Mar 16, 2016

Human Achievement of the Day: Polio Eradication


Polio used to be a parent’s worst nightmare. The virus mostly affects children, and hampers the brain’s ability to communicate with muscles. While its effects are usually temporary, polio can lead to permanent paralysis and even death. If the paralysis reaches the respiratory system, victims will be unable to breathe on their own, which led to the depressing sight of hospital wards filled with rows and rows of iron lungs (pictured below). Polio can also cause permanent muscle atrophy, making walking difficult long after the disease runs its course. It has no cure, so once a child catches it, they can only hope their case is a mild one.
Then, in the 1950s, Jonas Salk invented the polio vaccine—a human achievement that continues to improve millions of lives even today. Within just a few years, polio completely disappeared in the United States. Parents all over America no longer had to fear that the virus would rob their children of the ability to walk. Children no longer had to avoid their friends who might have infected them, and did not have to dread the possibility of spending two weeks inside an iron lung.
The developing world has been less fortunate. But more and more, some of the world’s poorest people are able to share in what the economist Julian Simon called “our victory against death.” Polio has been gone from the U.S. for decades, but it wasn’t until the 1980s that a global campaign to eradicate the disease began in earnest. Even in the current decade, regions of Africa continued to grapple with polio and its human costs—until now.
New York Times story recently celebrated the fact that the entire continent of Africa has not had a single case of polio for more than a year. That’s 1.1 billion people, polio-free. Millions of childhoods are safer than they have ever been from a disease that has been a scourge for thousands of years.
What made this human achievement possible? Jonas Salk’s vaccine, most obviously. But the root cause is what economist and historian Deirdre McCloskey calls the “Great Enrichment.” As more and more people come around to the types of values that Human Achievement Hour celebrates—progress, dynamism, openness, and a general pro-human outlook—the world gets ever richer. And nowhere are those values having a greater impact than in the developing world. The more that people celebrate and honor human achievement, the more of it there will be.
Thanks to that ethos, more people today actually have lights that they can leave on, or turn off, as they wish. And when they do turn out those lights for the night, they can sleep well, knowing that thanks to people like Jonas Salk and his many successors who are working on cures for malaria, HIV/AIDS, and other diseases, their children will grow up to be healthier and wealthier than they were.

Post Polio Litaff, Association A.C _APPLAC Mexico

Mar 13, 2016

Respiratory Muscle Weakness (RMW) and Bi-Pap and C-Pap use

Written  by Linda Rowan
Have you ever been told that you have Respiratory Muscle Weakness? (due to Polio) You can have this even if you didn’t have a diagnosis of Bulbar Polio or were not in an iron lung. This is what happened to me. I use a Bi-Pap at night and have to sleep almost upright (O2 level drops if you lie flat). The Bi-Pap machine (Bi-level Positive Air Pressure) pushes room air into your lungs on the INhale and then the pressure backs off (or lowers) on the EXhale (Bi-level pressure) so we can get rid of CO2 by exhaling it. (which is what people who are “normal” would do naturally.) Most “polios” who have Respiratory Muscle Weakness have trouble exhaling against the Continuous Positive Air Pressure (C-PAP) of a C-Pap. This happens because of atrophying (weakening) of the diaphragm and other respiratory muscles, (chest muscles and intercostal muscles) which are between the ribs, due to Polio. A Bi-Pap lowers the pressure on the exhale so that we can rid our bodies of excess CO2.
If you have Respiratory Muscle Weakness, and are given Oxygen without mechanical support (a Bi-Pap), the lungs “send a message” to the brain which signals the Respiratory Muscles: “we are getting enough oxygen, so you don’t have to work so hard.” Then if the respiratory muscles aren’t working to push air in and out of the lungs, the CO2 can build up which is very dangerous, and can be life threatening. (it would be helpful to read Dr. Oppenheimer’s article on this subject).
This is very complicated. Insurance companies have tried to put people with Polio Respiratory Muscle Weakness on C-Pap because I have been told they are much cheaper (by my Physiatrist). I tried to use one that my Respiratory Technician brought to me ( just to see what it was like) and had a feeling like I was being smothered.” I could not exhale against the continuous air pressure rushing in. *Every Post Polio does not need a Bi-Pap instead of a C-Pap.  For instance, if you have Sleep Apnea and Don’t have RMW, a C-Pap may work well for you. We had to submit a lot of documentation to Medicare for them to approve a Bi-Pap for me: A Sleep Study (interpreted by a qualified Sleep Technician and/or your Physiatrist or Pulmonologist) A PFT (Pulmonary Function test), the  VC (Vital Capacity) of your lungs, (mine was 31%) were required. And an ABG (Arterial Blood Gas, done in Respiratory at the hospital by a Respiratory Technician) to test if you are retaining CO2, was done, and a prior diagnosis of Post Polio Syndrome. If you have Respiratory Muscle Weakness and are not on Bi-Pap (yet), you may experience some or several of the following symptoms. Talk to your Pulmonologist or Physiatrist ASAP.
  • morning headache
  • confusion, or other cognitive deficiencies
  • excessive daytime fatigue and sleepiness
  • shortness of breath, and inability to have a productive cough
  • problems speaking without taking breaths between words
  • unexplained muscle pain in the chest and trunk muscles
  • trouble sleeping lying flat
Some of these symptoms may also be caused by other problems, such as heart trouble, (shortness of breath). The purpose of this article is primarily to explain what Respiratory Muscle Weakness is, and the difference between a Bi-Pap and a C-Pap.  I hope that after reading this you have a better understanding of RMW.
http://www.post-polio.org/edu/hpros/sum-anes.html


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