Pre-Operation Information...

Important Considerations for Post Polio Patients

 

Several people have commented about the Pre-Op Checklist article published in a previous edition of Polio Update. Since this article was originally provided, we have uncovered more info about the importance of careful screening of post-polio syndrome patients when general anesthesia is prescribed.  Consider the following:

· Some specialists now recommend that whenever polio survivors undergo any procedure involving general anesthesia, an overnight stay for observation should be requested. 

· Since polio survivors have a smaller blood volume due to muscle atrophy, you may want to bank your own blood slowly over the course of a few weeks prior to the procedure. 

· Research has shown that polio survivors are extremely sensitive to cold, and may wake up from anesthesia shivering.  Recovery room nurses need to be informed so they will have extra blankets to keep patients comfortable. 

· Also, polio patients may be twice as sedated from the anesthesia as other patients, so they may need additional assistance moving and standing to avoid fainting or falling. 

· There may be more vomiting, which needs to be monitored to avoid choking—positioning the patient on his/her side, if possible, may help.

 

You may obtain more detailed information by logging on at

www.post-polio.org or www.postpolioinfo.com.

 

 

Dr. Richard Bruno, a Clinical Psychophysiologist treating and studying mind/body problems, including chronic pain, fatigue and stress, as well as Post-Polio Sequelae (PPS), recommends the following:

 

· Anesthetic Rule of 2 – Polio survivors need the typical dose of anesthetic divided by 2 (this is only a guide to alert anesthesiologists that polio survivors usually need less anesthetic than others.)

· Post-Anesthetic Rule of 2 – Polio survivors require 2 times as long to recover from the effects of any anesthetics.  (Polio survivors may be more fatigued; prone to fainting, constipation, cold, or vomiting; sensitive to surgical medications (such as atropine-like drugs); and more prone to falling due to weakened muscles.)

· Rule of 2 for Pain – Polio survivors may need 2 times the dose of pain medication for 2 times as long.

· Rule of 2 for Recovery – Polio survivors should stay in bed 2 times longer than other patients.  (Polio survivors should get up slowly, and if physically possible, slowly sit up with feet dangling, then sit in a chair and stand only with assistance.)

· Rule of 2 for Length of Stay – Polio survivors need to stay in the hospital 2 times longer than other patients.  (The weakened body takes longer to recover.)

· Rule of 2 for Work – Polio survivors need 2 times the number of days of rest at home before they return to work or household duties.  (Polio survivors must be encouraged to rest and to return to activities slowly.)

· Rule of 2 for Feeling Better – Polio survivors need 2 times longer to feel “back to normal” again.