Saved by the 80% Rule

Ironing aprons after the Spring Sale at my church reminded me of a pleasant childhood memory.  I remembered when my mom taught me to iron by having me iron handkerchiefs.  This was a simple task I did successfully the very first time.  However, it is easier to get wrinkles out of a handkerchief than an apron.  Fortunately these aprons do not have to be ironed perfectly because they will be stacked in a box until next year and will come out a little wrinkled anyway. 

This got me thinking about the 80% rule.  Business managers use the 80% rule to keep down costs.  Some tasks that are 80% correct do not affect the bottom line while others have to be closer to perfect.  The rule says you need to think about striving for perfection because the last 20% requires nearly as many resources as the first 80%.  Business managers are paid to decide when a company should spend extra resources to approach perfection.  I wish I had known about the 80% rule when I was married.  When my husband did not smooth out the bedspread perfectly I would have known  this is an acceptable business practice.

I do not know where I got the idea that ALL work has to be done perfectly ALL the time.  I used to be a perfectionist, but now I think perfection should be a conscious choice rather than a habit.  

I live alone so when I am exhausted or frustrated I use the 80% rule.  homeafterstroke.blogspot.com

Arm and Leg Synergies are Different and the Same

The affected arm is dominated by the flexion synergy while the affected leg is dominated by the extension synergy. This means muscles that straighten the knee and point the toes are strong while muscles that bend the hip, knee, and ankle are weak.  I also cannot move a single joint. 

To point my toes I have to straighten my whole leg (photo on left).  To bend my ankle I have to bend my hip and knee (photo on right).  All this unwanted movement is exhausting.

 Problem: My weak hip and knee flexors do not always lift my leg high enough to clear my toes as I take a step.  The extension synergy forces my toes to point.  The photo on the left shows me stubbing my toes.                                                                                                                                                      Solution: I faithfully wear my leg brace because it lifts my toes up which prevents falls.  

Problem: The extension synergy makes my affected knee snap into a fully straightened position every time I take a step.  This abnormal movement will eventually damage my knee.  Muscles on the back of my thigh (see pink line) are too weak to stop my knee from snapping into this dangerous position.

Solution: My leg brace keeps my knee slightly bent (see green line) when I take a step.  I faithfully wear my leg brace because I do not want to have knee surgery.  homeafterstroke.blogspot.com

New Strategy for Obnoxious Able-bodied People

While struggling to get my sound arm out of the sleeve of my coat today, I thought about able-bodied people who insist on helping me.  People who grab an object out of my hand make me angry.  The last time I was treated this way I was 18 months old.  Nothing I have said has stopped people who insist they can quickly do what I am trying to do.  They are uncomfortable watching me struggle so they assume I am frustrated.  But struggling gives me confidence.

Let me give you an example.  I have never gone to bed with my coat on because I live alone.  Instead of feeling fear when I walk in my door, I relax because I know repeatedly wiggling my sound arm will get that arm out of its sleeve.  I know this because this strategy has never failed.  The next time an able-bodied person insists on helping me, I am going to tell then they are stealing an opportunity for me to have faith in persistance.  homeafterastroke.blogspot.com

More Good and Bad News

The good news is exercise can help stroke survivors regain control of their body.  I have done exercises for 17 years after my stroke.  Pain motivates me to exercise.  When I fell I broke a forearm bone (ulna) near my hemiplegic elbow which caused arthritis.  This produces a sharp pain if I do not stretch.  Before I get out of bed, I repeatedly bend and straighten this elbow and rotate this forearm.  I also have a bad back that creates agony if I do not stretch every day.  I get up in the morning to go to the bathroom and go back to bed to stretch my back while my muscles are still warm.  Skipping 2 days makes me stiff and skipping 3 days produces pain.  

Preventing fatigue also motivates me to exercise.  A stroke can create crushing fatigue that I cannot push through.  After 2 days of walking indoors I feel tired when I walk in the community.      So at the end of each day I write that day's aerobic activity on a monthly calendar I keep on my kitchen table.  At breakfast I can see if I sat at home the day before and plan the current day's aerobic activity.  Examples include Fitbit data when I walk in my neighborhood and shopping that requires me to push a cart and repeatedly lift objects.

The bad news is I can no longer be trusted to do exercises that maintain strength.  1st, gradually losing strength does not raise red flags that compel me to act.  2nd, I have a life so I no longer want to organize my day around home exercises.  However, I repeatedly do a few reps that do not disrupt the activity I am doing.  It is hard to find an excuse for not doing these brief exercises. 

For example, I get up from the computer every 20 minutes to turn off an alarm on my iphone in the kitchen.  This alarm prompts me to do 3 brief exercises.  Before I stand up, I lean down so my hand almost touches the foor and straighten my fingers ONE time.  When I sit back up, I reach back to touch the back of my chair with both forearms ONE time.  This stretches the muscle that pulls my arm across the front of my chest (pec major).  After I go to the kitchen to turn off the iphone alarm, I sit and open my hand THREE times.  

I also open my hand when I sit on my bed to use deoderant.        I open my hand ONCE before I take the cap off the bottle and ONCE after I put the cap back on.

homeafterstroke.blogspot.com