changed their lives. All four patients have suffered severe spinal cord injuries. But today, thanks to a technology called functional electrical stimulation, they're able to breath on their own, stand and walk, even do needlepoint again. ideastream's Karen Schaefer prepared this report.
Lazlo Nagy: I was injured June 24, 2002 in a motorcycle accident and I was paralyzed… I broke my neck.
Lazlo Nagy is 40 years old. Until his accident four years ago, he was a successful Chicago stockbroker. But when he woke up in the hospital, his life had completely altered. He was paralyzed from the neck down and couldn’t even breathe on his own.
Lazlo Nagy: At first, I didn’t believe it was happening. I really felt that… this thing is surreal. And I couldn’t move because I had a halo brace on my head and all I could do was stare up at the ceiling. I really couldn’t understand what was going on. And really for the first year, I cried myself to sleep every night.
Nagy spent a year in a nursing home attached by tubes and hoses to a ventilator. Then a doctor told him about a remarkable technology that could allow him to breathe without the large, noisy machine. He admitted himself to MetroHealth Medical Center where doctors implanted electrodes in the nerves that control muscle contraction of the diaphragm.
Lazlo Nagy: And seven weeks later I was able to breathe on my own off the ventilator, 24 hours a day, 7 days a week, and that really allowed me to just have a new lease on life.
The technology Dr. Greg Nemanaitis implanted is called functional electrical stimulation, or FES. It was pioneered at University Hospitals of Cleveland and first used on actor Christopher Reeve. Today it’s implanted as an outpatient procedure. Dr. Nemanaitis says Nagy was only the fourth patient to receive the technology. Since then 40 others have benefited from it.
Greg Nemanaitis: What they’re doing is they’re putting electrodes in the motor points where the phrenic nerves hit the diaphragm. The phrenic nerves are nerves that come from cervical level, C3, 4 and 5 that provide intubate to the diaphragm muscle that allows you to breathe again. And so what the electrodes did was to take the place of the phrenic nerve and allow for paced muscle contraction - diaphragm muscle contraction - to allow him to breathe.
The only external device is the small pacer that Nagy can tuck under his shirt. What’s even more remarkable, Dr. Nemanaitis says, is that implanting the FES system actually improved Nagy’s health. While still on the ventilator, Nagy suffered several bouts of pneumonia, a life-threatening condition in quadriplegics. But since then, he’s been infection free. And he’s actually built up enough muscle strength to breathe for short periods without electrical stimulation. But Dr. Nemanaitis says still few doctors recommend the technology to their spinal cord injury patients. And that’s why he’s taken Lazlo and three other patients to Boston.
Greg Nemanaitis: It’s difficult to take a research paper and put that into one of their patients. And I can understand that. You want to see it work, you don’t just want to hear about it. A picture’s worth a thousand words, but a patient is worth ten-thousand.
Diaphragm pacing is only one of several applications for FES technology. Patients that have the device implanted in lower extremities can eventually learn to change position, stand, even walk again. In the upper body, FES can help patients move their arms and open and close their hands. One woman has actually taken up needlepoint again. FES can even help patients regain control of their bladder and bowels, which allows them to leave the nursing home and dramatically reduce costs of their care. Dr. Nemanaitis believes one day soon stem cell researchers will find a breakthrough that will enable him to reconnect damaged spinal nerves.
Greg Nemanaitis: It’ll take time, though. In the meantime, what are going to do? Are you going to sit there and mope? Or are you going to do something to gain independence and control of your environment?
For Lazlo Nagy, the technology has meant a whole new life. He’s once again taking care of his 8-year-old son Richard, he recently bought a house and in August he and his girlfriend, physical therapist Jennifer Smith, will be married.
Jennifer Smith: We go for a walk almost every night in the neighborhood. And that’s something we couldn’t do if he was on a ventilator. We go to the store, we go to movies, we travel. I mean we can really do whatever we want.
Lazlo Nagy: It works. I don’t have to be sold or made a believer of, I’m living with it.
For 90.3 News, I’m Karen Schaefer.
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