Implants may help Reeve breathe

Christopher Reeve, the actor who has been paralyzed and on a respirator since breaking his neck in a riding accident eight years ago, has had electrodes implanted in his diaphragm in an effort to restore his ability to breathe naturally.

The results are extremely promising, said Dr. Raymond Onders, who performed outpatient surgery on Reeve at University Hospitals of Cleveland on Feb. 28. He can breathe without the respirator for more than two hours at a stretch compared with 10 minutes before the operation, Onders said.

As his diaphragm muscles regain strength over the next couple of months, Reeve may be able to wean himself permanently from the respirator.

While breathing on his own, he is regaining the ability to talk normally. And when he is breathing more normally — not through the ventilator's hole in his throat — his sense of smell is functioning for the first time since his accident.

Reeve, who was expected to describe his experience at a news conference today in Cleveland, is the third person to receive the experimental treatment, called diaphragm pacing via laparoscopy, which has been approved by the Food and Drug Administration for use in 35 patients.

In the treatment, tiny wires are threaded through small incisions directly into the diaphragm. Surgeons use a tubelike instrument that causes very little tissue damage and patients go home the same day of the operation.

If the federal agency approves the surgery, it is expected to cost about $10,000. It is now financed by the agency, the Department of Veterans Affairs and other donors for use in five patients. Hospital officials said that $2 million to $3 million more would be needed to complete the trial.

One of Reeve's major goals has been to get off the respirator, said Dr. John McDonald, the neurologist at Washington University School of Medicine in St. Louis who set up an intensive exercise program that has enabled Reeve, to wiggle his extremities, to sit up partly by himself and, with great effort using neck muscles, to breathe for short periods without a respirator.

"Once Chris can breathe naturally on his own, and everything so far says he will, his exercise program should work even better," McDonald said.

Reeve was a candidate for the treatment because the phrenic nerves that control breathing, which run from the spinal cord to the diaphragm, were not injured by his fall. But the nerves meet the spinal cord below the site of Reeve's injury, so they could no longer receive signals from the brain stem where breathing is initiated. As a result, they stopped functioning.