May 26, 2016

Going to the Bathroom at Night

A friend who works with the elderly who live at home told me many of the falls she see happen when elderly people go to the bathroom at night.  To keep me safe my OT suggested that I use a bedside commode at night.   Since I live alone I think it would be dangerous for me to drag the bucket to the toilet to empty it in the morning.  My fall in the bathroom happened a few days after I got home from rehab.  The big toe on my hemiplegic foot is now crooked because I tore ligaments.  
 
Thank goodness I learned how to go to the bathroom safely at night when I am not wearing my brace.  After my 2nd stroke I went home with a walker which made me feel safer than a cane.  I progressed to walking with a quad cane with 4 feet during the day, but still used the walker in the bathroom at night.  I did not mind that the walker slowed me down because I was half awake when I got up at night anyway.  I progressed to a single point cane during the day, but I still used the quad cane at night to get to the bathroom.  I currently use a light single point cane during the day that I bought at a medical supply store.  This lighter cane is less tiring to carry when I walk in the community.  However, the heavier single point cane I got in rehab makes me feel safer in the bathroom at night.  I keep that heavier cane next to my bed so it is within reach as soon as I sit up on the edge of the bed.

Bottom Line: I keep every walking aid I buy so I can use the more conservative device at night. 
I do not want to have an injury that would put me in a wheelchair.  Pushing a wheelchair with one arm and one leg on linoleum in wide halls in the hospital is hard.  I do not want to find out how hard it is to push a wheelchair on carpeting in my home.  I also do not want to end up in a long-term care facility because a fall does something much worse than break a big toe.

May 17, 2016

Getting Hand Use Earlier than Stroke Survivors Think is Possible

Current hand tests begin by asking clients to pick up small objects from a table.  If hand-to-hand transfers were added to adult hand tests, stroke survivors would see that their hemiplegic (paralyzed) hand can be useful earlier than they think is possible.  After an electrical stimulation device called NeuroMove helped me regain a little finger extension, I learned that those small movements done close to the body can make a hand functional.  If you pick up an object with your sound hand and open your hemiplegic hand 2-3 inches to receive the object from your sound hand
you may be able to do the tasks shown below.  This simple skill allows me to do 18 ADL tasks.  
 
Example #1- Using a shower hose to spray water at the crotch does not take care of the nooks and crannies.  After a hand-to-hand transfer, my hemiplegic hand holds the shower hose close to my body which frees my sound hand to do its job.  This little bit of hand movement means my mother, a nurse's aide in the Intensive Care Unit, and I are the only people who have washed my bottom.  Having my privacy invaded in such a personal way taught me to be grateful for hand-to-hand transfers.  
Example # 2 - When my hand was flaccid, I used to squeeze a deodorant bottle between my thighs so my sound hand could remove the cap.  Now my hemiplegic hand can open to receive a deodorant bottle from my sound hand during a hand-to-hand transfer and hold the bottle still while it is resting on my thigh.  The two black lines show how little shoulder movement is needed when ADLs are done close to the body.

Example # 3 -  There used to be teeth marks on the cap of my toothpaste tube.  Now my hemiplegic hand can open to receive a tube of toothpaste from my sound hand which then removes the cap.  The end of the tube is propped against my stomach because this new tube is heavy.  I do not want to drop the tube and splatter sticky toothpaste on the floor.  I live alone so I have to clean up every mess I make.
 

May 4, 2016

Grateful My PT Taught Me to Squat

I did NOT do this
I am glad my in-patient PT made me squat while reaching down with my sound hand to pick up plastic cones sitting on a low stool and place the cones on a shelf at head height.  She did NOT have me squat deeply like the body builder in the photo.  She had me
do a partial squat while leaning over to reach close to the floor. 

At first I loved squats because I felt safer when both feet were on the floor than when I had to repeatedly stand on one foot while walking.  When I learned how useful squats are I asked my PT to let me do them every day.  The list below shows the value of this basic skill I took for granted as an able-bodied person.  I have used this skill thousands of times in the 12 years since my stroke.
NOTE: Reaching for objects overhead is dangerous when I drop the objects on my head.

  A partial squat makes me more stable when I lean down to:
* Pull up my underwear up after toileting
* Pick up my cane after it has fallen on the floor for the thousandth time! 
* Get clothing out of the bottom drawer of the dresser
* Get shoes from the floor of the closet
* Get a milk carton sitting on the bottom shelf of the refrigerator
* Get a box of cereal from the bottom shelf of a kitchen cabinet
* Get a pot from the bottom shelf of a kitchen cabinet
* Place and remove dishes from the bottom rack of dishwasher
* Get a box of dishwashing detergent from under the sink
* Pull bed linen straight when making the bed
* Take a book from bottom of book shelf
* Plug a cord into a low electrical outlet 
* Pull clothes out of the dryer
* Fill a watering can with the garden hose
* Empty a waste basket
* Pickup a large bag of garbage I kicked down my stairs to put the bag in the garbage can
* Pick up purchases sitting in the trunk or on the floor of my car

May 1, 2016

Getting Out of the House Requires Rehearsal

Solving unexpected problems when I leave home is a buzz kill.  Now that I am a stroke survivor, community outings go much better if I check out the environment ahead of time.  If you cannot go on a trial run yourself, send a caregiver who can visualize solutions that will make your trip easier.  I am more confident and relaxed when I know I will not be startled by a nasty surprise. 

Here is an example of how rehearsal pays off.  I volunteered to sell raffle tickets for a fund raising event at my church.  I already knew how far handicapped parking is from the front door and how accessible the bathroom is.  The supplies I needed were stored downstairs where I could not get them.  I arrived early to: (1) see if there were barriers blocking access to where I would sit,
(2) give someone time to get the supplies for me, and (3) silently rehearse what I would say when people came to buy tickets.  Saying the same thing over and over made my word-finding problem disappear.  I enjoyed talking to people, ate a little food, listened to live music, and collected over $900 for my church.  Having fun and feeling useful are great antidotes to depression.