Being Cold
Original Post: Go figure. . . it is a warm 70 degrees today and my feet and legs are still so very cold. If this was spring or summer I would not have the terrible coldness. Do my feet and legs know that it is December? I am a great fan of the heating pad - sitting with my feet in the heating pad bag day and night! They get so cold it is such a distraction. I REALLY don’t like this. Anyone else?
Dr. Bruno’s Response: The problem is that it's already been chilly and your body told your blood vessels that it's winter. As a result, your arteries stay constricted and prevent the blood from flowing back to your heart, allowing it to dump your core body heat and make your legs cold. This has probably been the worst fall in years for polio survivors. The temperature is 32 when you get up and 62 by 4 o'clock! Hey, weather ! Please make up your mind!
PPS IS A DIAGNOSIS OF EXCLUSION. PPS - even cold “polio feet” - are always a Diagnosis of Exclusion.
If you are feeling unusually cold it’s a good idea to see your primary care doc. He/she will probably prescribe general bloodwork that includes thyroid tests (TSH, T4). In addition, if you have new or increased cold or pain in your legs or feet, it’s probably a good idea to see a vascular specialist for a Doppler venous study and an arterial ABI. Those tests will make sure your arteries and veins are "open for business."
Additional Post: Both of my legs are driving me batty with feeling cold. It's worse if I've been on my feet a bit more than I should. Once I've started dressing for winter, I keep dressing for winter, even if it gets a little warmer. I think it takes at least 2 days for our brains to figure out and adjust to temp change.
Dr. Bruno’s 2nd Response: I never actually measured the time, but I'd say that it takes at least five days of a consistent temperature for the body of a polio survivor to adjust. You know, any extreme in temperature isn't good for polio survivors.
From our 1985 National Survey, 33% of polio survivors report fatigue with heat! The brain's thermostat (the hypothalamus) is broken by the poliovirus on the up side as well as the down. You have two quick ways to dump body heat (vasodilation then sweating) and to conserve body heat (vasoconstriction then shivering). Dumping heat is much more effective than trying to stop becoming frozen.
Consider a desert dry 80 degrees F outside as a "normal" temperature. Polio survivors will be much more comfortable without sweating (and maybe without much vasodilatation) at 100 dry degrees than at 60 (the temperature (it seems) of most restaurants all year long.
So 20 degrees colder is more difficult for polio survivors to deal with than 20 degrees warmer.
Take a look at the articles in the Encyclopedia of Polio and PPS under the topic “Temperature”.