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New Jersey Distributes Polio Warning Card
By Mel Fabrikant Monday, January 04 2010, 03:51 PM EST
Wallet-sized card warns of anesthesia dangers in polio survivors and educates about Post-Polio Sequelae.
The New Jersey Department of Health has printed and distributed 10,000 wallet-sized cards with vital information on anesthesia dangers in polio survivors and on Post-Polio Sequelae, a disabling condition affecting New Jersey’s 50,000 polio survivors. Created by Dr. Richard Bruno, Director of the International Centre for Post-Polio Education and Research at Englewood Hospital and Medical Center, the yellow, double-sided card was suggested by the Ocean County post-polio support group to comply with New Jersey Senator Loretta Weinberg’s 2004 "Post-Polio Sequelae Public Awareness" bill.
"Doctors have forgotten about North America’s nearly two-million survivors of the polio epidemics of the 1940s and 1950s," said Dr. Bruno, who is also chairperson of the International Post-Polio Task Force. "Because of damage the poliovirus did to the stem of the brain, polio survivors are easily sedated and often get too much anesthesia." Bruno has seen polio survivors end up on a ventilator in intensive care after minor surgery or even a colonoscopy.
The New Jersey DOH card features a prominent, red "ANESTHESIA WARNING!" and lists easy sedation and difficulty breathing and swallowing as problems that can be avoided by using lower doses of anesthetics in polio survivors. The card also lists increased sensitivity to cold and pain as post-operative problems in polio survivors.
"The poliovirus kills neurons in the brain and spinal cord that produce the body’s own morphine," Dr. Bruno explained. Dr. Bruno’s research has found that polio survivors are twice as sensitive to pain as those who didn’t have polio. He recommends a general rule of thumb for treating polio survivors—"The Rule of 2": two times the usual amount of pain medication for two times as long, and the usual amount of anesthesia divided by two.
"All doses of medication must be adjusted for individual polio survivors," Dr. Bruno cautioned. "And, polio survivors should never have same-day surgery because of excessive sedation from even appropriate doses of anesthesia."
POST-POLIO SEQUELAE ALSO LISTED
The flip side of the DOH card lists the "late-effects of polio," called Post-Polio Sequelae, overwhelming fatigue, muscle weakness, muscle and joint pain, sleep disorders, cold intolerance and breathing and swallowing difficulties that can develop in midlife.
"Doctors are also unaware of Post-Polio Sequelae, or say that they ‘don’t believe’ in PPS," said Dr. Bruno. "PPS is very real and very treatable if polio survivors can reduce the ‘overuse-abuse’ of their remaining, overworked poliovirus-damaged neurons."
Groups may request cards by going online to NJ.gov/health/feedback.shtml. More information about anesthesia concerns and Post-Polio Sequelae can be found at PostPolioInfo.com.
International Centre for Post-Polio Education and Research
Englewood, New Jersey 07631 USA
877-Post-Polio 201-894-3724
PostPolioInfo@aol.com
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