Polio Place

Margaret Hinman and Marny Eulberg, MD, explain the Grand Junction, Colorado, Traveling Clinic and Mini Educational Meeting held September 2104. 

Planning and Publicity

The target population for the travelling clinic was the polio survivors in the Grand Junction area. Potential patients were identified through the Colorado Post-Polio Connections mailing list and from a list of previous support group members in the Grand Junction area. Those persons who were not on the Connections mailing list were contacted by phone if their number was available to see if they wanted to be sent the information about the clinic and the meeting.

Ultimately about 70 persons in the 813 to 816 zip code areas were contacted. This included people in Grand Junction, Montrose, Delta, Gunnison and other smaller towns in about 1 hour driving radius from Grand Junction.

The targeted population was sent an announcement and registration forms in the middle of March with an April 15 deadline for the May 13-15 clinic and May 16 mini educational meeting.

A follow up announcement was mailed after April 15 to the same population announcing just the mini educational meeting with a May 11 deadline for a phone-in response.

The Colorado Post-Polio Connections and Post-Polio Health International both had articles or announcements in their publications. On May 1, contact with the Grand Junction Sentinel newspaper resulted in an announcement of the mini educational meeting in their calendar section the Sunday before the event.

When the team was in Grand Junction, a patient who was evaluated contacted KREX TV who sent out a cameraperson who interviewed Dr. Eulberg and provided a short video on the mini educational meeting as news snippet that weekend.

From this search, 14 people received evaluations and 22 people attended the mini educational meeting.

Comments—the percentage of actual appointments to the number of contacts is quite high at about 20%.

The process for getting appointments and attendees for the mini educational meeting can be duplicated for future sites. There are most likely more polio survivors than were contacted in the area but the number of actual evaluations was reasonable for the time allotted. Word of mouth might result in more survivors being identified and might warrant another trip to Grand Junction in the future. The list of former support group members was a bonus and would be helpful if it is available when planning to go to other locations. Otherwise, the contacts will be limited to the Connections mailing list and the announcements in any easily accessible media outlets.

Traveling and Accommodations

The staff of the clinic and mini educational meeting drove two personal vehicles to Grand Junction.

Lodging included a suite and an additional room at the Airport Holiday Inn and Suites in Grand Junction. The suite was the site for the polio evaluations, allowing for an interviewing area and an evaluation area.

Comments—Two vehicles allowed ample accommodation for equipment and supplies and for team members to travel to and from Grand Junction according to their personal schedules. It will depend on circumstances, including the personal schedules of the volunteers and the amount of equipping needed to conduct the clinic whether this should be the norm for the travelling clinic.

The suite arrangement was almost ideal in terms of a site to conduct the clinic. The two rooms of the suite allowed the team to interview and take medical information in a comfortable seating area and then to administer the muscle testing using the foot of the bed as an examining table. It also helped conserve the time and energy of the volunteers in that they did not have to travel to another site to do the evaluations.

The bed was a little too soft to do one part of the muscle testing evaluation, but worked. In the future, a lightweight rigid board of some kind might be helpful. This should be something that can be easily transported and carried.

In setting future dates for the traveling clinic, a closer check on what other events are scheduled in the community could reduce the lodging costs incurred on Friday night as they were raised due to Mesa University’s graduation and the upcoming softball world series the following weekend.

Staffing

The staff of the clinic included Dr. Marny Eulberg, M.D., Maggie Hanlon-Hopkins, Physical Therapist, and Margaret Hinman, educational counselor. All are retired professionals and are volunteers.

Employing three staff persons was ideal. They worked well as a team utilizing their various skills and expertise to provide a thorough evaluation of the patients. Dr. Eulberg led the interviews. Maggie Hanlon-Hopkins conducted the muscle testing and Margaret Hinman assisted as part of the interview team and as a data recorder during the muscle testing process.

Comments—The clinic could be conducted with two persons if necessary, although Dr. Eulberg can conduct the muscle tests and Margaret Hinman can record muscle testing, the expertise of Maggie Hanlon-Hopkins was invaluable and hopefully can be duplicated at further locations.

Evaluations—The patient evaluations have four components:

• A written medical history of issues related to polio and co-morbities completed before the appointment
   
•  An oral interview to further gather information and more explanation of the items identified on the written medical history
   
• A manual muscle test of the polio affected areas
   
• A written report sent to the patient and his or her doctor of choice. The written report includes a summary of the information gathered, a copy of the muscle test and recommendations for the future.
   

Feedback from patients is attached to this document. All participants appeared to be pleased with the experience and grateful for the opportunity to have the evaluation. Some donated to Easter Seals Colorado c/o Post-Polio.

Of the 14 patients who were evaluated at the clinic, 3 were men and 11 were women. They came from Grand Junction, Gateway, Molina, Montrose and St. George, Utah. Their primary concerns included breathing problems and lower extremity functioning. The most pressing question was how they would continue to age with polio.

Educational Meeting

The purpose of the educational meeting was to provide an experience for polio survivors in the Grand Junction area that would encourage them to reestablish some sort of support/discussion group. Such a group would allow them to use each other and the resources available through Colorado Post-Polio and PHI in continuing to keep up with the results of their evaluations without the professionals provided by the clinic. It also allowed survivors meet each other, several of whom commented that they did not know that there were other survivors in the area.

The experience was set up as a model that could be duplicated without the leadership of a professional. This was stated at the beginning of the meeting along with strong encouragement for volunteers to organize further meetings.

The components of the meeting included:

• A three–hour time frame at a local deli that had a meeting room.
   
• An introduction and sharing of personal information such as name, etc. and an evaluation of the experience either in the clinic or of the opportunity to get together
   
•  A short video featuring Larry Becker talking about a philosophy of living with a disability
   
• A Q & A discussion led by Dr. Eulberg 
   
•  Lunch from the menu
   
• Cost--$15.00 payable at the door—the cost allowed this event to pay for itself.
   

Twenty-two persons attended, including spouses and adult children. The sharing was lively and personal, the information was well received, and two persons took home a leadership packet so that they could organize a follow-up meeting.

The original agenda included another video from PHI but time did not allow its showing. Future meetings in conjunction with the clinic could add ½ hour and include the video. However, not showing it did not detract from the success of the meeting.

Included in the event were coffee and a bagel midmorning snack. This is not necessary for future events.

Supplies and Equipment

Dr. Eulberg provided all supplies and equipment needed for the evaluations and for the meeting. This included all electronic equipment such as computers, projectors, and samples of items to show patients during the clinic.

With the clinic setting in a hotel room and the use of a bed as an examining table, some sort of firm surface to put on the bed would be useful.

Costs

Final costs for this clinic should be available from Colorado Post-Polio and Easter Seals.

In summary—In terms of a service to the polio community, the clinic and meeting were an almost flawless success. Feedback from the participants was positive, many expressing relief at the results, that they were doing something right and that their futures could not be as bleak as they imagined. All participants, including the volunteer staff, engaged in much laughter while doing the serious work of evaluations. This resulted in a positive experience that can be duplicated at other locations. The staff feels that this is worth the effort and the cost.