A Novel Approach to Breathing

 

Hillary Hallam, editor of LincPin, the newsletter of the Lincolnshire, England Post Polio Group asked me to write an article on my polio history.  It appeared in the print version of LincPin and is on their web site

 

A Novel Approach to Breathing
by Mary Clare Schlesinger

This is a story about the essence of my life: polio, breathing, and the medical care that gave me some of the “best breathing years” of my life.   Three months before the birth of my daughter, I had the opportunity to meet Dr. Kenneth Moser (1929-1997), and reaped the benefits of his excellent medical expertise along with the benefits of a lasting relationship.  Dr. Moser was the founding director of the University of California San Diego (UCSD) Department of Medicine’s Pulmonary and Critical Care Division.  Dr. William R. Auger described Dr. Moser as “always very good at pinpointing what is novel about pulmonary disease and pulmonary medicine and getting people to develop novel approaches in care that you just don’t see elsewhere.”

Polio found its way to me in 1952 when I was three years old in the small town of Sylvania, Ohio where I lived with my loving parents, my sister and five brothers.  An ambulance rushed me to Toledo Hospital on the day that my legs refused to walk.  I was in an iron lung for a while then transferred to Children’s Hospital where I stayed for four months.  My left side was permanently damaged and weakened by polio.  In an effort to correct scoliosis, Dr. Fred Hawkins performed a spinal fusion when I was 13 years.  The surgery left me in a full body cast for a year and then braces and a wheelchair.  However, I taught myself to walk in private, without professional help.  While I was away at college I noticed the first signs of shortness of breath.  A doctor at the Cleveland Clinic diagnosed my condition as “anxiety” and prescribed the tranquilizer, Librium.  Several years later and several episodes of bronchitis later, I found myself in West Penn Hospital in Pittsburgh, PA with oxygen tubes wrapped around my face, painful tests for blood gases and EKGs.  I recovered with a strong determination to live in a climate with less extremes.

The temperate climate of San Diego, CA was perfect for easier breathing.  My husband, Steve, and I left our families in the East and moved to the West coast to start our own family.  However, at 24 I developed complications during my pregnancy and the local medical establishment shunned my condition as “too risky.”  Fortunately, I met Dr. Moser who welcomed me with his expertise.

Unlike many doctors today, Dr. Moser was very familiar with polio.  His wealth of knowledge and gentle positive attitude emanated hope.  He explained the physiology of my condition with words I could understand along with words that were easy to hear.  The weakened muscles on the left side of my chest gave way to severe scoliosis, thereby compressing my lung and reducing its capacity.  The inflexibility of my rib cage combined with my weak chest muscles only compounded my breathing difficulty. And, in order to expand my lungs, I used extra effort.  In simplified terms, Dr. Moser proposed a treatment plan for the best breathing possible with my limited capacity.

 Although I don’t have asthma, Dr. Moser prescribed bronchial dilator medications when I was in my mid-20s.  At the same time, I learned breathing exercises with the focus on deep, slow breaths that I continue to do 10 to 15 minutes twice a day.  I also acquired an ultrasonic nebulizer (USN) that I use with a saline solution two times a day.  The USN treatment is followed by postural drainage and “tapping” on four sides.  Steve learned the “art of tapping” from a Respiratory Therapist.  Dr. Moser explained that the purpose of the USN is to keep my lungs clean and clear of secretions to reduce the risk of infections.  He explained further that the mechanics of my breathing caused more than the usual amount of bronchial secretions which are a breeding ground for bacteria.  The USN thins the secretions and makes it easier to clear my lungs with my reduced ability to cough.  I’m able to breathe more efficiently with the least amount of congestion.  These exercises are a part of my routine twice a day. When more sophisticated bronchial inhalers came on the market, Dr. Moser added them to my daily repertoire.

I enjoyed 10 years of easy breathing before polio found its way to me … again as Post Polio Syndrome (PPS).  With the gradual onset of PPS, Dr. Moser increased or changed some of the bronchial dilator medications.  He also found that some inhalers required more frequency, and new or different combinations, to make my breathing easier.

I became Dr. Moser’s “student” and gradually learned the intricacies of my own pulmonary function.  Extensive testing revealed that I had the most difficulty breathing IN rather than exhaling.  Every episode of bronchitis was treated quickly and aggressively.  Fortunately, I’ve never had to use a ventilator.

While Dr. Kenneth Moser pioneered the surgical removal of blood clots from the lung and was a world renowned leader in pulmonary medicine, he continued to follow my condition for many years.  Although he had to discontinue his private practice, I was fortunate to benefit from his expertise as his patient until 1993.  Dr. Moser consulted with my doctors even when he was recovering from heart surgery and later, fighting lung cancer.  He often commented to me or to his colleagues,  “There’s nothing about you that follows a textbook.”

On several occasions I related to Dr. Moser the frustration of trying to explain polio and its after-effects to doctors who are unfamiliar with it.  I shared many stories from fellow polio survivors whose lives were unnecessarily complicated by the medical profession.  I was especially appreciative of our unique relationship, as a patient and a friend, along with the rare opportunity to know a truly great man, Dr. Kenneth Moser.

Dr. Andrew L. Ries thoughtfully described Dr. Moser, “What set Dr. Moser apart was his concern for people … both the patients he cared for and the people he worked with.”  Before Dr. Moser passed away, I was thankful for the opportunity to express my deep gratitude, “I know my life has been fuller because of you and your excellent care.  I’m especially grateful to you … you made it possible for me to have the ‘best of life’.”

Pulmonary Medications: theophylline, albuterol, metaproterenol (inhaler), triamcinolone (inhaler), salmeterol (inhaler).

Mary Clare Schlesinger
DOB  1949

Height  4 ft. 11 in.(150 cm)
Weight  90 lbs.(41 kg)

Dylan, my service dog
Curly Coated Retriever
DOB  1990

 

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