Finding
Severely disabled patients require short periods in hospital for treatment and to give their relatives a rest.
Paper
Poliomyelitis Vaccines This Year
Abstract
sores. Bladder care is particularly important in the late stages of the illness; infection should be dealt with swiftly and resection at the bladder neck may be necessary if cystoscopy shows a bar. Male patients suffering from incontinence can obtain a portable urinal strapped to the thigh. Factors such as trauma and infection may affect the course of the disease adversely."2 Trivial febrile illnesses and minor trauma should be treated with care; ataxic patients should be careful to avoid falls and for this reason should be encouraged to carry sticks and use other walking-aids. The relapse rate is reported not to increase after surgical operations1 12 or during pregnancy."2-4 J. H. D. Millar' found an increase in relapses in the puerperium, but when the material was reviewed ten years later the clinical status of married women with children was no worse than that of single and married women without children. It would appear that when the disease is active and unstable, as in the early years, a relapse is more likely in the puerperium, but it becomes less so in the chronic phase of the illness. It seems desirable, if possible, to restrict pregnancy to a period of remission, ideally two years after a relapse. Disseminated sclerosis as such is not a reason for necessarily advising termination of pregnancy, but a pregnant patient should rest as much as possible during the last months of pregnancy and the puerperium. There is a great need for trained social workers to advise and visit patients at regular intervals. It is surprising how few are aware that they are entitled to wheel-chairs and other benefits. A patient's comfort can be considerably increased by simple gadgets and aids in the home. Day centres for occupational therapy, physiotherapy, and social and recreational purposes would be ideal for the severely disabled who are unable to work or care for themselves; and possibly these centres could rehabilitate other patients and train them for suitable occupations. Severely disabled patients require short periods in hospital for treatment and to give their relatives a rest.
Authors
Journal
British Medical Journal