Question Title: Aquatic Therapy

Forum: Neurology Forum
Topic: Neurology - General

Posted by CCF Neuro MD on August 31, 1997 at 15:42:10:

In Reply to: Aquatic Therapy posted by Marie Fox on August 26, 1997 at 15:54:25:

: Dear Doctors,

SDS patients have an e-mail server to share information with each other. One young lady (36 years
old) is seeking information on aquatic therapy to present to her insurance company which is balking
at covering a swimming pool. She is unable to use public facilities because she has only one kidney
and must be on guard against UTI's. She has had rapid progression of symptoms and doctors have
told her she has a short life expectancy. She is really grasping at straws trying to find something that
works and she says she feels much better when diving to the bottom of a pool because it stabilizes her
blood pressure.

She has searched the web for information but has been unable to find anything to help. Please
respond to this message and I will pass it along to her.

Marie Fox

I guess you mean the Shy-Drager syndrome when you mention "SDS". As you possibly know, the Shy-Drager syndrome is a neurodegenerative condition of unknown cause which leads to an insufficiency of the autonomic nervous system in combination with features of parkinsonism or ataxia. One of the major problems resulting from autonomic insufficiency is orthostatic hypotension, or a drop in blood pressure on assuming an upright position. This symptom can be aggravated by exercise which tends to pool blood in the blood vessels in the leg muscles. As mentioned by you, swimming is a preferred form of exercise in the Shy-Drager syndrome (and in other states of autonomic insufficiency), because swimming is commonly performed in the flat or recumbent position, and because the pressure of water decreases the pooling of blood in the dependent (or lower) parts of the body.
I do not, however, know of swimming having any beneficial effect on the natural course or prognosis of the Shy-Drager syndrome. In reality, there is no therapeutic measure known to alter the long-term course of this condition. Also, I do not feel that swimming is necessary or essential for the symptomatic treatment of the Shy-Drager syndrome.
To say the least, it is unreasonable to expect an insurance company to cover the cost of a personal swimming pool for the reasons you mention.
If your acquaintance lives near Cleveland and wishes to have a second opinion, she is welcome to see Dr. R. S. Burns, who specializes in the Shy-Drager syndrome and other movement disorders. She could call (800)223-2273 toll free, or (216)444-5559 for an appointment.
I wish her good luck.

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