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A
CORNOCOUPIA WITH THANKSGIVING GOODIES
A
LIGHT-FILLED CHANUKAH
and
the
MERRIEST
OF CHRISTMASES!!
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will
talk about Social Security Problems and the Prescription Drug Plan.
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CONTENTS
My “Adventures”
Expired Drugs – Toss Them
Information about Generic Drugs
Keys Locked in Your Car?
Research 1 – What is Being
Done?
What
Needs to be Done?
Telemarketers
FYI – ICE
A Clarification of Non-Paralytic Polio
No More Excuses
Gonna Be a Bear
Feed Your Heart
Odd Shoes
Anesthesia and Post-Polio Today
Credit Reports – Be the First to Know
Just a Smiler
Purging Polio
Ain’t it da Truth
******************************************
“MY ADVENTURES”
Well, this time I really don’t have any “adventures” except to tell you
what happened when I brought my car into the dealership to have the
air-conditioning looked at.
Everytime I take the minivan in for
service I make sure to tell them that I have a left-sided gas pedal and ask if
they want me to remove it. I’m always
told words to this effect – No, we all know you have the left sided gas pedal,
so don’t worry about it.
Well, that day after waiting to hear
that the air-conditioning had been fixed, I received a call from the dealership
that, somehow or another, the mechanic, when ready to drive the car out of the
shop, somehow stepped on the pedal and crashed into two other cars being worked
on in the repair bay. One of these cars,
it seems was on a lift soooooooo, the lifted tire wound up putting quite a dent
into the roof, the rest of the damage (fortunately) was also on the outside of
the car. There were, maybe, two panels –
the driver’s door and another one – that were without a dent of some kind.
The dealership agreed it was all their
fault and would take care of repairing it BUT first they had to contact their
insurance company who, they said, would contact me. After a two week period without hearing from
anyone, I called the dealership – they gave me the telephone number of their
insurance company, who I called and who then gave me the name of the adjustment
company they use for repair estimates.
When I called that company the young lady who answered when I told her
my name, said: “Oh, that’s the file that
we don’t know what happened to it – it’s somewhere in ‘la-la’ land.” However, she did take all the information
from me and promised that an adjuster/appraiser would be calling me either that
day or the next. Well, four days later,
after I again called, the adjuster called me and said they had given him the
wrong number for me. Anyway, he came
right over – checked over the minivan, taking numerous digital pictures of it,
and told me I would have the estimate within a day or two.
The next day the insurance company
called to tell me they had the estimate and that it came to $7,063.24 and said
that they would be sending me a Release to sign and a check made out for that
sum. She then faxed me over a copy of
the adjuster/appraiser’s findings – three pages.
I took the papers over to the
dealership and the service advisor took me over to the Body Shop, to speak to
the body advisor who would be in charge of repairing the damage. This young man told me it would take
approximately three (3) weeks (YES, 3 weeks) to repair it ONCE all the parts
were ordered and received. It seems they
are allowed to work on a particular car only 5 hours a day and, according to
the adjuster/appraiser, the minivan needed 87 hours of work….
Now, of course, they said they would
give me a car to use during that time.
But, as you know, I use a left-sided gas pedal, and after first shaking
his head that he didn’t know if they could find one, I gave him the number of
Van Get-a-ways to see if they could help out.
Well, seems they only have hand controls – so, still have a
problem. May be resolved by them giving
me a “good will” allowance enabling me to fly to my son’s on
******************************************
Reprinted
from
HealthSmart
By Dr. Tedd Mitchell
EXPIRED DRUGS:
TOSS ‘EM?
Dear Dr. Tedd:
Must I throw out any medication that’s past
its expiration date? If a drug expires
on one day, does that really mean it’s no good the next day?
BACK in 1979, a law was passed
requiring drug manufacturers to print an expiration date on the bottle or
package. That date is generally two to
three years from the date the drug was made.
The manufacturer guarantees that the medication (over-the-counter as
well as prescription) will have its full potency and safety through that date –
if left in the original, unopened package.
Does that mean it starts to degrade,
or break down, soon after that date? Probably not. It’s
important not to confuse a drug’s expiration date with its shelf life. As long as you don’t unseal the
manufacturer’s container, a drug may be good far beyond its expiration date.
We know this because back in 1985 the
Air Force wound up with a stockpile of medications that were just about to
expire. Not wanting to throw away
medicine (and money) unnecessarily, the Air Force asked the Food and Drug
Administration to check the drugs for safety and effectiveness. The FDA estimated that 80% of the medications
would remain safe for nearly three years past their expiration date.
Some people suspect that expiration
dates have as much to do with marketing as science. By dumping expired drugs and restocking,
pharmacies and families keep the economic machinery of the manufacturers
running. Of course, folks in the
pharmaceutical industry have a different view.
They say replacing medicines promotes public safety. Indications for medications change, and
labels need to be updated. New drugs are
developed that sometimes are more effective than the older ones.
The American Medical Association wants
more testing to see whether expiration dates can be lengthened. The AMA also points out that the downside of
expired drugs is lost effectiveness, not toxicity. Many people believe that taking an old
medication can be harmful, but the data just doesn’t support that.
PLAY IT SAFE:
SOME MEDICINES DON’T LAST
Even though testing has been
limited, I think it’s safe to say that using most medications for three years
after their expiration date is all right, with a few caveats:
□ Liquid or suspension medications. These don’t retain their potency
nearly as well as solid medications, so stick to the expiration date on the
package.
□ “Lifesaving” medications. Someone taking a medication for a
severe cardiac arrhythmia probably shouldn’t rely on an older drug to do the
trick.
□ Medications bottled by the pharmacist. Remember that expiration date
guarantees come from the manufacturer and are based on unopened packages. After a pharmacist breaks the seal, counts
out pills and puts them in a pharmacy bottle, he places a new expiration date
on that bottle. It’s generally limited
to about a year from the time the prescription is filled. This is called the “beyond use” date. So drugs you pick up from a pharmacy that are
in one of the pharmacy’s bottles may not last quite as long, although the three
year rule might still apply. Ask your
pharmacist.
A TIP: To improve the efficacy of the
medications in your home, store them in a cool, dry spot; the refrigerator is
probably best. That will help ensure
their long-term effectiveness.
FECPPSG Editor’s Note:- I, for
one, always ask either my pharmacist or doctor as the how long the particular
drug retains its effectiveness.
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The
following is reprinted from “Elder Update”, May-June 2005 – and most appropos after the previous article….
INFORMATION ABOUT GENERIC DRUGS
1.
What is a generic drug?
A generic
drug is a copy of a brand-name drug that is equivalent in drug in dosage, safety,
strength, how it is taken, quality, performance and intended use.
2.
Are generic drugs as safe as brand-name drugs?
Yes. The Food and Drug Administration (FDA)
requires that all drugs be safe and effective.
Since generics use the same active ingredients and are shown to work the
same way in the body, they have the same risks and benefits as their brand-name
counterparts.
3.
Are generic drugs as strong as brand-name drugs?
Yes.
FDA requires generic drugs to have the same quality, strength, purity
and stability as brand-name drugs.
4.
Do generic drugs take longer to work in the body?
No.
Generic drugs work in the same way and in the same amount of time as
brand-name drugs.
5.
Does every brand-name drug have a generic counterpart?
No.
Brand-name drugs are generally given patent protection for 20 years from
the date of submission of the patent.
This provides protection for the innovator who laid out the initial
costs (including research, development and marketing expenses) to develop the
new drug. However, when the patent
expires, other drug companies can introduce competitive generic versions, but
only after they have been thoroughly tested by the manufacturer and approved by
the FDA.
6.
What is the best source of information about generic drugs?
Contact your physician, pharmacist, or
insurance company for information on your generic drugs. You can also visit the FDA web site at
http://www.fda.gov/cder/ ogd/index.htm for more information.
Source:
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Keys
Locked In Your Car????
Did you know this??
If you lock your keys in the car and the spare keys are at home, call
someone on your (or someone else's) cell phone.
Hold your cell phone about a foot from your car door and have the other person
at your home press the unlock button of your key fob (clicker), holding it near
the phone on their end. Your car doors will unlock. Saves
someone from having to drive your keys to you.
Distance is no object you could be hundreds of miles away, and if you can
reach someone who has the other "remote" for your car, you can unlock
the doors (or the trunk!).
FECPPSG Editor’s Note:- The above article
was sent to me by Professor Michael Kossove who has been an avid PPS advocate
for the past 20 odd years. Thanks, Mike…
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The following article
was presented at the Post-Polio Health International’s Ninth International
Conference on Post-Polio Health and Ventilator-Assisted Living,
RESEARCH
1: WHAT IS BEING DONE? WHAT NEEDS TO BE DONE?
Update
on Modafinil Study
Olavo M. Vasconcelos, Md,
Post-Polio Syndrome (PPS) Fatigue: The New Challenge 50 Years After
the Salk Vaccine
Post-Polio Syndrome (PPS) is
the term used to describe the reemergence of symptoms decades after recovery
from acute poliomyelitis. Symptoms
include increasing muscle weakness, pain, and atrophy, fatigue, breathing and swallowing difficulties, sleep disorders, and cold intolerance. After starting, symptoms progress overtime
and lead to gradual functional loss.
Usually, but not always, PPS symptoms begin after 15 or more years of stable
function that follows recovery from paralytic polio.
Among the PPS symptoms, fatigue is the
earliest and most disabling. Because of
fatigue, many polio survivors are forced to leave work or lose the ability to
live independently. The fatigue of PPS
is not only debilitating, it affects the vast majority of polio survivor
population. Estimates show that 79% to
89% of patients with PPS suffer from fatigue.
A 1985 survey of 676 polio survivors showed that 91% of the sample
experienced new or increased fatigue, with 41% claiming an interference of
fatigue in performing work and 25% in self-care activities. A questionnaire completed by 276 Norwegian
subjects with PPS showed
that the prevalence of fatigue in PPS patients is significantly
higher than in matched controls.
The cause of fatigue in PPS patients
is only vaguely understood. It is
thought that multiple domains of subjects’ function are involved. In PPS patients, at least in part, fatigue is
related to the gradual loss of individual nerve cells that make contact with
other nerve cells (within the central nervous system), or with muscle fibers
(within the peripheral nervous system).
This results in subsequent loss of nerve transmission to these circuits. During the original polio infection, the
poliovirus destroys nerve cells in the brain and spinal cord, particularly but
not only, motor neurons. Among other
things, this can result in loss of muscle function, including weakness or
paralysis. However, to compensate for
this loss, surviving neurons sprout out extra branches that are able to
reestablish synapses (contacts), especially with orphaned muscle fibers that
have lost their original nerve supply.
Because of this process of reinnervation the
individual is able to regain function.
This is easily noticeable within the muscle system: body muscles are able to work again,
sometimes as well as before. Ironically,
these repaired circuits appear to wear down with aging. Some researchers have suggested that PPS
develops because these extra sprouts cannot “hold” forever, but instead get
weaker over time due to “over-use”.
Eventually, the sprouts degen-erate, and
function mediated by the neural contacts they have secured for years decline or
disappears. This explains why recovered
muscles gradually weaken and loose bulk when PPS settles in. An important lesson from the facts outlined
above is that the fatigue faced by PPS patients is complex and involves
multiple domains of function (emotional, intellectual, social, etc.) not simply
the physical (muscular) dimension.
Unfortunately, except for supportive
care, effective pharmacological therapies for the fatigue of PPS remain
elusive. This problem remains as one of
the most difficult new challenges faced by survivors of the last epidemics 50
years after the Salk vaccine.
Attempts at symptomatic management of
other PPS symptoms have not met with much success either. In the past, several groups of researchers
worked independently while investigating the origin of PPS and ways to reduce
the burden of the incapacitating fatigue.
About half a dozen clinical trials directed to reduce fatigue, the most
common and disabling problem faced by patient, were done but arrived at
negative results.
In year 2001 the PPS Program was
funded. The PPS Program is sponsored by
the Uniformed Service University (USUHS) and administered under the auspices of
the Henry M. Jackson Foundation (HMJ).
The mission of the PPS Program is to advance knowledge on the cause and
treatment of post-polio syndrome. To
achieve this goal several independent studies are taking place, some in the
form of clinical trials intended to test the effect of medications to reduce
the symptom burden in PPS patients.
Currently, the PPS Program is
enrolling volunteers to participate in a clinical trial on PPS fatigue. This study will test if a medication called modafinil (Provigil) can help
reduce the fatigue of patients with post-polio syndrome. This research is being done because, despite
intense work, there still is no effective treatment for PPS fatigue, the most
debilitating problem in persons with PPS.
The nature of PPS fatigue is poorly under-stood but a central element is
likely. This is supported by the damage
caused by the poliovirus to neurons is supra spinal areas of the central
nervous system, particularly the basal ganglia and reticular formation. Drugs reducing fatigue in neurological
conditions usually act by facilitating central catecholaminergic
tone. The centrally-acting a-adremergic agonist modafinil may help lower fatigue in PPS subjects. Modafinil has been
used successfully to reduce fatigue in patients with other neurological
disorders, including multiple sclerosis.
Other studies in our program are directed to investigate different
aspects of PPS. A second study (also
actively enrolling) is looking at alterations in the brain and spinal cord of
polio survivors that might help explain the development of PPS and the origin
of PPS symptoms. This one is not a
treatment trial. Instead, we are
employing electrophysiology techniques and magnetic resonance to map possible
residual abnormalities in the central nervous system induced by the poliovirus
during the original infection.
A third study is coming up soon. This one will examine if cognitive problems
that are common is survivors with PPS, by measuring the brain ability to
concentrate, sustain attention, register and memorize information, etc., with
the use of traditional neuropsychological tests. These studies aim to advance knowledge in
several different areas of PPS and hopefully, help us design and test
therapeutic interventions that can be safely used to reduce disability in polio
survivors. For more information, please
contact our research nurse coordinator, Ms. Kay Kelley, at 301-295-0231.
Olavo M. Vasconcelow,
MD
Post-Polio Syndrome Program (PPSP)
Uniformed
Henry M. Jackson Foundation (HJF),
FECPPSG Editor’s Note:- Although the conference was in June, I think that
if you are interested in taking part in any of the studies, you can still call
Ms. Kay Kelley as stated above.
This article was slightly edited.
************************************
The following was also e-mailed to
me by one of our members, Lisa Haines, from PA.
Thanks, Lisa. It’s another way to
“get even” with telemarketers…
TELEMARKETERS
The phone rang as we
were sitting down to dinner. I answered it and was greeted with, "Is
this William Wagenhoss?"
This didn't sound anything like my name, so I asked, "Who is
calling?"
The telemarketer said he was with The
Rubberband-Powered Freezer Company or something like that. I asked him if
he knew William personally and why was he was calling this number. I then
said, off to the side in a low voice, "Get really good pictures of the
body and all the blood."
I turned back to the phone and advised the
caller that he had called a murder scene and must stay on the line because we
had already traced this call and he would be receiving a summons to appear at
the local courthouse to testify in this murder case.
I questioned the caller at great length as to
his name, address, phone number at home, at work, who
he worked for, how he knew the dead guy and could he prove where he had been
about one hour before he made this call. The telemarketer was getting
very concerned and his answers were given in a shaky voice.
I proceeded to tell him we had located his
position at his work place and the police were entering the building to take
him into custody. At this point, I heard
the phone fall and the scurrying of his running away.
My wife asked me as I returned to our table, why
I had tears streaming down my face and so help me, I couldn't tell her for
about fifteen minutes. My food was cold, but oh-so-very enjoyable.
******************************************
E-mail is wonderful – the following
was sent to us by several of our members as well as some of my non-polio
friends…. It’s good advice.
FYI:- ICE
Paramedics will turn to a victim's cell
phone for clues to that person's identity. You can make their job much
easier with a simple idea they are trying to get everyone to adopt: ICE –
ICE stands
for In Case of Emergency. If
you add an entry in the contacts list in your cell phone under ICE, with the
name and phone # of the person that the emergency services should call on your
behalf, you can save them a lot of time and have your loved ones contacted
quickly. It only takes a few moments of
your time to set up.
Paramedics know what ICE means and they look for it immediately! ICE your
cell phone now.
FECPPSG Editor’s Note:- I just ICEd my cell phone.
******************************************
Reprinted from
Polio Heroes of
A
CLARIFICATION OF
NON-PARALYTIC
POLIO
By
Ernest W. Johnson, MD
(Dr. Johnson is editor of the
American Journal of Physical Medicine and Rehabilitation. He is a well recognized expert on Post-Polio
Syndrome.) Reprinted from Polio
For many years, most
physicians have understood that non-paralytic is a loose clinical term implying
that neither the patient nor the clinician-examiner reported functional
weakness. This determination was often
made without the understanding that 50% of the motor units can be lost before a
manual muscle grade of four occurs. This
means that many patients with acute polio were tabled non-paralytic
incorrectly, but certainly in a well-meaning way.
When the polio virus is
in the gastrointestinal tract of an individual and causes symptoms, the term
abortive polio has been used. This is
the condition that confers immunity on the individual and also prevents the
carrier state. This is why the Sabin (attenuated, live poliovirus) vaccine prevents the
invasion of the poliovirus into the central nervous system, but not the
poliovirus from living in the gastrointestinal tract.
In those individuals
whose immune systems, for whatever reason, permit the invasion of the central
nervous system by the poliovirus, a population of anterior horn cells will die. The number of these cells that die will
determine whether the clinician will be able to identify paralysis.
In
the late 1950s, our electromyographic studies
suggested that in all patients who experienced the invasion of the central
nervous system by the virus, pain, meningismus, and
positive spinal fluid findings revealed abnormal irritability (fibrillation and
positive waves) in many muscles that were clinically “normal”.
It
should be absolutely understood that patients who were told that they had non-paralytic
polio did, in reality, have polio which affected their anterior horn
cells. Now, 30 to 40 years later, these
patients are potentially subject to all of the vagaries and insults to the body
that affected other persons with post-polio syndrome.
******************************************
Reprinted from
Polio Heroes of
NO
MORE EXCUSES!
A
powerchair (not Manual) or scooter is not an
instrument of torture. (Although a
manual chair can be!) Using a powerchair or scooter will
not make you look stupid – at least not as much as pretending you don’t
need one while taking pain meds and stumbling around, falling down, requiring
surgery on hands, elbows, shoulders, knees, etc.
Using
a powerchair or scooter will give you more energy because you won’t be using all your
energy in trying to accomplish the impossible (i.e. – looking like you don’t
need one). Using a powerchair
or scooter will actually be more freeing. You will have the freedom to go where ever
you want, without having to have someone chained to you to push you here and
there – and then go off to look at something else that interests them and leave
you stranded. (Been there, done that!)
Using
a powerchair or scooter will relieve the strain on overtaxed shoulder muscles and joints
that were never meant to be walked on in the first place, thereby eliminating
much of the unnecessary surgeries which, by the way, will not last unless you change the way you do things. You may also find that you don’t need as much
or any of the pain meds.
Using
a powerchair or scooter will show that you are winning the battle! But you need to define your battles. You already had polio. No way to change that. You are having post-polio sequelae. Another done deal. These are battles people frequently think
that they need to fight against, but there is no way to win here. It’s happening. Live with it.
But the battle you can win is
the battle for independence! You can be
your own person again. It has been said,
“Fight only the battles you can win”.
Living life on your own terms is possible only if you have the stamina,
the balance, and the heart for it. We
all have the heart for it. . . we are polio survivors! What we don’t have are the balance and the
stamina. A powerchair
or scooter can help.
Do
you always walk to the grocery store 5 miles away? Do you walk to work? To
Church? Of course not! You use the technology available to you – a
car or public transportation. Do you mix
your cake batter with a spoon? Or do you
use an electric mixer? These are devices
that help to make our lives easier. So are powerchairs
and scooters. You are not giving in. . . you’re stepping up to an easier way of doing things.
And Boy! Are they ever fun!
If
you are thinking about it, it is probably past time to do it. And the sooner you start using a power
mobility aid, the longer you might retain the ability to walk and the easier it
will be on your arms and shoulders in the long run. I wish
you well.
(PH of TN Editor’s Note: This
article was not authored by name. I wish
I had written it! It sounds very much
like words of Dr. A. C. Higgins, MD of
FECPPSG Editor’s Note:-
As most of you know, I use a scooter – in fact, I’m on my third Electric
Mobility Rascal. Whenever I see a polio
(or other mobility impaired individual) that should be in a powerchair
or scooter I cringe. If I question them
as to why they’re not using a powerchair or scooter,
they’re answer is usually that they don’t need it – they aren’t that bad. Hopefully, this article will help some
realize that using such an aid will open many doors that have been closed to
them – such as going to the mall, going to theme parks, taking a “walk” with
the grandchildren…. Please, if you need
a powerchair or scooter, look into getting one.
******************************************
Now that we are finally getting into
the cooler weather, I thought I would reprint an e-mail I received a while ago
and had inserted into a newsletter a year or two ago – however, it’s still
appropriate. Soooo, here it is…
GONNA BE A BEAR
In this life I’m a
woman. In my next life I’d like to come
back as a bear. When you’re a bear, you
get to hibernate. You do nothing but
sleep for six months. I could deal with that.
Before you hibernate,
you’re supposed to eat yourself stupid.
I could deal with that too.
When you’re a girl bear,
you birth your children (who are the size of walnuts) while you’re sleeping and
wake to partially grown, cute, cuddly cubs.
I could definitely deal with that.
If you’re a mama bear,
everyone knows you mean business. You swat
anyone who bothers your cubs. If your
cubs get out of line, you swat them too.
I could deal with that.
If you’re a bear, your mate EXPECTS you to wake up
growling. He EXPECTS that you will have
hairy legs and excess body fat.
YUP, gonna be a bear!!!
FECPPSG Editor’s Note:- So, what do you think????
Oh, and thanks to Gary Fredericks for sending it to me last month.
******************************************
Reprinted from HealthSmart
–
FEED YOUR HEART
by Dr. Tedd
Mitchell
Trans fats are a main culprit in raising “bad” cholesterol, says a key study of women.
What
we know about the impact of diet on cholesterol has evolved over time. This is best evidenced by the changes in the
USDA food pyramid: the guidelines now
call for more liberal amounts of fats in the diet, while discouraging the
consumption of specific fats associated with hardening of the arteries.
Two
of the biggest offenders are saturated fats and trans
fats. Both are associated with coronary
heart disease and now are being targeted by nutritionists and the health care
industry. One reason for this is a study
published in The New England Journal of
Medicine in 1997 in which researchers looked at the type of fat intake in
coronary heart disease in women. In the
study, saturated and trans fats “took the cake” (pun
intended) when it came to heart disease.
Let’s
take a closer look at trans fats. They are produced by partially hydrogenated
vegetable oils, which make them into solid fats (such as margarine or
shortening). Some trans
fats also are found naturally in foods.
A high intake of trans fats raises the LDL (the
“bad” cholesterol), which in turn raises the risk for heart disease.
Trans fats are used in many products, including candies,
cookies, baked goods, fried foods, crackers and other processed foods made with
partially hydrogenated vegetable oils – a rather extensive list.
Unfortunately,
some in the food industry understand the potential problem with trans fats in the diet; they’ve worked to reduce the amount
in the products we buy. Frito-Lay, for
example, has made sweeping changes in many of its snack products, dramatically
reducing the amount of trans fats. In
But
it’s not up to others to improve our health.
We are responsible for our own health.
It is up to us to bone up on the facts.
The first step in improving our diet is understanding
more about it. To keep your heart
healthy, learn what raises cholesterol.
The new food guide pyramid can help you; visit mypyramid.gov for
details.
The
knowledge that you gain from learning more about cholesterol can help you and
your family. The heart attack you
prevent may be your own!
Contributing
Editor TEDD MITCHELL, M.D., is medical director of the Wellness Program at the
renowned Cooper Clinic in
==================
THE GOOD FATS
Increase your intake of these fat
sources:
nuts – vegetable oils – fish
THE BAD FATS
Limit these solid fats:
butter – shortening – margarine – lard
******************************************
ODD SHOES
Catherine has a shoe service. Do you need two different
size shoes? Do you need split-size shoes? She has a free listing web site which
also helps connect people with mutual shoe size needs at, www.Mermade.homestead.com/pedpals. html.
Her name is Catherine Beausoleil.....
4476SymcoAvenue
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Anesthesia and Post-Polio Today
with
Reported by Mary Clarke Atwood
Editorial Assistance by
Virginia Duboucheron and S.H. Calmes, M.D.
This report is based upon Dr.
Aspects of anesthesia included in this report are:
·
Requirements for
Excellent
Anesthesia
·
Post-Polio and
Anesthesia
Management
·
Types of
anesthesia
·
What Should your
Anesthesiologist Know or Do?
·
What Type of
Anesthesia is Best?
·
Preparing for
Surgery
· Frequently Asked Quest