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Post-Polio Syndrome

History

Family History

With a surgeon for a father, Nancy always knew she would some day pursue a medical career. Little did she know that at the age of 17, she would contract polio ending her participation in two favorite sports, golf and ice skating. After nine weeks in the hospital and one year in physical therapy, she attended Washington University.

She chose occupational therapy because she enjoys creatively working with people. She felt her experience with polio heightened her sensitivity to others who were adjusting to changes.

Work History

She reduced her work load in 1985 following the first evidence of increased muscle weakness and fatigue. She shifted work from providing direct services to children to directing a day program for pre-schoolers with disabilities. She needed to change her work and living environment while she was able and before retiring.

She and her husband recently moved to a rural area. She has resumed direct service to children on a part-time basis, traveling between nine rural schools. She is concerned that as her level of disability increases, she will not be able to continue working at her occupation or secure health insurance.

A dream of Nancy and her husband is to restore a 19th century, two-story farmhouse into a bed and breakfast. The house sits at the end of a gravel lane on 57 acres of farm land. She and her husband are remodeling and adapting the old farmhouse themselves. Meanwhile, they live in a modular home which they have adapted with a ramp entrance and wide doorways.

What functional problems do you anticipate she will have in her work?

What financial concerns may need to be addressed?

Medical History

1979 muscle transplant semitendinosus into quadriceps on the left leg.
Prior records have been requested from St. John's Hospital in Tulsa, OK where she grew up and was first diagnosed.

Who should be on the assessment team?

Jointly, occupational and physical therapists do a manual muscle test. Additional observations include:

• lateral sway
• pelvic obliquity
• no footdrop (one leg appears stronger)

What functional problems might she develop as she ages?

Nancy explains to her therapist, "I am catching my left foot on curbs, even though I changed from tri-focals to progressive lenses to try to reduce difficulties in walking."

She continues, "My back and left leg are giving me more problems lately; I suppose I will soon have to use a leg brace." "I'm using the shower instead of the bathtub and am finding it more difficult to push up off the toilet seat with my left arm. I only have enough energy to walk up one set of stairs a day."