Science helps patients conquer paralysis

March 21, 1995|By Douglas Birch | Douglas Birch,Sun Staff Writer

For most of us, it's a simple matter of making a fist.

For Jeannette Semon, who slowly clenched and unclenched her fingers at the Baltimore veterans' hospital yesterday, it's the spoils of a hard-won victory -- fought with the help of advanced medical technology.

The 31-year-old U.S. Department of Agriculture budget analyst is one of three people with spinal cord injuries who volunteered last year to let Baltimore physicians wire the muscles of one of their paralyzed hands to a surgically implanted electronic device.

Now, using a joystick taped to her left shoulder and an external computer the size of a hardcover book, Ms. Semon can transmit signals to the internal device to orchestrate the movement of muscles in her right wrist and hand.

Ordinarily, the body's muscles are controlled by nerve transmissions from the brain. A spinal cord injury can interrupt those transmissions. In Ms. Semon's case, both hands were left immobile by her injury.

After painstaking surgery, extensive therapy and fine-tuning of the computer software, Ms. Semon has learned to maneuver her right hand in somewhat the same way that hobbyists maneuver radio-controlled model aircraft. By moving a shoulder up or down, forward or backward, she can use her fist and thumb to trap a key, pen or other small object. Or she can curl her fingers around a soda can or a computer diskette.

It's far from the delicate motor control most of us have, and which she had before she was paralyzed six years ago -- when she injured her spinal cord during a leap into the surf at Nags Head, N.C. But she's grateful, once again, for the chance to do many of "the little dinky things" that most of us take for granted.

"I can't play the piano," Ms. Semon said, smiling. "But that's OK. I never could before anyway."

Ms. Semon, of Chantilly, Va., and the two other volunteers spoke at a news conference yesterday at the Veterans Affairs Medical Center, where medical specialists demonstrated the new technology.

The three are among 24 paralyzed people worldwide carrying the pager-size implant.

Dr. Peter H. Gorman, chief of the center's physical medicine and rehabilitative service, said the technology can work only in those paralysis patients who have not lost the ability to move their shoulders and who are able to straighten their arms.

Still, Dr. Gorman estimated that the device could one day help 14,000 of the estimated 90,000 people in the United States with quadriplegic spinal cord injuries. He said the veterans hospital is actively recruiting additional volunteers.

The technology, developed by P. Hunter Peckham and Michael Keith at Case Western Reserve University in Ohio, was first wired to an Akron, Ohio, man, in 1986. He still uses it.

Geoffrey Thrope, project director for the manufacturer, NeuroControl Corp. of Cleveland, said clinical trials of the device began in 1993. He estimated that it is still at least 2 1/2 years away from Food and Drug Administration approval for general use in this country.

Dr. W. Andrew Egleseder, a hand surgeon at the Shock Trauma Center, implanted the devices at the James L. Kernan Hospital, a facility that is also part of the University of Maryland Medical System.

He said the procedure requires careful testing, an average of seven hours of surgery, and a prolonged period of recovery.

Patients must also undergo rigorous training and physical therapy, including a two-week stay in the veterans hospital, said Linda M. Marshall, chief of occupational therapy at the hospital.

"All this takes a lot of effort and hard work on the part of the individual," Ms. Marshall said. "Each person has to be highly motivated."

Kevin Hara, 21, of St. Louis, a junior premedical student at Georgetown University in Washington, was one of the three volunteers treated in Baltimore. He was injured in a 1991 trampoline mishap.

After his implant surgery last June, Mr. Hara had to wear a cast for several weeks. Dealing with his paralysis was hard enough. He found the added immobility of living in a cast doubly frustrating.

"I really had second thoughts then, for a while," Mr. Hara recalled. But, gradually, after a long struggle, the device began to work. He began picking up his own pens and forks, brushing his teeth, shaving, taking notes in classes. Recently, he was able to take a multiple-choice test by himself -- without having to direct someone else to mark the answers.

"I find I think better," he said, "because I don't have to think things through. I can write them out."

As Mr. Hara demonstrated his writing skills at the press conference, another volunteer, Jo Heiden, a 30-year-old software engineer and free-lance artist from Arlington, Va., kidded him. "Since he's going to be a doctor, nobody needs to read it anyway," she said.

Ms. Heiden was a 19-year-old student at the University of Virginia in 1984 when she fell from a fourth-story balcony. After more than a decade, she's regained some of the use of her left hand.

"After you break your neck, anything where you don't have to say, 'Can you do this for me?' is just such a major gift," she said. "The first time I picked up a hamburger, I was thrilled."

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