Post-Polio Syndrome & M.E.
Post-Polio Syndrome & M.E. Courtesy of the British Polio Fellowship.
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| Whilst Post-Polio Syndrome (PPS) and M.E. resemble one another in many ways this does not mean that they are one and the same. Similar characteristics include fatigue, lack of endurance and aches, pains and weakness in muscles. Due to this similarity some PPS sufferers are misdiagnosed as suffering from M.E. (a condition far more familiar to modern doctors). The management of these symptoms is also similar being mainly based around pacing or energy management – that is striking a balance between over and under activity. The two diverge in their cause – PPS can only occur in a person with a history of Polio, and is not an immediate consequence but occurs 30 or more years later and can equally affect those who appear to have made a full recovery as well as those left with a permanent disability. Whilst there is not full agreement on the cause of PPS the most common theory is that overused motor neurons experience a premature ageing, to understand the reasoning behind this it is useful to have some understanding of Polio. Poliomyelitis (or infantile paralysis) is actually due to one of three viruses, which cause a range of symptoms from a short-term flu-like illness to paralysis ranging from one or more limbs requiring physiotherapy for rehabilitation, to the whole body including the muscles of breathing and swallowing necessitating the use of the most famous image of polio - the iron lung. Recovery can be complete with a return to normal life or partial with a lingering disability, most often paralysis or weakness of one or more limbs, in very rare cases total paralysis may persist indefinitely resulting in a long term dependence on ventilation in a similar way to those with severe spinal-cord injuries. In the developed world, Polio is virtually unknown now due to vaccination, though it does still occur in the developing world (such as parts of India and Africa) and anyone travelling there should ensure that they are vaccinated (check with your GP, they will know if the location you are visiting carries a risk of contracting Polio). Very occasionally parents or grandparents who missed out on vaccination when they were children can catch Polio from the contents of a newly vaccinated baby’s nappy. People who have had Polio should also be vaccinated as they will only be immune to one of the Polio viruses – the one they suffered from – not all of them, for Polio-affected people and anyone with a compromised immune system the dead (injected) vaccine is a safer alternative to the more familiar live (sugar-lump) vaccine. The symptoms of Polio are caused by one of the viruses attacking motor neurons (a type of nerve) in the spinal cord, sensory neurons (another type of nerve) are unaffected and as such ability to feel pain, heat, cold, touch, etc is not affected. These motor neurons (like all neurological tissue) cannot be re-grown once dead, therefore, in recovering from polio neighbouring motor neurons must sprout additional branches to supply the muscles that are now without – naturally enough these can easily be overworked. This leads to a second disability many years later – PPS. In parallel to these motor neurons now handling twice or more their normal load, unaffected limbs may have had to compensate for those disabled by the polio virus for example arms and shoulders may feel the consequences of years of using crutches to make up for weakened legs. The most common symptoms of PPS are those that are similar to M.E., including fatigue, muscle aches and weakness and lack of endurance. However, depending on the extent of the original illness there may be other symptoms, including increased sensitivity to cold (especially of limbs when circulation is affected) breathing problems (most commonly at night and characterised by a severe headache on waking that eases later) and swallowing and/or speech difficulties. Many of the symptoms of PPS can be stopped from progressing, if not reversed, by proper management, the most important part of which is pacing or energy management – over-activity can result in quicker tiring of limited neurological resources, whereas under-activity results in stiffened muscles requiring more effort to ‘get going’ again. Striking the right balance is the key! In practice this means doing what you want or need to do but building in breaks just before you get tired. It is also important to consider eating a healthy diet and not getting too overweight, giving up smoking, and it may also be necessary to consider using orthotics such as callipers or braces to support joints that are no longer able to support themselves adequately. Your doctor needs to be aware if you have had Polio as some drugs may have greater effects on Polio-affected people and will need to be prescribed with greater caution and carefully monitored, these include beta-blockers, sedatives and anaesthetics. If you would like more detailed information about PPS or what the BPF does (including a bi-monthly magazine, local branches and groups and benefits advice) contact us on: British Polio Fellowship Eagle Office Centre, The Runway, South Ruislip, Middlesex HA4 6SE Phone: 0845 4500 225 Fax: 0845 4500 226 Email: info@britishpolio.org Website: www.britishpolio.org © British Polio Fellowship |
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