“National Immunization Awareness Month (NIAM) is an annual observance held in August to highlight the importance of vaccination for people of all ages”

Centers for Disease Control and Prevention (National Immunization Awareness Month (NIAM) | Vaccines & Immunizations | CDC)

“Vaccines work by stimulating the body’s immune system to safely provide protection against viruses or bacteria that cause infection. After vaccination, the immune system is prepared to respond quickly when the body encounters the disease-causing organism.”.

Federal and Drug Administration FDA (Approved Drug Products with Therapeutic Equivalence Evaluations | Orange Book | FDA)

“Amyotrophic lateral sclerosis (a-my-o-TROE-fik LAT-ur-ul skluh-ROE-sis) is a nervous system disease that affects nerve cells in the brain and spinal cord. Also known as ALS, the disease leads to muscle weakness and other symptoms that get worse over time.

ALS often begins with muscle twitching and weakness in an arm or leg, trouble swallowing, or slurred speech. Eventually ALS affects the muscles needed to move, speak, eat and breathe. There is no cure for this fatal disease, but research into new therapies is ongoing.”

MAYO CLINIC (Amyotrophic lateral sclerosis (ALS) – Symptoms and causes – Mayo Clinic)

Over the past decade, understanding of the multiple destructive pathways that lead to neuronal death in amyotrophic lateral sclerosis (ALS) has greatly improved.  There is still no cure for ALS unfortunately with all the technology medicine has but there are therapies.

Home Care at some point in middle to beginning of late stage.

This would include a Home Health Assistant followed under a Visiting Nurse/RN with an Attending Doctor for follow up on the pt care=A whole team of medical care including as soon as needed:

PT and OT:

Physical therapy (PT) is the use of exercises and treatments to improve physical movement and overall mobility. Occupational therapy (OT) is similar but is focused on developing or maintaining the physical skills needed to perform everyday tasks. For example, a physical therapist might prescribe stretching exercises to limit discomfort and preserve range of motion or use pool therapy to help you walk and improve joint function. An occupational therapist may help you find new ways to brush your teeth or recommend equipment that can make your activities of daily living easier to perform.

Speech Therapy:

For people living with ALS with bulbar symptoms, ALS leads to speech problems when it attacks bulbar neurons. These are the nerve cells responsible for bringing messages from the lower parts of the brain (bulbar region) to the muscles that move the lips, tongue, soft palate (back of roof of mouth), jaw, and vocal folds (voice box). As nerves are lost to the disease, the muscles they control become weak and tight. This causes dysarthria-difficulty speaking).  A speech-language pathologist can help with both speaking and swallowing difficulties. This may include finding devices to help you communicate as your speech becomes harder for others to understand.

Respiratory Therapy:

A respiratory therapist can teach you new techniques for breathing and coughing, helping you keep your airway and lungs clear and healthy. When mechanical ventilators are needed, they can help you evaluate the options and choose the best ventilator for your needs.  An ALS diagnosis is shocking and frightening, but as with any disease, knowledge is power. Being aware of symptoms and how you can prepare for – and manage – them is key to quality of life and often, for peace of mind. The impact of ALS on breathing is one of the most daunting aspects of the disease and one for which you and your family can and should prepare for early in the ALS journey.

Psychotherapy:

Feeling sad or scared after being diagnosed with ALS is completely natural.

In time the patient with ALS has there life completed turned upside down when they need assistance with there activitities of daily living from independent in their ADLs.  It’s not unusual to feel depressed or anxious after getting diagnosed with ALS. If you have difficulty coping with the mental and emotional side of ALS, a counselor or psychiatrist can help.

Potential symptoms of depression include:  Prolonged feelings of sadness, hopelessness, worthlessness, anxiety, or guilt.   Irritability or angry outbursts over small matters. Changes in sleeping patterns, including insomnia or sleeping too much.  Changes in appetite.

Medications:

There are a number of medications that can help treat the various symptoms of ALS and new drugs are being developed all the time. Talk with your doctor or therapist to find out what is currently available and whether any such medications might be right for you.

There are currently four drugs approved by the U.S. Food and Drug Administration to treat ALS (Radicava, Rilutek, Tiglutik, and Nuedexta). Studies all over the world, many funded by The ALS Association, are ongoing to develop more treatments and a cure for ALS.

Radicava™ (edaravone)

The FDA approved Radicava™ in 2017, less than a year after Mitsubishi Tanabe Pharma America submitted a new drug application, making it the first new treatment specifically for ALS in 22 years.

Rilutek (riluzole, now generic)

This was the first FDA-approved drug available to treat ALS — in 1995. It inhibits glutamate release and prolongs life approximately three months. Riluzole is the generic name of Rilutek.

Tiglutik (thickened riluzole)

The first and only thickened liquid form of riluzole, Tiglutik was approved by the FDA in September 2018. This formulation contrasts with the oral pill form of riluzole that has been on the market for ALS for more than 20 years. It is designed to avoid potential problems of crushing tablets.

Nuedexta®

Indicated for the treatment of pseudobulbar affect (PBA), which is characterized by frequent, involuntary, and often sudden episodes of crying and/or laughing that are exaggerated and/or don’t match how you feel. PBA occurs secondary to a variety of otherwise unrelated neurologic conditions. Nuedexta® (dextromethorphan HBr and quinidine sulfate) was FDA-approved in 2011.

“Sciatica, the sharp, radiating pain that travels from the lower back down the leg, is one of the most common nerve-related conditions. Its lifetime incidence reaches up to 40%, it peaks in the 30s and 40s, and the large majority of cases resolve without surgery. Here is the 2026 data on how common sciatica is, what causes it, and how recovery works, from primary sources only.

• Sciatica has a reported lifetime incidence of 10% to 40%.
• The annual incidence is about 1% to 5%; disc-related sciatica affects ~2.2% yearly.
• It accounts for roughly 5% to 10% of all low back pain cases.
• Peak incidence is in the fourth decade (30s), most common ages 30–50.
• The most common cause is a herniated lumbar disc pressing on a nerve root.
• An estimated 80% to 90% improve without surgery.
• About 30% still have troublesome symptoms at one year, showing why early care matters.”

Desert Spine and Pain (https://desertspineandpain.com/post/sciatica-statistics-2026)

Sciatica pain patterns, 1. Compression of the L4 nerve can result in pain radiating from the lower back down to the knee.
2. Compression of the S1 nerve can result in pain radiating down to the foot, MendMeShop TM ©2011

Causes

Risk factors

Risk factors for sciatica include:

• Age. Age-related changes in the spine, such as herniated disks and bone spurs, are the most common causes of sciatica.
• Obesity. By increasing the stress on your spine, excess body weight can contribute to the spinal changes that trigger sciatica.
• Occupation. A job that requires you to twist your back, carry heavy loads or drive a motor vehicle for long periods might play a role in sciatica, but there’s no conclusive evidence of this link.
• Prolonged sitting. People who sit for prolonged periods or have a sedentary lifestyle are more likely to develop sciatica than active people are.
• Diabetes. This condition, which affects the way your body uses blood sugar, increases your risk of nerve damage.

Complications

Although most people recover fully from sciatica, often without treatment, sciatica can potentially cause permanent nerve damage. Seek immediate medical attention if you have:

• Loss of feeling in the affected leg
• Weakness in the affected leg
• Loss of bowel or bladder function

“Sciatica is nerve pain from an injury or irritation to your sciatic nerve. In addition to pain, it can involve tingling or numbness in your back or butt that may radiate down your leg. You may also feel symptoms in your feet or toes.

There are two main types. No matter which type you have, the symptoms often feel the same. These include:

• True sciatica: This type happens when an injury or condition directly affects the sciatic nerve.
• Sciatica-like conditions: These conditions feel like sciatica but have other causes. They relate to nearby nerves or the group of nerves that form the sciatic nerve.

Healthcare providers often use the term “sciatica” for both types. The difference usually matters most when your provider recommends treatment.”

Cleveland Clinic (Sciatica: What It Is, Causes, Symptoms, Treatment & Pain Relief)

Sciatica is pain, tingling, or numbness produced by an irritation of the nerve roots that lead to the sciatica nerve. The sciatic nerve is formed by the nerve roots coming out of the spinal cord into the lower back. It goes down through the buttock, then its branches extend down the back of the leg to the ankle and foot. When something presses on the sciatica nerve, like a herniated disc, it presses on that nerve which causes the pain from the buttock that can radiate all the way down to the foot. The intensity of the pressure on the nerve and where its pressed decides if it goes to the foot or less. Other causes of sciatica nerve damage:

The most common cause -a bulging or ruptured disc in the spine pressing against the nerve roots that lead to the sciatic nerve.

-Sciatica Nerve Damage can be a symptom of other conditions that affect

*Narrowing of the spinal canal due to spinal stenosis. This spinal canal narrowing pinches on the sciatica nerve.

*Bone spurs-they are growths that are small forming along joints caused by arthritis.

*Simply injury (like a car accident or fall) causing nerve root compression=again the same result-pinching the sciatica nerve.

*Pregnancy-not as common as a cause as the others listed.

*Rarely but also tumors could cause the problem also.

What are the symptoms?

Symptoms of sciatica include pain that begins in your back or buttock and moves down your leg and may move into your foot.

*Weakness, tingling, or numbness in the leg may also occur.

*At times a inconsistent stabbing feeling or pricking feeling in the ankle or foot

*Sitting, standing for a long time, and movements that cause the spine to flex (such asexercises using the knee to chest) which may make symptoms worse.

*Walking, lying down, and movements that extend the spine (such as press-ups) may relieve symptoms.

How is sciatica diagnosed?

Sciatica is diagnosed with a medical history and physical exam. Sometimes x-rays and other tests such as magnetic resonance imaging (MRI) are done to help find the cause of the sciatica.

What are the Complications?

Although most people recover fully from sciatica, often without any specific treatment, sciatica can potentially cause permanent nerve damage. Seek immediate medical attention if you experience:

-Loss of feeling in the affected leg  -Weakness in the affected leg

-Loss of bowel or bladder function

How is it treated?

In many cases, sciatica will improve and go away with time. Initial treatment usually focuses on medicines and exercises to relieve pain. You can help relieve pain by:

*Avoiding sitting (unless it is more comfortable than standing).

*Alternating lying down with short walks. Increase your walking distance as you are able to, without pain.  

* Takingacetaminophen (tylenol) or Motrin (Ibuporfen) or Advil or Aleve (Naproxen). All are nonsteroidal anti-inflammatory drugs which decrease the swelling of the inflammation around the area or injury to the back which will decrease the pain. More inflammation=more pinching on the nerve.

*Using a heating pad on a low or medium setting for 15 to 20 minutes every 2 or 3 hours. Try a warm shower in place of one session with the heating pad. You can also buy single-use heat wraps that last up to 8 hours. You can also try an ice pack for 10 to 15 minutes every 2 to 3 hours. There is not strong evidence that either heat or ice will help, but you can try them to see if they help you.

*Additional treatment for sciatica depends on what is causing the nerve irritation. If your symptoms do not improve, your doctor may suggest physical therapy, injections of medicines such as steroids, stronger medicines such as muscle relaxants or opiates.                                                                                                                                                

*Physical Therapy or chiropracter therapy or some form of therapy for 6 to 8 weeks.

* If the therapy is uneffective than the last resort in most cases is surgery that ranges from:

– laser surgery

– scrapping of the vertebrae pinching the nerve with leaving the rest of the vertebrae spacing the spinal cord in place or removing the vertebrae pinching the nerve and replacing it with cement (not cement we use for sidewalks that we know of).   It’s natural to want to return to your regular activities as soon as possible after surgery, but a lot depends on the type of operation you get.

 In two common methods, vertebroplasty and kyphoplasty, your surgeon makes a small cut in your back, which lets you recover faster. If you get spinal fusion surgery, the cut is larger, and it will take a longer time to heal.

 -small endoscopic surgery that is microsurgery removing pieces of the vertebraepinching which has a test called a discogram (injecting a dye right into the injured disc and than a ultrasound of the area is done to show the surgeon the exact route he has to follow to cure the problem. The surgeon numbs the area that he will repair with the pt wide awake; he makes a incision about 2/10 of an inch, using the cat scan as a guide for his eyes inserting a scope inserting a grabber that goes in the scope removing disc fragments that are pressing on the nerves causing the pain. It takes about 30 minutes for this procedure with only a small bandage covering the incision followed with the patient leaving the hospital in less than a few hours.                                                                                                                                                               *Other self-care treatments that may be helpful include:                                                                                                                                                -Cold packs. Initially, you may get relief from a cold pack placed on the painful area for up 20 minutes several times a day. Use an ice pack or a package of frozen peas wrapped in a clean towel.                                                                                                                                   

-Hot packs. After two to three days, apply heat to the areas that hurt. Use hot packs, a heat lamp or a heating pad on the lowest setting. If you continue to have pain, try alternating warm and cold packs.                                                                                                                                   -Stretching. Stretching exercises for your low back can help you feel better and may help    relieve nerve root compression. Avoid jerking, bouncing or twisting during the stretch and try to hold the stretch at least 30 seconds.     -Over-the-counter medications. Pain relievers such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve) are sometimes helpful for sciatica.

References:

National Cancer Society

Web MD

Mayo Clinic

Dr. Bruce Hensel M.D. (chief medical editor channel 4)/Dr. David Ditsworth Surgeon – does back scoping -Robert Forrest Physical Therapy in Santa Monica, California.

“SAR is Severe Acute Respiratory Syndrome‑associated Coronavirus Disease.

Severe Acute Respiratory Syndrome (SARS) was a global disease outbreak in 2003 that was caused by a coronavirus called SARS-associated coronavirus (SARS-CoV). The illness was first reported in Asia in February 2003.

CDC worked with the World Health Organization in late February to investigate and confirm outbreaks of SARS in Southeast Asia.

The illness spread to 29 countries, where 8,096 people got SARS and 774 of them died. The SARS global outbreak was contained in July 2003.”

Center for Disease Control and Prevention – CDC (Severe Acute Respiratory Syndrome-associated Coronavirus Disease (SARS-CoV)| CDC)