9/08/2016

Wheelchair racer Josh George will have hands full at Rio Paralympics



If the Olympics captivated you with inspiring stories last month in Rio de Janeiro -- such as runners Abbey D'Agostino and Nikki Hamblin falling and helping each other up to complete the women's 5,000 meters -- prepare for many more awesome, inspiring athletes this month at the Paralympics. These athletes picked themselves up from far worse falls yet became great examples to everyone: just keep going.
Consider five-time Paralympic medalist Josh George, who will compete in an astounding five events in Rio, his fourth Games. George fell out of a 12-story window when he was 4 years old. While he punctured his lungs and was paralyzed from his mid-chest down, he survived the 120-foot fall, perhaps an indication of his physical and mental strength. "I stuck the landing," he said with a laugh.
"I landed straight up and down on my feet in these short, little bushes next to the building, That's what really saved me," George added. "The combination of landing on my feet and in those bushes and the fact that when you're 4, your bones still aren't fully formed so they still have a little give to them. They absorbed enough for me to survive."
George, 32, has a great sense of humor and outlook on life, along with a love of sports. Despite needing a wheelchair to get around, he grew up playing basketball and tennis, swimming, racing track and more. His parents made sure that he used sports to continue moving forward.
"I give my parents all the credit in the world," he said. "They could not have handled the situation any better. They were amazing. They took it all in stride. They never looked at me as disabled. I was just as able as anybody else in their eyes, and that's how they treated me. I just had to use the wheelchair instead of walking."
The athletic activity turned out to be more than just fun and games for George.
"Sports created seeds of creative problem solving," he said, "to be able to find opportunities to maximize my potential. And it carried over in life. Once you learn how to recognize opportunities and once you learn how to utilize different tools to accomplish your goals, it gives you confidence in your ability to approach problems in your future and know you'll be able to figure out a solution."
After playing wheelchair basketball at the University of Illinois, George has concentrated on track, an endeavor in which he has won five Paralympic medals, including gold in the 100 meters and silver in the 800 at the 2008 Beijing Games. In Rio, where the festivities start with Wednesday's opening ceremony, he will compete in the 400, 800, 1,500, 5,000 and marathon wheelchair races.
"I'm going to have my hands full," he said.
His hands also will be on the improving carbon-fiber wheelchairs that he says help racers put their power into forward momentum. "It doesn't necessarily make you faster, but it makes you more efficient," he said.
That efficiency helps especially over longer distances, such as the marathon. Wheelchair racers complete marathons considerably faster than runners -- George's personal best is 1 hour, 22 minutes, 55 seconds -- though uphill portions can be more grueling since the racers are relying on nothing but arm strength. Going downhill is much faster, with some reaching speeds of 40 mph, but that also leads to potential crashes.
"It's exciting," George said, "but sometimes you end up with your stomach in your throat."
It all makes the race as compelling as the regular marathon, and perhaps more so. It is like watching the combination of a running and cycling race.
Wheelchair racing is growing in attention and popularity. George says that when people see him arrive in an airport with his wheelchair now, they will ask him whether he will be racing in the city marathon. He usually is, having won eight marathons in Chicago, Los Angeles, London and the Twin Cities.
George also writes -- he studied journalism at Illinois -- and you can follow his experiences in Rio at joshgeorgeracing.com. He also is running a campaign called "Maximize Your Potential" that urges everyone to achieve their highest goals.
They can see that is possible in the Paralympics, which George hopes people will watch so they can witness how great the athleticism is -- especially in the United States.
"We have an interesting relationship with disability," George said of Americans. "It's very much a medical model where we think it's people who are broken or injured or old. And that's far from the case. We all have a different disability, but we're not really overcoming that disability. The overcoming part has come and gone. The struggle has come and gone. We are all out there now to maximize our abilities as an athlete and compete for a gold medal in the same sense the Olympians are."
Paralympians have picked themselves up. And now they are providing the same exciting thrills and inspiration as Olympians.

Post Polio Litaff, Association A.C _APPLAC Mexico

The Polio Crusade

THE POLIO CRUSADE IN AMERICAN EXPERIENCE A GOOD VIDEO THE STORY OF THE POLIO CRUSADE pays tribute to a time when Americans banded together to conquer a terrible disease. The medical breakthrough saved countless lives and had a pervasive impact on American philanthropy that ... Continue reading..http://www.pbs.org/wgbh/americanexperience/polio/

Erradicación de La poliomielitis

Polio Tricisilla Adaptada

March Of Dimes Polio History

Dr. Bruno

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A 41-year-old man developed an acute illness at the age of 9 months during which, following a viral illness with headache, he developed severe weakness and wasting of the limbs of the left side. After several months he began to recover, such that he was able to walk at the age of 2 years and later was able to run, although he was never very good at sports. He had stable function until the age of 18 when he began to notice greater than usual difficulty lifting heavy objects. By the age of 25 he was noticing progressive difficulty walking due to weakness of both legs, and he noticed that the right calf had become larger. The symptoms became more noticeable over the course of the next 10 years and ultimately both upper as well as both lower limbs had become noticeably weaker.

On examination there was wasting of the muscles of upper and lower limbs on the left, and massively hypertrophied gastrocnemius, soleus and tensor fascia late on the right. The calf circumference on the right exceeded that on the left by 10 cm (figure1). The right shoulder girdle, triceps, thenar eminence and small muscles of the hand were wasted and there was winging of both scapulae. The right quadriceps was also wasted. The wasted muscles were also weak but the hypertrophied right ankle plantar flexors had normal power. The tendon reflexes were absent in the lower limbs and present in the upper limbs, although the right triceps was reduced. The remainder of the examination was normal.

Figure 1

The patient's legs, showing massive enlargement of the right calf and wasting on the left

Questions

1
What is that nature of the acute illness in infancy?
2
What is the nature of the subsequent deterioration?
3
What investigations should be performed?
4
What is the differential diagnosis of the cause of the progressive calf hypertrophy?

Answers

QUESTION 1

An acute paralytic illness which follows symptoms of a viral infection with or without signs of meningitis is typical of poliomyelitis. Usually caused by one of the three polio viruses, it may also occur following vaccination and following infections with other enteroviruses.1 Other disorders which would cause a similar syndrome but with upper motor neurone signs would include acute vascular lesions, meningoencephalitis and acute disseminated encephalomyelitis.

QUESTION 2

A progressive functional deterioration many years after paralytic poliomyelitis is well known, although its pathogenesis is not fully understood.2 It is a diagnosis of exclusion; a careful search for alternative causes, for example, orthopaedic deformities such as osteoarthritis or worsening scoliosis, superimposed neurological disorders such as entrapment neuropathies or coincidental muscle disease or neuropathy, and general medical causes such as respiratory complications and endocrinopathies.3

QUESTION 3

Investigations revealed normal blood count and erythrocyte sedimentation rate and normal biochemistry apart from a raised creatine kinase at 330 IU/l (normal range 60–120 IU/l), which is commonly seen in cases of ongoing denervation. Electromyography showed evidence of denervation in the right APB and FDI with polyphasic motor units and complex repetitive discharges, no spontaneous activity in the left calf and large polyphasic units in the right calf consistent with chronic partial denervation. Motor and sensory conduction velocities were normal. A lumbar myelogram was normal. Magnetic resonance imaging (MRI) scan of the calves is shown in figure2.

Figure 2

Axial T1 weighted MRI scan (TR 588 ms, TE 15 ms) of the calves, showing gross muscle atrophy and replacement by adipose tissue on the left, and hypertrophy of the muscles on the right, with only minor adipose tissue deposition

QUESTION 4

The differential diagnosis of the progressive calf hypertrophy is given in the box.

Causes of calf muscle hypertrophy

Chronic partial denervation

  • radiculopathy

  • peripheral neuropathy

  • hereditary motor and sensory neuropathy

  • spinal muscular atrophy

  • following paralytic poliomyelitis

    Neuromyotonia and myokymia

  • Isaac's syndrome

  • generalised myokymia

  • neurotonia

  • continuous muscle fibre activity due to: chronic inflammatory demyelinating polyradiculopathy, Guillain Barre syndrome, myasthenia gravis, thymoma, thyrotoxicosis, thyroiditis

    Muscular dystrophies

    Myositis

    Infiltration

  • tumours

  • amyloidosis

  • cysticercosis

    Link here