Printer-Friendly Version

Forward to a Colleague

Permission for Use

Register for CEU

Post-Polio Syndrome

Closing Viewpoints

Patient: My life has changed for the better even as I face the late effects of polio. Our home is now accessible for me as well as our guests after the addition of a large accessible bathroom, a ramped breezeway to the garage and stair lifts up to the guest rooms and down to the basement room I use for weaving and gardening. We've moved into our retirement dream house and opened our bed and breakfast. To help maintain my mobility, I bought a pair of crutches to use with my leg brace. I have also made changes in my work that will tax me less physically. I teach part-time now in a city where I can swim. Both work and leisure are important activities in maintaining my mental and physical health. I have access to a team of rehabilitation professionals and a national Polio support network based in St. Louis as well as my local internist, nursing and therapy colleagues.

Internist: I work closely with Nancy on routine medical needs, but also refer to orthopedic, pulmonary or rehabilitation specialists when the need arises. Nancy has made remarkable and practical changes that allow her to maintain her work and lifestyle as a polio survivor in rural Missouri.

Physiatrist: On Nancy's last visit, I checked her muscle strength and gait to determine if there was much change from her visit 18 months ago. I listened to her concerns and asked her what she wanted to do about them. I asked about her general physical health and what I need to do to support her. I didn't try to tell her what to do. Nancy describes it as a non-directive attitude. Our team has the resources for dealing with medical as well as psychological developments. If medicine is needed, I can prescribe it, but we generally take a conservative approach to treating symptoms of PPS.

Nurse Practitioner: Nancy had to give up some of her direct service to young children to take a job as an educator. She now visits families with foster and Medicare children less often, once or twice a month, for the health department. However, she is educating a group of direct service providers who can carry on the kind of work she has begun in our area. As she moves closer to her retirement dreams, she is giving her knowledge and wisdom in new ways. Her bed and breakfast has become a restful haven for students and for other people with disabilities who enjoy getting away to the country for a weekend. She has demonstrated that old buildings can be esthetically pleasing and accommodating for all people.

Physical Therapist: Nancy got the leg brace re-evaluated with the help of the orthotist and physiatrist. After considering the options, Nancy ordered her own Lofstrand crutches. This will give her the stability she needs for remaining mobile while wearing the leg brace. Her own creative adaptations as an occupational therapist may make this step of depending on adapted devices easier. A vigorous exercise program would be contraindicated for Nancy. She loves to swim and wisely recognizes this as one way she can maintain her strength and flexibility as a polio survivor.

Occupational Therapist: To go from using only a cane for walking to using a leg brace and crutches will cause a major function change in work, home and the community. It potentially alters Nancy's self-image and sense of independence.

Orthotist: Nancy revisited the physiatrist, P.T. and me this year and together we determined that the leg brace would work best if used with Lofstrand crutches. Nancy has been proactive and purchased the crutches before they become imperative and will be experimenting and adapting over time to the changes required in her lifestyle. Adjustments and repairs will still require driving unless we can locate an orthotist in the area.

Respiratory Therapist: In Nancy's case, the breathing muscles are normal but learning some deep breathing and relaxation techniques has helped her with the adjustments she is facing. When she is getting drowsy during long drives in the car, she stops. She practices deep breathing and does some deep pressure exercises against the roof and dashboard of her car. These techniques help her relax as she stretches and opens up her oxygen intake. These are simple, small changes that make a big difference in terms of her ability to pace herself and carry out the work she loves.

Psychologist: Nancy was able to cope with job and lifestyle transitions very successfully. She has been someone who does not hide her disability, consequently, she has been able to more fully integrate it into her self-image and create a successful and meaningful life. She moved from directing a school for special needs children in the city to private practice in a rural area. She is discontinuing some of her direct service and gaining the time and energy to develop new pursuits. She is moving into teaching and following her dream of running a bed and breakfast in retirement. She knows her needs and is not timid to ask for help. Our job is to help post-polio survivors navigate the changes resulting from PPS, the aging process, and the depression or anxiety that often accompanies these losses.