For polio survivors coping with the late effects of polio, one of the biggest challenges in the management of the condition is coping with stress. Studies have shown that stress can contribute to the onset of cardiovascular disease and also worsen symptoms of other conditions. This is especially true of post-polio, where emotional stress can manifest as physical stress, further weakening already overused muscles.
Because post-polio syndrome requires significant and unexpected lifestyle changes, everyday stress can easily double. The sudden onset of post-polio forces once independent people to pace daily activities and possibly rely on mobility aids. The way polio survivors adjust to these lifestyle changes, as well as the memories stirred by childhood polio, contributes to stress factors.
In the 1940s, American cardiologist Meyer Friedman identified two types of personalities — Types A and B. Friedman said that Type A personalities exhibit traits such as being workaholics, always busy, driven and somewhat impatient. People with Type B personalities, by contrast, are laid back and easygoing. Type A personalities are less likely to release control, tend to overexert themselves and may deny symptoms altogether. These unhealthy reactions make those with Type A personalities more susceptible to chronic distress.
The distress caused by unexpected and potentially disabling post-polio problems, according to a 1986 March of Dimes Research Foundation study by Drs. Richard Bruno and Nancy Frick, produces a variety of physical, emotional, cognitive and behavioral reactions. Symptoms of chronic stress, explains Joan Headley, executive director of Post-Polio Health International, St. Louis, may include difficulty falling asleep, feeling like one’s mind is racing, forgetfulness, muscle tension, headaches, gastrointestinal distress, irritability, overeating and feeling overwhelmed.
In addition, research indicates that those with Type A traits are less likely to take rest breaks and use mobility aids, both of which slow the progression of post-polio. By contrast, those who accept change as a part of life, or Type B personalities, experience fewer adverse effects of stress. With that said, transitioning unhealthy stress reactions to calm acceptance can greatly impact the management of post-polio symptoms.
For Larry Kohout, a polio survivor currently coping with post-polio and a self-prescribed Type A personality, that description rings true. “When I was first diagnosed with post-polio syndrome, I just refused to acknowledge and wanted to keep on using the tried and true ‘use it or lose it’ that had been so successful all those years,” says Kohout. The Type A traits caused Kohout to ignore his symptoms for many years until he finally realized that he was endangering himself by not slowing down.
To alter Type A behavior and get back on a healthy stress track, people with post-polio must get involved in the management of the condition and monitor symptoms. The most important steps are to first learn about post-polio syndrome, particulary what can be expected and effective ways to manage symptoms, and then accept that muscle loss will occur with aging. To help slow the progress, people with post-polio should take frequent breaks, participate in calming exercises that do not overstress muscles (ask your doctor about a yoga and meditation), and rely on mobility aids when necessary to reduce the stress to muscles affected by polio.
For more information on post-polio syndrome, visit Post-Polio Health International at www.post-polio.org/ipn/fact.html.