Ask Dr. Maynard
Welcome to Ask Dr. Maynard, a new feature of Post-Polio Health. Frederick M. Maynard, MD, a longtime member of PHI’s Board of Directors, is a recently retired physiatrist, a specialist in physical medicine and rehabilitation. He dedicated a significant portion of his academic and clinical practice over the last 25 of his 40-year medical career to the unique problems of polio survivors.
Questions posed to Dr. Maynard by PHI Members in Post-Polio Health ...
2011
Question: I had polio in 1940. With treatment and exercise I was able to live a “normal” life and taught school for many years. At age 50, I started having new weakness. I am now 79 and my legs have shown greater weakness. I wear a full brace on my left leg and a short brace on my right leg. Lately I have been falling, even with my walker. My left leg is very swollen but medical tests do not show anything. Could the late effects of polio be causing the swelling?
Question: Do you know of any polio survivors who are experiencing numbness in their affected areas? I did some physical therapy recently for about six weeks using both sides of my body to improve the strength in my unaffected leg, and noticed that my left arm (the affected side) was becoming numb and then later in the day, my left leg would also become numb (just the top part of my arm and leg). My family doctor is sending me to a neurologist to see if I have a pinched nerve but he and I both think it is polio related. Since I have stopped physical therapy it has quieted down, especially if I use Aleve®, a heating pad or warm water at the pool. I'd appreciate your advice.
Question: I had all three types of polio. I was paralyzed from my throat down and was unconscious. Now I am 69 years old and have been diagnosed with Postural Orthostatic Tachycardia Syndrome (POTS). Could polio, post-polio and POTS Syndrome have any connection and/or relationship?
Question: My physiatrist says that paraplegics have a lot more diabetes, so I started wondering how post-polio and spinal cord injury compare with regard to the disease.
Question: My father-in-law is 88 years old and has post-polio syndrome. He has had trouble sleeping for the past several years, and he claims that it “takes more medication for people with post-polio syndrome.” My wife is his caregiver and controls his medications so he will not overdose. What is your professional opinion?
Question: I have a severe rotator cuff tear and an orthopedic surgeon has recommended a shoulder replacement because of the severity of the tear and the presence of significant arthritis. I had polio in my right leg and use my left leg to lift/stabilize myself on crutches. Apparently the increased dependency has weakened my arms and, perhaps, injured them. The surgery may help or may create complications. Can you share any knowledge to help me make an informed decision?
Question: I’ve asked my doctors in the past about PPS, and they indicate that at my age – 65 – it is highly unlikely that I could develop PPS since it has been so many years since I contracted polio. Do you have any statistics on PPS occurring 60 years after having polio?
Question: My physician retired, and my new primary care doctor is “re-evaluating” everything. I am nervous because he is questioning my medications, and I am not sure he understands my history. Can you help me understand his approach and offer assuring advice as he and I get to know each other? I am especially concerned about my new doctor’s making me reduce the pain medications I need.
Question: I am a polio survivor who has had untoward and paradoxical responses to muscle relaxants and meds in particular, but also possibly to lidocaine pain patches used for the first time this year. I was hospitalized, through the emergency room, with cellulitis of my stronger leg while on vacation. I don’t remember the first few days in the hospital, and suspect this was treatment-related. I found it scary to think that my medical history information was not treated as important! I would like to know if this reaction relates to being a polio survivor. I’m open to new information and suggestions of how to avoid this in the future
2010
Question: I read about muscle wasting in people who age (sarcopenia) in the syndicated column of "Dr. Donohue." As a 78-year-old polio survivor who is getting weaker, I am not sure if it is post-polio weakness or aging weakness. Is there a way to tell the difference? Does it matter? Are the management recommendations for each cause?
Question: Has there ever been a study of whether antidepressants help relieve muscular pain and fatigue? Is it a plausible treatment for people who have had polio?
Question: I am a polio survivor with PPS. Recently I began to suffer severe knee instability, but a sports medicine specialist recommended against braces, saying they would inhibit the muscles from regenerating. It seems to me that polio-atrophied muscles will not regenerate anyway and that braces would at least help to prevent collapse. Your thoughts?
Question: Can a Grade 3 concussion cause the onset of post-polio syndrome (PPS)? I developed the symptoms during recovery from a concussion and have been diagnosed as having PPS.
Question: Are there any nutritional issues that polio survivors should pay special attention to? Are there any particular dietary needs or concerns? Any supplements that are beneficial?
Question: Can I regain some muscle mass and strength through exercise? I would love to work my legs harder, but have heard that I could damage my muscles since they may not have the capacity to recover. Should I experiment with a strenuous routine to see if I can improve strength, or do I risk doing damage and further deteriorating my legs?
Question: I have seen advertisements for products that claim to "cure" PPS. From all I know, there is no cure. Do these products have any beneficial ingredients that may help us?
2009
Question: I am aware that as polio survivors recovered from the initial bout with polio, we went through a process called denervation. Does this process of losing anterior horn cells (AHCs) and establishing new nerve pathways continue with post-polio
syndrome?
Question: As my leg muscles become weaker, I notice that now I use my toes more than my whole foot when I walk. A polio friend of mine has made the same observation about his method of walking. Is this coincidence or is there a connection between weak leg muscles and using toes more to walk?
Question: I am 69 and had polio in my right foot when I was 20 months old. I have had tendon transplants, heel cord lengthening surgery, and some toes fused. ... Since a total hip replacement, I tire much more easily and walk with a cane. ... Should I walk as much as possible (30 minutes or so a day) or “save my strength” ...?
Question: I am a male age 60 who contracted polio at age six months and Guillain-Barré syndrome at age 40. I was diagnosed with post-polio syndrome at age 55. Four weeks ago I had testosterone pellets implanted when I found out I had a major testosterone deficiency. ...I felt compelled to write to you and describe the results in hope that you may pass them along. I have no logical answer other than the testosterone replacement.,,, Can you explain the lack of response?
Question: Often we polio survivors have very few options that are helpful in understanding our circumstances and what direction to take. Thank you for being available to provide this important service. Here is my question in three parts. ... (PPS) is not life threatening. Is this still a valid statement? Is there any evidence to the contrary? ... does PPS affect the brain’s ability to function normally in speech, sight or thought processes (through stress or brain lesions)?
Follow-up Question: In Vol. 25, No. 1 (page 3), Dr. Maynard responded to a question about “using my toes more than my whole foot to walk now.” .... Ms. Toher asked, “What can I do about this?
Question: People in my post-polio support group say I need to see a “polio doctor.” What is a polio doctor? Do you agree that polio survivors must see a physician with such a designation? Do I need my old medical records?
Question: Is there a definitive medical position if polio survivors should take the flu vaccine each year? Last year when I went to get the vaccine, the staff notified me that Guillain-Barré syndrome is one of the risk factors of the vaccine. Should one not take the vaccine if you have a history of paralysis?
Question: I have concerns regarding the H1N1 vaccine. Are polio survivors considered an at-risk group?
