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Post Polio Syndrome

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    Originally posted by Lindox
    Yes, Sue the swimming pool is like a refuge. I'm sure you have experienced this too.

    As far as BP changes..that is not effected in me at all. Just have problems with too drastic of changes in temperature. Either way.

    And I don't know if anesthesia affects SCI folks...but it does a number on PPS..well did a number on us before PPS. Any surgery I ever kidneys and bowels would not regain function for a worrisome time.
    And I believe it was happening with all of us polios.
    We were the only ones on enemas..and caths. after surgeries usually. And the SCI of course.

    Also often given oxygen. So be careful even with light dose anesthesia. Even having a wisdom tooth removed can leave you out of it for twice to three times as long as anyone else..and those oral surgeons get skeereed as all heck.

    This happened even before PPS came around and the surgeon was calling the ambulance. I told him just use the novacaine..but he didn't listen.

    So be careful..but don't let it rule your life..really don't have too.

    Thanks Sue for starting this forum..hope others can offer some of what they are doing for TMS, MS, and all the other S's.

    First, I didn't start this forum. You folks did. Wise got a lot of requests through the forums for information on ALS, polio, TM and MS. Then he just started getting email questions. So since it appeared we had members that had non-traumatic injuries who needed information also, well, it was just a matter of asking someone to moderate. Since my SCI is non-traumatic I know a bit about TM, way too much about spinal strokes and some about MS because I have a cousin with a particularly nasty form of the disease. I am still learning on everything else.

    As far as anesthesia and spinal cord injuries, our biggest problem is autonomic dysreflexia. Surgical procedures below the level of injury can cause pain that sends blood pressure rocketing and the pulse to slow down to almost nothing. So oxygen isn't the problem it is having an anesthesiologist that knows the signs of AD while a person is under and can take them deeper under, stop the procedure if absolutely needed or suggest the operation be done in segments if possible.

    Pain medication that can effect the kidneys or respiratory strength send many people with T-6 injuries or above to the ICU instead of regular post-operative recovery so pain meds can be given at a dose necessary to avoid AD while also monitoring vitals. There are times when a respirator may be needed short term (we're not talking right after the injury that caused the paralysis here) and, obviously to ICU staff, a foley to deal with the bladder. I say obviously because with bladder ultrasounds intermittent caths can now be done as needed instead of a set schedule that IV fluids might throw off.

    I would think that most with PPS might want to ask about twilight anesthesia or have a dentist use nitrous oxide for things like wisdom tooth removal along with novacaine. I've had laughing gas pre-SCI at the dentist and in normal use the patient can give the dentist a sign like lifting a hand if you feel you have had enough. Most people drive home immediately after the gas also because it clears from the lungs quickly. In PPS it sounds like you would want a friend to drive you.

    I think we have covered twilight anesthesia in the Care Forum for colonoscopies. Again, for SCIs, we might wake up in the ICU and spend a few hours there until cleared to go home. Mainly this is to monitor pulse and blood pressure. Once a colonoscopy is done normally there is no lingering pain so post-test pain meds aren't necessary. Just very nice to know the test center knows what AD is before they start the procedure.

    For PPS I would definitely discuss this when scheduling the test if a history of polio or current PPS would put you in a risk category the main anesthesiologist needs to know about. They can then do a bit of research on your oxygen needs after this kind of procedure and the accompanying anesthesia.

    I've been under all the way once since my spinal stroke and that was for a laparotomy. Kind of like exploratory surgery using chopsticks. I had one stitch in my navel and one on my right side afterwards. With a serious history of colon cancer on one side of the family and esophageal cancers and 3 bleeding ulcers on the other side of the family (that required removal of portions of their stomachs) my doc wasn't taking chances. All clear and I had 4 pretty polaroids to take home also. Amazing. I figured everything inside would be rather red looking from blood but nope. I have pretty guts.

    With laproscopic surgery though you should all know that if the area being operated on requires a good field of vision you will have carbon dioxide pumped into, using my case, the abdominal cavity. The gas leaves the body by going up. So you will wake up to rather painful shoulders/upper back. In recovery I had a wonderful nurse wrap heated blankets around my shoulders and I stayed for an extra hour so I could get 2 more doses of fentanyl in my IV. Then home and serious pain as I laid on my back long enough to get undressed. Once into a night shirt I laid back down on my side that had the least pain because they really do try to keep the pumped area small in these kind of procedures. Laid a microwavable rice pack on the painful shoulder and relief was immediate. Off to sleep was easy. So depending on what kind of laproscopic procedure you have I would go over all past complications so the surgeon knows what might come up as a problem.

    And just like anyone who has to deal with opiates for pain buy a bottle of colace or pericolace while taking these meds. Colace is a stool softner and peri-colace is a laxative. Even dentists now know to warn patients who may take an opiate for a day or two after root canals or the like.

    Anyone else have starnge or unexpected complications from surgery or tests due to their polio or PPS?
    Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

    Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied and are based solely on my experiences as a SCI patient. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.