"Is
heat intolerance also a post-polio problem? …"
by Richard Bruno PhD This article is from the Polio
Post News North Central Florida Post-Polio Support Group Sept 03
Question:
I read about ‘cold
intolerance’, that Polio Survivors are always cold. My feet are always cold in the winter, but I
have the most trouble in summer. I get
exhausted in the heat, especially when it’s humid. Is heat intolerance also a post-polio
problem?
Dr Bruno’s
Answer:
You bet. In our 1985
National Post-Polio Survey cold caused muscle weakness in 62% of polio
survivors, muscle pain in 60% and fatigue in 39%. But that survey also found
that 39% of Polio Survivors have fatigue when it’s hot.
Whether it is cold or
hot, polio survivors have three strikes against them when it comes to
controlling their body temperatures.
First, the poliovirus damaged the hypothalamus, the part of the brain
that serves as the body’s thermostat.
Second, the polio virus killed neurons in the spinal cord that make the
veins in your skin become smaller or larger as the temperature changes.
Basically, polio
survivors’ veins are always too big.
When its cold outside warm blood pools in those big veins near the
surface of the skin, causing heat in the blood to radiate into the air, the
skin to get very cold and to look purple or even blue. When it’s hot outside, or when polio
survivors take a long hot bath or shower, the skin becomes lobster red as the
veins and the arteries open wide and hot blood rushes to the skin.
When polio
survivors stand up, gravity pulls blood into the open veins in
their legs and blood pressure can drop, causing fatigue, light
headedness or even a faint. And then
there’s the third strike: Polio
survivors who have smaller leg muscles due to polio damage causing muscle
atrophy, have more blood pooling in the lower legs, since muscle contraction is
needed to help to pump blood back toward the heart.
So, since your body now
can’t regulate its own temperature, you will have to do it. Our 1983 study found that polio survivors’
nerves function as if it is 20 degrees colder than the temperature of their
skin. So in winter, polio survivors
should dress as if it is 20 degrees colder than the outside temperature. You need to dress in layers so that you can
regulate your body temperature by changing the amount of insulating clothing
covering your body.
But the trick is to stay
warm from the word go. You should dress
straight after showering when your skin is warm and red. Try wearing heat-retaining socks or even
long-johns. (If you ever need surgery
remember to remind the doctors and nurses that you get cold easily so they can
provide a heated blanket in the recovery room.)
When it is
hot, stay out of the sun, move more slowly and take more frequent
rest breaks with your feet elevated to make it easier for blood to flow
back to your heart so that you can prevent foot swelling and keep your
blood pressure up. It’s especially
important to have smaller amounts of food for lunch, have cool foods and cold
drinks, and to take a feet-up break after eating, since midday is when polio
survivors have the most trouble with dropping blood pressure and fatigue
It’s also a good
idea to take cooler baths or showers in summer and to keep the air
conditioning turned up. Cool the car
down too before getting in during the summer.
But be careful. Whether you’re being chilled by winter winds or by
air-conditioning in summer, always cover your upper body, especially your neck,
to prevent muscle spasms and headaches caused by cold air blowing on your
muscles.
Many polio survivors don’t
realise that they can have as many symptoms and sometimes even more, during the
change of seasons, when the thermometer goes up and down from day to night and
from day to day. Autumn and spring
bring increases in symptoms, especially muscle pain and headaches, as polio
survivors’ temperature-challenged bodies can’t decide if they
should sweat to stay cool or shiver to stay warm. Layering of clothing is especially important
in a thermally-confused world for the bodies of polio survivors, unable to
adapt to the temperature.
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Tessa’s
Comments: With
summer approaching, excessive sweating in the heat can lower our potassium
levels making it more difficult to cope with the heat of summer. Heat drains us of energy when potassium
is low and palpitations and heart problems can occur. Low potassium also increases muscle
weakness and swelling. As you need
a doctor’s prescription to get Slow K now, an alternative is
boiling potato skins and drinking the water (make it into soup) to get more
potassium. (Never throw your vegetable
water away – full of minerals.)
Other good food sources include most nuts, sunflower seeds, carrots,
apricots, avocados and of course bananas. |
