Dr Bruno from USA writes extensively on post polio.  Re-issue of summary of article written several years ago

1. Listen to Yourself – Listen to your own bodies; observe how your feel, both physically and emotionally; keep track of activities and related symptoms.

2. Activity is Not Exercise – The more you overuse your muscles, the more strength you may lose. Muscles affected by polio lost at least 60% of their motor neurons, and limbs you thought were not affected lost as much as 40%. Conserve to preserve. Stretching may help pain, and non-fatiguing exercise for specific muscles can help prevent further loss of strength. Bracing may also help.

3. Brake, Don’t Break – Dr. Bruno’s research showed that taking two 15-minute rest breaks per day was effective treatment for PPS symptoms. Another study showed that by pacing activities, less fatigue results.

4. A Crutch is Not a Crutch – Adding a brace is not a sign of failure or of giving up. You use three times less energy using a short leg brace on a weakened leg. Overworked muscles and joints hurt and weaken motor neurons, but adding assistive devices can decrease symptoms. You don’t drive your car until it’s out of gas, so why drive your body until it’s out of neurons?

5. Just Say “No” to Drugs, unless – Many studies have not found that any drug effectively treats PPS. Yet, at least two studies have shown that polio survivors are twice as sensitive to pain as everyone else and usually need more pain medication for a longer time after surgery or an injury.

6. Sleep Right All Night – Many have disturbed sleep due to pain, anxiety or sleep disorders, such as sleep apnoea or muscles twitching. A sleep study may be beneficial if you awaken at night with your heart pounding or choking, or awaken in the morning with a headache and not feeling rested.

7. Some Polio Survivors Like It Hot – According to Dr. Bruno, some have cold and purple-looking feet because the nerves that control the size of blood vessels were destroyed by the poliovirus. He found that polio survivors’ nerves and muscles function as if it’s 20 degrees colder than the actual temperature. When going outside, dress in layers that hold in your body heat.

8. Breakfast is the Most Important Meal of the Day – Recent studies show that the less protein polio survivors have at breakfast, the more severe their fatigue and muscle weakness during the day. He suggests 16 grams of low-fat protein for breakfast and small snacks throughout the day. (maybe he should try carnitine!)

9. Do Unto Yourself as You Have Been Doing For Others – Polio survivors often became super-achievers, doing everything for everyone except themselves. Many don’t ask for help. Accepting assistance is not the same as being dependent. Accepting assistance can keep you independent.

10. Make Doctors Cooperate Before They Operate – According to Dr. Bruno, polio survivors are easily anaesthetised because the part of the brain that keeps them awake was damaged by the poliovirus. They stay anaesthetised longer and can have breathing trouble. Even nerve blocks using local anaesthetics can cause problems. He suggests that we have lung function tests before having a general aesthetic. Provide a complete polio history and any new problems to your surgeon and anaesthesiologist before surgery. He recommends that polio survivors not undertake same-day surgery or outpatient tests requiring anaesthesia, but rather plan to stay overnight at the hospital for observation.

(For a copy of “Preventing Surgical and Anaesthesia Complications” go to www.postpolioinfo.com/PostPolio/index.htm).