Catalogue by source - B [Lincolnshire Post-Polio Library]

Catalogue [by source]

IMPORTANT NOTES FOR FIRST-TIME READERS

INDEX - B
Bach, John R., MD
Ballinger, Paul, MRCP, MRCGP, DCH, DRCOG
Barnes, Gregory, B.S., R.P.T.
Benditt, Joshua, MD
Benjamin J.
Bollenbach, Eddie, B.A, M.A.
Bruno, Richard L., Ph.D.

Bach, John R., MD

Title: Airway Secretion Clearance by Mechanical Exsufflation for Post-Poliomyelitis Ventilator-Assisted Individuals: Author(s): John R. Bach, MD, William H. Smith, Jennifier Michaels, MD, Lou Saporito, BA, Augusta S. Alba, MD, Rajeev Dayal, BS, Jeffrey Pan, BS
Original Publication: Arch Phys Med Rehabil Vol 74:170-177, February 1993.
Abstract/Extract: Pulmonary complications from impaired airway secretion clearance mechanisms are major causes of morbidity and mortality for post-poliomyelitis individuals. The purpose of this study was to review the long-term use of manually assisted coughing and mechanical insufflation-exsufflation (MI-E) by post-poliomyelitis ventilator-assisted individuals (PVAIs) and to compare the peak cough expiratory flows (PCEF) created during unassisted and assisted coughing. Twenty-four PVAIs who have used noninvasive methods of ventilatory support for an average of 27 years, relied on methods of manually assisted coughing and/or MI-E without complications during intercurrent respiratory tract infections (RTIs). Nine of the 24 individuals were studied for PCEF. They had a mean forced vital capacity (FVC) of 0.54 ± 0.47L and a mean maximum insufflation capacity achieved by air stacking of ventilator insufflations and glossopharyngeal breathing of 1.7L. The PCEF were as follows: unassisted, 1.78 ± 1.16L/sec; following a maximum assisted insufflation, 3.75 ± 0.73L/sec; with manual assistance by abdominal compression following a maximum assisted insufflation, 4.64 ± 1.42L/sec; and with MI-E, 6.97 ± 0.89L/sec. We conclude that manually assisted coughing and MI-E are effective and safe methods of airway secretion clearance for PVAIs with impaired expiratory muscle function who would otherwise be managed by endotracheal suctioning. Severely decreased maximum insufflation capacity but not vital capacity indicate need for a tracheostomy.
© 1993 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Title: Pulmonary dysfunction and its management in post-polio patients: Author(s): John R. Bach and Margaret Tilton
Original Publication: NeuroRehabilitation 8 (1997) 139-153
Abstract/Extract: Respiratory dysfunction is extremely common and entails considerable risk of morbidity and mortality for individuals with past poliomyelitis. Although it is usually primarily due to respiratory muscle weakness, post-poliomyelitis individuals also have a high incidence of scoliosis, obesity, sleep disordered breathing, and bulbar muscle dysfunction. Although these factors can result in chronic alveolar hypoventilation (CAH) and frequent pulmonary complications and hospitalizations, CAH is usually not recognized until acute respiratory failure complicates an otherwise benign upper respiratory tract infection. The use of non-invasive inspiratory and expiratory muscle aids, however, can decrease the risk of acute respiratory failure, hospitalizations for respiratory complications, and need to resort to tracheal intubation. Timely introduction of non-invasive intermittent positive pressure ventilation (IPPV), manually assisted coughing, and mechanical insufflation-exsufflation (MI-E) and non-invasive blood gas monitoring which can most often be performed in the home setting, are the principle interventions for avoiding complications and maintaining optimal quality of life © 1997 Elsevier Science Ireland Ltd.

Title: Pulmonary Dysfunction and Sleep Disordered Breathing as Post-Polio Sequelae: Evaluation and Management: Author(s): John R. Bach, MD and Augusta S. Alba, MD
Original Publication: Orthopedics December 1991 Vol 14 No 12 1329-1337.
Abstract/Extract: Post-polio sequelae can include sleep disordered breathing and chronic alveolar hypoventilation (CAH). Both conditions develop insidiously and can render the post-polio survivor susceptible to cardiopulmonary morbidity and mortality when not treated in a timely and appropriate manner. These conditions can be diagnosed by a combination of spirometry, noninvasive blood gas monitoring, and ambulatory polysomnography Sleep disordered breathing is most frequently managed by nasal continuous positive airway pressure, while tracheostomy ventilation is the most common treatment for ventilatory failure. We report the more effective and comfortable techniques recently made available for managing sleep disordered breathing and the use of noninvasive treatment options for CAH, respiratory failure, and impaired airway clearance mechanisms. One hundred forty-three cases are reviewed.

Ballinger, Paul, MRCP, MRCGP, DCH, DRCOG

Dr. Ballinger is a General Practioner based in Cannock, Staffordshire, U.K.

Title: Unusual Cases: Postpolio syndrome: Author(s): Paul Ballinger MRCP, MRCGP, DCH, DRCOG
Original Publication: UPDATE The Journal of Continuing Education for General Practitioners 4th November 1998 Volume 57 Number 8 774-776
Abstract/Extract: Of the estimated 30,000 Britons with residual limb weakness from old poliomyelitis, about a quarter go on to develop postpolio syndrome (PPS) many years after the original illness. The weakness and muscle pain they endured as children revisits them after 30-40 years of stability, only this time in a more chronic, insidious and deceptive fashion.
Additional Note: According to the Audit Bureau of Circulations, a previous issue of Update (20 May 98) was distributed to 32,457 subscribers under Controlled Circulation Terms of Control which offers free subscription to "Full time general practitioners and vocational trainees in the national health service and clinical tutors in post-graduate centres and FHSA general managers and doctors".

Barnes, Gregory, B.S., R.P.T.

For articles with Barnes, Gregory, B.S., R.P.T. as co-author or contributor see the following catalogue entries:

P - Perry, Jacquelin, M.D., D.Sc. (Hon)
Article:	The Postpolio Syndrome - An Overuse Phenomenon

Benditt, Joshua, MD

For articles with Benditt, Joshua, MD as co-author or contributor see the following catalogue entries:

E - EASTER SEAL SOCIETY OF WASHINGTON
Article:	An Approach To The Patient With Suspected Post Polio Syndrome

Benjamin J.

For articles with Benjamin J. as co-author or contributor see the following catalogue entries:

Pentland B Dr
Article:	Survey of the Late Effects of Polio in Lothian

Bollenbach, Eddie, B.A, M.A.

For a detailed list of all articles by Eddie Bollenbach in our library see our catalogue Polio Biology.

Bruno, Richard L., Ph.D.

Dr. Bruno is currently located at The Post-Polio Institute, Englewood (NJ) Hospital and Medical Center.

Title: Be True To Your PPS And Your Teeth Won't Be False To You:
Preventing Complications In Polio Survivors Undergoing Dental Procedures: Author(s): Richard L. Bruno, Ph.D.
Original Publication: PPS Monograph Series. Volume 6(1):1-8. Hackensack: Harvest Press, 1996.
Abstract/Extract: Unfortunately, only a handful of specialists treat Post-Polio Sequelae (PPS) - the unexpected and often disabling fatigue, muscle weakness, joint pain, cold intolerance, and swallowing, sleep and breathing problems - occurring in America's 1.63 million polio survivors 40 years after their acute polio. However, all medical professionals need to be familiar with the neurological damage done by the original poliovirus infection that today causes unnecessary discomfort, excessive physical pain and occasionally serious complications with surgery. This is a brief overview to inform patients and professionals about the cause and prevention of complications in polio survivors undergoing dental surgery.

Title: Bromocriptine In The Treatment Of Post-Polio Fatigue:
A pilot study with implications for the pathophysiology of fatigue: Author(s): Richard L. Bruno, Ph.D., Jerald R. Zimmerman, M.D., Susan Creange, M.A., Todd Lewis, Ph.D., Terry Molzen, M.A., and Nancy M. Frick, M.Div, Lh.D.
Original Publication: American Journal of Physical Medicine and Rehabilitation, 1997 (in press)
Abstract/Extract:
Objective: Determine the effectiveness of bromocriptine in the treatment of severe and disabling post-polio fatigue.

Title: The Cause And Treatment Of Post-Polio Fatigue: Author(s): Richard L. Bruno, Ph.D., Nancy M. Frick, Lh.D., Susan J. Creange, M.A., Todd Lewis, Ph.D., and Terry Molzen, M.S.
Original Publication: Healthy Partnerships. Ontario: March of Dimes, 1995
Abstract/Extract: Fatigue is the most commonly reported, most debilitating and least studied Post-Polio Sequelae (PPS) affecting the nearly 2 million North American polio survivors. Among polio survivors, 91% reported new or in creased fatigue, 41% reported fatigue significantly interfering with performing or completing work and 25% reported fatigue interfering with self-care activities . Fatigue was reported to be triggered or increased by physical overexertion in 92% and by emotional stress in 61%. Importantly, polio survivors distinguish between the physical tiredness and decreased endurance they associate with new muscles weakness, and a 'brain fatigue' that is characterized by problems with attention and thinking. Between 70% and 96% of polio survivors reporting fatigue complained of problems with concentration, memory, attention, word-finding, maintaining wakefulness and thinking clearly, with 77% percent reporting moderate to severe difficulty with these functions.

Title: Do PPS Cometh After A Fall?

Author(s): Richard L. Bruno, PhD
Original Publication: "New Mobility", May, 1997
Abstract/Extract:

About once a month I get a call from an attorney somewhere in these litigious United States. I am asked to be the expert witness for a polio survivor who's been rear-ended in their car, hit by a bus, taken a header down some stairs or simply slipped and fell.

Regardless of the type of accident, the lawyer always asks the same question: Can a traumatic event trigger Post-Polio Sequelae, the new and sometimes disabling muscle weakness, fatigue, pain and respiratory problems that occur is as many as 77% of polo survivors?

Title: Fainting And Fatigue: Causation or Coincidence: Author(s): Richard L. Bruno, Ph.D.
Original Publication: CFIDS Chronicle, 1996; 9(2): 37-39.
Abstract/Extract: As the former autonomic nervous system fellow at New York's Columbia-Presbyterian Medical Center, and in my current incarnation studying chronic fatigue in polio survivors, I have read with special interest the reports from Johns Hopkins University describing neurally mediated hypotension (NMH) in adults and adolescents with CFIDS.

Title: A Letter to a Polio Survivor: Also reproduced in Issue No.5 - May 1997 of LINC-PIN
Author(s): Professor Richard L. Bruno PhD
Abstract/Extract:
The following is a genuine letter which has been depersonalised.
Publication at the suggestion and with the permission of Professor Richard L. Bruno PhD
Dear Polio Survivor:
1) You were asked if you have evidence that you in fact had polio.

Title: The Neuroanatomy Of Post-Polio Fatigue: Author(s): Richard L. Bruno, Ph.D., Jesse M. Cohen, M.D., Thomas Galski, Ph.D. and Nancy M. Frick, M.Div.
Abstract/Extract: Fatigue is the most commonly reported, most debilitating and most poorly understood Post-Polio Sequelae (PPS). Postmortem studies of fifty years ago documented frequent and severe poliovirus-induced lesions within the reticular activating system (RAS). Recently, neuropsychological testing has documented marked attention deficits in polio survivors reporting severe fatigue. However, neither of these findings has been related to the pathophysiology of post-polio fatigue. Magnetic resonance imaging of the brain was performed in 22 polio survivors carefully screened to eliminate the effect of comorbidities. Subjects rated the severity of their daily fatigue and subjective problems with attention, cognition and memory. Small discrete or multiple punctate areas of hyperintense signal (HS) in the reticular formation, putamen, medial leminiscus or white matter tracts were imaged in 55% of the subjects reporting high fatigue and in none those reporting low fatigue. The presence of HS significantly correlated with fatigue severity and subjective problems in attention, concentration, staying awake, recent memory and thinking clearly. The lack of significant correlations between HS or fatigue severity and age, severity of the acute polio, depressive symptoms or difficulty sleeping militates against these factors as either causing HS or producing fatigue. These preliminary findings suggest that poliovirus-induced lesions in the RAS may underlie the subjective fatigue and attention deficits associated with PPS fatigue.

Title: The Neuropsychology Of Post-Polio Fatigue: Author(s): Richard L. Bruno, Ph.D., Thomas Galski, Ph.D., John DeLuca, Ph.D.
Original Publication: Archives of Physical Medicine and Rehabilitation, 1993; 74: 1061-1065.
Abstract/Extract: To test the hypothesis that post-polio fatigue and its concomitant cognitive deficits are associated with an impairment of attention and not of higher-level cognitive processes, six carefully screened polio survivors were administered a battery of neuropsychological tests. Only subjects reporting severe fatigue, and not those with mild fatigue, demonstrated clinically significant deficits on all tests of attention, concentration and information processing speed while showing no impairments of cognitive ability or verbal memory. These findings suggest that an impaired ability to maintain attention and rapidly process complex information appears to be a characteristic in polio survivors reporting severe fatigue, since these deficits were documented even when their subjective rating of fatigue was low. This finding supports the hypothesis that a polio-related impairment of selective attention underlies polio survivors' subjective experience of fatigue and cognitive problems.

Title: The Pathophysiology Of Post-Polio Fatigue:
A Role for the Basal Ganglia in the Generation of Fatigue: Author(s): Richard L. Bruno, Ph.D., Robert Sapolsky, Ph.D., Jerald R. Zimmerman, M.D., and Nancy M. Frick, Lh.D.
Original Publication: The pathophysiology of a central cause of post-polio fatigue. Annals of the New York Academy of Sciences, 1995; 753: 257-275.
Abstract/Extract: Fatigue is the most commonly reported, most debilitating and least studied Post-Polio Sequelae (PPS) affecting the more than 1.63 million American polio survivors. Post-polio fatigue is characterized by subjective reports of problems with attention, cognition and maintaining wakefulness, symptoms reminiscent of nearly two dozen outbreaks during this century of post-viral fatigue syndromes that are related clinically, historically or anatomically to poliovirus infections. These relationships, and recent studies that associate post-polio fatigue with clinically significant deficits on neuropsychologic tests of attention, histopathologic and neuroradiologic evidence of brain lesions and impaired activation of the hypothalamic-pituitary-adrenal axis, will be reviewed to described a role for the reticular activating system and basal ganglia in the pathophysiology of post-polio fatigue. The possibility of pharmacologic therapy for PPS is also discussed.

Title: Polio and CFS/ME: Author(s): Richard L. Bruno
Abstract/Extract: Poliovirus being replaced by OTHER similar viruses is very different than polio being "with us again in a disguised form," polio being more common than ever, being caused by the polio vaccination" or poliovirus "changing." There is no consistent evidence of ANY virus, even the Coxsackie viruses, being "found in elevated levels in chronic fatigue syndrome patients." However, "replacing" the poliovirus with a similar virus is a different story and may be what's happening in CFS.

Title: Polioencephalitis, Stress And The Etiology Of Post-Polio Sequelae: Author(s): Richard L. Bruno, Ph.D., Nancy M. Frick, M.Div., and Jesse Cohen, M.D.
Abstract/Extract: Post-mortum neurohistopathology from 158 individuals who contracted polio before 1950 are reviewed that document polio virus-induced lesions in reticular formation, hypothalamic, thalamic, peptidergic and monoaminergic neurons in the brain. This polioencephalitis was found to occur in every case of poliomyelitis, even those without evidence of damage to spinal motor neurons. These findings, in combination with data from the 1990 National Post-Polio Survey and new magnetic resonance imaging studies documenting post-encephalitis-like lesions in the brains of polio survivors, are used to present hypotheses that polioencephalitic damage 1) to aging reticular activating system and monoaminergic neurons is responsible for post-polio fatigue and 2) to enkephalin-producing neurons is responsible for hypersensitivity to pain in polio survivors. Hypotheses are also presented that the anti-metabolic action of glucocorticoids on polio-damaged, metabolically vulnerable neurons is responsible for the fatigue and muscle weakness reported by polio survivors during emotional stress. Suggestions for the treatment of Post-Polio Sequelae based on these hypotheses are also presented.

Title: Polioencephalitis and the Brain Fatigue Generator Model of Post-Viral Fatigue Syndromes: Author(s): Richard L. Bruno, Ph.D., Nancy M. Frick, Lh.D., Susan Creange, M.A., Jerald R. Zimmerman, M.D., and Todd Lewis, Ph.D.
Original Publication: JOURNAL OF CHRONIC FATIGUE SYNDROME, 1996 (in press).
Abstract/Extract: Fatigue is the most commonly reported and most debilitating Post-Polio Sequelae (PPS) affecting millions of polio survivors world-wide. Post-polio fatigue is associated with: 1) subjective reports of difficulty with attention, cognition, word-finding and maintaining wakefulness; 2) clinically significant deficits on neuropsychological tests of information processing speed and attention; 3) gray and white matter hyperintensities in the reticular activating system on magnetic resonance imaging of the brain; 4) neuroendocrine evidence of impaired activation of the HPA axis.

Title: Polio Feet - There's a reason you have cold feet - but you can keep warm and stay cool: Author(s): Richard Bruno, Ph.D.
Original Publication: New Mobility, March 1996
Abstract/Extract: The process that cause "Polio Feet" to turn blue and cold and become difficult to move when it's only cool is the same process that caused paralysis after the original polio.

Title: Polio Survivors Abroad: Canadian Roulette, Rue Britannia: Author(s): Dr. Richard Louis Bruno
Abstract/Extract: Over the past few years much heat has been generated by suggested solutions to the difficult problem of reforming the American health care system. A solution promoted by the Clintons', but despised by their free-market Republican opponents, is a single-payer health care system very much like the ones in Canada and Great Britain. Such systems, where treatment is paid for by the government, provide medical care to all citizens regardless of their ability to pay. Or do they?

Title: POST-POLIO SEQUELAE AND THE PARADIGMS OF THE 50's:
Newtie, Ozzie and Harriet versus Paradigms of Caring and a Future for Rehabilitation in America: Author(s): Richard L. Bruno, Ph.D.
Original Publication: Presentation: The 45th annual John Stanley Coulter Memorial Lecture presented to the American Congress of Rehabilitation Medicine, Alexandria, Virginia, June 24, 1995
Archive: Archives of Physical Medicine and Rehabilitation, 76 (12): 1093-1096.
Abstract/Extract: We find ourselves at an extremely interesting and extremely extreme point in our nation's history. The pendulum of what American's believe government should do has swung all the way from FDR's New Deal, gaining momentum as it flew past LBJ's Great Society to hit Bill Clinton squarely between the eyes. In listening to the political rhetoric since last year's Republican coup, I believe that not only have the times changed but also that time itself has changed. I have the feeling it is not June 24, 1995. It feels to me as if the clock has been turned back exactly forty years. So, put on your poodle skirts, slick back your D.A. and let's return to those thrilling days of yesteryear so we can view the childhood and adolescence of rehabilitation through the eyes of those who have grown up with it: the survivors of America's polio epidemics. Let's see what lessons have been learned, now that both the polio poster children and rehabilitation have reached mid-life, and ask this most important question: Given the current ideological timewarp, will polio survivors - will rehabilitation itself - have any future at all, let alone enjoy their golden years?

Title: PPS Questions and Answers, March, 1995: Also reproduced in Issue No.4 - March 1997 of LINC-PIN
Author(s): Drs Richard Bruno and Nancy Frick (Compiled by Tom Walter)
Original Publication: From America Online computer information service PPS Bulletin Board
Abstract/Extract: These general answers and our on-line discussion on 3/7/95 represent what is written in the medical literature on PPS, our newest research and how we treat patients at the Kessler Post-Polio Service. They are NOT intended as therapeutic recommendations for you personally nor as a substitute for your being evaluated by your own personal doctor and a doctor who knows about PPS.

Title: Predicting Hyperactive Behavior as a Cause of Non-Compliance with Rehabilitation:
The Reinforcement Motivation Survey: Author(s): Dr. Richard L. Bruno
Abstract/Extract: Non-compliance with therapy is a significant problem in vocational rehabilitation. Significant amounts of professional time and money are wasted treating patients who are unwilling or unable to participate in their own rehabilitation. The client with chronic musculoskeletal pain - depressed, without energy (i.e., "anergic") and refusing to attend therapy - is the exemplar of non-compliance. However, clients with chronic pain and other disabilities demonstrate a different type of non-compliance, characterized by chronic hyperactivity and refusal to decrease behaviors that are known to maintain or increase symptoms. To document the occurrence of hyperactive non-compliance, 80 clients treated for chronic musculo skeletal pain (CMP) and 41 clients treated for Post-Polio Sequelae (PPS) were studied prospectively and administered the Beck Depression Inventory (BDI) and the Reinforcement Motivation Survey (RMS). Forty percent of the CMP clients and 79% of the PPS clients who were discharged from therapy demonstrated hyperactive non-compliance. CMP clients as a group had significantly elevated BDI and RMS Type A behavior and Negative Reinforcement Motivation scores, while PPS clients as a group had elevated Sensitivity to Criticism and Failure scores, as compared to controls. Significantly elevated Type A behavior and Sensitivity to Criticism and Failure scores were associated with hyperactive non-compliance as well as completion of therapy. These findings indicate that hyperactive non-compliance is an frequent cause of treatment failure in rehabilitation clients and that the RMS may be of use in identifying potentially non-compliant clients and the form non-compliance will take. The design of individualized rehabilitation programs to manage non-compliance and maximize the probability of completing therapy is described.

Title: Preventing Complications In Polio Survivors Undergoing Surgery: Author(s): Richard L. Bruno, Ph.D.
Original Publication: PPS Monograph Series. Volume 6(2). Hackensack:Harvest Press,1996.
Abstract/Extract: Unfortunately, only a handful of specialists treat Post-Polio Sequelae (PPS) - the unexpected and often disabling fatigue, muscle weakness, joint pain, cold intolerance, and swallowing, sleep and breathing problems - occurring in America's 1.63 million polio survivors 40 years after their acute polio. However, all medical professionals need to be familiar with the neurological damage done by the original poliovirus infection that today causes unnecessary discomfort, excessive physical pain and occasionally serious complications after surgery. This is a brief overview to inform patients and professionals about the cause and prevention of complications in polio survivors undergoing surgery.
Includes: POLIO SURVIVORS' PRE-OP CHECKLIST

Title: The Psychology Of Polio As Prelude To Post-Polio Sequelae:
Behavior modification and psychotherapy: Author(s): Richard L. Bruno, Ph.D. and Nancy M. Frick, M.Div.
Original Publication: Orthopedics, 1991, 14(11) :1185-1193.
Abstract/Extract: Even as the physical causes and treatments for Post-Polio Sequelae (PPS) are being identified, psychological symptoms - chronic stress, anxiety, depression and compulsive, Type A behavior - are becoming evident in polio survivors. Importantly, these symptoms are not only themselves causing marked distress but also are preventing patients from making the lifestyle changes necessary to treat their PPS. Neither clinicians nor polio survivors have paid sufficient attention to the acute polio experience, its conditioning of life-long patterns of behavior, its relationship to the development of PPS and its effect on the ability of individuals to cope with and treat their new symptoms. This paper describes the acute polio and post-polio experiences on the basis of patient histories, relates the experience of polio to the development of compulsive, Type A behavior, links these behaviors to the physical and psychological symptoms reported in the National Post-Polio Surveys and presents a multimodal behavioral approach to the treatment of PPS by describing patients who have been treated by this Post-Polio Service.

Title: Silicon, Sex and Polio Survivors: Author(s): Dr. Richard L. Bruno
Original Publication: Post-Polio Service, Kessler Institute for Rehabilitation 1995
Abstract/Extract: Last January I got a brand new Macintosh computer that came with a modem. Ever since I've been "surfing" the Internet, hardly stopping for food or sleep. You'd be amazed at what I'm finding on the disABILITIES bulletin boards: Sex. Yes, unbridled, undiluted and unimpeded discussions about sex among people with all kinds of disabilities, from high-level quads to quadruple amputees. However, there is one place where I've heard no discussion of sex: the Post-Polio bulletin board. There are lots of questions about PPS that you had the answers to years ago: Do I have ALS; does exercise make you weak; where can I get a scooter? But, not one question or comment about sex.

Title: Stress and "Type A" Behavior as Precipitants of Post-Polio Sequelae:
The Felician/Columbia Survey: Author(s): Richard L. Bruno, PhD, and Nancy M. Frick, MDiv, LhD
Original Publication: In LS Halstead and DO Wiechers (Eds.): Research and Clinical Aspects of the Late Effects of Poliomyelitis. White Plains: March of Dimes Research Foundation, 1987.
Abstract/Extract: A behavioral profile has begun to emerge from studies of persons who survived acute poliomyelitis and are now experiencing post-polio sequelae. Persons who had polio have been shown to be employed full time at four times the rate of the general disabled population. Persons who had polio have more years of formal education on average than the general population, and marry at approximately the same rate as those who are not disabled. These data, combined with our own experience with thousands of persons who had polio, indicated that "polio survivors" are competent, hard-driving and time-conscious overachievers who demand perfection in all aspects of their personal, professional, and social lives. It appeared that those who survived polio exhibit "Type A" behavior and would therefore experience chronic emotional stress.

Title: Ultimate Burnout: Post-Polio Sequelae Basics: Author(s): Dr. Richard Louis Bruno
Original Publication: New Mobility, 1996; 7: 50-59
Abstract/Extract: It's 8:00 p.m. and only one light is burning at corporate headquarters. Mr. Gray, MBA, the 55-year-old CEO, is awakened by the phone. He lifts his head from the desk to answer and hears his wife asking when he's coming home. Feeling as if he weighs a ton, his muscles burning, Mr. Gray wheels himself to the car and, with barely enough strength to pull his chair in behind him, drives home. He greets his kids, rolls into the bedroom, and throws himself on the bed. It's the third night this week he has gone to bed without dinner and slept in his clothes.

For additional articles with Bruno, Richard L., Ph.D. as co-author or contributor see the following catalogue entries:

F - Frick, Nancy M., M.Div, Lh.D.
Article:	Post-Polio Sequelae: Physiological and Psychological Overview
K - Kessler Institute for Rehabilitation
Article:	Post Polio Sequelae True Answers for Friends and Family
L - Leicestershire Post-Polio Network
Article:	The Mayo, The Lancet, and The Revolting Polios

See also Post-Polio Research: The State of the Art, 1998 - Offsite article

NOTES

It is the intention of the Lincolnshire Post-Polio Network to make all the information we collect available regardless of our views as to it's content. The inclusion of a document in this library should not therefore be in any way interpreted as an endorsement.

People who had polio and are experiencing new symptoms need to be assessed by medical professionals who are experienced in Post-Polio to determine what is wrong and to give correct advice. We can only make these documents available to you. YOU must then take what you believe to be relevant to the medical professional you are seeing. We are collecting and collating everything we can to enable medical professionals to make informed decisions. Other medical conditions must be looked for first, Post-Polio Syndrome is by diagnosis of exclusion.

"Source" in the context of this catalogue primarily means original author. In a few cases it will be an organisation or conference.

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The Lincolnshire Post-Polio Network takes great care in the transcription of all information that appears at this site. However, we do not accept liability for any damage resulting directly or otherwise from any errors introduced in the transcription. Neither do we accept liability for any damage resulting directly or otherwise from the information available at this site. The opinions expressed in the documents available at this site are those of the individual authors and do not necessarily constitute endorsement or approval by the Lincolnshire Post-Polio Network.

Document preparation: Chris Salter, Original Think-tank, Cornwall, United Kingdom.
Primary Document Reference: <URL:http://www.ott.zynet.co.uk/polio/lincolnshire/library/cs_b.html>
Secondary Document Reference: <URL:http://www.zynet.co.uk/ott/polio/lincolnshire/library/cs_b.html>
Last modification: 7th January 2002
Last information content change: 29th February 2000