The Polio Paradox

June 3, 2002
Bruno, chairperson of the International Post-Polio Task Force and director of the Post-Polio Institute, has made an important contribution to the available literature on post-polio syndrome (PPS). Since the early 1980s, many polio survivors who were diagnosed with the disease during epidemics that occurred before the vaccine became available (in 1954) have been experiencing serious symptoms of muscle weakness, fatigue, joint pain, excessive coldness and difficulty in swallowing. In an informed scientific overview of polio, the author explains how motor neurons, damaged during polio's onslaught on the body, have been overworked and are dying off, leading to PPS. Of great interest is Bruno's overview of the harsh manner in which medical professionals treated children with polio during the 1940s and '50s. Separated from their families, these young people were subjected to painful treatments that did not work and told that they should suppress their emotions, hide their disability as much as possible and overcome the disease by hard work and striving to appear normal. This resulted in a rash of polio survivors who became Type A overachievers who denied their own needs. Bruno's paradox is that this very Type A behavior is a hindrance to treating PPS, which must be managed by self-care, including slowing down physically, avoiding stress, accepting help from family members and utilizing assistive devices such as braces and wheelchairs, when necessary. Bruno provides a wealth of advice that will encourage anyone experiencing PPS to seek treatment. Included also is a helpful discussion of chronic fatigue syndrome and its relationship to PPS.

July 15, 2002
Bruno (The Post-Polio Workbook), a psychophysiologist and founder of the Post-Polio Institute at the Englewood Hospital and Medical Center, NJ, has been on the front lines of research and treatment of post-polio syndrome (PPS) since the 1980s, when polio survivors began presenting new and alarming symptoms overwhelming fatigue, cold intolerance, difficulty concentrating, and muscular weakness. Undermining the theory that the original virus had been reactivated, the pioneering work of Bruno and other researchers linked neuronal damage, overuse of weakened muscles, Type A behavior, stress intolerance, and permanent changes to the brain from the polio virus as the true causes of PPS. In his book, Bruno discusses the history and care of polio patients, the identification of and research into PPS, and the approach to treating the symptoms. His text mixes facts with patient narratives and includes helpful tables and line drawings as well. Unlike Julie Silver's Post-Polio Syndrome or Managing Post-Polio, edited by Lauro Halstead, Bruno's work also addresses chronic fatigue (CF), multiple sclerosis, fibromyalgia, Gulf War syndrome, and spina bifida disorders that share symptoms, brain changes, and stress links similar to PPS. Indeed, Bruno's research provides intriguing evidence for a shared mechanism underlying the cause of many fatigue disorders. However, this possibility is treated at the very end of the book, and individuals with these conditions may find reading 275 pages before getting to this information daunting. For collections where Silver's or Halstead's books are popular. Lisa McCormick, Jewish Hosp. Health Sciences Lib., Cincinnati

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