Polio the second time around


DEAR DR. DONOHUE: I am 78 and had polio when I was 17. I have lived with weakness on my left side. About a year ago, I started feeling a lot of fatigue. I saw an endocrinologist, who tested for low testosterone and thyroid. I took medicines that fixed both problems, but I still feel very fatigued. How do I determine if the fatigue is caused by postpolio syndrome? — T.M.

ANSWER: Postpolio syndrome does not mean that the polio virus has returned. It does mean that nerve cells adjacent to those attacked by polio are starting to shrink and die. Those nerve cells took over the work that the polio-killed nerve cells had done. This takes place many decades after the original attack. The result is muscle weakness and sometimes muscle pain. The most prominent symptom is fatigue.

No test proves postpolio syndrome. If a person has a doctor who knows what polio had done to that person’s muscles, he or she can detect whether new muscles have been added to the list of those that are not functioning. Rarely does such a lucky knowledge of doctor familiarity with the previous muscle involvement exist.

Fatigue, however, is a classic criterion of postpolio syndrome. If, in addition to fatigue, you have new muscle weakness or new muscle pain, then you can be quite sure it’s postpolio syndrome that’s to blame.

Although no medicine exists to reverse the weakness, therapy with nonexhausting exercise is helpful. For the fatigue that is so common with this syndrome, pacing yourself and taking rest breaks, even naps, during the day can restore pep.

A neurologist is the doctor you want to consult.

You’d be wise to contact Post-Polio Health International, an association dedicated to helping those who were stricken by polio and those who have post-polio syndrome. The phone number is 314-534-0475 and the website is www.post-polio.org.

TO READERS: Questions about breast cancer and its treatment are found in the booklet on that subject. To obtain a copy, write: Dr. Donohue — No. 1101, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I will be 81 this February. The most notable event in that time was congestive heart failure in 1997. This past May, three burly ambulance personnel had to lift me off the bathroom floor because I was unable to move. After half a dozen doctors prescribed many different tests, I still had no diagnosis. My new GP believes I had rhabdomyolysis. It would be wonderful to have a few words about it from you. — L.O.

ANSWER: Rhabdomyolysis (RAB-doe-my-OL-luh-siss) is something that makes me think of athletes exercising to exhaustion on hot days or Army recruits doing the same. That’s not true. It can happen to anyone. It’s massive damage to muscles, with release of their contents into the blood. Some of those materials cause kidney shutdown. Potassium released by the cells causes heartbeat irregularities. Overheating, crush injuries, high fever and heatstroke are some of its causes. The urine turns dark reddish-brown. Pain is prominent. It’s an emergency. If you did have it, you have made a complete recovery. Most young people do. Some older people don’t.

DEAR DR. DONOHUE: I have MRSA. I got it in the hospital after abdominal surgery. I have two young grandsons. I don’t want to pass it to them. I’ve been told that unless I have open sores and touch the sores, and then touch my grandsons, they cannot get infected. Is that true? — M.R.

ANSWER: MRSA (pronounced “mersa”) is a staph germ resistant to many of the commonly used antibiotics. You are not a threat to others or to your grandchildren. If you were, your doctors would not have released you from the hospital. I am sure that in the hospital you must have received the appropriate antibiotics. Your grandsons are not in danger of picking it up from you.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.