Can You Help?
(continued)
ITEM CYH11-102
I want to find my medical records before I see a physician about my post-polio problems. Where should I start?
First of all, your medical records might be of interest, but probably of little real value to your physicians for treatment decisions. You can contact the records department of the hospital, or its current legacy institution, and ask if any records from the year you were hospitalized are available. In many areas of the country, records from that period have been lost or destroyed. Some are available on 'microfisch' or similar long-term storage tape files. Do inquire, but you may not be successful.
Assuming records are not available, and even if they are and do describe specific muscles with residual weakness, the one thing you can do is to seek an evaluation by a physician who is at least familiar with post-polio syndrome, such as a local neurologist or physiatrist (physical medicine & rehabilitation specialist).
If there is doubt as to whether you had polio, for example, they could perform an EMG (electromyography) test. One reason is to establish that muscles show a pattern of electrical activity compatible with having remote (old) polio involvement; that is, they look to have lost the normal number of motor nerve cells.
Secondly, the test will show if the nerve/muscle cell status is stable, or unstable; and this can then guide your physicians and therapists in treating you, including how much exercise and how concerned you/they need to be about overexercising/overusing muscles.
They or you may also wish to check the following reference in the medical literature to become familiar with the use of the EMG test information for guiding management. See Halstead, L,Carrington, G,Pham,B.(1995). National Rehabilitation Hospital Limb Classification for Exercise Research, and Clinical Trials in Post-polio Patients. Annals of the New York Academy of Sciences, (May) 753,343-353.
ITEM CYH11-101
I had polio, still walk but have scoliosis. I am having increasing problems with constipation. I am working with my physician. Is the treatment for constipation different if the cause is from post-polio problems?
No, the treatment is not different. Effective prevention steps can be challenging and relate to additional risk factors for constipation among polio survivors. These include: low activity levels/immobility from extensive paralysis or "PPS fatigue"; limited push for evacuation from lack of abdominal muscles; limited positions to assume for defecation because of trunk/limb muscle weakness. Diet, fiber, fluids and regular habits are the mainstays of prevention. Laxatives can and should be used cautiously on a regular basis, but are needed for early treatment in order to prevent the more severe problems of impaction that require hospitalization and more drastic measures. The above sounds easy, but the details for individuals can be very challenging. -Fred Maynard, MD
ITEM CYH11-100
Luiz Baggio Neto, from Associação Brasileira de Síndrome Pós-Poliomielite, has asked PHI to gather opinions on AN ICD - 10 CLASSIFICATION OF POST-POLIO SYNDROME.
The International Classification of Diseases (ICD) is an inventory of all human diseases known. It was created by the World Health Organization (WHO) to provide statistical references and to show the prevalence of diseases in the population.
The ICD is also an important medical support in the planning and assistance in public health programs of many countries, because the legislation and the benefits in the public health and social insurance are based in the ICD.
The ICD-10 does not list Post-Polio, but only Polio Sequelae (classification is B-91).
Although Post-Polio Syndrome is a consequence of poliomyelitis, it can be seen as another medical entity and not just sequelae of polio. Points in support of this thesis include:
- Not all polio survivors have post-polio syndrome.
- A small percentage have new unexplained weakness.
- It is distinctly different than the acute episode.
- Some of the symptoms of post-polio include new weakness, new pain and new excessive fatigue, sleeping disorders, and increased cold intolerance.
The Escola Paulista de Medicina of Universidade Federal de São Paulo – UNIFESP (a Brazilian university specializing in medicine and medical research) and ABRASPP – Associação Brasileira de Síndrome Pós-Poliomielite (www.abraspp.org.br) – has introduced to the ICD committee the request to create a specific classification of Post-Polio Syndrome (PPS) in the present IDC-10.
The request is under discussion at this moment. If you believe that the classification of PPS is important to the health system or the social insurance of your country, please send your opinion to ABRASPP: diretorpresidente@abraspp.org.br (Luiz Baggio Neto)
