THE THOMAS FRANCIS, JR. MEDAL IN GLOBAL PUBLIC HEALTH

Polio’s Effects Linger for a Lifetime

Patients with lasting reminders of a long-ago epidemic make their way to a clinic at the University of Michigan Health System every Thursday. Some arrive on crutches and canes, others in wheelchairs.

Fifty years after the triumphant announcement that polio could be defeated, it still exacts a heavy toll on these Americans.

The patients are fitted for leg braces and other orthotics that stabilize them when they walk. Many have their joints rotated back into position. Sometimes the doctor and the orthotics expert talk to them about whether a wheelchair might offer them more comfort, mobility and independence than they can maintain by walking with crutches.

Ten to 40 years after the initial onset of polio symptoms, many patients suffer from “post-polio syndrome,” or PPS, which can cause fatigue, muscle weakness (often in an unaffected limb), joint pain, and muscular atrophy.

“It’s a forgotten population,” says Ann Laidlaw, M.D., director of the University of Michigan’s Post-Polio Clinic. “We’re able to educate patients about post-polio syndrome. Patients are grateful that we are here for them, and that we understand what they’re going through.”

The clinic is part of the Department of Physical Medicine and Rehabilitation and is one of only three clinics in the state designed to treat patients with the complex set of issues that make up Post-Polio Syndrome and other conditions that are common among people who had polio in the past.

Laidlaw and Mark Taylor, a certified prosthetist/orthotist, work with several patients each Thursday. The patients here are some of the estimated 300,000 polio survivors in the United States who have or are at risk for PPS, according to a statistic from the National Institute of Neurological Disorders and Stroke.

“With polio patients, deformities develop, such as joint deformities and leg-length discrepancies,” says Taylor, director of clinical and technical services at the U-M Orthotics and Prosthetics Center. “We’re trying to keep our patients mobile so they can stay employed and stay independent in their own homes. As the population gets older, that becomes more and more difficult.“

Taylor, 53, has learned about post-polio conditions first-hand. When he was 9 months old, he contracted polio at the same time as his father. They were living in Idaho, and an iron lung had to be shipped to them to help Taylor’s father. The machine didn’t arrive in time to save his father’s life.

Taylor was raised by his grandparents on an Idaho farm. Polio left him paralyzed from the waist down, until he regained mobility in his right leg at age 3. Since then he has had hip surgery to relocate bone, tendon transfers in his foot, and other procedures. Taylor’s experience helps him understand what other polio survivors are going through, he says, since many of them are experiencing the same problems and having the same surgeries.

Patients come to the clinic from all over the Midwest, and as far away as Oklahoma. The popularity of the clinic is based in large part on the fact that few clinics deal specifically with PPS or other polio-related problems, says Laidlaw, a physical medicine and rehabilitation specialist at the U-M Health System.