PPS Pain Tips Plus

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</div> </tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 16 WIDTH="622"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="622" HSPACE="0" VSPACE="0"></tD> </tR> </TABLE></div> <div> <B>A special THANK YOU to Tomincal for consolidating this information:</B></div> <div> <TABLE BORDER="0" CELLPADDING="1" CELLSPACING="1" WIDTH="286" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="VOID" RULES="NONE" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=CENTER HEIGHT= 19 ><NOBR><div> <B><IMG SRC="159670c0.jpg" border=0 width="359" height="12" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></div> </NOBR></tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 16 WIDTH="282"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="282" HSPACE="0" VSPACE="0"></tD> </tR> </TABLE></div> <div> <B>These tips from the collected wisdom of the Internet Polio Mail List --</B></div> <bR> <div> <B>NUMERO UNO -- "Lifestyle Adjustment"</B></div> <div> <B>The 'sine qua non' without which none of the other tips or aids seem to do much good.</B></div> <bR> <div> <B>That means reducing physical exertion / activity AND mental stress to the level of one's current capabilities.</B></div> <bR> <div> <B>Dr. Perry, over 40 years at the polio clinic of Rancho Los Amigos Medical Center in Downey says we should exercise normal (if any) muscles normally but not do anything that causes PPS-affected muscles pain or weakness or fatigue that lasts more than 10 minutes.</B></div> <bR> <div> <B>Assuming the person has been thoroughly checked for any other conditions that could mimic PPS symptoms and be treated -- and that any orthopedic anomalies that could be causing pain have been treated -- here's a partial list of some tips that PPSers have reported seem to work for them, alone or in combination:</B></div> <div> <B>1)   Moist heat applied to the painful area.</B></div> <div> <B>2)   Light massage to the painful area.</B></div> <div> <B>3)   Ice packs applied to the painful area.</B></div> <div> <B>4)   Chiropractic or osteopathic 'adjustment' of neck / back / joints; postural       </B></div> <div> <B>       improvement -- Alexander, Feldenkrais, etc.</B></div> <div> <B>5) "Alternative" therapies such as acupuncture or electro-acupuncture to the ear        </B></div> <div> <B>      lobe; magnetic field therapy; naphazoline eyedrops.</B></div> <div> <B>6)   Dietary supplements such as ginger, pycnogenol, cayenne pepper, glucosamine  </B></div> <div> <B>      and chondroitin sulfates, calcium and magnesium, St. Johnswort.</B></div> <div> <B>7)  Treatment of sleeping difficulties, i.e., insufficient amount of deep, Stage IV  </B></div> <div> <B>       sleep.</B></div> <div> <B>8)   Treatment of breathing difficulties, i.e., insufficient amount of oxygen and or too </B></div> <div> <B>      much carbon dioxide, especially during sleep.</B></div> <div> <B>9)   Use of assistive and adaptive aids, as necessary, to reduce stress and strain to    </B></div> <div> <B>       muscles and joints; assuring that all body parts that require it, e.g., neck, head,  </B></div> <div> <B>       back, shoulders, are properly supported at all times.</B></div> <div> <B>10)   For inflammation of muscles / joints -- use of arthritis-type drugs: NSAIDs (Non-</B></div> <div> <B>        Steroidal Anti-Inflammatory Drugs). Over-the-counter types like Aspirin, </B></div> <div> <B>      Ketoprofen or prescription types like Relafen, Voltaren, Naprosyn.</B></div> <div> <B>11)  For 'nerve' pain -- use of antidepressant prescription drugs --</B></div> <div> <B>       Elavil (amitriptyline) -- an anti-depressant of the tricyclic type -- is the first                  </B></div> <div> <B>       choice  in drug therapy by many PPS specialist docs (and also Fibromyalgia    </B></div> <div> <B>       specialists for those with PPS pain AND trouble sleeping, at dosages less than  </B></div> <div> <B>       would be used for clinical depression. But a lot of us don't tolerate it well.</B></div> <div> <B>            And for those (and also those who DON'T have sleeping problems), one of  </B></div> <div> <B>       the SRUB class of anti-depressants (Serotonin ReUptake Blockers) such as   </B></div> <div> <B>       Zoloft or Paxil -- also in smaller doses than would be used for clinical </B></div> <div> <B>       depression -- may be of help.</B></div> <div> <B>12)   Occasional and/or careful use of muscle relaxants such as Quinine or </B></div> <div> <B>         Methocarbamol.</B></div> <div> <B>13)    Hormone Replacement Therapy, especially for post-menopausal, post-</B></div> <div> <B>         hysterectomy women and others with lower than normal levels of estrogen,</B></div> <div> <B>         testosterone, thyroid. DHEA and pre-cursors; Melatonin.</B></div> <div> <B>14)   Generic Tramadol Hydrochloride, recently available in the U.S. as the </B></div> <div> <B>         prescription drug Ultram and in Mexico as Tradol, is an artificial opiate "pain</B></div> <div> <B>         pill" that appears to be safer and without the negative side effects of narcotic                                                                                                                                                                                         </B></div> <div> <B>         pain medications. Some docs, though, are questioning claims that it is not </B></div> <div> <B>         addictive.</B></div> <div> <B>15) LISTEN  TO  YOUR  BODY ! ! !</B></div> <div> <B>-----</B></div> <div> <B>NOTE:</B></div> <div> From the research I have done on people dealing with the problems of<B> MS, </B>please note that while heat will help a PPSer, it will litterly paralyze someone with MS. Many of the other suggestions, however will help with the MS.....i.e.<B> Knowledgeable </B>Chiropratic treatment.  I will be looking into this subject and posting it asap, so please come back.</div> <bR> <div> BTW, there are people that are dealing with both conditions.  I will try to make notes as I comment on the various differences.  Thank you for your patience.</div> <div> <IMG SRC="2ba57350.gif" border=0 width="87" height="53" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <div> <FONT SIZE="4" COLOR="#BF0000" FACE="Arial" ><B>Attention </B></FONT>- <B>This applies to all people dealing with </B><B>PPS, MS, ALS and Guillian- Barre Syndrome</B></div> <div> <B>The following article was copied from the July-August  2001</B></div> <div> <B>"Polio Outreach of Washington" </B><FONT SIZE="2" COLOR="#0000CC" FACE="Arial" ><B>Bi-Monthly Newsletter</B></FONT></div> <bR> <div> <B>Eat Well, Be Well</B></div> <div> by <B>Dr. Richard L. Bruno</B></div> <bR> <div> <IMG SRC="2bb284b0.gif" border=0 width="40" height="75" ALT="steaming hamburger as protein source" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"> <B>"BREAKFAST? Sorry, don't have the time.</B> In the morning there's too much to do, like showering and dressing and getting to work. I grab a cup of coffee (or two or three) and maybe a donut at work...</div> <bR> <div> <B>LUNCH? Don't think so.</B> I'm still catching up from my late morning start. I grab a cup of coffee (or two or three) and maybe wolf down half a Big Mac...</div> <bR> <div> <B>"DINNER? I'm either too tired or hungry as Patton's Third Army</B>. I either defrost a pieces of pizza and drag my self into bed or eat everything that isn't nailed down!" <B>"So why am I totally exhausted but can't stop gaining weight?"</B></div> <bR> <div> Americans are not very good at taking care of themselves. American's with disabilities are no better, and maybe a little worse, at self-care because it takes so much time to do things non-disabled folk do in a flash, like showering and dressing. There's hardly any time or energy left for planning meals, shopping, cooking... or even eating.</div> <bR> <div> However, people with disabilities pay a higher price for lack of self-care than do people without disabilities. For those who use wheelchairs good eating habits and proper nutrition are essential, not only for general good health, but also to prevent bowel and urinary problems, to prevent weight gain, and to maintain a decent level of energy.</div> <bR> <div> <B>Polio Survivors Vs. Breakfast.</B> One group of people with disabilities shows the consequences of poor eating habits: North America's 1.8 million polio survivors. Nearly 76 percent of polio survivors experience Post-Polio Sequelae (PPS), the often disabling symptoms -fatigue, muscle weakness, joint and muscle pain, cold intolerance, and difficulty sleeping, swallowing, and breathing - that occur about 40 years after their original bout with polio.</div> <bR> <div> PPS requires polio survivors to use new assistive devices or aids they discarded years ago, like braces, canes, crutches, wheelchair and scooters, to slow down and to rest during the day. The problem is, polio survivors are Type A, hardworking, pressured, perfectionist super-achievers who have pushed themselves beyond their physical limits and allow no time for self-indulgent luxuries - like food.</div> <bR> <div> Dr. Susan Creange at the Post-Polio Institute discovered that polio survivors with blood sugar levels in the low normal range have as much difficulty paying attention and concentrating would diabetics with blood sugar low as if they had taken too much insulin.</div> <bR> <div> "Polio survivors' Type A diet' - three cups of coffee breakfast, skipping lunch and eating pizza for dinner actually starving their nervous systems' and causing symptoms," says Crenage. The relationship between and PPS was seen in <U>the </U><B><U>1998 National Post-Polio Survey:</U></B><B>  the less protein polio survivors had at breakfast more severe were their daily weakness and fatigue.</B></div> <bR> <div> <B>Why do polio survivors function as If they have low blood sugar and report more symptoms when they don't eat protein at breakfast?</B> Because polio survivors are running their nervous systems on "half a tank of About 50 percent of all brain stem and motor neurons killed decades ago by the polio virus. What's worse metabolic apparatus, the internal power plant, of neurons. that survived the original polio virus infection was severely damaged.</div> <bR> <div> So polio survivors have been running their full-tilt, Type A lives on half the normal number of neurons, neurons are less able to use their only source of fuel, blood sugar. Dr. Creanage found that even normal levels of blood sugar were not enough to fuel the remaining polio-virus-damaged metabolically impaired neurons. And that's where protein at breakfast comes in.</div> <bR> <div> <B>PROTEIN: The fuel that keeps on giving.</B> Protein vides a long lasting, "slow-release" supply of blood s throughout the day. Polio survivors who had protein breakfast reported less PPS symptoms because their tank stayed full longer. They didn't need to "fill-up" through the day with short-lasting sugar fixes, like soda or candy bars.</div> <bR> <div> When we ask our post-polio patients to eat protein every<B> </B>day at breakfast, and have small, non-carbohydrate snacks throughout the day, they report an almost immediate reduction in nearly all the symptoms of PPS, especially fatigue.   But, a "protein power" diet is neither a fad nor a miracle: it's just common sense. No engine can be expected to run without gas.</div> <bR> <div> <B>And having protein at breakfast isn't good</B><FONT SIZE="2" COLOR="#000099" FACE="Arial" ><B> only </B></FONT><B>for </B><FONT SIZE="2" COLOR="#000099" FACE="Arial" ><B>polio </B></FONT><B>survivors</B>. Mom was right breakfast is the <B>most </B>important meal of the<B> </B>day for everyone, but <FONT SIZE="2" COLOR="#000099" FACE="Arial" >especially </FONT>for <B>people with damaged or compromised</B><FONT SIZE="2" COLOR="#000099" FACE="Arial" > </FONT><B>nervous systems. </B><FONT SIZE="2" COLOR="#000099" FACE="Arial" >Folk<B> </B>with </FONT><B>MS </B>(for whom low energy and fatigue can be disabling<B>)</B><FONT SIZE="2" COLOR="#000099" FACE="Arial" ><B> </B></FONT>those with <B>ALS and Guillian-Barre Syndrome need to feed their damaged neurons</B> first thing in the morning.</div> <bR> <div> <B>Those with spinal cord injuries, CP and spine bifida, who use more energy just getting showered and dressed that does a non-disabled person who runs a mile, also need protein early and often. It's a good  idea to eat breakfast before showering to "break your fast" and fill your tank before your neurons need  the fuel.</B></div> <bR> <div> <B>Our patients worry that using a wheelchair, resting more and having breakfast will cause them to get fat and more PPS symptoms. A four-year follow-up study found the U.S. and Swedish polio survivors, living their typical it or lose it" lifestyles without using new assistive devices or resting, lost equal amounts of leg muscle strength, a percent per year. However, when subjects from the two countries look separately, the Swedes gained only 6 c per year, while the Americans gained over 2 pounds; that's 220 percent more weight!.</B></div> <bR> <div> Although weight gain alone is not responsible for the progression of muscle weakness in polio survivors it is Americans' high fat, Big Mac diet that causes them to get fat You can fuel your neurons, <FONT SIZE="2" COLOR="#000099" FACE="Arial" >feel </FONT>stronger and less fa without gaining weight, if you choose low fat, low cholesterol sources of protein. In fact many of our patients, even as they slow down, sit down more, and use a scooter, lose weight (about a pound per week) if they eat more protein, reduce portions size and limit carbohydrates.</div> <bR> <div> <B>We aren't recommending one of those "all protein, no carbohydrate" diets. We </B></div> <div> <B>aren't recommending a "diet" at ~ a method for eating healthy every day. We suggest </B></div> <div> <B>16 grams of protein at breakfast; that's about 1/4 of the daily protein requirement (70 grams) for a 150-pound person. (Always check with your doctor, especially if you have I problems, before changing your diet and ask to have your cholesterol measured at least once a year at your check up.) Look at the list of protein-power, rich foods breakfast and select different breakfasts so you can have vanety throughout the week. Remember, you want foods that have more grams of protein than they do fat.</B></div> <bR> <div> <B>12 MInute </B><B>Breakfast</B> <B>-2 hard boiled eggs (12 g) and an English Muffin (4.5 g)</B></div> <div> <I><B>8 </B></I><B>Minute </B><B>Breakfast </B><B>-3 scrambled egg whites (log) and a bagel (6 g)</B></div> <div> <B>7 mInute breakfast </B><B>- </B><B>Toasted bagel (6 g), lite cream cheese (3 g) </B><B>+ </B><B>I glass 2% milk (8 g)</B></div> <div> <I><B>4 </B></I><B>minute breakfast </B><B>- </B><B>Yogurt (12 g) and 1 ounce of low-fat cheese (69)</B></div> <div> <B>2 </B><B>minutes </B><B>breakfast </B><B>- </B><B>1/2 cup low-fat cottage cheese (14 g)</B></div> <bR> <div> <B><U>  Great</U></B><B> </B><B><U>Protein</U></B><B> </B><B><U>Fat</U></B></div> <div> <B>  </B><FONT SIZE="2" COLOR="#000099" FACE="Arial" ><B>Lite Cottage Cheese-1 cup (28 g)</B></FONT></div> <div> <B>  Salmon-3 ounces</B></div> <div> <B>  Yogurt-8 ounces</B></div> <div> <B>  Tofu-10 g</B></div> <div> <B>  2 Egg Whites (6.8 g)</B></div> <div> <B>       Bagel (6.0)</B></div> <div> <B>  Egg Beaters 1/4 cup (5.0 g)</B></div> <bR> <bR> <div> <B><U>Higher</U></B><B> </B><B><U>Fat</U></B><B>:</B></div> <div> <B>Swiss Cheese 1 ounce (8 g)</B></div> <div> <B>Slim Fast </B><B><U>Meal</U></B><B> </B><B><U>On-The-Go</U></B><B> 8.Og</B></div> <div> <B>Lite'n Lively Cheese (1 oz. </B><I><B>) </B></I><B>6.4g</B></div> <div> <B>Cream Cheese (Lite 1 oz.) 2.9</B></div> <bR> <div> <B><U>Lower</U></B><B> </B><B><U>Protein</U></B></div> <div> <B>Quaker Life 5.2</B></div> <div> <B>English Muffin 4.5 g</B></div> <div> <B>Oatmeal (I package) 4.4 g</B></div> <div> <B>Cheerios(1.5cups= I oz)4.3g</B></div> <div> <B>Shredded Wheat(1 ounce) 3.1 g</B></div> <div> <B>Total Cereal (1 cup) 2.8 g</B></div> <bR> <bR> <div>   <FONT SIZE="1" COLOR="#0000CC" FACE="Arial" >Stickers & Stuff</FONT><FONT SIZE="2" COLOR="#9933FF" FACE="Arial" ><A HREF="id35.htm" TARGET="_top" TITLE="Stickers Stuff"><U><IMG SRC="1469f680.jpg" border=0 width="159" height="104" ALT="Back Buttom " ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></U></A></FONT>    <FONT SIZE="3" COLOR="#3333CC" FACE="Arial" ><A HREF="id32.htm" TARGET="_top" TITLE="Seborrheic Dermatitis"><U><B><IMG SRC="13ba3730.jpg" border=0 width="163" height="115" ALT="Forward Button " ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A></FONT><FONT SIZE="1" COLOR="#0000CC" FACE="Arial" > Seborrheic Dermatitis</FONT>                                   </div> <bR> </td> </tr></table></body>