Strength of Individual Muscle Groups

Neuroexam.com - Strength of Individual Muscle Groups


Patterns of weakness can help localize a lesion to a particular cortical or white matter region, spinal cord level, nerve root, peripheral nerve, or muscle. Test the strength of each muscle group and record it in a systematic fashion. It is wise to pair the testing of each muscle group immediately with testing of its contralateral counterpart to enhance detection of any asymmetries. Muscle strength is often rated on a scale of 0/5 to 5/5 as follows:

* 0/5: no contraction
* 1/5: muscle flicker, but no movement
* 2/5: movement possible, but not against gravity (test the joint in its horizontal plane)
* 3/5: movement possible against gravity, but not against resistance by the examiner
* 4/5: movement possible against some resistance by the examiner (sometimes this category is subdivided further into 4–/5, 4/5, and 4+/5)
* 5/5: normal strength

Surgery Info - Support Thanks

Just to say hello to everybody, and thank everybody, especially those on the Facebook page http://www.facebook.com/group.php?gid=83611409371&ref=nf (I think you may need to register on Facebook to see this page)that my friend Ousmanou Yacoubou has created to support my efforts.

I am grateful to him and the so many of my childhood friends, some of whom I had lost touch with for more than a decade who rushed to do practical things to make things better for me.

I am thinking of Fabrice Tenga, Yves Fotso, Claude Tadonki, Eric Sile, and many others

I am also grateful to people that I did not know who stood up for me. I am thinking of Erin & Mary Anastasi, Beth Williams , and many others too numerous to name

Thanks for your comforting words, prayers and actions. They have truly made a difference for me.
I had my latest surgery on Tuesday 06/09 in Beijing, China at Chuiyangliu Hospital. It lasted for eight hours, a combination of 4 operations.
- I had one operation to transfer abdominal muscles to my quadriceps. If this succeeds I will someday be able to lift my leg upwards or climb stairs without aid. It is too early to say any thing about it. I just know right now that my abs hurt from having muscles poached from it. This operation is what makes Prof. Qin so unique to me. Every time I suggested such a surgery to a physician in the US or Europe, they dismissed me as if was insane.
- I had one operation to remove nails from my tibia bones from the previous surgery.
- I had one operation to further correct mild talipes equinus (foot bent forward) on my foot
- I had one operation to further eliminate knee contractures that remained despite 2 years intense physical therapy

I am still bed stricken but my room was specially wired to allow me to use the internet from my bed. It helps keep me somewhat busy.

I have a 4 Gigabite size recording of the essential parts of the surgery that prof Qin kindly provided to me. I think it can teach a lot to many in need and I will post some of it when practically possible.

This blog is currently blocked in China for reasons I do not know and I am making this post using a very cumbersome proxy.

Medical Bills Cause Most Bankruptcies - Well Blog - NYTimes.com

Medical Bills Cause Most Bankruptcies - Well Blog - NYTimes.com

"Nearly two out of three bankruptcies stem from medical bills, and even people with health insurance face financial disaster if they experience a serious illness, a new study shows."

Can a country that allows such events to happen be considered a "rich" country?

What does it say about it?

Please volunteer to translate if you can - Help Make Information on Surgical Treatment Options for paralytic post polio patients available

More information is available at:

http://knol.google.com/k/phil-kongtcheu/helping-make-surgical-treatment-options/24v2kgtuvzk2v/17#

or by clicking on the title. The particpation form is the link below.

http://spreadsheets.google.com/viewform?formkey=cklwQkdzX01GOFJ6c2Z2MUU5b3hyQlE6MA..

Thank you!

Post Surgery Diet & Nutrition

Based on my earlier surgeries, I have prepared this list of foods, spices, teas and nutritional supplements in anticipation of my next surgery that might help speedy recovery for extended surgery patients.


Uploaded on authorSTREAM by kongtcheu

Do You Believe in Fairies, Unicorns, or the BMI?

Do You Believe in Fairies, Unicorns, or the BMI?

I just could not resist posting this linked piece that expresses one of my frustrations about some of the mumbojumbo, pseudo-scientific and utterly sophistic aspects of American general health prescriptions for good health. This installment is about BMI or Body Mass Index. What a fraud!

Read and enjoy!

Blogspot Block in China

Since last Saturday all blogs on blogspot.com seem to have been blocked here in China. I now have to access my blog through very convoluted and annoying means which will reduce my posts for a while.

Youtube has been blocked for a while also now.

See also:
http://markschinablog.blogspot.com/2009/05/blogspot-blocked.html

Post-Surgical Nutrition: Speed Your Healing With A Good Diet & Supplement Plan | The Diet Channel

Post-Surgical Nutrition: Speed Your Healing With A Good Diet & Supplement Plan | The Diet Channel

Good to know while preparing for surgery!

Polio infection seen in death of Minnesotan

Received this e-mail from Dr.Bruno today on whose polio related e-mail list I am:


Polio infection seen in death of Minnesotan
The Associated Press - Tuesday, April 14, 2009

Minnesota health officials are investigating the death of a person who was infected with a strain of the polio virus.

The patient was infected with the live polio virus that was used in the oral vaccine, which was discontinued in the U.S. in 2000, the Department of Health said Tuesday. The vaccine now in use is injected and doesn't contain live virus, and officials said this case poses no risk to the general public.
"This is a very rare occurrence and does not signal a resurgence of polio," State Epidemiologist Ruth Lynfield said in a statement.
The patient died last month with polio symptoms that included paralysis, but the department said it's not known to what extent polio contributed to the death. The patient also had a weakened immune system and multiple health problems.
It's likely the patient became infected from someone who had received the live-virus vaccine before its use was stopped, the department said. Aaron Devries, an epidemiologist with the department, said testing here and at the Centers for Disease Control and Prevention showed that the patient probably acquired the virus 10 to 15 years ago and continued to carry it around all these years. He said they don't know why the patient became ill from it only recently.
The department said it was working to determine if any health care workers might have been exposed. It said only unvaccinated people or people with deficient immune systems who had direct, ungloved contact with the patient's bodily secretions would be at any risk.
Citing patient privacy laws, the department did not release any details about the victim.
Officials said this type of polio infection is very rare. Only 45 cases of vaccine-derived paralytic polio disease in people with immunodeficiencies have been reported in the world since 1961, according to the Centers for Disease Control and Prevention.
In these rare cases, the health department said, someone who has either never been vaccinated or has a weak immune system can get the polio virus from someone who has been vaccinated and is excreting the virus in their stools. Sometimes, but not always, these infections result in illness, as happened in this case.
The other reported U.S. instances of vaccine-derived polio infection also occurred in Minnesota , in 2005. Five children from the Amish community near Clarissa in central Minnesota , which had low rates of immunization, were infected but did not develop outward symptoms.
Lynfield said they suspect the reason all the U.S. cases were detected in Minnesota was because of its advanced public health reporting system.
The CDC says the oral vaccine is still used in countries where naturally occurring polio is still a threat because it's better at stopping the spread of the virus. The U.S. switched to the injected vaccine because wild polio has already been eliminated from the Western Hemisphere , and the few cases of polio that were occurring, about 8-10 per year, were caused by the oral vaccine itself, not the wild virus.
The last case of naturally occurring paralytic polio occurred in the U.S. in 1979, but health officials said the new case was a reminder for people to make sure their immunizations and their children's shots are current. Most people in the U.S. have been vaccinated against polio.
But vaccination rates against polio are dropping, warned Dr. Richard L. Bruno, chairman of the International Post-Polio Task Force and director of The Post-Polio Institute at New Jersey 's Englewood Hospital and Medical Center . He noted that the CDC estimates that more than 1 million U.S. toddlers aren't vaccinated against it. And he said there's always a danger polio could return via another country where it's endemic.
"We must do more to vaccinate America 's children against this deadly and disabling disease," Bruno said. " America 's next polio epidemic could be just a car or plane ride away."

______________________________________________________________________________

INTERNATIONAL
POST-POLIO TASK FORCE
International Centre for Post-Polio Education and Research
at Englewood Hospital and Medical Center
Englewood, New Jersey 07631 USA
877-Post-Polio 201-894-3724
PostPolioInfo@aol.com
PostPolioInfo.com

For Immediate Release

POLIO KILLS IN MINNESOTA

DEATH GIVES “NIPP IT YEAR” NEW EMPHASIS

Tuesday April 14, 2009: The Associate Press today reported the death of a person infected with the live poliovirus used in the oral vaccine that was discontinued in the US nine years ago. The health department says the patient died with polio symptoms, but it's not known to what extent polio contributed to the death. The patient also had a weakened immune system and multiple health problems. The Minnesota department of health says the patient most likely became infected from someone who had received the live-virus vaccine before its use was stopped.

"For reasons we don't understand, the live poliovirus remained inside this person for ten years, mutated and became virulent, then contributed to the person’s death,” said Dr. Richard Bruno, chairperson of the International Post-Polio Task Force. "This death is the latest sad reminder that polio may be forgotten in the US , but that it is far from gone.”

Alarming Drops in Polio Vaccination in US Border States and Ports of Entry.

Unfortunately, rates of polio vaccination have decreased in the US in spite of six other US polio cases since 2005 -- five of them in Minnesota -- caused by poliovirus imported into the US, and in spite of polio breaking free of vaccination efforts last month in Africa, with Kenya and Uganda reporting their first polio cases and deaths in twenty years.

“The latest Centers for Disease Control data show drops in polio vaccination in twenty states and in ten large US cities," said Dr. Bruno, who is also director of The Post-Polio Institute at Englewood Hospital and Medical Center . “The CDC estimates that more than one million US toddlers are unvaccinated."

“Even Minnesota has had a decrease in polio vaccination, which is obviously disturbing,” said Dr. Bruno. “It is frightening that states with the largest drops lie next to Mexico and Canada , across whose borders the poliovirus is believed to have been imported into the US since 1997.” Seventy percent of the states that border Canada had drops in polio vaccination as did Arizona , Texas and New Mexico .

City Children Living in Poverty Have Lowest Polio Vaccination Rates.

Dr. Bruno is also concerned about cities that are major points of entry into the US -- New York , Philadelphia , Houston and Seattle -- where drops in polio vaccination were also reported.

“Toddlers living in poverty have the lowest polio vaccination rates -- below 87% in Boston , Indianapolis , Memphis and Phoenix , and below 85% in Detroit , Houston and Seattle -- rates lower than in Western Pacific countries that include Cambodia , Mongolia and Vietnam ,” said Dr. Bruno. "I’m worried that those who recently had polio in the US are canaries in the mine shaft."

"NIPP IT YEAR” Underscored by Minnesota Death.

The International Post-Polio Task Force proclaimed 2008-2009 “National Immunization for Polio Prevention in Infants and Toddlers -- or ‘NIPP IT’ -- YEAR,” to prompt parents, healthcare professionals and state health officials to ensure that all American children receive four doses of the injectable, inactivated polio vaccine by age two.

“‘NIPP IT YEAR’ is intended to raise awareness of the need for polio vaccination, to stop state legislatures from allowing parents to refuse vaccinations for their children because of a “philosophically objection” to vaccines, and hopefully ‘nip’ America’s next polio epidemic in the bud,” said Dr. Bruno.

The polio vaccine has been a victim of its own success. Young parents do not vaccinate because they have not experienced the devastation, death and disability caused by diseases vaccines eliminated, or are unaware that polio remains a scourge transportable from Africa, Pakistan , Afghanistan and India .

"With the ease of air travel, what will happen when a polio-infected individual lands in one of America's potential polio pockets, like New York City, and passes poliovirus to the estimated 24,000 infants and toddlers in that city who are not immunized?” asked Dr. Bruno “We must do more to vaccinate America's children against this deadly and disabling disease. America 's next polio epidemic could be just a car or plane ride away."

###

Believing in Treatments That Don’t Work - Well Blog - NYTimes.com

Believing in Treatments That Don’t Work - Well Blog - NYTimes.com

This is another illustration of health care practitioners who tend to push irrelevant treatments on patients. A practice that is often the case for post polio patient in developed countries facing doctors with limited clinical experience with the disease

Senate Takes on Out-Of-Network Insurance Issue - NYTimes.com

Senate Takes on Out-Of-Network Insurance Issue - NYTimes.com

United HealthCare, United HealthCare, ...
American Health Insurance...

Calf augmentation using free TRAM flap. [Microsurgery. 1999] - PubMed Result

Calf augmentation using free TRAM flap. [Microsurgery. 1999] - PubMed Result

Look at the results of this article:

From Calf_Augmentation

This picture was taken one year post surgery on this 27 year old Korean from Stanford CA who is a post polio patient who had atrophy of the posterior compartment musculature of her
left calf with a foot drop . The authors of the article assert the results were excellent.

Which just prompts the Chico Marx quote:"Who you gonna believe, me or your own eyes?"

Based on this picture I draw a rather negative conclusion on the outcome and sees it as exemplifying the sometimes clueless physicians whose sense of their own importance tend to lead them force their own theory against recalcitrant facts.

As many of the testimonies (See for example Eileen Gruba) I share in this site and the books reviewed show, there are many of them in the post polio treatment business. I see this as further evidence.

I have the same condition, perhaps a more severe one, since I did not had any of the corrective surgeries this female had as a child.

Rather than doing cosmetic surgery as she did, starting in 2006, I had muscle transfer surgeries to strenghten my Achille's tendon. Then the tibia was lengthened to equalize both lower legs, which helped correct the foot drop.

Now I am doing calf strengthening physical therapy to steadily grow the calf muscle. I feel more confident that over time I will get better and more natural results that give intrinsic strength to my leg and body, including and beyond the cosmetic appearance.

Slide the whole article:

Skin Deep - With a Buzz Cut, I Can Take on Anything - NYTimes.com

Skin Deep - With a Buzz Cut, I Can Take on Anything - NYTimes.com

For me writing and sharing privacy has been my new way to face a dreadful condition. Earlier, like Jacob in the bible, I changed my name to become Obi-Wan Yoda, the Jedi Knight.

John Hope Franklin, Black Historian, Dies at 94 - Obituary (Obit) - NYTimes.com - About Heart Failures in Blacks and Post Polio

John Hope Franklin, Black Historian, Dies at 94 - Obituary (Obit) - NYTimes.com

Reading about John Hope Franklin's death (A very fine and admirable man) today led me to investigate Congestive Heart Failure. In 2007, after surgery on my leg, I experienced heart failure and was kept in emergency care with daily IVs and put on respirators for the best part of my over four months hospitalization.

It happened as I just woke up in the middle of night unable to breathe and called the nurse. She checked my pulse and heartbeat rate which were alarmingly low. She called then called the attending physician and the rest for me was history.

As I read the article at http://www.medicinenet.com/congestive_heart_failure/article.htm, I am taken aback by the descriptions which mirror my experience. As long as I can remember, I have had an instinctive preference for multiple pillows when sleeping.

"Symptoms of heart failure include shortness of breath, which occurs with exertion as the disease progresses. Lying flat increases blood return to the heart; thus patients may complain of shortness of breath (orthopnea) when lying down. Another symptom is paroxysmal nocturnal dyspnea, a term used to describe wakening in the middle of the night with shortness of breath that is more long-lasting than simple orthopnea. Patients often describe having to stand by a window to try to catch their breath. Patients end up sleeping on two or three pillows to elevate the head and chest, or in a recliner.

Increasing shortness of breath can be tempered by the medications; however, over time, the symptoms worsen and quality of life suffers. Eventually, the disease wins, breathing fails, and so does the patient."


Since that hospital episode, I overwhelmed with a deep sense of uncertainty over my future . In 1990 as I was starting college, I was diagnosed with a deformed right mitral valve. My cardiologist said that somehow, just like my right leg, my heart had found a way to function with it and that for the time being it was unnecessary to perform surgery. He just recommended that I had this monitored every few years. I decided to forget about it then in order not to over worry.

Over the years, I have noticed that every infection or disease I have ever faced affects disproportionally my right side, whether they be skin or teeth irritations or else

And then I read this which suggest how much more blacks are likely to face early heart failure
http://www.washingtonpost.com/wp-dyn/content/article/2009/03/23/AR2009032301802.html

The conjunction of racial predisposition and post polio weakness makes me worry...

If anyone has any thoughts on the subject they want to share..please do....

Health Insurers Ease Stance on Pre-Existing Conditions - NYTimes.com

Health Insurers Ease Stance on Pre-Existing Conditions - NYTimes.com
It sounds to me like they are playing an end run around the problem and in the end it won't mean anything good for people like us...

A Reflection of How Society Views the Disabled

Merrill Streep rightly called Trump to account for his mocking a Disable NY Times reporter in the heat of the 2016 presidential election campaign.

Here is Trump doing the mocking:

But it should be remembered that he is hardly the first one to do so. Indeed in 2009, a fresshly sworned in Obama made fun of Special Olympics people on Jay Leno, and I blogged then about it as:

"President Obama is getting a rap over his comments on special olympics people, but the sad reality is how much society consciously or unconsciously looks down on the disabled and does not want to be associated with them in any form.

To my fellow paralytic polio survivors I just say this: someday, somewhere over the rainbow we can overcome. If we can come together and share and learn from one another, we will get out of it stronger than anyone who ever looked down on us

Someday, somewhere over the rainbow,..."

Contractures, Hamstring Contractures and the Paralytic Polio Sequelae Patient

Contractures in general and hamstring contractures in particular are a common condition to post polio paralytic sequelae survivors.

For example, hamstring contractures often occur because nerves paralysis often destroys the quadriceps muscles, eliminating the force that normally stretch and counterbalance the hamstring forcing it to lengthen. Over time, the hamstring fails to keep up with growth of the femur causing increased flexion deformity of the knee as time goes by.

The treatment for this condition vary from physical therapy, braces up to surgery depending on the severity of the contractures. In general the least severe forms can be remedied with:

• Physical therapy, some times in conjuction with braces.

• When this is insufficient, surgery is the recommended alternative. Cerebral palsy surgeons usually have a lot of experience with this type of surgery

Below are some of the readings that have helped and informed my understanding and expand on the above.

Recommended Reading:

http://www.worldortho.com/dev/index.php?option=com_content&task=view&id=529&Itemid=290

http://www.mda.org/publications/quest/q34contrc.html

http://www.lifebridgehealth.org/body_rubin.cfm?id=1514

http://www.holisticonline.com/Remedies/Arthritis/arth_ankle-and-feet-exercises.htm

http://www.ejbjs.org/cgi/content/full/88/4/840

http://www.meb.uni-bonn.de/dtc/primsurg/index.html

http://www.physicaltherapyjournal.org/cgi/reprint/69/8/695.pdf

http://www.nhshealthquality.org/nhsqis/files/Passive%20Stretching%20Final1Dec05.pdf

This article seems to indicate that passive stretching is a poor method to fight the sort of contractures referred to herein

Well - Vitamin Pills - A False Hope? - NYTimes.com

Well - Vitamin Pills - A False Hope? - NYTimes.com

I am not too surprised about this one. Everytime I tried a multi-vitamin regimen in pill form, I felt kind of edgy. Ultimately I decided that may be it was because of PPS (Post Polio Syndrome), I could not absorb the vitaminic load in pill form all at once.

So I started cooking my food and adding the pills I find helpful for my regiment as condiment. I have liked the results I have seen on my body. My contention here is that the failure of most of these vitamins to reach the desired result is due the supply mechanism of nutrients rather than anything else. Vitamins thoroughly mixed food when ingested are better absorbed by the body, enabling the vitaminic nutrient to act as expected. It seems pills rather overwhelm the body in un-natural ways, thereby reducing their effectiveness. When you think about it kind of makes sense since medicinal pills are effective because the overwhelm an acute ailment; by contrast, vitamins are more designed to complement a permanent lifestyle. It is therefore not surrising an overwhelming and concentrated intake may become problematic.

Here are some of my choice supplements (Vitamins B Complex +Vitamins C; Resveratrol):
Do a Google search if you do not know what these do for you.

Riveting Story - "In the Shadow of Polio"

The Saturday Profile - In Mozambique, Singing a Song of Sanitation and Hoping to Change Habits - Biography - NYTimes.com

The Saturday Profile - In Mozambique, Singing a Song of Sanitation and Hoping to Change Habits - Biography - NYTimes.com

Worthy of note. Illustrates the cultural prejudices against disabled people in underdeveloped countries

Polio Treatment centers in the world that I know of

This a list of Centers that I know can provide specialized surgical help for the treatment of various neuro musculo skeletal post polio impairments.

Country:US

Hospital for special surgery

This hospital has one of the best reputations in the US for specialized surgeries and frequently ranks at the top of US news & world report rankings for orthopedics
However after browsing its ages I have not seen anything specifically directed towards polio treatment.
Recommended for Bones deformities:& physical therapy
http://www.hss.edu/
Bones deformities:
Website: http://www.hss.edu/condition-list_limb-lengthening-deformity.asp

With primary residence in Jersey City, NJ, I wanted to go and check this hospital for myself. Initial Consultation: $350. Most insurance won't reimburse or won't reimburse enough.

Pakistan
The Post Polio & Rehabilitation Surgery Clinic
http://www.omchospital.com/Inline/polio.html
The website is currently blocked from China, but when I checked it two years ago it seemed to have an integrated approach to the treatment that I liked a lot.
However, right now there is the country risk
China
Prof. Qin Sihe
According to Prof. Qin's book, "The surgical treatment of the post poliomyelitis sequelae" published in Chinese, China still has about 2 million people with various degrees of polio related impairments. Qin himself has performed surgeries on over 15000 cases.
He is currently my primary physician on the disease in cooperation with Guangji Hospital in Beijing. He already performed surgeries on me an I plan to have a couple more surgeries with him this year. If you ever go to see him, mention my name 孔书 （pronounced: kongshu in Chinese）. His website:http://www.qinsihe.com

Mayo Clinic
Website: http://www.mayoclinic.com/health/post-polio-syndrome/DS00494
Emphasis is on Post Polio Syndrome effects, but the center has excellent reputation and top tier related surgical specialties. I tried to go there in early 2006 but the process of scheduling an appointment was too tortuous for me. I had to have a physician referral first and then wait for a couple months

Post Polio Institute
I should also mention the post polio institute in Englewood NJ. The website contains a lot of useful information about how to handle Post Polio Syndrome effects. He is very active in having PPS survivors rights recognized in the US and bring great awareness to the disease in general. His practice does not emphasize surgical options.
Website: www.postpolioinfo.com/

Country: Turkey
Istanbul
Sema Hospital
Website: http://www.semahastanesi.com.tr/2008/en/icerik.php?id=123
Found through web search. Inquire for yourself.

Most Centers that do limb lengthening also correct bone related deformities. There are too many to name; a simle google search should help find one near where you live

Introduction to polio - If you're not too sure about the subject

This short 6 minutes movie gives you a laid back simplified introduction to the disease, how it works, its history and the people who suffered from it.

Inspiring Stories: Eileen Gruba

Eileen tells here more eloquently than I probably could many of the feelings and situations that I have experienced myself so I will begin by sharing this. Hopefully I will package more substantive material as time goes by.

Polio: Eileen Grubba's Story -- powered by http://www.livestrong.com