“I can really feel my body in the water.” Maybe that’s why Arjola Trimi, born in 1987, Paralympic swimming champion, has among her trophies – between Olympic, European and World Games – 7 gold, 6 silver and 5 bronze medals. A female athlete since she was a child, Arjola has always practiced swimming, but her competitive career only begins in 2013.
In 2012, in fact, her life changes, when a degenerative spastic tetraparesis – a form of paralysis that involves in particular the muscles of her legs and arms – takes away her sensitivity from her legs to her pelvis.
With her and Dr. Fabio Intelligente – anesthetist and coordinator of the Antalgic Therapy Service for chronic pain of the anesthesia unit and surgical day hospital at Humanitas – we talked about her illness and treatments to keep pain under control.
Swimming, illness and a new self-awareness
“When the disease occurred I rediscovered swimming – explained the athlete: getting into the water and not being able to swim for me was difficult, but the competition helped me a lot to perceive and rediscover my body. “After the despair and anger, there comes a time when you pick up the pieces and try to figure out what to do,” she confided, “you become aware of yourself, what has changed and what to do from that moment on.
What was the triggering factor of Arjola’s disease “is still a mystery, from the medical point of view – the swimmer explained again – but now I am aware of what is my new normality, certainly more difficult than before, but over time I have managed to build a daily life. Arjola’s hope is that “the research will go on” and that “it will be more and more guided by the interaction and feedback between doctor and patient, which is a fundamental principle”.
Among the main symptoms of spastic tetraparesis are paralysis of voluntary limb muscles, stiffness and hypertension, and muscle contractures. In addition, patients who suffer from it often lose coordination. Symptoms that are also the cause of “very strong pains”, – explained Arjola – “which were not manageable with first treatments”.
For this reason, for some years now Arjola has been following an analgesic therapy, also known as pain therapy, at Humanitas, which manages to control rigidity, contractions and muscle spasticity.
“This type of therapy has helped a lot – explained the champion – because I had no more pain so strong as to compromise my everyday life: from a semi-lying position I managed to return to sitting” and “the pains were much more controlled: I could manage better and be independent, as well as to practice my sport in the best way.
“After several attempts at treatment with drugs to be taken orally, I was directed towards this type of treatment: now I have a kind of pump that contains morphine and baclofen with which you inject a paradoxically smaller amount of drugs than I took orally, but that is much more effective, because it comes directly to the spinal cord and has an immediate effect.
“It is a reservoir implanted at the subcutaneous level – as explained by Dr. Intelligente – which brings the drug up to the level of the arachnoid space, i.e. in the area of the meninges. This allows infusing a quantity of the drug with much more effectiveness than those administered intravenously or by mouth.
To put an end to pain and return to daily life
“Being able to control pain, in any situation, can help to improve the quality of life; even for pathologies for which there is no definitive cure you can still benefit from analgesic therapy”, explained Dr. Intelligente.
“This applies to all patients: for example for those suffering from chronic pains, such as arthrosis” or “even acute and particularly disabling phases including shingles, also known as the Fire of St. Anthony” as well as the pains that often affect athletes. “They can be managed and this helps to live better,” said the doctor.
Different and personalized administrations
The instruments for administering analgesic therapy are different: from infiltrations, for example for back pain, to drugs, to radio frequency technologies or neuromodulation interventions and even techniques of regenerative medicine.
The modalities are different and decided by the doctor according to the characteristics of the patient and his pain: “they are consolidated and targeted techniques – assured the professor: our peculiarity is to look for more and more precise techniques. Thanks to ultrasounds or X-rays we can be more and more precise and certain to administer the therapy in the right place, thus giving the maximum possible effectiveness. It’s a type of treatment that you can customize, it’s almost tailor-made,” concluded the doctor.