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advice is that all patients with ALS and respiratory symptoms, or an FVC less than
50%, should be offered NIV. In general, NIV may be used with the NeuRx DPS
® .
Mechanical ventilation. At some point, ALS reduces the ability to breathe so much
that invasive ventilation becomes the only choice for survival. Invasive ventilation
uses a tube placed through the throat connected to a ventilator. This can prolong life
for several years.
BEFORE SURGERY: WHAT TO EXPECT
Your healthcare provider will need to do breathing tests to see if your breathing
problems can be treated using the NeuRx DPS
®
. These tests include checking how
well your lungs are working (breathing out and breathing in). One test checks the
maximum amount of air you can force out of your lungs (forced vital capacity or FVC).
Another test checks how strong your breathing muscles are when you breathe in. A
blood test may be done to see how much oxygen and carbon dioxide are in your
blood. In another test, a small monitor is placed over your finger during sleep. The
monitor measures the level of oxygen in your blood. The results of any one of these
tests can show if you could be a candidate for the NeuRx DPS
®
.
SURGERY: WHAT TO EXPECT
The surgeon will make a short cut (incision) in the skin of your abdomen. This incision
will give the surgeon access to your diaphragm. The incision will be about half an inch
long. A tube will be placed into the incision. Carbon dioxide gas will be pumped
through the tube to fill your abdomen. A small tool with a camera on the end
(laparoscope) will be inserted into the tube in your abdomen. After the surgeon looks
into your abdomen, 3 more incisions will be made. These incisions will also be about
half an inch long. A tube will be placed in each incision for the surgeon to work
through.
The surgeon will then insert a tool called a probe through one of the tubes. The probe
will help the surgeon find the best location to place the electrode wire tips in the
diaphragm. The surgeon will use the probe to test several locations on the
diaphragm.
Once the surgeon has found the 4 best locations, the surgeon will remove the probe.
The surgeon will then insert the tips of 4 electrode wires in these locations. The
surgeon will put the other ends of the 4 electrode wires on the outside of your body.
These 4 wires will come out through your skin in the same area. A fifth electrode wire
is then placed just beneath the skin in the same area to complete the wiring.