Jun 20 2012

Polio Perspecvtive

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Polio Perspective – December, 2017

Millie Malone Lill, Editor        Wilma Hood, Publisher

In This Issue

DECEMBER 6, 2016

Synthetic Cannabis-Like Drug Reduces Sleep Apnea


INDEPENDENCE DAY – by Millie Malone Lill





DECEMBER 6, 2016

Protein has achieved a venerated status in the dietary world for everything from building muscle to preventing weight gain.  But can you get too much of a good thing?

Protein powders that come in chocolate, strawberry, and cookies and cream flavors are doled out by the scoopful and mixed into smoothies, making it possible to effortlessly consume protein in amounts that far exceed dietary recommendations. A canned protein drink can contain almost as much protein as an eight-ounce steak, and snack bars or a small bag of protein chips can pack more of the macronutrient than a three-egg omelet.

But while some nutritionists have encouraged the protein craze, a number of experts are urging caution. They point out that protein powders and supplements, which come from animal products like whey and casein (byproducts of cheese manufacturing) or from plants like soy, rice, pea or hemp, are a relatively new invention. The vast majority of Americans already get more than the recommended daily amounts of protein from food, they say, and there are no rigorous long-term studies to tell us how much protein is too much.

“It’s an experiment,” said Dr. John E. Swartzberg, chairman of the editorial board of the University of California, Berkeley, Wellness Letter. “No one can tell you the long-term effects, and that’s what worries me as a physician. No one can tell you what the results are going to be in people’s bodies 10 or 15 years later.”

People need sufficient protein in the diet because it supplies indispensable amino acids that our bodies cannot synthesize on their own. Together they provide the essential building blocks used to make and maintain muscle, bone, skin and other tissues and an array of vital hormones and enzymes.

But the average adult can achieve the recommended intake — 46 grams of protein a day for women, and 56 grams for men — by eating moderate amounts of protein-rich foods like meat, fish, dairy products, beans or nuts every day. There are about 44 grams of protein in a cup of chopped chicken, 20 grams in a cup of tofu or serving of Greek yogurt, and 18 grams in a cup of lentils or three eggs.

American men already consume much greater amounts, averaging nearly 100 grams of protein a day, according to a 2015 analysis of the 2007-2010 National Health and Nutrition Examination Survey. The revised Dietary Guidelines for Americans, released in January, cautioned that some people, especially teenage boys and adult men, should “reduce overall intake of protein foods” and eat more vegetables.

Among the groups that fall short on protein intake are teenage girls, who may not eat properly, and elderly people, who are at risk of losing muscle mass and whose appetites often slacken with age. Indeed, many of the earliest nutritional supplement products, like Boost and Ensure, were devised with the elderly and malnourished in mind. (Professional athletes who work out many hours a day also need to increase protein intake considerably, as do women who are pregnant or breast-feeding.)

Yet the protein supplement market is booming among the young and healthy, with retail sales of sports nutrition protein powders and other products in the United States alone projected to reach $9 billion by 2020, up from about $6.6 billion last year, according to the research firm Euromonitor International.

“People think carbs are the enemy, protein is your friend,” said Eleanor Dwyer, a research analyst with the firm, and “that any health concerns are overblown.”

Experts note, however, that there is only so much protein the body can use. “The body only digests and absorbs a certain amount of protein at every meal,” about 20 to 40 grams, said Jim White, a registered dietitian and exercise physiologist who spoke on behalf of the Academy of Nutrition and Dietetics. “People think that if they fill up with protein, it will be a magic bullet, whether for weight loss or to get in better shape and build muscle — but that’s not proving to be true.”

“You can eat 300 grams of protein a day, but that doesn’t mean you’ll put on more muscle than someone who takes in 120 grams a day,” Mr. White said. Meanwhile, “you’re robbing yourself of other macronutrients that the body needs, like whole grains, fats, and fruits and vegetables.”

Short-term studies suggest that high protein, low carbohydrate diets may promote weight loss and help to preserve lean muscle, and that eating protein helps satisfy hunger. But a recent small trial found that older women who lost weight on a high protein diet did not experience one of the important benefits that usually follow weight loss, an improvement in insulin sensitivity, which reduces the risk of developing Type 2 diabetes. Large population studies also suggest an association between habitual high protein intake and a heightened risk of diabetes.

Doctors also have concerns about the long-term effects of maintaining a high protein diet. Studies show that protein-rich diets do not preserve muscle mass over the long term, and doctors have long cautioned that a high-protein diet can lead to kidney damage in those who harbor silent kidney disease by putting extra strain on the kidneys. Up to one in three Americans are at risk for kidney impairment because of high blood pressure or diabetes, according to the National Kidney Foundation.

Furthermore, some researchers worry that the muscle building properties that consumers seek in protein may be a double-edged sword, perhaps even leading to an increased risk of cancer.

“One of the benefits and concerns about high protein intake, especially animal protein, is that it tends to make cells multiply faster,” said Dr. Walter Willett, chairman of the department of nutrition at the Harvard T. H. Chan School of Public Health. “That’s good in early life, when you’re a growing child. But in later life, this is one of the fundamental processes that increase the risk of cancer.”

Several large observational studies have linked high-protein diets with an increased incidence of cancer, heart disease and other ills. One study led by Valter Longo, the director of the Longevity Institute at the University of Southern California in Los Angeles, followed a nationally representative sample of 6,381 adults. It found that those who ate a high protein diet between the ages of 50 and 65 were four times more likely to die of cancer than those who consumed less protein.

By eating large amounts of protein several times a day, “you’re generating a very novel environment that the body has never seen before,” said Dr. Longo, the founder of a company called L-Nutra that makes foods for healthy aging. “Even if you went back to a time when people ate a lot of meat, they would not have had pure proteins being fed multiple times a day.” He added that most of our early ancestors did not live past age 50.

Skeptics dismiss these concerns as speculative, saying they are not supported by adequate evidence. And some nutritionists advise adults to consume twice as much protein as currently recommended.

“There is a distinction between what is absolutely minimally required and a more optimal intake level,” said Stuart M. Phillips, a professor of kinesiology at McMaster University in Hamilton, Ontario, whose research has been supported by trade groups like the National Dairy Council and the National Cattlemen’s Beef Association. He advises adults to eat 30 to 40 grams of protein at every meal to help alleviate the loss of muscle that can occur with aging.

Where you get your protein is also important. Consumer groups have warned about the potential contamination of protein products, which are categorized as dietary supplements and loosely regulated. A Consumer Reports test of 15 protein powders and drinks in 2010, for example, found arsenic, lead, cadmium and mercury in some of the products tested.

Duffy MacKay, the senior vice president for scientific and regulatory affairs at the Council for Responsible Nutrition, an industry group that represents supplement manufacturers, dismissed concerns about toxic substances as “a lot of smoke.”

“These are all made from naturally derived materials that come from plants and animals, and in any naturally derived materials there are going to be trace amounts of environmental chemicals,” Mr. MacKay said.

But Mr. White, like many dietitians, said he recommended eating whole foods, rather than supplements. If you’re looking for alternatives to raise your smoothie’s protein content, for example, he suggested protein-rich foods like yogurt and peanut butter.

“Nothing beats real food,” Mr. White said. “With many supplements, you just don’t know exactly what you’re getting.”





Summary: Dronabinol, a drug that contains a synthetic version of the molecule tetrahydrocannabinol, appears to be both safe and effective in treating obstructive sleep apnea, a new study reports.

Source: Northwestern University.

A synthetic cannabis-like drug in a pill was safe and effective in treating obstructive sleep apnea in the first large multi-site study of a drug for apnea funded by the National Institutes of Health. The study was conducted at Northwestern Medicine and the University of Illinois at Chicago (UIC).

There is currently no drug treatment for sleep apnea, a sleep breathing disorder affecting about 30 million individuals in the United States. In sleep apnea, breathing is interrupted, and these pauses can last from a few seconds to minutes and may occur 30 times or more an hour. Untreated apnea raises the risk of heart disease, diabetes, sleepiness, cognitive impairment and a motor vehicle accident.

Participants in the trial had reduced apnea and decreased subjective sleepiness.

The common treatment for sleep apnea is a CPAP (Continuous Positive Airway Pressure) device that delivers air (acting like an air splint) to prevent collapse of the airway and breathing pauses. But adherence to the device can be challenging for many patients, some who simply stop using it.

“There is a tremendous need for effective, new treatments in obstructive sleep apnea,” said co-lead study author David W. Carley, the Katherine M. Minnich Endowed Professor Emeritus of Biobehavioral Health Sciences, Medicine and Bioengineering at UIC.

Researchers investigated the effect of dronabinol, a synthetic version of the molecule Delta-9 THC (tetrahydrocannabinol), which is in cannabis, on sleep apnea in a Phase 2 trial. The trial was the largest and longest randomized, controlled trial to test a drug treatment for sleep apnea.

Dronabinol was approved by the Food and Drug Administration more than 25 years ago to treat nausea and vomiting in chemotherapy patients.

Drug targets the brain in new approach

The drug treatment was a new approach in that it targeted the brain rather than the physical problem of collapsing airways. This reflects the new belief that sleep apnea is not just a physical problem but may be caused by multiple factors. One of those is poor regulation of the upper airway muscles by the brain, said co-lead author Dr. Phyllis Zee.

Zee is the Benjamin and Virginia T. Boshes Professor of Neurology at Northwestern University Feinberg School of Medicine and director of the Northwestern Medicine Sleep Disorders Center.

“The CPAP device targets the physical problem but not the cause,” Zee said. “The drug targets the brain and nerves that regulate the upper airway muscles. It alters the neurotransmitters from the brain that communicate with the muscles. Better understanding of this will help us develop more effective and personalized treatments for sleep apnea.”

While CPAP is highly effective, some patients simply refuse to use the machine. Even people who want to use it often only stick with it for about four hours a night, on average, Carley said.

“So the best they can get is a roughly 50 percent improvement in their apnea,” Carley said. “When people take a pill to treat apnea, they are treated for the entire night.”

The final version of the paper will be published Dec. 5 in the journal SLEEP.

How the study worked

In the study, 73 adult patients with moderate or severe sleep apnea were divided into three groups. One group was given a low dose of the drug, a second group received a higher dose and the third, a placebo. Participants took the drug once daily before bed for six weeks.

Six weeks of treatment by the highest dose of dronabinol (10 milligrams) was associated with a lower frequency of apneas or hypopneas (overly shallow breathing) during sleep, decreased subjective sleepiness and greater overall treatment satisfaction compared to the placebo group. The severity of their disorder was reduced by 33 percent compared to complete compliance with the mechanical treatment, although complete compliance for the night is rare.

Real marijuana not the same as apnea drug

Can a person simply ingest or smoke marijuana and get the same benefits for sleep apnea?

No, said Zee. “Different types of cannabis have different ingredients,” she noted. “The active ingredient may not be exactly the same as what’s indicated for sleep apnea.”

“Cannabis contains dozens of active ingredients, but we tested just purified delta-9 THC,” added Carley.

Larger scale clinical trials are needed to clarify the best approach to cannabinoid therapy in obstructive sleep apnea, the authors said.

Can a person simply ingest or smoke marijuana and get the same benefits for sleep apnea?

UIC has licensed intellectual property related to the experimental drug treatment used in the study to the pharmaceutical company RespireRx.

Researchers have attempted to identify drugs to treat sleep apnea for nearly 35 years, but to no avail, Carley said.

Carley developed the idea that dronabinol might be useful in treating sleep apnea more than 15 years ago. He and colleagues tested the concept in an animal model of apnea, publishing their findings in the journal SLEEP in 2002 and launched a subsequent pilot study in humans in 2007. Those encouraging findings from the small-scale pilot study formed the basis for this multi-center clinical trial led by Carley and Zee.

“By providing a path toward the first viable obstructive sleep apnea drug, our studies could have a major impact on clinical practice,” he said.



By Millie Malone Lill

Going from walking to using a scooter or a power chair?  It’s a hard transition.  We were raised to avoid such things as braces, crutches, canes, walkers and most importantly The Dreaded Chair.  When the exercises were so painful they made tears come to my eyes, I persevered because I did not want to end up in a chair.  That point was pounded into my head by doctors, nurses, physical terrorists, oops I mean therapists and my parents.  The absolute worst thing that could ever happen to me is that I would be unable to walk and have to use a wheelchair.

Today, reading some posts from my polio friends online, I heard buzz words like loss of independence,  failure, giving in, giving up,  and my least favorite what will people think?  I’ve addressed that last one many times, but I’ll try to be as brief as possible as I answer it now.  People are not likely to be thinking of you.  Use what is best for yourself and get over yourself.

As for the others, I find that we don’t seem to have a clear picture of ourselves.  If I don’t use my crutches, I won’t look disabled, right?  Probably wrong.  I will look like I am drunk, or I will look very much disabled as I lurch from side to side, crashing into stuff and falling down from time to time.  But if I use a walker, I’ll look old as well as disabled.  Well, honey, guess what.  If you are a polio survivor, chances are pretty good that you are both old and disabled. 

I tried to avoid my power chair, too, at first.  I tried it out in my living room, unknowingly set to the Rabbit speed as opposed to Turtle and promptly shoved my couch into the middle of the living room.  That scared me.  I was not going to be using this dangerous machine again!  So I continued as I’d been doing.  I walked slowly, head down, watching for things to trip over like a leaf on the sidewalk or my shadow.  I avoided going places, always mentally checking out the distance I’d have to walk and if it was worth the pain and fatigue I’d have later. 

At last, I realized that my power chair was a tool.  No one expected me to walk to the next town, that would be silly with my car sitting right in the driveway, ready to carry me there.  Well, now it was too far to walk to the post office to get my mail, so why not use that handy dandy furniture mover to go there?  I tried it.  Hey!  This was fun!  I could actually get some fresh air, could look at the trees and the clouds and the people instead of the sidewalk.  Pain?  What pain?  I wasn’t exhausted when I got to the post office, either.  What a deal!

Giving up?  Giving in?  No, I was fighting back.  Polio had taken enough from me and I was not going to let it take one more thing.  I got a van and a lift and all of a sudden I had a life.  I could go to the mall and shop till my companions dropped, come home and still have a teaspoon or so of energy left over.  I grew up within easy driving distance of the Henry Dourly Zoo, but I’d never been there because I couldn’t do the walking.  Well, hooray, now I could use my chair, spend the entire day and actually see everything.

The day I realized that my power chair was the key to my freedom, that was my Independence Day.  I could go where I wanted, when I wanted.  I didn’t need to find some sucker willing to push me in a manual chair…and there was not a long line of volunteers for that job, I might add.  Don’t be afraid of ending up in a chair.  There are far worse things than that, I do assure you.



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Why you should still get your polio vaccine even though polio is eradicated in India


After beating polio, she is on a mission to eradicate it.


She gave her sister a voice




Pennsylvania Polio Survivor’s Network


Polio Epic


Southern Nevada Association of Polio Survivors


Polio Australia


Polio Matters


Post Polio Health




A Cold Winter Ahead

It’s late fall and the Indians on a remote reservation in Oklahoma asked their new chief if the coming winter was going to be cold or mild.

Since he was a chief in a modern society, he had never been taught the old secrets. When he looked at the sky, he couldn’t tell what the winter was going to be like.

Nevertheless, to be on the safe side, he told his tribe that the winter was indeed going to be cold and that the members of the village should collect firewood to be prepared.

But, being a practical leader, after several days, he got an idea. He went to the phone booth, called the National Weather Service and asked, ‘Is the coming winter going to be cold?’

‘It looks like this winter is going to be quite cold,’ the meteorologist at the weather service responded.

So the chief went back to his people and told them to collect even more firewood in order to be prepared.

A week later, he called the National Weather Service again. ‘Does it still look like it is going to be a very cold winter?’

Yes,’ the man at National Weather Service again replied, ‘it’s going to be a very cold winter.’

The chief again went back to his people and ordered them to collect every scrap of firewood they could find.

Two weeks later, the chief called the National Weather Service again. ‘Are you absolutely sure that the winter is going to be very cold?’

‘Absolutely,’ the man replied. ‘It’s looking more and more like it is going to be one of the coldest winters we’ve ever seen.’

‘How can you be so sure?’ the chief asked.

The weatherman replied, ‘The Indians are collecting a whackload of firewood’

7 Responses to “Polio Perspecvtive”

  1. Thomas Christian says:

    Ole better git a hearing ade?

  2. ruth says:

    thanks for this news letter. My sister is having the same feeling of when she had polio at 6. I am helping her learn what could be happening. thanks for this as the doctor is not talking about it.

  3. Millie Lill says:

    Ruth, read all you can online and I also suggest that you join one of the Facebook polio sites. You can learn a lot from those of us who have been there and done that.

  4. Hilary Boone says:

    Why do we still have so much hassle trying to get decent medical care. Sharing experiences really does help us realise ‘It’s not just me’ which slightly lessens the frustration and stress. Millie as usual you have done a great job.

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