Question: I am 83 and had polio when I was 6, affecting my right leg. I received the Sister Kenny treatment in St Michael’s Hospital in Newark, NJ in the spring of 1942. My leg is 1/2 inch shorter and one of my quad muscles and my calf atrophied. I have led a pretty normal life with one weak leg. I started singing in a choir as a Boy Scout and continued in church choirs and in later years a community chorale. While singing I have found that I cannot walk and sing like most of the other singers. I run out of breath. Nevertheless, I have had lung capacity tests that have shown good capacity, and it is only trying to sing and walk that gives trouble. My other activity was as a scout leader for 35 years where I hiked and swam with the boys over the years. As I have aged, I discovered my left arm and hand also have some palm atrophy. I have no opposing muscle strength with the thumb on the left hand. I am also short of breath when I walk uphill. Is it possible that
some of the lung muscle was also affected and is causing the shortness of breath and how can it be checked? I do have a cardiologist. He diagnosed a dilated aortic root, an artery that is 70% blocked and a leaky valve that he is watching. I had the breathing and walking problem prior to the heart problems.
Answer: You pose a difficult diagnostic challenge because your heart problems AND/OR post-polio involvement of your breathing muscles might be responsible for your symptoms of SOB (shortness of breath) on exertion. If it was from the polio, the fact that you are noticing some new atrophy in your left hand/arm suggests that you may be having some weakness involving the left diaphragm because its motor nerve supply is located adjacent to motor nerves to the left arm/hand in the spinal cord where the polio virus caused myelitis and cell death. You could be evaluated by a pulmonologist with expertise in neuromuscular diseases affecting breathing and with testing involving not only breathing capacities, such as Forced Vital Capacity in standing and lying down positions, but also fluoroscopy (moving picture X-ray) of the diaphragm in full inspiration/expiration to see if the left side is weakened/paralyzed. You could show this recommendation to
your local doctors as appropriate. If all breathing tests prove normal, your heart problems may be sufficient to explain your symptoms. This could be confirmed with exercise capacity testing on a treadmill with monitoring of your cardiac output. Although your heart problems were only recently diagnosed, they could have been present for a longer time.
Post-Polio Health (Vol. 35, No. 2, Spring 2019)