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Being healthy is a choice, but sometimes a person cannot choose when he.she is afflicted with a disease. Vivian, this young girl from West Java suffered from a rare disease, namely chronic myeloid leukemia. Chronic Myeloid Leukemia (CML) is one form of leukemia which is characterized by increased and irregular growth of myeloid cells in the bone marrow and accumulates also in the blood. Vivian had to undergo chemotherapy for the disease. After chemotherapy, Vivian's pain did not end immediately. She experienced disruption of mobilization, muscle weakness and deconditioning due to the CML he suffered. Muscle weakness is the inability of the muscles to function normally and this is relative to the normal condition of one's muscle ability. Deconditioning is a process of complex physiological changes after a period of inactivity, bedrest or an inactive lifestyle. It causes functional losses in certain aspects such as mental status, level of continence and the ability to achieve activities of daily life.
The condition experienced by Vivian was caused by the treatment that she took that required her to be in bed for quite a long time. His mobility was disrupted, his road pattern was not normal and his right foot did not tread perfectly. It was a barrier for Vivian to do daily activities. The doctor suggested that she use a medical device in the form of external modification shoes so that her mobilization could improve. The price of medical devices reaches millions of rupiah and is not covered by any insurance. Vivian's father was a laborer with an income of Rp 900,000 and her mother does not work. They hope Vivian can return to normal as before and achieve her dreams.
Let's help Vivian recover!
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Deconditioning is a complex process of physiological change following a period of inactivity, bedrest or sedentary lifestyle. It results in functional losses in such areas as mental status, degree of continence and ability to accomplish activities of daily living. It is frequently associated with hospitalization in the elderly. The most predictable effects of deconditioning are seen in the musculoskeletal system and include diminished muscle mass, decreases of muscle strength by two to five percent per day, muscle shortening, changes in periarticular and cartilaginous joint structure and marked loss of leg strength that seriously limit mobility. The decline in muscle mass and strength has been linked to falls, functional decline, increased frailty and immobility. The authors describe a three-pronged strategy to combat deconditioning that includes a model of care appropriate to the growing population of elderly clients, the creation of an "elder-friendly" hospital environment and an exercise program.
CHRONIC MYELOGENOUS LEUKEMIA
Chronic myelogenous leukemia (CML), also known as chronic myeloid leukemia, is a myeloproliferative disorder characterized by increased proliferation of the granulocytic cell line without the loss of their capacity to differentiate. It accounts for 20% of all leukemias affecting adults.
Signs and symptoms
The following are signs and symptoms of progressive disease:
Uncharacteristic muscle weakness or inability of the muscles to perform normally, relative to that person’s normal ability. The symptom will usually be identified when a person is performing exercise or some muscular activity, such as climbing stairs, or carrying goods. It is however distinct from the weakness (or tiredness) that many will feel when run-down and fatigued as a result of normal activities
It must be recognised that true weakness is different from that experienced by people as a result of fatigue, but normal daily activities. In the case of muscle weakness as a symptom of a disease or condition, there is usually a measurable loss of muscle strength, and possibly a reduction in muscle tone as the muscle begins to waste away. There are however literally thousands of possible causes for muscle weakness, making diagnosis very difficult.
Because muscle contraction requires a signal from the brain, down the spinal cord, to the muscle, the cause of true weakness may lie anywhere along this chain. It may thus be metabolic, neurological, toxic or directly muscular.
Some of the more common causes include strokes, brain problems such as tumours, degenerative problems such as multiple sclerosis, and muscular problems such as muscular dystrophies and polymyositis. A variety of other diseases can cause weakness, including diabetes, Cushing’s syndrome (excess cortisol), Lupus and Guillain-Barré syndrome, to name a few of the thousands of possibilities.
Dependent entirely on the cause of the condition, which must be ascertained first. For this reason, a diagnosis and the resultant recommended treatment are crucial, which is why muscle weakness that is persistent and unexplained should be treated in consultation with a doctor.
When to see a doctor
A doctor should be seen as soon as muscle weakness becomes a recurring or persistent problem. If the weakness cannot be explained (as with exercise or a strenuous period of work, for example), and occurs suddenly, then a doctor’s diagnosis should be sought. Similarly, if muscle weakness is one of many symptoms, a doctor should be seen for treatment of the actual underlying cause of the problem.
What to expect at the doctor
Typically, doctors will perform a detailed patient history to ascertain a full medical picture of the condition. This includes a time pattern of the symptoms (time-frames, medical history, activity history), quality of the weakness (constant or variable, impact of weakness on daily activity and normal function), location, aggravating factors, and any other relieving symptoms.
The doctor will typically then seek further tests, usually of the blood, to eliminate possible causes. In some cases, where a neurological cause is possible, MRI or CT scans may be performed, as well as specialised metabolic tests (thyroid, muscle biopsies and so forth).
Again, the treatment is dependent on the diagnosis and varies widely. For neurological problems, physical therapy may be required, whereas for a metabolic problem, medication may be required.
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