Most ALS patients claimed that ALS is a even more cruel disease than cancer. So what is the reason why they might say thing like this? Amyotrophic Lateral Sclerosis is caused by the injury of the upper and lower motor neurons, resulting in the gradual weakness and atrophy of the muscles including limbs, trunk, chest and abdomen. More than 200,000 people around the world are living with ALS. Amyotrophic Lateral Sclerosis is a rare disease caused by both genes and environment, which can be divided into three stages: muscle weakness or atrophy in the early stages, movement, swallowing, dysarticulation as the disease progresses, and ultimately, most patients die of respiratory failure or infectious pneumonia.

The early symptoms of ALS show up only slightly through muscle condition and swallowing function, which are hard to notice. There are two types of ALS. In the beginning of this illness, the symptoms are quite different but as time passing by the symptoms become similar. The first type of ALS starts from limbs’ diseases that affect about 75 percent of patients (Peter J). The weakness of the limb muscle is an early symptom occurring initially in approximately 20 percent of cases (Laura J). Motor neuron degeneration leads to brief subcutaneous muscle twitches, which are visible and torturous (Elizabeth). Patients may feel slight difficulty swallowing food and choke more often than usual (Peter J). Patients with leg onset will fall or trip while walking or running, and drag their legs while walking. Arm-onset patients may have difficulty doing tasks that require skillful manual labor, such as buttoning a shirt, inserting a key into a lock or even writing (Peter J). The second type of ALS is the medulla oblongata disease (Peter J). The presence of dysarthria in individuals is distressing (Elizabeth). Different from the first type of disease, the medulla oblongata disease’s patients can move their limbs at first (Peter J). However, the patients begin to speak with slurred words, and the flexibility of the tongue decreases (Peter J). As you can tell, the patients in the first stage suffer from different kinds of pain, but one thing is for sure that symptoms are all gruelling and bring inconvenience to patients’ life.

In the middle stage, patients have to tolerate both mental and muscle damage. Patients of ALS suffer from muscle damage: muscle weakness becomes all over the body (Armon). Furthermore, some muscles are paralyzed, while others are weakened. This will lead to a loss of muscle mass and permanent shorten of unused muscles (Klasher). An example of this shorten is contractures, which prevent joints from straighten such as elbows(ball). Joints that influenced by the disease will be painful and rigid (Armond). What is horrible is that ALS patients may not be able to stand up on their own if they fall down. ALS patients will also experience other difficulties led by muscle problems, such as difficult speaking, swallowing, and breathing (Armon). ALS patients’ weakness in swallowing muscles will cause choking and difficulty in chewing food, known as dysphagia (Ball). Weakness in swallowing muscles, instead, will cause respiratory insufficiency, especially when people are lying on the ground (Ball). Another symptom emerge in the middle stage of ALS is that some patients cannot control their laughter or crying (Armon). Even these patients have the exact opposite feelings of their behaviors, they cannot help it. These are called the pseudobulbar palsy (Armon).

In the late stage, the patients will suffer from a series of physiological difficulties, which mostly include respiratory and eating problems; half patients will pass away 3 months of beginning symptoms and there is no method can cure ALS. Aspirating food into the lungs can result in aspiration pneumonia, a leading death cause of ALS patients (Sabatelli). Despite of eating difficulties, aspiration is also a big challenge for ALS patients (Sabatelli). As the disease progresses, lung function will diminish as the diaphragm and intercostal muscles of the rib cage that support breathing weaken (Hobson). Therefore, patients cannot breathe easily and it is hard for ALS patients to live through (Hobson). Sometimes, the weaken of lung can happen before the stiffness of limb (Hobson). What make ALS a horrible disease are the high death rate and lack of treatment (Kiernan). Most patients die from respiratory failure or pneumonia (Kiernan). Most people with ALS die between two and four years after the diagnosis (Hobson). Guitarist Jason Becker has lived since 1989 with the disorder and he was diagnosed to have ALS when he was 20(Kiernan). Another well- known ALS patient is Cosmologist Stephen Hawking lived for 55 more years following his diagnosis (Kiernan). He was brilliant and so strong when he faced ALS that he lived a much longer life than predicted (Kiernan).

 Amyotrophic Lateral Sclerosis, a rare and horrible disease, consists three stages: muscle weakness is most common in the early stage, dysphagia and pseudobullar affect will emerge on the middle stage, and patients will die because of respiratory difficulties in the end. Nevertheless, scientists are trying to solve this disease and proposes many solutions. It is possible that ALS can be cure in the near future. Several methods have been proposed to cure ALS: there are eye-gaze access to AAC technology which help patients to communicate, management of respiratory system which improve patients’ comfort, and elastic head support device which solve the problem of muscle weakness.

Works Cited

Armon, Carmel, “What are the milestone stages and corresponding times of occurrence in amyotrophic lateral sclerosis (ALS)?” Medscape. Lorenzo, Nicholas, January 14, 2018. medscape.com/answers/1170097-81854/what-are-the-milestone-stages-and-corresponding-times-of-occurrence-in-amyotrophic-lateral-sclerosis-als.

Ball, Laura J., et al. “Monitoring Speaking Rate by Telephone for Persons with Amyotrophic Lateral Sclerosis.” Journal of Medical Speech - Language Pathology, vol. 13, no. 4, 2005, www.questiaschool.com/read/1G1-141652406/monitoring-speaking-rate-by-telephone-for-persons.

Elizabeth, K. Hanson, “Dysarthria in Amyotrophic Lateral Sclerosis: A Systematic Review of Characteristics, Speech Treatment, and Augmentative and Alternative Communication Options.” Journal of Medical Speech - Language Pathology, M. Yorkston, Kathryn; Britton, Deanna, Vol. 19, No. 3, September 2011. www. Quest -iaschool.com/library/journal/1G1-266957325/dysarthria-in-amyotrophic-lateral

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Hobson, EV, et al. "Supportive and symptomatic management of amyotrophic lateral sclerosis". Nature Reviews. Neurology.

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Kiernan, MC, et al. "Amyotrophic lateral sclerosis". Lancet. 377 (9769): 942–55. Thelancet, www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61156-7/fulltext. Accessed 28 Feb. 2020.

Klasner, Estelle R., and Kathryn M. Yorkston. “Speech Intelligibility in ALS and HD Dysarthria: The Everyday Listener's Perspective.” Journal of Medical Speech - Language Pathology, www.questiaschool.com/read/1G1-133706268/speech-intelligibility-in-als-and-hd-dysarthria-the.

Laura J Ball, “Monitoring Speaking Rate by Telephone for Persons with Amyotrophic Lateral Sclerosis.” Journal of Medical Speech - Language Pathology, Beukelman, David R.; Ullman, Cara; Maassen, Kristin; Pattee, Gary L. Vol. 13, No. 4, December  2005, www.questiaschool.com/library/journal/1G1-141652406/monito-ring- speaking-rate-by-telephone-for-persons.

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