"For years I had always had a bad leg and if I fell, I would have to crawl over to something so I could pull myself up. Once, I fell crossing Dodge Street in Omaha. I couldn't get up so I had to crawl to the sidewalk and pull myself up by the light pole."

Ehlers paused long enough for the hearer to get a mental picture of this dignified woman crawling across a city street on her hands and knees.

Smiling even wider, she continued, "And the light pole was right in front of a bar."

The obvious conclusion followed that she appeared to have over-indulged. Although Ehlers can tell the incident with self-depreciating humor, her falling was a result of having had polio in 1952. The effects of that disease have manifested themselves again, long after her initial recovery.

Ehlers was a young woman, teaching at a country school when polio struck.

"I hadn't been feeling well all week, and on Friday afternoon, we went for a walk through somebody's pasture. All of a sudden, I could hardly get up the hill to return to the school. It was not the flu, it was polio. I never made the connection between falling and having had polio because I never was paralyzed."

Post-Polio Syndrome symptoms affect about 80 percent of those who have had polio. The original disease damaged motor neurons, causing muscles to fail, necessitating the use of the braces, crutches and iron lungs that were so prevalent among those who suffered from polio. In later years, those same motor neurons can stop working entirely, again causing paralysis, leaving the individual frustrated and confused about what is happening to her/his body. Common sense and the "use it or lose it" mantra of exercise therapy can make a post-polio patient begin a regimen of strengthening exercises that are the worst possible cure for post polio syndrome.

Polio survivors have been known to beat up their neurons to the point where they stop working. And getting them back after that is a real struggle.

"I have learned to conserve to preserve," Ehlers says.

Not all polio survivors have Post-Polio Syndrome, and not all who have PPS have the same symptoms. Some of the more common symptoms of Post-Polio Syndrome are:

* Extreme Fatigue

* Night Pains

* Frequent Falls

* Difficulty Swallowing

* Difficulty Breathing

"In 1995, I saw an article written by Dr. Kip Burkman, director of rehabilitation services at Immanuel Medical Center, about PPS and asked my doctor to make an appointment with him for an evaluation. I was put through a series of physical tests in order to have the diagnosis made. That's when I learned that you need to conserve your muscles because you will continue to lose strength."

As former polio patients age, the neurons damaged 50 years ago, become less effective. Exercises, other than in a heated pool can further damage fragile neurons. Ehlers drove three times a week to Immanuel Medical Center in Omaha for one year to exercise in their heated pool before Fremont Area Medical Center made one available for out-patient use.

"Fortunately, they have a pool maintenance group that meets twice a week and is affordable for those who qualify for treatment. I am so thankful for that. Before I knew I had PPS, I decided to enroll in an exercise program at FAMC. I was losing strength and feared losing mobility. When I went to enroll in this arthritis exercise program, I was told that arthritis exercises are the worst possible regimen for PPS."

Anesthesia is a risk to people who have had polio because of their increased sensitivity to the motor relaxants commonly used during surgery. Post-polio patients have found that use of these drugs can cause severe muscle pain after surgery or can result in paralysis. Sleep apnea may worsen after anesthesia and patients may be at risk for vomiting as anesthesia begins. Polio survivors contemplating surgery should inform their anesthesiologist that they have had polio so that appropriate precautions may be taken.

The most common triggers for the pain associated with PPS are physical over-activity, exercise, cold exposure, emotional stress, anxiety and type A behavior. The simplest way to prevent the pain spasms is not to overdo, to stay warm and to relax. Many polio survivors are back on breathing machines and in wheelchairs due to PPS. Those who once defeated polio must be aware of the consequences of overuse of those muscles affected by the disease. Ehlers attended a support group for polio survivors.

"It was an eye-opener to see how this disease has affected sufferers of polio. Some people even came on gurneys because this disease has progressed to that stage. I feel blessed that my symptoms are not more severe."

Ehlers paused, then smiled again.

"I was engaged to John (Ehlers) when I had polio. I am so grateful that he is willing to do many household tasks because I have little strength left in my hands," she grins wider - "besides, he is a good cook."

For more information about Post Polio Syndrome, contact Nebraska Polio Survivors Association, P. O. 45139, Omaha, NE 68145-0139.