The Zipping Challenge is Not What You Think

Velcro tabs do not keep me warm.  When I sit in the car, gaps form between the Velcro tabs which lets body heat escape.  Connecting the two halves of the zipper are relatively easy.  My right affected hand only needs a gross grasp to hold the female end of the zipper still while my left sound hand inserts the male end in its slot.                                                                            Challenge #1.  Zipper teeth do not mesh together if they are not perfectly aligned.  Only my sound hand can keep the two sides of the zipper perfectly aligned after they are joined so I can zip my coat  (see next 2 photos). 

Arrows show my sound index finger pushing up on the bottom of my coat to keep the zipper joined.  My sound thumb and middle finger pinch the bottom of the coat to hold it still as I  zip.  My affected hand pulls on the fabric zipper tab (white rectangle).     

After I broke my forearm I lost the tip pinch needed to grasp the fabric tab on the end of the zipper.  I attached one end of a tiny carabiner in the hole of the metal zipper tab (S-biner, size 2 from Home Depot).          I insert my hemiplegic index finger in the other hole of the carabiner and pull the zipper up a few inches.  The top photo shows my current coat has a zipper ring so I no longer need a carabiner.

Challenge #2.  My affected hand can pull the zipper tab up only two inches.  Going higher forces my wrist to bend due to the flexion synergy.  After two inches I switch hand positions.  My affected palm presses against my stomach to keep the bottom of the coat still while my sound hand finishes the zipping.  I unhook the carabiner and put it in my coat pocket so it is not visible at front of my neck.  homeafterstroke.blogspot.com

How I Feel Less Guilty About Asking For Help

I live alone so I am both a stroke survivor and a caregiver.   I use 7 strategies to keep my volunteers from burning out (18 years) and feel less guilty about asking for help.

1. Prioritize.  I cut down the number of requests by identifying what I need versus what I want.  I need someone to get on a ladder to change the batteries in my smoke detectors.

2. Build trust.  People do not need special training to know they are being taken advantage of.  When I ask for help I let my volunteers know I do everything I can before I contact them.  People feel good about helping when they know they are really needed.  This strategy builds trust.

3. My husband would groan rule.  I cannot ask people to do things that would make a husband groan.  I cannot ask someone to buy a live tree, transport it, drag it into my house, use an ax to trim the base so the tree fits in the stand, and tighten and loosen the tree stand to reposition the tree until it is straight.  So I bought an artificial tree.  John takes it out of the box and snaps the four pieces together.

4. Let them choose WHAT to volunteer for.  I e-mail a request and let people choose things they want to do.  Peggy who loves to sews repaired the sleeve on my raincoat.  Barbara who is a computer technician volunteered to help me set up the router for my internet service.  Letting people choose what to do means I do not risk rejection because I have asked the wrong person.

5. Let them choose WHEN to volunteer.  After they volunteer I ask them when would be a good time for them.  Everyone has busy lives so it is less of a burden when I fit into their schedule.

6. Make a list and stick to it.  Before someone comes I make a list of the things I need done so my volunteer knows when he or she is done.  I stick to the list instead of looking around and saying "there is one more thing I need you to do."  This list also reminds me to get materials my volunteers need.  Before John comes to replace the batteries in my smoke detectors I buy 9-volt batteries.

7. 80% rule.  The 80% rule means some things can be mostly correct rather than perfect.  After my stroke I gave myself permission to not make everything perfect.  For example, the seam of my bedspread is supposed to be where the edge of the mattress is (see the black line).
It is only fair to extend the 80% rule to my volunteers.  Nobody wants to hear that they did not do it the way I used to do it.
homeafterstroke.blogspot.com

Finally - Real Help for Caregivers

As an OT, I sat through discharge meetings where caregivers were silent.  Some may have been too stunned to ask questions.  Others may have thought problems would disappear because the stroke survivor would completely recover (1).  Reality may not set in until caregivers struggle to get a family member inside his or her home.  I learned how intense demands are on caregivers after I went home alone after a stroke.  After 17 years, I know how many caregiver tasks have to be done to keep a stroke survivor out of a long-term care facility. 

I was excited when I read about a caregiver questionaire that is given before a stroke survivor is discharged from rehab (2).  Before the client goes home, staff ask caregivers what they were thinking as they answered each question.  This creates an opportunity to change what caregivers know and encourage them to ask for help before they get into trouble.  A dialogue is so much better than handouts.   homeafterstroke.blogspot.com

1.  Lutz B et al. Improving stroke caregiver readiness for transition from inpatient rehabilitation
        to home. The Gerontologist. 2016; Vol 00:No.00,1-10. doi10.1093/geront/gnw135.                    2. Camicia M, Lutz B, Harvath T, Joseph, J.  Using the Preparedness Assessment for the                    Transition Home After Stroke Instrument to identify stroke caregiver concerns predischarge:            Uncertainty, anticipation, and cues to action.  Rehabil Nurs. 2021 Jan-Feb 46(1):33-42.

The Final Shoe Solution

Being forced to stay home during the covid-19 pandemic helped me remember why I work so hard to solve problems caused by my leg brace and shoes.  I would be severely depressed if I had lacked the confidence to walk safely in the community during the 16 years since my stroke.

Neither the white duct tape in the photo or double-sided tape have glue strong enough to stop my leg brace from pushing the shoe insert out of place.  When the shoe insert slides to one side my foot tilts so most of my weight is on the outside edge of my hemiplegic foot (ankle inversion).  Walking on a foot that is not flat is unsafe and tiring.  I am currently using T-Rex Ferousiously Strong double-sided mounting tape to see if it keeps the shoe insert in the center of the shoe.

Long socks that reach the knee prevent skin chafing as the brace rubs the top of the calf.  However, the only knee-high socks made for women are brightly colored socks used during soccer.
I cut the top off a man's white tube sock so it covers the top my calf.  I have washed them many times.  They fray eventually but hold together for a long time.  I am happy that what people see is black socks with black shoes and beige socks with beige shoes.


My THICK leg brace creates a leg-length discrepancy by making my hemiplegic leg longer than my sound leg.  Wearing 2 socks on my sound foot makes my sound leg a little longer.  The 2nd sock also keeps my foot from sliding inside the extra wide shoes
I need to accomodate my brace.  Having my sound foot slide inside my shoe makes walking tiring and puts strain on my hip and knee.  I wish I had known about this 2 sock solution before my sound knee needed joint replacement surgery.


The long sock I pull over the short ankle sock gets stretched out which makes it easier to don.  I bought permanent ink pens to mark the stretched sock in each pair.  A black pen works for white and beige socks.  The silver pen I use on black socks fades in the wash so I have to repeatedly mark them.

If you read this entire post you may understand why I do not think this is my last post about my shoes.   homeafterstroke.blogspot.com