The San Antonio Polio Survivors’ Association Newsletter, THE PHOENIX, is intended to share, with our readers, information of interest to them, including medical opinion of others. It is not intended to offer specific advice or as a substitute for professional health care. Opinions, products, or services mentioned, herein, are not necessarily endorsed by the San Antonio Polio Survivors’ Association or the Warm Springs Resourcenter for People with Disabilities or Warm Springs Rehabilitation Foundation, Inc.; 5101 Medical Drive; San Antonio, Texas 78229-4801

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Reprinted from Polio Network News, now Post-Polio Health, with permission of Post-Polio Health International (www.post-polio.org. (Spring Volume 19 Number 2 pages 8 - 9) Any further reproduction must have permission from copyright holder.

Improving Communication with Our Doctors

Henry D. Holland, MD, Richmond, Virginia
(Henry4FDR@aol.com)

Why am I qualified to offer these suggestions? I have had the experience of being a patient many times in my life.

I have used a ventilator since I had a permanent tracheostomy in 1970. This treatment resulted from the damage initially caused by polio in 1950. I have an intensified interest in post-polio syndrome because I have experienced its effects since about 1990.

I have been a physician since 1966, and my specialty is psychiatry. I am currently a clinical professor at the School of Medicine of Virginia Commonwealth University (formerly the Medical College of Virginia), and each year I instruct second year medical students in the technique of interviewing patients.

Most physicians follow the medical model, which is generally based on the scientific method. The thorough physician would get a complete history from you and possibly members of your family, perform a physical examination, try to obtain copies of previous medical records from other medical sources, and would get laboratory and other objective tests. Routine tests usually include a complete blood count, blood chemistries including electrolytes, liver enzymes, kidney screening tests, cholesterol, and others. A chest x-ray and thyroid function studies might also be included.

I think it is essential and extremely important to have a doctor who will listen to you. As a patient I think it is equally important for you to present your history of polio and post-polio syndrome symptoms in a concise manner and as objectively as possible. I recommend that you answer the physician’s questions in a similar manner. If your doctor seems hurried, that is a distinct disadvantage for both you and him/her. It is a good idea to write some notes so you remember to tell the doctor about the onset of symptoms, when the symptoms seemed to progress, and what you have done that seemed to increase the symptoms or decrease the symptoms.

Most physicians will formulate a possible or differential diagnosis based on the history and physical exam even before the objective test results are known. In some cases, treatment may be started at that time. After the results of the objective tests are known, often the diagnosis can be made.

The diagnosis of post-polio syndrome is one of exclusion. The usual symptoms – weakness, fatigue, and pain – are very similar to other conditions. Therefore, your physician must exclude these other possible disorders as an explanation for your symptoms. The most important initial factor is to make sure that your physician knows of the history of polio in your life.

My initial diagnosis in 1991 was a self-diagnosis. A neurologist and a pulmonary doctor did not think that I had post-polio syndrome, but I am not sure that they knew much about it. Fortunately my primary care (internal medicine) doctor was willing to listen to what I had to say. He was also willing to read the articles that I brought him. Admittedly, I had an advantage because, as a physician, my opinions and observations were not immediately dismissed.

As a patient, you can become frustrated early on in the diagnostic process. Hopefully your physician will be honest and not defensive and will admit if he/she knows little about the disorder. This is likely a good sign that the physician is willing to learn. If you can afford it, give your doctor either Managing Post-Polio, A Guide to Living Well with Post-Polio Syndrome (1998) by Lauro Halstead, MD (www.nrhrehab.org) or Post-Polio Syndrome: A Guide for Polio Survivors and Their Families (2000) by Julie Silver, MD, now in paperback (www.polioclinic.org). A gesture of this type can be mutually beneficial, but I would not recommend presenting any literature with a know-it-all attitude or to a doctor with a similar attitude. A little humility is good for both the doctor and the patient.

I often hear that polio is not taught any more in medical schools. I think this is an inaccurate perception. Infectious diseases, including polio, are taught in accredited medical schools despite the possibility that an American physician may never see an actual case. I have never seen a case of leprosy, bubonic plague, elephantiasis, or yellow fever. However, I studied and was quizzed on all of these diseases.

Post-Polio Syndrome is probably taught less because this disorder is a “syndrome.” A syndrome is a group of symptoms that collectively indicate or characterize a disease, a psychological disorder, or another abnormal condition. The causes of some syndromes are known and others are not known. When the cause of a syndrome is not clearly known, the teaching emphasis would be on recognition. As treatment may vary or change, a precise treatment plan may be suggested but with reservation. This is the case with post-polio syndrome. For example, how much exercise is enough or how much exercise is too much? The treatment of post-polio syndrome is more individualized and less empirical than known disease processes.

The average physician may never have a case of post-polio syndrome cross his/her office threshold. If a case does, that physician may focus on other causes before considering the diagnosis, assuming that he/she knows about post-polio syndrome and assuming you told him/her your polio history.

Communicate honestly about the severity of your symptoms. Many polio survivors minimize the severity and dysfunction of their symptoms. Don’t hesitate to tell your story with complete disclosure of how bad you are feeling or hurting. It is important for you to communicate with clarity and emphasis about what has changed and what you are experiencing. You could simply complain of fatigue, pain, and weakness, but if you explain how the fatigue, etc., is limiting, then your doctor will begin to understand. For example, if you report that walking up a flight of steps is no longer possible without resting or extreme effort, you are more objective in your description than simply reporting fatigue. You, as a polio survivor, understand what you are experiencing. If the doctor has a genuine ability to empathize, he/she may also be able to understand. However, the doctor may worry about missing some-thing that is more treatable than post-polio syndrome, such as a malignancy, multiple sclerosis and other CNS diseases, HIV, or any other disease that might present with a complaint of fatigue, pain, or weakness.

The successful doctor/patient relationship depends in part on a feeling of comfort between the two personalities involved. The patient wants help with a problem and trusts the doctor to use his/her expertise in solving the problem. The doctor’s goal is to diagnose correctly the patient’s problem and initiate the appropriate treatment promptly.

This process will be more rewarding if the doctor and the patient have mutual respect, are not competitive, and both are capable of listening with attention and interest. If a doctor does not seem interested, finding another doctor would be wise. If the doctor admits unfamiliarity with post-polio syndrome and is not interested in learning more, then that doctor should refer you to a colleague who is both more knowledgeable and more interested.

The best outcome is to find a doctor who knows about post-polio syndrome or is willing to learn, is a good listener, is not obviously hurried, respects all of his/her patients, and takes a genuine interest in you as a patient with a problem and as a person. You will know when you have found a doctor with whom you can relate.


Dr. Henry Holland has graciously granted SAPSA permission to reprint the above article and Post-Polio Health Spring 2003 Volume 3 Number 2 has also granted permission to San Antonio Polio Survivors Association for reprinting this article for your use and knowledge.

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The next is a little bit of “childish” humor received by one of our members and has passed it on. I thought it might be a little fun to share with you. I am sure that some of us have experienced some similar “witticisms” of the youngest generation:

“NUDITY
I was driving with my three young children one warm summer evening when a Woman in the convertible ahead of us stood up and waved. She was stark naked! As I was reeling from the shock, I heard my 5-year-old shout from the back seat, "Mom! That lady isn't wearing a seat belt!

HONESTY
My son Zachary, 4, came screaming out of the bathroom to tell me he'd dropped his toothbrush in the toilet. So I fished it out and threw it in the garbage. Zachary stood there thinking for a moment, then ran to my bathroom and came out with my toothbrush. He held it up and said with a charming little smile, "We better throw this one out too then, 'cause it fell in the toilet a few days ago.

OPINIONS
On the first day of school, a first-grader handed his teacher a Note from his mother. The note read, "The opinions expressed by this child are not necessarily those of his parents."

KETCHUP
A woman was trying hard to get the ketchup to come out of the jar. During her struggle the phone rang so she asked her 4-year-old daughter to answer the phone. "It's the minister, Mommy," the child said to her mother. Then she added, "Mommy can't come to the phone to talk to you right now. She's hitting the bottle."

MORE NUDITY
A little boy got lost at the YMCA and found himself in the women's locker room. When he was spotted, the room burst into shrieks, with ladies grabbing towels and running for cover. The little boy watched in amazement and then asked, "What's the matter haven't you ever seen a little boy before?"

ELDERLY
While working for an organization that delivers lunches to elderly shut-ins, I used to take my 4-year-old daughter on my after noon rounds. The various appliances of old age, particularly the canes, walkers and wheelchairs, unfailingly intrigued her. One day I found her staring at a pair of false teeth soaking in a glass. As I braced myself for the inevitable barrage of questions, she merely turned and whispered, "The tooth fairy will never believe this!"

DRESS-UP
A little girl was watching her parents dress for a party. When she saw her dad donning his tuxedo, she warned, "Daddy, you shouldn't wear that suit." And why not, darling?" "You know that it always gives you a headache the
next morning."

DEATH
While walking along the sidewalk in front of his church, our minister heard the intoning of a prayer that nearly made his collar wilt. Apparently his 5-year-old son and his playmates had found a dead robin. Feeling that proper burial should be performed, they had secured a small box and Cotton batting, then dug a hole and made ready for the disposal of the deceased. The minister's son was chosen to say the appropriate prayers and with sonorous dignity intoned his version of what he thought his Father always said: "Glory be unto the Faaaather, and unto the Sonnn ... and into the hole he gooooes."

SCHOOL
A little girl had just finished her first week of school. "I'm just wasting my time," she said to her mother. "I can't read, I can't write and they won't let me talk!"

BIBLE
A little boy opened the big family bible. He was fascinated as he fingered through the old pages. Suddenly, something fell out of the Bible. He picked up the object and looked at it. What he saw was an old leaf that had been pressed in between the pages. "Mama, look what I found", the boy called out." What have you got there, dear?" With astonishment in the young boy's voice, he answered, "I think it's Adam's underwear!"”

Author Unknown
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The following is printed with the author’s permission. It is reprinted with the hope that it will help with our increased knowledge and understanding of how the polio virus really works. We have been filled with so many suppositions that it is refreshing to finally see an article which explains the subject with conciseness and more general understanding. Dr. Bollenbach is a retired Microbiologist as well as a Polio Survivor himself so he does speak with some authority.

GENERATIONAL “FLOW-ON” OF POLIOMYELITIS
By Eddie Bollenbach, PhD

I'd like to give my impressions and ideas about transplacental transmission of the poliovirus.

Do you know how viruses are cultivated to produce vaccines? They must Be grown inside living tissues and a very convenient way to do this is to use chicken embryos inside eggs. The reason this is convenient for so many viruses, from influenza to polio, is that embryonic and even fetal tissue is very susceptible to infection by a wide variety of viruses. The point of this is that if a human fetus in-utero was infected by a pregnant mother, the fetus would be severely damaged and would very likely die. This is because the viruses grow inside these cell producing a "cytopathic effect". This means the cells get altered in ways which, especially in fetuses, would result in catastrophic damag.For example, large cells with more than one nucleus, cells with visible bodies inside, and other anomalies.

Dick Bruno, in his New Mobility magazine column, addressed the issue of pregnancy and fetal safety by providing the following facts. In the 1950's thousands of women came down with polio while pregnant. In Los Angeles and Illinois there was a study of 1000 such women and at birth or stillborn not one fetus showed any sign of polio. Even with the normal rate of stillbirths, on autopsy of these fetuses showed no sign of the polio virus or even a cytopathic effect. However, having polio while pregnant did pose a serious health risk for the mother as more deaths during pregnancy and childbirth occurred for them. Pregnant women were 5 times more likely to die if they had polio.

In another study addressed in the same article, babies less than six months of age, born between 1897 and 1956 were studied. 150 cases were identified. Four of these babies showed signs of paralytic polio at birth. So it seems that in very rare cases the mother's antibodies do not protect the fetus. I believe, in some of these, there was a misshapen placenta.

Let's move on to some more data: Lauro S. Halstead, MD, Director of the Post-Polio Program at the National Rehabilitation Hospital in Washington, DC, and member of PHI'S Medical Advisory Committee, stated about this question::"I know of no study that indicates there is a connection. To the contrary, we know that mothers who got polio when pregnant did not pass on the virus to their children. Some viruses cross the placental barrier, but polio is not one of them."

Following Halstead's lead, I found comments by the CDC in Atlanta, on the danger of oral live polio vaccine administration during pregnancy. The CDC reiterates the lack of evidence for fetal damage due to poliovirus but if the mother is vaccinated with live Sabin vaccine, there is a concern about SV40 which is a virus that apparently does cross the placenta and can infect the fetus. Such infections may cause an increased risk of cancer.

If your mother had polio during pregnancy there is a chance that during birth her shedding of virus from feces, or less likely blood, could have caused an infection. If this occurred, it might be difficult to tell, in an infant, if some motor neurons were damaged. Virus shedding occurs for as long as a month in some individuals although they are not infectious, generally, because the virus has a very high mutation rate and all virulent virus is cleared within a week or two after an active infection. But that is a possibility.

I don't know if anyone here has PPS because of a fetal infection. All the evidence on this taken since the late 1800's have been unremarkable and rare. With all the polio in the 40's and 50's one would expect positive information about fetal contraction of virus if it were a common event. We would have seen it. I do know there are a lot of physical problems that are common in our age group: fibromyalgia, chronic fatigue Syndrome, back problems, arthritic problems, lupus, MS. heart problems, chronic infections, Crones disease, and the list goes onto the point where we would all fall asleep. None of us escape all of these and many have common symptoms to PPS. Currently the guidelines at the NIH to help diagnose PPS include a history of paralytic polio. It would be pretty hard to convince them that PPS is the result of a parent's polio during pregnancy although I believe, and wrote an article in the Jan/Feb 2000 issue of the The American Journal of Physical Medicine and Rehabilitation, on Late Functional Loss in Non-Paralytic Polio. In that same issue were similar papers by Bruno and Halstead. soa history of paralytic polio, to many of us at least, is not required. In summary, I think anyone who feels they have PPS as a result of transplacental infection will have a hard road in convincing health care professionals of it unless an EMG shows typical old polio damage with resprouting. You might also show a higher titer of anti-polio antibodies for one of the three strains. Now if that happened I would be convinced. My co-author Marcia Falconer worked with live poliovirus at MIT and they did the anti-body test there but it is not generally available.
*References*

http://www.newmobility.com/review_article.cfm?id=358&action=browse

Post-Polio International (Halstead)
http://www.post-polio.org/netwkg_a.html

Falconer, M and Bollenbach, E "Late Functional Loss in Non-Paralytic Polio, Jan/Feb 2000.
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The following was sent to us from one of the members of SAPSA and it is appropriate advice, I think, to pass along for our safety.

An attorney's advice and it's FREE! Read this and make a copy for your files in case you need to refer to it someday.
Maybe we should all take some of his advice!

A corporate attorney sent the following out to the employees in his company:

The next time you order checks, omit your first name and have only your initials and last name put on them. If someone takes your check book they will not know if you sign your checks with just your initials or your first name but your bank will know how you sign your checks.

When you are writing checks to pay on your credit card accounts, DO NOT put the complete account number on the "For" line. Instead, just put the last four numbers. The credit card company knows the rest of the number and anyone who might be handling your check as it passes through all the check processing channels won't have access to it.

Put your work phone # on your checks instead of your home phone. If you have a PO Box use that instead of your home address. Never have your SS# printed on your checks (DUH!) you can add it if it is necessary. But if you have it printed, anyone can get it.

Place the contents of your wallet on a photocopy machine, do both sides of each license, credit card, etc. You will know what you had in your wallet and all of the account numbers and phone numbers to call and cancel.

Keep the photocopy in a safe place. I also carry a photocopy of my passport when I travel either here or abroad.

We've all heard horror stories about fraud that's committed on us in stealing a name, address, Social Security number, credit cards, etc.

Unfortunately I, an attorney, have firsthand knowledge because my wallet was stolen last month. Within a week, the thieve(s) ordered an expensive monthly cell phone package, applied for a VISA credit card, had a credit line approved to buy a Gateway computer, received a PIN number from DMV to change my driving record information online, and more.

But here's some critical information to limit the damage in case this happens to you or someone you know:

We have been told we should cancel our credit cards immediately. But the key is having the toll free numbers and your card numbers handy so you know whom to call. Keep those where you can find them easily.

File a police report immediately in the jurisdiction where it was stolen, this proves to credit providers you were diligent, and is a first step toward an investigation (if there ever is one).

But here's what is perhaps most important: (I never even thought to do this).

Call the three national credit reporting organizations immediately to place a fraud alert on your name and Social Security number. I had never heard of doing that until advised by a bank that called to tell me an application for credit was made over the Internet in my name.

The alert means any company that checks your credit knows your information was stolen and they have to contact you by phone to authorize new credit.

By the time I was advised to do this, almost two weeks after the theft, all the damage had been done.

There are records of all the credit checks initiated by the thieves' purchases, none of which I knew about before placing the alert. Since then, no additional damage has been done, and the thieves threw my wallet away this weekend (someone turned it in). It seems to have stopped them in their tracks.

The numbers are:
Equifax:1-800-525-6285
Experian:(formerly TRW): 1-888-397-3742
Trans Union:1-800-680-72 89
Social Security Administration(fraud line):1-800-269-0271

We pass along jokes on the Internet; we pass along just about everything. Pass this information along. It could really help someone you care about.

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The following little piece does give you food for thought ---- especially about small acts of kindness we show to one another…….”bread cast across the water”…. Type of thing. It is amazing how the acts do come back to you in one form or another at a time when you really could use it.

A GLASS OF MILK

One day, a poor boy who was selling goods from door to door to pay his way through school, found he had only one thin dime left, and he was hungry.

He decided he would ask for a meal at the next house. However, he lost his nerve when a lovely young woman opened the door.

Instead of a meal he asked for a drink of water. She thought he looked hungry so brought him a large glass of milk. He drank it slowly, and then asked, How much do I owe you?

You don't owe me anything, she replied. "Mother has taught us never to accept pay for a kindness."

He said..... "Then I thank you from my heart."

As Howard Kelly left that house, he not only felt stronger physically, but his faith in God and man was strong also. He had been ready to give up and quit.

Many year's later that same young woman became critically ill. The local doctors were baffled! They finally sent her to the big city, where they called in specialists to study her rare disease.

Dr. Howard Kelly was called in for the consultation. When he heard the name of the town she came from, a strange light filled his eyes. Immediately he rose and went down the hall of the hospital to her room.

Dressed in his doctor's gown he went in to see her. He recognized her at once.

He went back to the consultation room determined to do his best to save her life. From that day he gave special attention to her case.

After a long struggle, the battle was won.

Dr. Kelly requested the business office to pass the final bill to him for approval. He looked at it, then wrote something on the edge and the bill was sent to her room. She feared to open it, for she was sure it would take the rest of her life to pay for it all. Finally she looked, and something caught her attention on the side of the bill. She read these words.....

"Paid in full with one glass of milk"
(Signed) Dr. Howard Kelly.

Tears of joy flooded her eyes as her happy heart prayed: "Thank You, God, that Your love has spread broad through human hearts and hands."

There's a saying which goes something like this: Bread cast on the waters comes back to you. The good deed you do today may benefit you or someone you love at the least expected time. If you never see the deed again at least you will have made the world a better place - And, after all, isn't that what life is all about?

Now you have two choices.

You can send this page on and spread a positive message. Or ignore it and pretend it never touched your heart.

The hardest thing to learn in life is which bridge to cross and which to burn.....

GOOD FRIENDS ARE LIKE ANGELS, YOU DON'T HAVE TO SEE THEM TO KNOW THEY'RE THERE!

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The Tea Cup

There was a couple who used to go England to shop in a beautiful Antique store. This trip was to celebrate their 25th wedding anniversary. They both liked antiques and pottery, and especially tea-cups. Spotting an exceptional cup, they asked, "May we see that? We've never seen a cup quite so beautiful."

As the lady handed it to them suddenly the tea-cup spoke, "You don't understand." It said, "I have not always been a tea-cup. There was a time when I was just a lump of red clay. My master took me and rolled me pounded and patted me over and over and I yelled out, "Don't do that. I don't like it! Let me alone", but he only smiled, and gently said; "Not yet!!"

"Then. WHAM! I was placed on a spinning wheel and suddenly I was spun around and around and around. 'Stop it! I'm getting so dizzy! I'm going to be sick!', I screamed. But the master only nodded and said, quietly; 'Not yet.' He spun me and poked and prodded and bent me out of shape to suit himself and then......

"Then he put me in the oven. I never felt such heat. I yelled and knocked and pounded at the door. 'Help! Get me out of here!' I could see him through the opening and I could read his lips as he shook his head from side to side, 'Not yet'.

"When I thought I couldn't bear it another rminute, the door opened. He carefully took me out and put me on the shelf, and I began to cool. Oh, that felt so good! 'Ah, this is much better,' I thought.

"But, after I cooled he picked me up and he brushed and painted me all over. The fumes were horrible. I thought I would gag. "Oh, please stop it, Stop it!!", I cried. He only shook his head and said. "Not yet!".

"Then suddenly he put me back in to the oven. Only it was not like the first one. This was twice as hot and I just knew I would suffocate. I begged. I pleaded. I screamed I cried. I was convinced I would never make it. I was ready to give up. Just then the door opened and he took me out and again placed me on the shelf, where I cooled and waited ---- --- and waited, wondering what's he going to do to me next?

"An hour later he handed me a mirror and said "Look at yourself." And I did. "I said, 'That's not me; that couldn't be me. It's beautiful. I'm beautiful!

"Quietly he spoke: I want you to remember, then,' he said, 'I know it hurt to be rolled and pounded and patted, but had I just left you alone, you'd have dried up. I know it made you dizzy to spin around on the wheel, but if I had stopped, you would have crumbled'. I know it hurt and it was hot and disagreeable in the oven, but if I hadn't put you there, you would have cracked.

I know the fumes were bad when I brushed and painted you all over, butif I hadn't done that, you never would have hardened. You would not have had any color in your life. If I hadn't put you back in that second oven, you wouldn't have survived for long because the hardness would not have held. Now you are a finished product. Now you are what I had in mind when I first began with you.'

The moral of this story is this:

God knows what He's doing [for each of us]. He is the potter, and we are His clay. He will mold us and make us, and expose us to just enough pressures of just the right kinds that we may be made into a flawless piece of work to fulfill His good, pleasing and perfect will.

So when life seems hard, and you are being pounded and patted and pushed
almost beyond endurance; when your world seems to be spinning out of control; when you feel like you are in a fiery furnace of trials; when life seems to"stink", try this.... Brew a cup of your favorite tea in your prettiest tea cup, sit down and think on this story and then, have a little talk with the Potter.

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The following sent to the editor from a friend in Rockport. I do not know if the subject of the information is true or an urban legend. Anyway, whether true or not, it is a cautionary tale that gives one something to think about the next time he/she licks an envelope or stamp.

Interesting information....

I always simply tape my envelopes closed... now I'm glad I do. Isn't this interesting! I work in a factory and we have 2 employees who used to work in an envelope factory. They told me that when the machine jams up, they use whatever water is handy to thin out the glue. This includes water that they just mopped the floor with. Since then, I've avoided licking envelopes...
1. If you lick your envelopes... You won't anymore!!! A woman was working in a post office in California. One day she licked the envelopes and postage stamps instead of using a sponge. That very day the lady cut her tongue on the envelope. A week later, she noticed an abnormal swelling of her tongue.

She, went to the doctor, and they found nothing wrong. Her tongue was not sore or anything. A couple of days later, her tongue started to swell more, and it began to get really sore, so sore, that she could not eat. She went back to the hospital, and demanded something be done. The doctor took an x-ray of her tongue and noticed a lump. He prepared her for minor surgery. When the doctor cut her tongue open, a live cockroach crawled out!!!! There were roach eggs on the seal of the envelope. The egg was able to hatch inside of her tongue, because of her saliva. It was warm and moist... This is a true story reported on CNN.

2.) Andy Hume wrote: "Hey, I used to work in an envelope factory. You wouldn't believe the things that float around in those gum applicator trays. I haven't licked an envelope for years!"

3.) To All: I used to work for a print shop (32 years ago) and we were told NEVER to lick the envelopes. I never understood why until I had to go into storage and pull out 2500 envelops that were already printed for a customer who was doing a mailing and saw several squads of roaches roaming around inside a couple of boxes with eggs everywhere. They eat the glue on the envelopes. I think print shops have a harder time controlling roaches than a restaurant. I always buy the self-sealing type. Or if need be I'll use a glue stick to seal that has the type of glue that needs to be wet to stick.

PASS THIS ON, if you like, TO YOUR FRIENDS.
After reading this you will never lick another envelope 0r stamp ever again.

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Squeezing Every Last Drop

The local bar was so sure its bartender was the strongest man around that they offered a standing $1000 bet. The bartender would squeeze a lemon until all the juice ran into a glass, and hand the lemon to a patron. Anyone who could squeeze one more drop of juice out would win the money.

Many people had tried over time, including the professional wrestlers and bodybuilders, but nobody could do it. One day a scrawny little man came in, wearing a tie and a pair of pants hiked up past his belly button.

He said in a squeaky, annoying voice, "I'd like to try the bet." Even the hillbilly chicks burst into laughter.

After the laughter had died down, the bartender said, "OK," grabbed a lemon, and squeezed away. He then handed the wrinkled remains of the rind to the little man.

But the crowd's laughter turned to total silence as the man clenched his fist around the lemon and six drops fell into the glass. As the crowd cheered, the bartender paid the $1000, and asked the little man, "What do you do for a living? Are you a lumberjack, weight lifter, or what?"

The man replied, "I work for the IRS."
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The next item will be the final item for this edition of the newsletter. It is an informative item about the care of our laundry dryers. The article might possibly save us having to replace the heating unit and does save on electricity costs. The information was contributed Cynthia Ruiz, one of our fellow Polio Survivors.

Dryer sheets

(This was sent to me by a friend.)
I had a wonderful morning, the heating unit went out of my dryer! Why does everything seem to fall apart this time of year!???
The guy that fixes things went in to the dryer and pulled out the lint filter. It was clean. We always clean the lint from the filter after every load of clothes. He told us that he wanted to show us something. He took the filter over to the sink and ran hot water over it.
Now, this thing is like a mesh....I'm sure you know what your dryer's lint filter looks like.
WELL......the hot water just laid on top of the mesh!!! It didn't go through it at all!!! He told us that dryer sheets cause a film over that mesh and that's what burns out the heating unit. You can't SEE the film, but it's there.
He said the best way to keep your dryer working for a very long time (and to keep your electric bill lower) is to take that filter out and wash it with hot soapy water and an old toothbrush (or other brush) at least every six months. He said that makes the life of the dryer at least twice as long!
How about that???!!!!
Learn something new everyday! I certainly didn't know dryer sheets would do that. So, thought I'd share!
Note: I went to dryer and tested my screen by running water on it. Not one drop went through! I used warm soapy water and a brush. It took all of 30 seconds. I ran the water again and it gushed through it. No puddling. No problems.
That repairman knew what he was talking about.
Just thought I’d share!
Cynthia

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Several members of our group have suggested that we place the “Kitty” for collection of the $1.00 at each meeting to be placed on a table near the entrance of the meeting room. So no one will feel embarrassed if they can not contribute anything at individual meetings. As we all know, there have been times when we have been unable to contribute monetarily. Let us know how you feel about this suggestion, please.

Until next time……..

Ethel E. Killgore Taylor, Editor
The Phoenix
San Antonio Polio Survivors’ Association

What's In A Name?

What do the following pairs of drug names have in common:

Atenolol - Tenormin
Warfarin - Coumadin
Lanoxin - Digoxin
Temazepam - Restoril
Naproxin - Naprosyn

If you answered that one of each pair is the brand name, and one is th generic, you would be right.

Would your elder know that the container labeled Atenolol is essentially the same medication that last month came labeled as Tenormin? How about if the tablets don't look the same?

Would you?

Ask the pharmacist to make a note in the computer to always label generic drugs as "substituted for" the brand name if there's a change being made from one to the other. Samples from the doctor's office are almost always branded. When the doctor writes a prescription to be filled at the pharmacy it may well be for a generic. They don't always look the same, and they will certainly be labeled differently.

This can cause confusion. If the patient doesn't realize or doesn't want to admit to confusion, bad things can happen. Get both names on the container.

Why Every Caregiver Needs A Team

This comes directly from my inbox last week. This person and I exchanged a couple of emails. I've paraphrased her question, because it's a common one. I've re-printed my final answer just about verbatim.

Sadly, I never heard back. I hope she sought good advice from a "team," because otherwise she and her mother/aunt will only have a partial picture of what's before them and they'll probably never really know what their options could have been.

Question: My mother and my aunt live together in my mother's house. They are both getting on in years and they both have some medical problems. They would like to talk to an attorney about how to preserve their assets and get the care they need at home. Can you refer me to someone?

My Answer: If anything cries out for a team approach, your question does. I don't think any one individual is going to have all your answers.

1. An estate planning attorney will be able to give you advice about how to structure a will, create a trust, and preserve an estate. He or she will probably not be the best person to advise you about how long the money will last or how best to invest it because this isn't an attorney's area of expertise. Knowing how long the money will last is a function of how old
the individual is, what the medical issues are, and how much several different things cost in your area. It's an unusual attorney who is knowledgeable in these things.

2. A CPA will help you with your taxes and any possible deductions for medical and care expenses. A CPA isn't an investment advisor or a care counselor.

3. A certified financial planner will be able to help you with investments and growing/preserving the estate. He or she will have information about long-term care insurance (more for you than your mother and your aunt, as they probably no longer qualify). A good investment advisor will have some
information about the costs of long-term care, but it will most likely be generic information provided by national insurance carriers.

A stockbroker, insurance agent or "investment advisor" at your bank is not a financial planner - they have a vested interest in selling you the "products" offered by their institutions. You should consult with an independent CFP who will offer you a plan for a fee and then let you decide whether you want to use the planner's services to implement the plan. Yes, it costs, but it's worth it.

4. An experienced care counselor will be able to give you information about what you can expect in your own individual eldercare situation - how diagnosed medical issues can be expected to progress, things that can be done to increase safety at home, what things cost in the local area, who provides what kind of help, and how to put together a long-term care plan
given the financial, emotional and physical facts. The information you will get from a geriatric assessment is valuable to both your certified financial planner and your estate planning attorney as they assess your particular financial and legal situation.

So, I think you need four advisors, working as a team. You and any advisors you consult will be working blindly if you don't know what to expect or what your real long-term care options are.

If your relatives already have a good plan for passing on whatever is left of their estates when the time comes, you might be best off to start with a geriatric assessment and a good financial planner. If they don't have up-to-date individual estate plans (will, powers of attorney, advanced
directives, trusts, etc.) add an estate planning attorney into the mix right away.

Best regards,

Molly