Small Steps: The Year I Got Polio

Intercostal expansion is an action whereby intercostal muscles expand the ribs upward and outward to likewise expand the thoracic cavity, in order to draw air into the lungs. Polio patients may experience paralysis of the intercostal muscles, which leads to respiratory difficulties; increased respiratory difficulties often required the patient to spend time in an iron lung, which could breathe for the patient until they gained enough strength to do so on their own.

An iron lung is a tube-shaped respirator that encloses a patient’s entire body save for their head and controls air pressure in the enclosed space to facilitate breathing. The metal machine is attached to massive bellows that emit strong gusts of air in and out, thereby expanding and contracting a patient’s lungs. In polio patients, the machine is used to assist with breathing when the severity of their muscle weakness makes independent breathing impossible.

March of Dimes is a nonprofit organization based in the United States, which prioritizes the general health of mothers and babies. The organization was originally called the National Foundation for Infantile Paralysis and was founded in 1938 by President Franklin D. Roosevelt—who had polio—to fund polio research and raise money to cover patient care. The term “March of Dimes” was created by Eddie Cantor, who jokingly asked the public to send dimes to the White House; the joke was taken seriously, and 2,680,000 dimes were sent in.

Occupational therapy is a treatment method designed to prepare patients for the activities of everyday life; it prepares patients to function in and adapt to life outside hospital and rehabilitation settings. This treatment also aims to promote independence, inclusion among others, higher personal well-being, and improved physical health. Among polio patients, especially children, occupational therapy was employed to reteach fine motor skills and also to distract young patients from the drudgery of long illness by diverting their attention to new interests. This dynamic promoted independence; a stronger sense of self; and improved physical, mental, and emotional health.

An oxygen tent is a sheet of plastic draped over a patient from their waist to the back of their head like a canopy. Inside the plastic, oxygen is released at a higher-than-normal level to facilitate breathing. An oxygen tent is a more desirable alternative to the iron lung; during Peg’s youth, the process was used for polio patients whose breathing was difficult but not critical enough to require a respirator.

Physical therapy is a treatment technique used for various diseases or injuries. Physical therapy treatment plans are specific to the patient and their needs and are optimized for effective recovery. The treatment aims to restore movement and function, strengthen muscles, and alleviate or lessen pain. With polio patients, common physical therapy methods include massages, heat treatments, and stretching exercises. Physical therapy aims to stretch the affected muscles of polio patients back to normal size so that the patients may strengthen their muscles and regain a higher level of function.

Poliomyelitis is a debilitating and life-threatening disease caused by the poliovirus, which attacks nerve cells and weakens the muscles of the body. Slight nerve damage can result in temporary muscle weakness, while severe nerve damage can lead to extensive and potentially permanent paralysis. Poliomyelitis was first known as infantile paralysis but is more commonly known as polio. The three types of polio include respiratory polio, which causes difficulty in breathing; spinal polio, which affects the spinal cord and causes paralysis in a patient’s arms and legs; and bulbar polio, which is the rarest and most serious form of polio and impairs a patient’s ability to talk or swallow. There is no cure for polio and no medication to repair damaged nerve cells.

Post-polio syndrome occurs decades after the initial poliovirus infection and successful recovery, yet the cause is not known for sure. Symptoms of post-polio syndrome include muscle weakness, joint pain, fatigue, muscle atrophy, breathing issues, and difficulty swallowing. The progression of post-polio syndrome is most often gradual and can be further slowed by physical therapy.

A spinal tap, also known as lumbar puncture, is a medical test whereby a doctor inserts a needle into a patient’s spinal column and withdraws fluid. The procedure is used in diagnostic testing, particularly for diseases affecting the central nervous system (i.e., the brain and spine). Because poliovirus mainly affects nerves in the spinal cord or brain stem, lumbar puncture was often used to confirm a suspected diagnosis of poliomyelitis.