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Polio's Pull From
Past
January 21, 2003
By WILLIAM HATHAWAY, Courant Staff Writer
Ed Bollenbach thought he had had
his final encounter with polio in Yonkers, N.Y., in 1954, when
the disease cut his legs out from under him while he was
walking home from second grade.
But 30 years later,
Bollenbach, an avid bicyclist, cross-country skier and
swimmer, felt pain and weakness in his back and right leg, the
same areas hit hardest in his youth by the polio
virus.
The
microbiology and chemistry professor at Northwestern
Connecticut Community College in Winsted visited several
doctors before one told him he had post-polio syndrome, a
condition marked by extreme muscle weakness and fatigue that
was only beginning to be recognized in 1984.
By some
estimates, as many as 40 percent of the nation's 600,000 polio
survivors might be afflicted with the syndrome, which usually
surfaces 10 to 40 years after initial onset of the disease.
Yet no effective treatment is available.
"I went from
being a pretty athletic guy to somebody who needs a motorized
scooter to get around the house," said Bollenbach, now
56.
Bollenbach is among the last generation of
Americans who will struggle with the crippling legacy of the
feared disease, which disappeared in the United States in the
years after the introduction of the first polio vaccine in
1955.
Polio epidemics paralyzed or killed thousands of
children and adults during outbreaks in the last century,
sometimes forcing patients into iron lungs when their
respiratory systems were attacked.
The polio virus
infected people who had ingested minute amounts of fecal
matter from contaminated water or unsanitary facilities.
Panicked parents kept children away from swimming pools and
other public places during outbreaks.
Many polio
survivors did make full recoveries. By the early 1980s,
Bollenbach raced bicycles and was a long-distance swimmer and
a competitive whitewater canoeist.
But then he felt his
muscles begin to hurt and then weaken, just as had happened
when he was a child.
Polio survivors like Bollenbach
had recovered because surviving nerve cells compensated for
the loss of others by making more connections than normal to
muscle groups, said Dr. Phil Arnold, a physiatrist - a
physician specializing in physical medicine and rehabilitation
- who originally diagnosed Bollenbach and who treated many
cases of post-polio syndrome before he retired.
That
means polio survivors had no reserve of nerve cells, and as
they lost those cells to aging, they became more susceptible
to muscle fatigue and weakness, Arnold
said.
Bollenbach, who has researched post-polio
syndrome during the last 20 years and written several articles
on the disorder, said he isn't so sure that is the full
explanation.
He points out that many polio survivors,
including some severely afflicted in their youth, never
develop post-polio symptoms. One study detected fragments of
polio-virus protein in the blood of people with post-polio
syndrome and not in the blood of other polio survivors, he
said, suggesting some other mechanism might be at
work.
Before post-polio syndrome was understood, most
polio survivors were told to exercise strenuously to rebuild
muscle strength.
"Patients were encouraged to exert
themselves," said Dr. Michael Collins, a physiatrist at
Gaylord Hospital in Wallingord. "It turns out that was not
right."
In fact, excessive exercise actually makes
symptoms worse, Collins and Arnold say.
"The body needs
stimulus, but only just to the point of fatigue, no further,"
Arnold said. "You try to find that limit - and then
stop."
That is particularly difficult for post-polio
patients to accept, Bollenbach said. He said he and many
others with post-polio rebel against using the leg braces and
wheelchairs they had depended on as
children.
Bollenbach has a vivid recollection of
collapsing several times on his walk home from school in 1954
and of the first few weeks he spent in an isolated
infectious-disease ward with few lights and no windows, a
petrified 7-year-old tended by nurses wearing
masks.
"It was like being abducted by aliens,"
Bollenbach said.
He spent six months at the hospital
recovering and undergoing physical therapy.
"But I
didn't feel as bad then as I do today," said Bollenbach, who
retired from teaching last year.
Besides using a
motorized wheelchair and a scooter, he wears a brace on his
lower right leg.
"My biggest problem is my lower back
and right hip," he said.
Despite the pain and weakness,
he still manages to swim three times a week.
"You
adapt," he said. "But you never really get used to it."
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