New York

Monday 12 May 2008

With so many taxi’s in New York City, you wouldn’t believe how difficult it was to flag one down at 8.00am this morning. The compounding problem was that it was really cold and starting to drizzle. The front desk had already told me that a private taxi they had called quoted a flat rate fee of $70 to take us 12 miles across the Hudson River to New Jersey. Apparently there is an $8.00 toll charge but that seemed like an obscene amount of money to me. By the time we finally did get a taxi to stop, I was chilled to the bone and when he quoted a $60 flat rate, I just agreed. Although I had a map, this driver was unfamiliar with the area and proceeded to get lost on a major freeway in peak hour traffic. It was not the best way start to the day but it does make a good story!

As a result, we were late arriving for our appointment with Dr Richard Bruno but thankfully so was he, due to a spectacle malfunction of some sort. Quoting from his bio, “Dr. Richard Bruno is a Clinical Psychophysiologist treating and studying mind/body problems, including chronic pain, fatigue and stress, as well as Post-Polio Sequelae (PPS).” (http://members.aol.com/harvestctr/pps/bios.html) Wikipedia explains that “While psychophysiology was a discipline off the mainstream of psychological and medical science prior to roughly the 1960 and 1970s, more recently, psychophysiology has found itself positioned at the intersection of psychological and medical science, and its popularity and importance have expanded commensurately with the realization of the inter-relatedness of mind and body.” Many people will be aware of his book, “The Polio Paradox” which works on this principle and has made a big difference in the lives and understanding of many polio survivors.

Dr Bruno has recently moved from a practice suite within Englewood Hospital to a modest clinic a bit further down the road. One of the reasons for this is so that patients don’t feel anxious by having to enter a hospital setting in the event of previous unpleasant memories. His clinic sees 4 new patients per week, 2 ‘local’ (up to 2 ½ hrs drive away) and 2 from everywhere else. He has treated many polio survivors from all over the world. During the initial assessment, Dr Bruno will see the patient for 1 hour, followed by other specialists including a medical doctor, physical therapist, orthotist, dietitian, occupational therapist, and orthopedist.

Dr Bruno’s main focus is on assisting the patient with ‘reprogramming’ the habits of a lifetime from overworking/overachieving to regulating their pace to match their energy capacity. He likened the people he sees who present with PPS as “driving a car on an empty tank”. We also talked about the need for people to eat a proper diet and ensure they get enough protein to strengthen the muscle – especially in the morning. Dr Bruno cited the case of one patient whose energy levels made a dramatic improvement in a short period of time due to eating a solid, protein rich breakfast in the morning. “It’s not rocket science”, he said. However, it can’t be denied that there is a science involved in working with people to achieve their goals of stopping the incremental deterioration of muscle function and increase energy levels. For more than 20 years, Dr Bruno has developed that science and has been responsible for countless successful outcomes.

Dr Bruno is also big on keeping the immunization message on the national agenda and, in response to one of his initiatives, “Actiononline”, the Journal of the United Spinal Association, printed the following information earlier this year:

“The Centers for Disease Control has reported that 92% percent of US toddlers are vaccinated against polio. Ninety-two percent sounds good, until you realize that leaves more than one million US children unvaccinated. Between 2005 and 2006, polio vaccination dropped in 20 states and in 10 large cities. While any reductions in polio vaccination are troubling, the location of the cities and states where vaccination dropped is frightening. The cities are major points of entry into the US—New York, Philadelphia, Houston, and Seattle—where a nearly 4% drop was reported. It’s no surprise that toddlers living in poverty have the lowest polio vaccination rates—below 87% in Boston, Indianapolis, Memphis, Phoenix, Detroit, Houston, and Seattle—rates lower than in Vietnam.

Equally frightening, the states with drops in vaccination are on our borders with Mexico and Canada. Arizona, Texas, and New Mexico reported polio vaccination reductions as did 70% of the states that border Canada. Even Minnesota had a decrease, which is both frightening and incomprehensible, since five Minnesota children caught polio in 2005 after coming in contact with someone who imported the poliovirus across the US border.

Polio’s recent importation into America and the drops in vaccination have prompted the International Polio Task Force [headed by Dr Richard Bruno] to create 2008 “The National Immunization for Polio Prevention in Infants and Toddlers”—or “NIPP IT”—Campaign.

“NIPP IT” aims to “nip in the bud” America’s next polio epidemic by asking each state’s department of health to declare April 19-26 (also National Immunization Week) “NIPP IT Week,” to prompt parents, health care professionals, and state health officials to ensure that all American children receive four doses of the injectable, inactivated polio vaccine. The NIPP IT Campaign was launched in partnership with “Every Child by Two” (ECBT.org), the organization co-founded by former First Lady Rosalynn Carter to promote immunization of all children by age two.”

Dr Bruno and I went on to discuss the concept that government and funding bodies have the idea that PPS will not be an issue for very much longer due to the age demographic of polio survivors. However, he provided statistics of the numbers of Americans who were still contracting polio years after the vaccine had been introduced in 1955. Population-adjusted numbers also hold true for Australia which means there are many Western polio survivors who are still only in their 40’s and, therefore, have a lot more living to do. We also need to think about the people in countries where polio is still prevalent, or have only more recently become ‘polio free’ (how long this remains the case is in direct proportion to how scrupulously the immunization rate is kept up).

All in all, it was an interesting discussion, and Dr Bruno and I concluded with the idea of possibly collaborating with Rotary International to distribute promotional material via their members to raise awareness of PPS in the community. We also realize that Rotarians often suffer from ‘polio fatigue’ due to all the work they have done through the years with the Polio Eradication Program. However, we both believe there are many, many more polio survivors experiencing PPS than those who have known how and where to seek advice, so public awareness campaigns are still required.

We left Dr Bruno to see his patient, who had been waiting patiently while I packed up the video recorder and took a couple of photos. It was raining fairly steadily and Jill and I decided to look for lunch before figuring out how to get back to Manhattan. In the end, convenience won out and I decided we should get a taxi. Now, this was almost as difficult as the morning but only because there were NO taxis on the street. Jill finally went into a travel agency who took pity on our bedraggled selves and rang one for us. Guess how much to get back? $60.00! Must be a magic number. So, I ended up $120.00 poorer in the purse, but considerably richer for the experience.

Early to bed tonight (didn’t manage it last night) and off in search of some sights tomorrow. You’d think there must be something around this town to look at, eh? Hopefully, the weather will clear up a bit for it . . .