Q: I have a friend who has syringomyelia. Several years ago she lost 100+ pounds. Her problem is that she was left with a lot of excess loose skin. She calls it her water balloon. This balloon causes her to lose her balance while sitting and walking, which is already impaired due to her disease and she has had several bone breaks from falling down – the latest being a partial hip replacement. She lost her left arm due to her disease and cannot understand why none of her doctors will refer her to a plastic surgeon to have the excess skin removed. It is very obvious that she needs this procedure.
Once she falls, she has a hard time maneuvering all of that loose skin in order to get back up. She has had to rely on neighbors or paramedics to help her off the floor. Have you any suggestions on how she can get a recommendation for this procedure in order for her insurance to help pay for it? Please help me help her. Thank you.
A: A syringomyelia is a fluid-filled cyst within the spinal cord. Over time, the cyst may enlarge, causing damage to the spinal cord, pain, weakness, stiffness, and more. The causes for this complicated-appearing word to occur include having spinal cord tumors or injuries caused by inflammation around the spinal cord and Chian malformation. The latter may begin during teenage years or during early adulthood and is the result of brain tissue protruding into the spinal canal. Conditions such as meningitis (inflammation of the membranes that surround the brain and spinal cord), injury, and scar tissue following surgery can lead to syringomyelia. Early signs and symptoms may include muscle weakness and atrophy, a loss of reflexes, scoliosis (curvature of the spine). neck/arm/back/facial pain, and bladder and bowel concerns.
Magnetic resonance imaging (MRI) is a reliable tool for diagnosis. If a syrinx has developed within the spinal cord, it will be visible through this process. If a physician chooses temporarily to monitor the condition, repeat MRIs and neurological examinations will identify progression of the syringomyelia, since treatment will depend on its severity. When the condition affects a person’s quality of life, surgery may be recommended. The purpose of such procedure is to remove pressure the syrinx places on the spinal cord – thus hopefully restoring the normal flow of cerebrospinal fluid.
Now, on to your friend’s problem. You don’t indicate how much she weighs now and how she lost such an enormous amount of weight. She has a huge problem with her syringomyelia and her excess weight further hampers her. My recommendations might be compared with locking the barn door after the horse gets out, but let’s give it a try. Her hospital’s physical therapy department should be able to provide direction regarding her gait abnormality and set up an exercise program for her. A nutritionist at the same hospital should be able to review her diet and make recommendations for weight loss and muscle toning. Nothing will show results overnight but each day she adheres to a program is to her advantage. She should be monitored periodically by her physician to be assured there are no other medical problems that could impede her progress. It’s easy to take the position that a plastic surgeon can simply remove excess fatty tissue from her body but what must be understood is that the benefits must outweigh the risks, no matter how simple or complex a procedure is. A surgeon will only operate if he or she knows your friend is healthy enough to undergo a surgical procedure and without knowing her medical history, I would not venture a guess if this is feasible or not. Surgery inflicts trauma on the body, no matter how minor it may appear. She might make an appointment for a consultation. If she has problems walking and sitting that causes her to fall, she might consider using a wheel chair when she is fatigued. Many arm and leg exercise programs can be accomplished initially through sitting in a chair or even in a wheel chair but anything she does should be okayed by her physician before it is begun.
I wish I could be more positive but I strongly feel she must take an active role in her health care if she wants results. It will be hard work, but worth it in the long run.
