Living With Polio
There is no official certification for a “polio doctor.” The most common use of this informal designation is a physician with knowledge, experience and interest in evaluation and treatment of polio survivors.
Given the most common new disabling medical problems of polio survivors, physicians with expertise in neuromuscular disease management that includes the ability to recognize and treat chronic musculoskeletal pain and respiratory problems are ideal. The specialty background of these physicians is most commonly neurology, physical medicine & rehabilitation, orthopedics and family practice.
Polio survivors do not need to see a “polio doctor” to receive good care. However, if a survivor is experiencing a series of new unexplainable and disabling symptoms and is unable to obtain satisfactory help, then seeking an evaluation by a polio doctor/ post-polio clinic can be very helpful. These physicians most commonly will provide consultation services to your parent’s primary care physician and may provide continuing comprehensive follow-up of post-polio related problems.
Many survivors need a network of medical providers (orthopedist, pulmonologist, orthotist, physiatrist, neurologist, etc.) and may need help with coordination and communication among them. A primary care physician can fill this role, although many polio survivors do this function themselves, because they are sufficiently sophisticated with medical and rehabilitative issues. You as a family member may need to assume this role at certain times.
The best way to frame the issue is this. Are current providers meeting the medical and rehabilitative needs of your loved one? If they are not, then specialist consultations are appropriate. If they need a comprehensive evaluation of medical concerns and functional changes, then seeing a ‘polio doctor’ is invaluable.
If a health professional or facility that provides a comprehensive evaluation is not available, consider the following specialists, in alphabetically order, who may be involved in post-polio care.
Behavioral Health Specialist
Your family member might benefit from seeing a behavioral health specialist. This person might be a psychologist, social worker, licensed counselor, marriage and family therapist, or even a member of the clergy. All behavioral health specialists know about depression, anxiety, and coping with life changes. Some have a special interest in working with elders, people with disabilities, and/or trauma survivors. Rehabilitation psychologists and counselors and gero-psychologists are examples of specialists in the first two areas.
Geriatricians have special training in treating the elderly. They focus on improving the health, independence and quality of life of older people. There are 6,400 “geriatric specialist physicians” practicing in the US, and they may be hard to find, but the field of geriatrics includes not only physicians, but physicians’ assistants, registered nurses, nurse practitioners and long-term care nurses.
Medical social workers (MSWs) provide psychosocial support to individuals, families, or vulnerable populations so they can cope with chronic, acute, or terminal illnesses. They also advise family caregivers, counsel patients, and help plan for patients’ needs after discharge from hospitals. They may arrange for at-home services, such as meals-on-wheels or home care.
Neurologists are physicians who diagnose and treat disorders of the nervous system. They address diseases of the spinal cord, nerves, and muscles that affect the operation of the nervous system. An important aspect of a neurologist’s daily duties is to offer advice to other physicians on how to treat neurological problems.
Occupational therapists (OT) enable people to live life to its fullest by helping them promote health and prevent—or live better with—illness, injury or disability. OTs work in hospitals, skilled nursing facilities and other places that treat people who are aging, rehabilitation centers and health and wellness facilities. They assess how a person accomplishes tasks and suggest better ways. Such tasks include getting on and off the toilet, in and out of a car, chair or bed, swallowing, driving, etc.
Orthopedists are physicians who specialize in the diagnosis and treatment of disorders of the bones, ligaments, tendons and joints. Setting broken bones, repairing and replacing joints (such as knees and hips), straightening spines and developing prosthetics to replace body parts are specialized skills of this specialty.
Orthotists (a.k.a. certified orthotist – CO; certified prosthetist and orthotist – CPO; certified prosthetist – CP) evaluate and treat musculoskeletal disorders by designing and fitting custom-made orthoses or braces. Orthotists work to restore mobility and prevent or limit disability. Be aware that no one specialty “owns” bracing anymore and many specialties get very little training in prescribing braces. However, bracing is always included in the training of physiatrists. Check with the insurance company to see which medical specialty needs to write the prescription.
Physiatrists, or physical medicine and rehabilitation (PM&R) specialist, are physicians who are experts at diagnosing and treating pain and at maximizing function lost through injury, illness or disabling conditions through provision of non-surgical treatments, and coordinating a team approach with other physicians and rehabilitation professionals. They treat the whole person and focus on not only treatment, but also on prevention.
Physical therapists (PTs) help improve movement and alleviate pain as an alternative to surgery or pain medications. PTs also treat new weakness and loss of mobility for tasks such as walking, climbing stairs and transferring. PTs teach patients how to prevent or manage a health condition, and are uniquely qualified to help design appropriate fitness programs to promote health and wellness. Physical therapists provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings and nursing homes.
Pulmonologists are physicians who specialize in the diagnosis and treatment of diseases and disorders of the lungs and respiratory system. Because of the variety of clinical problems encountered, they have knowledge of internal medicine. They are also known as respiratory physicians and respirologists.
Respiratory therapists (RTs) work to evaluate, treat, and care for people with breathing disorders. Most respiratory therapists work in hospitals where they perform intensive care, critical care, and neonatal procedures. An increasing number of respiratory therapists work in skilled nursing facilities, physicians’ offices, home health agencies, specialized care hospitals, medical equipment supply companies and patients’ homes.
Speech and language pathologists (CCC-SLP), sometimes called speech therapists, assess, diagnose, treat, and help to prevent disorders related to speech, language, cognitive-communication, voice, swallowing, and fluency. Speech-language pathologists use special instruments and tests to analyze and diagnose the nature and extent of the problems.
Excerpt from PHI’s “Post-Polio Healthcare Considerations for Families and Friends.”©
Post-Polio Health International distributed this survey – “Post-Polio Medical Care: Post-Polio Specialist and Primary Care Physicians” – to its Membership and the community in mid-2014. The Results and Observations were published in the Fall of 2014.