Polio Place

A service of Post-Polio Health International

Spanish

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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Pain

Pain can be due to any number of factors ranging from very benign to quite serious. Polio survivors who are experiencing pain should undergo a comprehensive medical evaluation to diagnose its cause. Pain is most often due to overuse of muscles, tendons, ligaments and/or joints, and primary interventions are directed at alleviating or eliminating the overuse factors.

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Wellness

Throughout life, people move in one direction or another on the wellness continuum ranging from maximum performance on one end to serious illness or premature death on the other end.

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Non-Fatiguing General Conditioning Exercise Program (The 20% Rule)

Stanley K. Yarnell, MD (retired), California

The non-fatiguing general conditioning exercise program using the 20% rule was designed to restore stamina or endurance for those individuals who have continued to be bothered by profound fatigue following surgery, illness or trauma.

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PHI's Statement on Exercise for Polio Survivors

Advising all polio survivors not to exercise is as irresponsible as advising all polio survivors to exercise.

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Exercise - The Basics

Muscle stretching and joint range-of-motion exercises are important whenever there is muscle weakness. Preventing tightness, where muscles are weak, is important to maximize function and is particularly important in the chest wall and abdominal musculature if there is a limitation of breathing capacity. Preventing tightness in the hip and knee is important to maximize walking ability when there is significant weakness of the hip and thigh musculature.

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Underventilation

New breathing problems in aging polio survivors can be insidious and often not recognized by either polio survivors or health care professionals. Individuals who used an iron lung, or barely escaped one, during the acute phase should be aware of potential problems to avoid underventilation and possible respiratory failure. Those survivors who did not need ventilatory assistance during the acute phase, especially those who had high spinal polio and who have upper body weakness and/or diaphragm weakness, may also be at risk.

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