BIOTECHNOLOGY Man can cough again with help from device

A doctor's invention allows the quadriplegic to clear his throat and lungs.
CLEVELAND (AP) -- Just five weeks ago, Ronnie Moore could not do what most people take for granted. He could not cough.
Now Moore, a quadriplegic, can cough any time he wants by simply pressing down on a black control box on the tray of his wheelchair.
Recently, he achieved his first cough, bringing a smile to his face and to the face of his doctor, Anthony DiMarco, a research scientist at MetroHealth Medical Center in Cleveland.
"That was the first cough performed electronically by a quadriplegic," Dr. DiMarco said.
Five weeks ago, three electrodes the size of pencil erasers were surgically implanted near the surface of Moore's spinal cord to activate the nerves emanating from his lower thoracic spinal cord. Wires connect the electrodes to a small receiver implanted under his skin, just below his rib cage.
A small external battery pack attached to the receiver activates the electrodes to contract the abdominal muscles, causing them to generate a cough.
Breathing easy
"I feel air moving out of my throat," said Moore, a man in his 50s, who lives in Madison, about 40 miles east of Cleveland.
He said the process was not painful.
"I've had muscle spasms that hurt worse than that," he said.
When Moore presses 1 on the control pad, he produces a single cough. Pressing 2 on the pad produces a series of three coughs.
Moore was paralyzed from the neck down in a 1998 car accident. He is the first patient to participate in a four-year, $1.5 million study paid for by the National Institutes of Health.
Dr. DiMarco says three quadriplegics are scheduled to receive the implants in September.
Not being able to cough made Moore much more susceptible to respiratory infections like bronchitis and pneumonia -- a leading cause of hospitalization and death in paraplegics and quadriplegics.
He also has not been able to clear his throat of food or secretions without help from an attendant at the nursing home where he lives.
Dr. DiMarco said it will take at least three weeks before medical personnel can determine how much electrical current is needed to give Moore consistent, strong coughs.
"This will make him more like a normal person who can cough anytime he wants to," the doctor said.
Moore said he looks forward to eating dinner without having to worry about choking.

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