March 26, 2015

Arthritis + Stroke = Modified Joint Protection

Five years ago an x-ray showed early signs of arthritis in my sound thumb.  I did not worry about it until this thumb started to ache.  I have overused my sound hand for 11 years and need it to last for another 20 years.  Below are examples of joint protection principles for the thumbs of stroke survivors.  I had to modify these principles which were written for two-handed people with arthritis.

1. Use Stronger Joints.  Pouring from a full milk container forces me to squeeze the sides of the container tightly so it will not slip out of my hand.  Squeezing tightly makes my thumb ache.  So I pour milk two-handed.  The arrow is pointing at my hemiplegic (paralyzed) hand.  The muscles of my hemiplegic shoulder, elbow, and wrist are doing the heavy lifting while my sound hand makes sure the spout is aimed correctly.  I appreciate not feeling pain every morning when I prepare cereal for breakfast.

2.  Minimize Force.  I cannot swallow pills with liquids so every day I open a container of yogurt.  Manufacturers put strong glue on the lid to maintain a tight seal.  Opening the lid makes my thumb ache because I have to grip the tab so tightly.  My hemiplegic thumb cannot help my sound thumb on this task.  I reduce the force I exert by wearing a rubber finger cot
used for counting money.  Greater traction means my thumb can pinch less forcefully.
I cannot avoid using my sound thumb to open the top of a sock to get it on my foot. The photo on the left shows my thumb and index finger stretched far apart.  This makes my thumb ache.  Now I open the sock barely enough to get the sock over my toes.  Other fingers do the hard work of pulling the sock up the rest of the way.

3.  Avoid Static Positions.  Holding a book for a long time with my sound hand makes my thumb ache. So I place my Actto bookrest on a laptop desk covered with non-slip shelf liner.  An arrow in the photo points at a clear colored tab that adjusts the angle (i.e. more vertical or more horizontal).  With the bookrest sitting on my laptop desk I can reach behind and easily release and reclamp this tab with one hand.

The photo on the right has an arrow pointing at a clear colored plastic arm that holds the book open.  There is enough friction to fight the weight of the open book but I can easily reposition the plastic arms (e.g. far out for a big book and close in for a thin book).  I have loved to read all my life so I am glad an assistive device lets me enjoy this activity without pain.

March 3, 2015

Frustrated by a Right Handed World

I was right-handed until a stroke paralyzed my right side.  Now that my left hand is my dominant hand I've learned the world discriminates against left-handed people.  Switching hand dominance at 58 years old was an eye opener.  The aggravation goes beyond right-handed (1) scissors and (2) can openers.  (3) The shutter button on cameras is always on the right.  When I hold a camera with my left hand a finger often covers the lens when my index finger depresses the shutter button.  (4) Computer labs make sure there is room to maneuver a mouse on the right side, but don't always leave room on the left.  (5)  Left-handed drivers have to reach around or through the steering wheel to put the key in the ignition which is always on the right.  (6) Many credit card machines put the slot you swipe your card through on the right side.  When the slot is on the top, left-handed people have to push the card away from their dominant side unless the card can be swiped in either direction.  The plastic stylus you sign with is frequently attached to the right side with a very short cord.

(7)  Before my stroke my right hand used to close a jar by turning the lid clockwise and the back of my fingers used to get closer to my forearm (see photo on left).  Now that I use my left hand to turn the lid it's my thumb that gets closer to my forearm.  This new wrist position doesn't match 50 years of muscle memory.  It took me three years to stop making a lid tighter when I wanted to loosen it.

Left handers I've talked to say they solve these problems by using their right hand.  The only advantage left-handed people have is the QWERTY layout of a keyboard.  You can type thousands of words on the left side of the keyboard with the the left hand but can type only a few hundred words on the right side with the right hand (Wikipedia.org).  (8) Deciding which hand to write with is only the beginning.  Left-handed people have to decide which hand to use until the day they die.