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Warning-sign checks

Acute flaccid myelitis: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    These concerns generally need timely clinical review but are not always emergencies.

    Trouble breathing, choking, inability to swallow saliva, blue or gray lips, confusion, or unusual difficulty waking requires emergency care.

    And for anyone, someone who:

    • is bleeding heavily and it will not stop with firm pressure
    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Contact the care team promptly for increasing pain, loss of previously gained function, new joint stiffness, skin injury from a brace, swallowing changes, or problems with mobility equipment.

    New or rapidly worsening weakness requires urgent reassessment.

    And for anyone, someone who:

    • has a wound that is hot, spreading red, or leaking pus
  3. 3

    Does any of this apply?

    Book an appointment

    Follow-up is usually coordinated among neurology, rehabilitation medicine, primary care, physical therapy, and occupational therapy.

    Depending on the symptoms, the team may also include pulmonology, orthopedics, speech-language pathology, mental health care, and peripheral nerve surgery.

    Routine visits may assess:

    • Muscle strength, reflexes, movement, and daily function
    • Breathing strength, cough, sleep, and airway clearance
    • Swallowing, speech, nutrition, and growth
    • Joint flexibility, posture, and spine or limb alignment
    • Pain, fatigue, mood, school participation, and family needs
    • The fit and usefulness of braces, wheelchairs, or other equipment

The article also says

Recovery can continue beyond the first few months.

Changes may be uneven, with improvement in some muscles but not others.

A home exercise plan should be guided by the rehabilitation team because excessive strain may not help severely weak muscles.

Every sign above is quoted from the sofidex article on Acute flaccid myelitis. If you are not sure, err upward — it is always reasonable to be checked.