he Post-Polio Clinic at the Montreal Neurological Institute and Hospital is the only clinic of its kind in Canada. If you call to make an appointment, it is therefore possible that you will have to wait a few months before being able to meet one of the specialists. In order to help you determine whether or not it is beneficial for you to make an appointment at the Post-Polio Clinic, we asked a few questions to ^Dr.  Daria A. Trojan, physiatrist and director of the Clinic, who agreed to answer it.

Who should consult at the Post-Polio Clinic of the Montreal Neurological Institute and Hospital? 

Dr. ^Trojan  :  Anyone who has had polio can come to the Post-Polio Clinic with a referral from a doctor, preferably their family doctor.

Although the majority of patients come to the Post-Polio Clinic because they have new problems related to the initial polio, there is no need to wait for physical condition to deteriorate. Patients come here for an assessment of their difficulties and to learn how to better cope with their symptoms. If they have no new symptoms but have weaknesses stemming from their initial polio, we can also assess them and recommend preventive measures that match their needs.

Is it important for people who have had polio to go to the Post-Polio Clinic or can they manage their symptoms without going?

Dr. ^Trojan  : This is a personal decision that can be discussed with the family doctor. If there are new difficulties related to the initial polio, it is recommended to have an evaluation by a doctor and not to do self-diagnosis. The main symptoms of post-polio syndrome (new weakness, fatigue, and pain) can be due to many other conditions and not necessarily PPS. Fatigue, for example, is very common even in the general population and can be due to a series of causes, such as anemia, thyroid problems, obstructive sleep apnea-hypopnea, etc. Since there is no specific diagnostic test for PPS, any new symptoms require evaluation for potential causes, some of which may be treatable.

What should we expect when making a first appointment at the Post-Polio Clinic?

Dr. ^Trojan  :  During the first appointment, the patient is first assessed by one of the clinic's two physicians. The doctor usually asks for certain tests to be done, such as blood tests (which can be done the same day at the Montreal Neurological Hospital), X-rays, CT or MRI (magnetic resonance) scans, pulmonary function tests, electromyograms, sleep studies, or bone densitometry evaluations.

Patients may need only one or a few of these tests. Most of the tests mentioned (except blood tests) are done at different times, and many of them can be done in the area where the patient lives, especially if the patient lives far from the Clinic. Patients may also be referred, as needed, to other specialists or health care professionals, including specialists in lungs, sleep, endocrinology, orthopedics, rheumatology, psychology, dietetics, orthotics, or to social workers. These consultations will not necessarily take place on the same day as your first appointment at the Clinic.

Many patients will also be referred to physiotherapy or occupational therapy during their first visit. Patients can also be referred to resources outside the hospital, such as their CLSC or a local rehabilitation center.

For patients living in the regions, can a single appointment help them or do they have to come back to Montreal several times to be treated?

Dr. ^Trojan  :  We believe that a single appointment may be sufficient for an initial consultation. We see most patients every 6 to 12 months depending on the evolution of their situation.

In the case of people who live outside Montreal, we can issue recommendations to their family doctor. These patients can also return, if they wish. Currently, patients from Jonquière and Quebec meet with us on an annual basis.