Good News about arthritis in my Good Hand

Eighteen years of overuse damaged the cartilage in the finger joints of my sound hand.  This produced bone-on-bone pain and swelling.  Fear about losing the use of my good hand motivated me to follow the joint protection principles I wrote about on February 11th, 18th, and 25th.    

After 2 months the pain and swelling in my good hand receded.  For example, a painful hand no longer wakes me up before my alarm clock goes off.  To see if the brief pain in my middle finger also disappears I decided to stop doing crossword puzzles.  Currently I am reading books I got from the library while I drink my morning coffee.  Thank God I have a book easel.  My post of          April 28, 2020 shows how I read hands-free.   

Now I have to figure what to do with my aching good shoulder.  Moving objects I use regularly to the bottom shelves in my kitchen cabinets has helped.  Now I have to tackle the ache I feel when I drive for 45 minutes.  When I visited Point Pleasant Beach recently, I was concerned about the ache I felt in my shoulder towards the end of the ride. This was a surprise because my good shoulder does not hurt when the steering wheel pulls to the left as I slow down to stop for a light.  However, keeping my car in its lane during long slow curves on the highway takes sustained effort.  My plan is to see if new tires and a front end alignment makes a difference. 

Bottom Line: Pain turned into a guide for what to do about arthritis.  homeafterstroke.blogspot.com

Organizing My Purse is a Vital Shopping Strategy

Trying to find something in my purse by digging around with one hand is awful.  Organizing my purse reduces frustration when I go shopping.  Every woman organizes her purse differently so my examples are intended to help stroke survivors realize a purse does not have to be a buzz kill.

I put my car key on a green wrist coil to make it easy to retrieve.  I grab the wrist coil instead of searching for the key.  I made the mistake of setting the key down to pick up an object on my car seat and then locking and shutting the door.  Seeing my car key on the dashboard was awful.  The AAA car service unlocked my car after I waited for an hour.  When I made this mistake a 2nd time I knew I needed the sensory cue of the coil around my wrist to tell me I have my car key before I get out of my car.                                                                                                My house key is on a straight flexible coil that is hooked on my purse.  All I have to do is pull on the coil to make my house key slip out my purse.   

I can handle credit cards quickly because I keep them in a zippered compartment that holds only a driver's license, one credit card, an ATM card, and a library card.  While sitting in the parking lot I place the card I need vertically so it stands out from the other cards which are horizontal.  Cards go back in this zippered compartment in a flash.  Less frequently used cards like my health insurance card are in another compartment.    homeafterstroke.blogspot.com

The Whacky Grasp That has No Name

My sound hand can place small objects between the index and middle fingers of my affected hand so this hand can hold objects still.  As an OT I know this is a weird grasp that has no name.            As a stroke survivor it makes me really happy.

The index and middle fingers of my affected hand can hold a toothbrush so my sound hand can squeeze toothpaste on the brush.  

The index and middle fingers of my affected hand can hold a cotton swab still while my sound hand cuts it in half.  This creates smaller pieces of cotton I put in my ears before I use hair spray on my short hair. 

I use my teeth to pull a rubber glove on my sound hand.  I do not want to touch shopping carts and transfer what my hand picked up to my car key, car door, and steering wheel.  When I get my groceries to my car, I use my teeth to pull the glove off inside out.  I do not want to leave a dirty glove in the cart so I place it between the index and middle fingers of my affected hand.  

I unlock  my car door and put the used glove in a cup in my car.

Then I put my groceries on my back seat.  

homeafterstroke.blogspot.com

Paratransit Skills

An article about community mobility skills (1) reminded me that OTs do not know if clients can use paratransit without knowing the demands of the systems available to them.  Here is a comparison of two systems I used.  One covers the state of New Jersey.  The other covers only my county.    

Language.  To qualify for the county service I only had to give my address and diagnosis during a brief phone conversation.  The state required a one hour in-person interview where I had to give specific examples to explain why I could not take public transportation.  Giving my diagnosis was not enough.  When making a reservation, both systems asked me what ambulatory device I used (e.g. cane, wheelchair) so they knew what type of vehicle to send.

Balance.  My balance is poor so I would fall if I was standing when the vehicle started moving.  Both services did not allow the drivers to start driving until I was seated and had my seat belt fastened.  Vehicles that carried wheelchairs had tie-downs which the drivers handled. 

Strength.  The county provides door-to-door service which means the driver provides physical assistance to go up and down stairs and carry packages.  The state provides curb-to-curb service.  This meant the driver stood by the vehicle while I got myself in and out of the house, on and off the vehicle, and transported packages.  Both services had vehicles with a wheelchair lift to get a client in and out of the vehicle.

Endurance.  I had to wait for the county service to pick up a few seniors that wanted to go to the senior center.  I had a short 2 mile ride with the seniors before I was dropped off at the grocery store.  The state service picked me up from 20 minutes before to 20 minutes after the time I requested (a 40 minute window).  The state may run long trips with multiple riders who have different destinations.  When I had to wait for other people to be picked up and dropped off, I might ride for an hour before reaching my destination.  With both services I had to be at the door so I could see the vehicle pull up which would wait only 5 minutes.  I bought a folding three-legged stool with a shoulder strap that hunters use so I could sit down if I got too tired in a store.  

Planning Ahead.  For the county a reservation had to be made 2 weeks in advance and they asked only for my name because they took me to only one destination.  For the state a reservation could be made 24 hours in advance and they asked for my paratransit identification number.  To remember the pick-up times at each end of my trip I wrote them on a calendar for the day of the trip.  The county service required only the name of the store because the person making the reservation was local and knew the area.  The state service required exact addresses and names of cross streets because the person making the reservation was miles away.  I got out a list of this detailed destination information before making a reservation.  Both services had a two bag limit.  This meant I had to plan multiple trips when I needed bulky objects like toilet paper.  I also had to plan repeated trips because paratransit took me to only one destination at a time - grocery store, drug store, doctor, dentist, out-patient therapy, etc.

Money Management.  The county service was free.  The state service required exact change.  They told me the cost of a one-way fare when I made a reservation.  Cost was based on what it would cost me to make that trip on public transportation (e.g. bus fare of $2.25).  I kept a supply of one dollar bills and coins.  homeafterstroke.blogspot.com

1. Dickerson A, Davis E.  Ckecklist of community mobility skills. OT Practice. 2020;October:13-16.

Handicapped Parking

Handicapped parking is more than being close to the door of a store.  The wider handicapped space is very helpful.  It is difficult to load purchases in the car because a regular parking space leaves very little room to open the car door.  Able-bodied people solve this problem by leaving their shopping cart at the back of their vehicle and walking the bags to the open car door.  I have poor balance so walking with a bag in my sound hand instead of a cane is a fall hazard for me.  The wider space lets me pull the cart up to my open car door to unload my bags.

A regular size parking space is difficult for another reason.  It is hard to get in and out of a car when I can open my car door only two feet.  This small opening makes it hard for me to maneuver a heavy leg brace that will not let me point my toes.  A wide handicapped parking space is especially important for someone in a wheelchair.  They need the car door to open widely so they can slide from their wheelchair onto the car seat.  homeafterstroke.blogspot.com