Polio Place

A service of Post-Polio Health International

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Linking with an Anesthesiologist

Why is it so hard to link up ahead of time with the anesthesiologist who will do my case?

Daily anesthesia staffing is a complex equation! It is extremely difficult to know ahead of time who will be doing which case on a particular day. There is a constant flux of anesthesia staff (people get sick), other needed staff such as techs, incoming emergency cases, obstetric anesthesia cases, cases may move from one OR to another and so on. And, anesthesia group size is increasing; it is not unusual to have groups of over 100 anesthesiologists.

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What is New (2014)?

What’s new in anesthesia that I need to know?

This is a brief listing. Answers will be expanded as time allows in the session.

a. Better measurement of quality of care in anesthesia and better recognition of where problems are and how they could be improved.

b. Increasingly sophisticated knowledge of ventilation problems and better management of respiratory problems postop.

c. Recognition that many patients are left with residual neuromuscular block and the possible complications.

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Anesthesia and Weight Loss Surgery

What are the issues in bariatric (intestinal surgery that can facilitate weight loss) surgery for post-polio patients?

This sounds like a “quick fix” for obesity but is an area full of possible problems. There are no reports of post-polio patients having bariatric surgery.

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Anesthesia and Colonoscopy

“Do I really need to have a colonoscopy? It requires anesthesia, and I’m afraid of that.”

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Weakness

New muscle weakness is the hallmark of post-polio syndrome and can significantly impact activities of daily living. Some amount of new muscle weakness is likely to occur in about half of post-polio individuals (Jubelt & Drucker, 1999). Muscle weakness is most likely to occur in muscles previously affected during the acute poliomyelitis followed by a partial or full recovery (Cashman et al., 1987; Dalakas & Illa, 1991).

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Evaluation Suggestions

To evaluate for post-polio syndrome, one must establish that an individual had paralytic polio and that current symptoms are due to the aftereffects of the remote polio and not due to other medical, orthopedic, or neurologic conditions. A comprehensive evaluation is done by a physician with input from members of a health care team who are experienced in the assessment and management of individuals who have neuromuscular diseases and/or functional limitations.

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Diagnosis

 The criteria for diagnosing post-polio syndrome include:

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Anesthesia

Modern anesthesia has become extremely safe, but many survivors fear it because of reports of problems during and after anesthesia. Potential problems include a greater sensitivity to the paralyzing drugs (muscle relaxants), possible need for mechanical ventilation after surgery, and pain problems after surgery. All survivors, especially those with a history of respiratory involvement, need to tell their surgeon and anesthesiologist about having had polio (Calmes, 1997).

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Anesthesia and colonoscopy

Selma H. Calmes MD, Retired Anesthesiologist

Many polio patients fear anesthesia. Multiple surgeries in childhood were common for those who had polio and anesthesia care then was not as sophisticated as it is today. Modern anesthesia is much improved since the time of polio epidemics! In this session, an anesthesiologist familiar with modern anesthesia practice and polio will answer recent, common questions asked by post-polio patients. If time, the audience can ask their own questions.

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