Have you ever had polio and now you're losing your limbs again? Let's learn about this (Post-Polio Syndrome)!

Do you remember the disease called polio in the past? Maybe you too have had it and had a hard time recovering. If you recover and then feel tired and weak for years, it could be a symptom of a condition called Post-Polio Syndrome''. Let's talk about this in a simple way today, so that you can understand it.

What is Post-Polio Syndrome?

Simply put, Post-Polio Syndrome'' or PPS'' is when a person who has previously recovered from polio experiences muscle weakness again over a period of years – perhaps 10, 20, or 40 years. The muscles may also become atrophied or even shrunken.

As you may remember, polio, or Poliomyelitis'', is a disease caused by a virus called Poliovirus.'' Most people who get it don't show any major symptoms, and some people experience a mild fever. However, for some people, it can cause serious conditions like paralysis and sometimes even death.

There were three main types of this (Poliovirus). They are types 1, 2, and 3. Now, types 2 and 3 have been eliminated from the world. Only type 1 is still seen in some parts of the world. Polio is almost gone in Sri Lanka now. But people who were infected in the past can get this (PPS) condition.

Who is more likely to develop Post-Polio Syndrome''?

This condition only occurs in people who have had polio in the past. It usually starts to appear after 10 years or more. Sometimes it can occur even after 40 years.

Research has found that between 30% and 40% of people who have had polio develop this condition. Also, if you have had a previous bout of polio, meaning your limbs were very weak, you may experience more severe symptoms if you develop PPS.

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How common is Post-Polio Syndrome''?

Actually (Post-Polio Syndrome) is a very rare condition nowadays. The reason for this is that polio is also very rare now. Polio vaccine has eradicated polio from many countries in the world, including Sri Lanka. However, since there are still several countries where polio is present, and there are still people who have had polio in the past, (PPS) patients are seen from time to time.

What are the symptoms of (Post-Polio Syndrome)?

The main and first symptom of Post-Polio Syndrome'' is that the muscles that were weakened during the polio infection gradually lose their strength again. These symptoms can vary from person to person. Some people may be affected by them to a greater or lesser extent.

These are some of the common symptoms:

• Gradual muscle weakness: A feeling that an arm, leg, or other muscle that was previously weak due to polio is gradually becoming weaker again.
• Tiredness:It's not just tiredness, it's an unbearable, overwhelming feeling of tiredness. It's like you get tired even after doing a little work.
• Muscle atrophy: This means that the muscle fibers gradually shrink and become smaller.
• Muscle pain and twitches: Muscles hurt, sometimes it feels like the muscles are just jumping up and down, twitching.
• Joint pain: Pain may occur in joints such as knees and elbows.
• Bone deformities: For example, there may be things like scoliosis.

Imagine, there is a person named Nimal, who contracted polio when he was a child and his right leg was a little weak. He lived a normal life for many years. But now, at the age of 50, he feels like his right leg is slowly losing its strength again. He feels very tired when he climbs a flight of stairs or walks for a short distance. That's how it affects him.

In addition, if this (PPS) affects the muscles used for breathing or the muscles used for swallowing, breathing difficulties and swallowing difficulties can occur.

In some severe cases of PPS, the symptoms can resemble those of the neurological disease Amyotrophic Lateral Sclerosis (ALS). However, it is important to remember that this is not the same as ALS.

What causes (Post-Polio Syndrome)?

Scientists still haven't figured out exactly what causes Post-Polio Syndrome. However, there is one theory about it. That is, when you recover from polio, your body's nervous system changes.

Think of it this way, the polio virus (Poliovirus) damages some of our nerve cells (Neurons). These nerve cells are the ones that carry messages to make muscles work. So, when polio is over, instead of the damaged nerve cells, the healthy remaining nerve cells start working more. These healthy nerve cells, from their main branches (Axons), make other small branches (Dendrites), and take over the control of the muscle fibers that the damaged nerve cells controlled. It's like one worker taking over the work of the others.

So, scientists think that after years of working beyond their capacity, those initially healthy nerve cells gradually weaken and become tired. Those little branches (dendrites) gradually shrink. Then those muscles that were previously working well also start to weaken again. That is probably the reason for this PPS'' condition, which is currently thought to be the cause.

Is (Post-Polio Syndrome) a contagious disease?

No. Post-Polio Syndrome is not a disease that can be transmitted from one person to another. However, the polio virus is a very contagious virus. That is why it is very important to protect yourself from the disease by getting the polio vaccine.

How to recognize (Post-Polio Syndrome)?

There is currently no specific test that can accurately confirm the presence of Post-Polio Syndrome''.

Instead, doctors diagnose the condition by performing a physical exam, taking a detailed medical history (such as whether you have had polio in the past and when), and asking about your current symptoms. They also want to make sure that the symptoms are not caused by another medical condition.

Your doctor may perform several tests to check for PPS and rule out other conditions, such as:

• Spinal MRI (Magnetic Resonance Imaging) and CT (Computed Tomography) scans: These can check for any problems with the spine and its associated nerves.
• Electromyogram (EMG) test: This tests the electrical activity of the muscles and the nerves that control them. This helps determine whether the muscle weakness is caused by a nerve problem or a problem with the muscles themselves.
• Muscle Biopsy: Sometimes, a small piece of muscle is taken and examined under a microscope. This can help identify changes in the muscle.
• Spinal Fluid Analysis: A test that takes a small amount of fluid from your spine. This can help to check for other neurological problems.

How is (Post-Polio Syndrome) treated?

Unfortunately, there is currently no specific treatment that can completely cure Post-Polio Syndrome (PPS). Therefore, the main goal of doctors is to control the symptoms and improve your Quality of Life.

If you have PPS, it is very important to see a doctor who specializes in neuromuscular conditions.

Here are some ways to help manage the symptoms of PPS:

• Non-fatiguing exercises: Exercises that do not cause pain or excessive fatigue can improve muscle strength and reduce overall fatigue. You can find out what these are by asking a physiotherapist.
• Cardiorespiratory endurance training: This is the process of improving the level of work your heart, lungs, and muscles can do together during prolonged exercise. You should definitely talk to your doctor before starting this type of training.
• Mobility aids: Using things like canes, walkers, wheelchairs, or scooters can make it easier to get around and reduce muscle fatigue.
• Occupational therapy:An occupational therapist can make necessary changes to your environment to make everyday tasks around the house (e.g., getting dressed, cooking) easier.
• Speech therapy: If you have difficulty swallowing due to PPS, a speech therapist can help.
• Lifestyle changes: Your doctor will likely advise you to eat a healthy diet, control your weight, get enough sleep, and stop smoking . These things can help manage symptoms and improve your overall health.

Additionally, psychotherapy can help you and your family cope with PPS. It can also be helpful to join support groups where you can talk to others who are going through the same thing and share your experiences.

Can (Post-Polio Syndrome) be cured?

No, according to current information, there is no cure for Post-Polio Syndrome''. Treatments are aimed at managing symptoms and helping to make life easier.

How to prevent (Post-Polio Syndrome)?

The only way to prevent polio is to prevent getting polio. The only way to do that is to get the polio vaccine. Children are usually given four doses of the polio vaccine starting at 2 months of age. If you didn't get this vaccine as a child, you can get it as an adult.

However, if you have already had polio and recovered, there is nothing you can do to prevent getting PPS in the future. Scientists still don't have a clear idea why some people who have had polio develop PPS while others don't.

What is the prognosis of (Post-Polio Syndrome)?

The outlook for Post-Polio Syndrome (PPS) varies from person to person. It depends on which muscles are affected and how severe the symptoms are.

The symptoms of PPS can make it difficult for you to do things on your own. However, things like mobility aids and occupational therapy, which we discussed earlier, can help a lot.

Your overall health is at greater risk if your breathing muscles are weakened by PPS, or if your swallowing muscles are weakened.

Does Post-Polio Syndrome'' shorten life expectancy?

In most cases, the lifespan of someone with Post-Polio Syndrome'' is normal. PPS'' is a life-threatening condition that is very rare.

When should you see a doctor about (Post-Polio Syndrome)?

If you have had polio in the past, and years later you feel like your muscles are slowly getting weaker again,Definitely see a doctor and talk about this.

If you have been diagnosed with PPS, you should see your doctor regularly to make sure your treatment plan is working and to make any necessary changes.

The important thing is that not everyone with Post-Polio Syndrome is affected in the same way. The best way to know exactly how this condition affects you and what to expect is to see a doctor who specializes in neuromuscular diseases and PPS. They are here to help you.