May 24, 2020

Bathing Can Be Exhausting

As an OT I did not know how tiring a.m. care is because I never watched a stroke survivor do one task after.  Here is why bathing leaves me feeling refreshed instead of exhausted and frustrated.

Washing.  I do not struggle to soap up a washcloth one-handed or chase a bar of soap after I drop it.  I pour shower gel on a nylon poof and knead it a few times to get it soapy.  To wash my sound arm, I use a gross grasp in my affected hand to hold the nylon poof.  I do not struggle to wring out a washcloth one-handed.  I hang the nylon poof on a suction-cup hook, hose it down, and let it air dry.  I use shampoo suds to wash my face.

I press down on the nylon poof that is resting on my thighs to squeeze out suds so my sound hand can soap up my crotch.  Before I could hold the shower hose with my hemiplegic hand,
I used my forearm to press the shower hose against my stomach to rinse my crotch.  Water runs downhill.  This freed my sound hand to deal with the nooks and crannies.  If my husband was alive I would still want to bathe this private part of my body.

Drying.  My towel rack is next to the shower so I can reach it while sitting on my shower chair.  I drape the towel over one shoulder while I dry my arms and trunk.  When I get out of the shower I stand to dry my crotch with the towel draped over my shoulder.  My shoulder carries the weight of the towel so it is easy for my sound hand to manipulate the free end.  I never hold up my affected leg to dry it.  I don a terrycloth bathrobe which dries my buttocks and thighs.  I let my calves air dry while I brush my teeth and comb my hair.

Dressing.  For the 1st year after my stroke, dressing was easier if I rested after bathing.  I laid on the bed in my bathrobe with a towel under my wet hair and listened to music on the radio.

May 17, 2020

How I Escape from Covid-19

I have been reading e-books on Hoopla to pass the time while sitting at home during the covid-19 pandemic.  I recently reread My Antonia by Willa Cather.  This book brought back fond childhood memories of my father driving across Illinois and Iowa to visit my grandparents before there were interstate highways.  State highways built before World War II wove through miles of wheat fields that moved in the wind like ocean swells.  When we came to an intersection we could see cars for miles in all directions because the land is so flat.  One of Cather's characters described the land this way - "I wanted to walk straight through the red grass and over the edge of the world which
could not be far away."

When I moved east to New Jersey I freaked out for years when I drove on narrow state and county roads with sharp curves.  Not being able to see on-coming traffic around a bend was unnerving.  For years I also missed seeing the horizon at sunset.  I have gotten used to the closed-in landscape of the densely populated east coast, but the open vistas of the middle-west still thrill me.

I am grateful that a stunning writer who won a Pulitzer Prize helped me reconnect home with
happy memories.

May 10, 2020

Covid-19 Made Me Smarter

Currently over 4,700 covid-19 deaths in New Jersey have occured in long-term-care facilities so
I am very motivated to do what it takes to stay in my home.  For example, my cleaning lady has not come for 6 weeks because of the pandemic.  When I smelled dust and started to sneeze I felt compelled to try vacuuming until it is safe for Isabel to be in my home for two hours.

I vacuumed years ago so I already knew 2 tricks.  (1) Vacuuming is exhausting because it requires stepping forwards and backwards abruptly a hundred times so I vacuum only one room a day.
(2)  I knew tripping on the cord was a huge fall hazard.  Thankfully I can hold the cord out of my way.  I rest the cord in my partially curled hemiplegic fingers and use shoulder abduction to hold the cord away from my body.

I discovered 2 new tricks to make vacuuming easier.  (3)  I do not step forwards and backwards.
I stand still and move the vacuum forward and backwards only one arm's length.  Then I take two steps sideways to clean a two-vacuum wide path before moving forward.  Most of my falls have happened when I step backwards but I feel stable when I step sideways.  (4)  Instead of vacuuming in parallel rows the way people cut grass, I start by vacuuming around the perimeter of the room and gradually work towards the center.  Making 90 degree turns is easier than 180 degree turns.

May 2, 2020

Another Happy Accident

I love my kitchen garbage can except for 1 thing.   As it gets full, the weight of the garbage pulls the liner down.  The notch (see arrow) does not keep the liner in place.  Garbage can get caught between the liner and the can - yuk. 

Recently I saw 2 metal clips resting on my counter that I forgot to put away.  I thought the clips might hold the liner in place.  Voila - the tiny black clips next to the hinge do the job.  I am so happy.  Serendipity saved me again.  Having a master's degree in OT is not enough.

I had to do in-store shopping to find a kitchen garbage can I can use.  I discovered I cannot use a garbage can that opens by stepping on a pedal.  This mechanism requires me to slowly step on the pedal so the lid does not fly open.  My balance is not good enough to do this.  I learned garbage cans with openings in the lid that swing open when touched are small so the edges can get spattered with food - another yuk.

A model made by Hefty has a lid that hangs over the side (see arrows).  I lift the lid with the back of my hemiplegic fist so my sound hand is free to dump the garbage.

April 28, 2020

Reading One-Handed

After my stroke I still enjoy reading, but holding a book one-handed is tiring and frustrating.
I am glad I found a book holder that works for every size book.  The clear plastic page holders (see black arrow) move in and out so they adjust to thin and thick books.

The easel arm is also adjustable.  I release the lock (white arrow) and tilt the book holder so it is more horizontal or more vertical.  This gives me a good reading angle regardless of the size of the book or the resting surface I am using.

I found this Actto book holder at amazon.

April 19, 2020

Working Smarter Instead of Harder

Struggling to control half of my body is exhausting.  I do not need additional fatigue caused by frustration that a stroke can create every day until I die.

I get reader's fatigue when I read my long procedural posts like "Bathing Can Be Exhausting,"
"I Am the Queen of Velcro," "Applying Make-up One-handed," and "Things You Don't Learn in Driving Rehab."  However, modifying 1 or 2 steps makes life easier which encourages me to get rid of more frustration.  A gradual accumulation of solutions produces these long procedural posts.  The good news is repetition turns long adapted procedures into a routine I do not have to think about.  Repetition is a gift that keeps on giving.

April 10, 2020

Eyedrops After Cataract Surgery

People who do not have someone to put drops in their eyes four times a day need help.  Task modification helped me succeed after my recent cataract surgery.  It is easy to drop a tiny 5 ml bottle.  It is also difficult to squeeze the stiff sides of a tiny bottle.  I am glad I found the Autosqueeze Eye Drop Bottle.  The big wings are easy to hold and require only a gentle squeeze.

Before I lie down on my bed I gather two bottles of eye drops and a Kleenex tissue.  I put a pillow on my chest (not stomach) and put my sound elbow on the pillow.  This support makes my hand remain steady instead of bobbing around as I hold the bottle in the air.  To stop myself from blinking I distract myself by looking through the opening formed by my thumb and index finger instead of the bottle.  I try to get the drop in the inner corner of my eye.

When I put the cap back on I need to stop my hand from bobbing up and down and accidentally touching the tip of the bottle.  I keep my hand still by pressing my elbow firmly against the pillow.

April 3, 2020

Tiny Habits

Fogg explains how I make my life easier after a stroke (1).  He says Behavior = Motivation + Ability
+ Prompt (MAP).  Motivation is unreliable because it comes in waves that vary from day to day, morning to evening, and even minute to minute.  Motivation also fails because it is usually attached to outcomes like save $500.  An outcome is not a behavior I promise to do.  Finally, motivation can be highjacked by the "go big or go home" philosophy.  Fogg says motivation is more effective when it is linked to a tiny behavior - like straightening my shoulders one time when I stand up after sitting for awhile.

A is for ability which is how much skill the task requires.  Stroke survivors and caregivers can find ways to make a task easier by reading blogs and books written by stroke survivors (see About Me page and my Blog List on the right side bar).  Although I am an OT sometimes I need help solving a problem.  However, an OT or PT evaluation never identifies all my concerns.  I start every new round of therapy by walking in the door with a list of problems I want them to solve.

P is for prompt.  Prompts like to-do lists and calendar alerts on my iphone are SO easy to ignore.  Fogg and I believe in the power of established routines to trigger a new behavior.  The tricky part of using an established behavior to prompt a new behavior is finding what Fogg calls the trailing edge of an old behavior.  For example, I kept forgetting to put drops in my eye after eating breakfast.
I did not succeed until I discovered the last thing I do after breakfast is rinse my cereal bowl.
Now I rinse the bowl and think about using eyedrops to rinse my eye after my recent cataract surgery.  "After breakfast" was too vague.

1.  Fogg BJ.  Tiny Habits.  New York: Houghton Mifflin Harcourt; 2020.

March 28, 2020

The Only Cutting Board That Works Great

I had a 2nd stroke so I got serious about a low salt diet.  Unfortunately, food does not have much flavor without salt so I started adding aromatics like onions.  The standard cutting board for one-handed people shown on the right is not that helpful.  Impaling food on 1 nail allows the food to swivel.  Two raised edges on the left back corner holds food still ONLY if you push the knife towards the corner.  Food like peanut butter gets smeared on the raised edge.

A cutting board that works much better is the Swedish cutting Board (1). The part I use the most is the adjustable vise (see red knob) that can be taken apart to be washed.  The vise makes it easy to spread food on bread and slice a thin English muffin, a soft tomato, or a whole head of lettuce.  Instead of 2 nails, I impale meat on 9 prongs.  This small section lifts out of the cutting board so I can put it in the dishwasher.  See the empty space in Figure 7.8 below.

For safety I cut food by using my palm to push down on a large chef's knife.  This lets me keep the ends of my paralyzed fingers away from the blade (see arrow in Figure 7.8). 

This cutting board is more expensive than a regular board but I think it is worth every penny. It makes food preparation safer, faster, and less frustrating.

1. Dutton, R. My Last Degree: A Therapist Goes Home After a Stroke, 2nd ed. 2013; Booklocker.

March 15, 2020

So I Was Not Just Paranoid

A National Institutes of Health study found the corona virus can live on cardboard for 24 hours and 2 to 3 days on plastic and stainless steel (1).  I have not heard anyone sneeze or cough in public since the coronana virus surfaced yet it took only days to travel 50 miles to reach my area.  Money that changes hands many times and people who touch items as they unpack cartons at stores are possible vectors for this rapid spread.  Shopping while wearing a glove on my sound hand and using a credit card instead of cash (see previous post) was not just paranoia.  Thank God I rehearsed before the virus came to my area because initially I made mistakes.  For example, I grabbed the handle of my car door with the glove I had pushed the shopping cart still on my hand.

Now before I open my car door I turn the glove inside out.  Then I put it in a plastic cup in my car door.  I use a tissue sitting on the passenger seat to remove the foam from my hemiplegic thumb and put it in an isolated container.

The weather got warm so I can no longer put my credit card in my coat pocket to keep from digging through my purse for it.  I put the card in a tiny purse (see arrow) and hung it from my big purse.  The tiny purse has a velcro closure which is easy to open one-handed.  It hangs in front of my stomach where it is harder for someone to open it without me noticing.