Doctor Confidentials: Amyotrophic Lateral Sclerosis Ice Bucket Challenge

The other day, I was involved in a discussion about the "ALS Ice Bucket Challenge". I'm sure this has been a common topic of discussion amongst people lately, given how viral the campaign for raising awareness has been. It kind of caught me off guard though, when the person I was speaking with said, "I get that this campaign raises awareness for ALS, but how many people doing the challenge even know what ALS is? I know I don't even know what the acronym stands for".

As a medical student/resident, you develop your own vocabulary. I often find myself telling a story to my friends and they look at me like I'm speaking a foreign language. It's easy to forget that common knowledge to someone in medicine is not the same as common knowledge in other professions. So, for anyone who doesn't know what the disease entails or what the acronym stands for - I have put together a mini lesson:

ALS: Amyotrophic Lateral Sclerosis, also known as Lou Gehrig's disease after the famous Yankee baseball player who had the disease

What is it?

- Neurodegenerative disease involving both upper and lower motor neurons (see below for signs)

- Progressive and incurable

Who does it affect?

- 1 to 3 people per 100,000

- Genetic or familial in only 10 percent of cases

- No ethnicity predominantly

- Men more than women before age 65-70, then affects each sex equally

- Most commonly occurs in 7th and 8th decades

What are the features?

- Upper motor neuron signs: slowness, hyperactive reflexes, spasticity

- Lower motor neuron signs: weakness, muscle atrophy/pain, visible muscle twitching (fasiculations)

How does it usually present?

- asymmetric limb weakness, difficulty with swallowing and speech are the most common

Why is it fatal?

- ALS eventually leads to neuromuscular respiratory failure or inability to swallow

The ALS Ice Bucket Challenge:

By now, you have to have been living under a rock to not have heard of this campaign. How it started though, seems to be less publicized. Initially having nothing to do with ALS, the "ALS Ice Bucket Challenge" as we know it was started when a golfer named Chris Kennedy was nominated for the Ice Bucket Challenge. The original challenge involved the ice and the bucket, but allowed you to make donations to a charity of your choice. Since he had a relative affected by the condition, he chose the ALS Association. He posted the first video on July 16th, 2014 and the campaign caught on like wild fire. Within a month, Martha Stuart, Oprah, Lebron James and Mark Zuckerberg had all posted their videos. But is this just a social media trend?

Many articles lately have scrutinized the campaign. Opinions about the challenge have been voiced by associates at TIME magazine, Forbes, among many other notable magazines and newspapers. The most popular concern amongst critics seems to be regarding those people who participate in the challenge, but don't donate to the charity. However, as of today, the ALS Association has received 22.9 million dollars since July 29th, compared to only $1.9 million during the same period last year (http://www.alsa.org/news/media/press-releases/ice-bucket-challenge-081914.html).

So, while I am not a huge fan of social media fads, I believe the proof is in the pudding - it's likely about time I accept my nominations and keep this icy ball rolling.

Oh, and don't forget to donate :)

Cheers to getting chilled!