Post-Polio Health, Volume 27, Number 2, Spring 2011
Ask Dr. Maynard
Frederick M. Maynard, MD
Question: My physician retired, and my new primary care doctor is “reevaluating” everything. I am nervous because he is questioning my medications, and I am not sure he understands my history. Can you help me understand his approach and offer assuring advice as he and I get to know each other? I am especially concerned about my new doctor’s making me reduce the pain medications I need.
Frederick Maynard, MD, retired physiatrist
Pain control in people with postpolio problems is highly individualized because there is no one source of pain. I would NOT endorse the use of a Duragesic patch (fentanyl transdermal system) for long-existing pain in a person with PPS because I think it is a “dead end” in regard to long lasting relief from pain.
Carol Vandenakker, MD
Physical Medicine & Rehabilitation
University of California, Davis, Health System
Presented at PHI’s 9th International Conference: Strategies for Living Well (June 2005)
A. You must start with a good primary care physician.
1. Keys to finding a good doctor:
a. Look for a physician you trust and can communicate with.
Communication is a two-way street. Participants in any relationship must have a mutual respect for the values, experiences, and skills that each brings to the encounter. Everyone is responsible for his/her own feelings, and experts recommend that feelings be expressed in the first person. Acknowledge them but do not place responsibility for them on someone else. For example, saying, “When such and such happens, I feel...” is preferable to saying, “You make me feel ….”
WHO ESTABLISHES THE POST-POLIO CLINICS IN THE STATES AND HOW ARE THEY ORGANIZED?
Joan L. Headley, MS, Executive Director
There is no official certification for a “polio doctor.” The most common use of this informal designation is a physician with knowledge, experience and interest in evaluation and treatment of polio survivors.
AN EFFECTIVE TOOL IN POST-POLIO MANAGEMENT
Mahboon ur Rahman, Peshawar, Pakistan
Brief Description of Work: Muscle power of polio-afflicted children were assisted and evaluated by Oxford Muscle Testing Chart. The chart as a diagnostic tool gives strength of muscles for the purpose of surgical interventions or physical regime.
To evaluate for post-polio syndrome, one must establish that an individual had paralytic polio and that current symptoms are due to the aftereffects of the remote polio and not due to other medical, orthopedic, or neurologic conditions. A comprehensive evaluation is done by a physician with input from members of a health care team who are experienced in the assessment and management of individuals who have neuromuscular diseases and/or functional limitations.