I Never Thought I Would Say This

I thought the hardest thing I have ever done was to recover from a stroke.  A very close 2nd source of stress is moving to Michigan.  My single spaced To-Do List shows what I have to do in the next 4 weeks.    I have a 2nd To-Do List for selling my house.  😢    

In the 1st year after my stroke a gratitude list helped me deal with stress.  Each day I wrote 3 to 4 word phrases describing events that gave me 5 seconds of happiness.  Reading that list at the end of the day changed the way I felt about how my day had gone.  I hope writing a gratitude list now will help me cope too.  When I feel sorry for myself I also say "I am moving towards a time when I am happy and safe."

Thank God I started working on my move two months ago.  For example, I struggled to find ways to get rid of monstrously big furniture.  I am also glad I paid a woman to come one hour every week to do tasks that require two good hands.  Taking a table to the curb for my township to pick up is too much for me.  homeafterstroke.blogspot.com

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

My Pill Map

I take 10 pills a day so I need a system to make sure I take them correctly.  I am highly motivated because my pills can help prevent another stroke.  For example, taking a baby aspirin every day thins my blood.  Once a week I open all my bottles to put my pills in a 7 day pill box.  Two or three times a year I put 2 tiny pills in one day's compartment but no pill in the next day's compartment.  They are so small they can slip out of my hand without my feeling it.  I catch this mistake with my back-up strategy. 

When I dump the pills I need for the day, the first thing I do is put my 3 bedtime pills in a small blue container.  Fortunately, these 3 pills are oblong and different colors.  Then I put my daytime pills on a hot pad that has a floral pattern and stitched seam lines.  I place each daytime pill in the same position to create a V shape.  If there is a gap in the V shape I know I am missing a pill.  

Fortunately I have excellent pill recognition.  For example,  I know the baby aspirin has rounded edges and tiny letters printed on one side (top arrow).  The medicine I take for my thyroid is also a tiny white pill, but it is completely flat and has a line through the center (bottom arrow).  homeafterstroke.blogspot.com

Freaked Out and Then Aggravated

I took Tylenol for three years because osteoarthritis had created bone-on-bone pain in my neck and low back.  I read on line that Tylenol can damage the liver so I freaked out when my feces turned yellow.  The liver secretes bile which turns feces brown.  My gastroenterologist said my feces would have been gray if my liver was not working at all.  I read the liver can repair itself, but I was not taking any chances.  On February 18th I stopped taking Tylenol.  Two weeks and 5 days later my feces turned brown. 

Now my arthritis pain kicks in every night which makes it difficult to fall asleep.  So I use hot packs that CVS calls Peas.  I put them in my microwave but am very careful to not overheat them.  When I touch them briefly they do not feel hot, but if I keep my hand on them I can feel the heat.  I am very conservative about the time I set the microwave for - 45 seconds for the big Peas and 30 seconds for the Peas I put on my neck.  The heat takes half an hour to be affective which is aggravating.  But it is better than rubbing my body and rocking while I watch TV at night because the dull ache makes me suffer.  homeafterstroke.blogspot.com 

Joint Protection Principles Part 2

Avoid a Prolonged Grasp.  A phone with a head set means my painful sound hand does not have to hold a phone for an hour when I talk to family and friends.  

I have an Accto book holder.  Movable arms (see arrow) accommodate different size books.  A lever in the back adjusts the tilt.  I recently read for half an hour while holding a magazine.  Pain in my hand woke me the next morning before my alarm clock went off.

Lift with the Strongest Joint: I use my elbow to lift heavy objects like

cereal and milk containers.  My painful sound hand acts as a pivot to aim the container opening while my affected arm controls how far I lift the containers. homeafterstroke.blogspot.com

Joint Protection Principles Part 1

I am trying not to freak out because I have osteoarthritis from overusing my sound hand for 18 years.  Xrays confirm I have bone-on-bone contact which causes pain.  I cannot count on another disease killing me before my sound hand becomes useless.  So I am using the pain in my index and middle finger to tell me which joint protection strategies are helpful.  For example, when I put away a stack of clean cereal bowls, it hurts to lift a stack of 3 bowls but not 2.  My hope is that reducing pain means I am putting less stress on my joints which will make my hand useful longer.

Slide Rather Than Lift.  I used to fill up my kettle and then carry it to the stove.  Now I put in water for only 1-2 coffee cups and slide it on a dishrag from the sink to the stove.  No pain.

I use my kitchen cart to roll clean dishes from my dishwasher to the cabinets.  This means I do not have to make multiple trips to carry all these heavy objects to put them away.  I lift dishes from waist height to only the 1st cabinet shelf.  No pain.   

Avoid Repeated Gripping.  I cannot stand to watch the same commercials 4 times every hour for months so I constantly change the TV channels with my remote control.  My remote is not heavy, but my painful thumb and middle finger have to hold it tightly because it wobbles as my painful index finger pushes a button. 
 

Now I place the remote on my palm while my sound hand rests on my couch. When my thumb reaches over to press a button, my palm presses the remote against my thigh which holds it still. No pain.  homeafterstroke.blogspot.com

What I Did Not Know as an OT

A friend told me how disappointed she was after she wore a light backpack while walking on the boardwalk at the beach.  It has been six months since her shoulder surgery so she did not expect her shoulder to ache after this walk.  Her story reminded me of how I felt when I had setbacks in my recovery from a stroke and total knee replacement surgery.  Her story reminded me of when I told my therapist I was discouraged because of a setback.  My therapist tried to reassure me by saying lots of people have setbacks.  This made me realize that seeing a setback is not the same as experiencing one.  

What I did not know as an OT was that being able to deal with powerful emotions and negative thoughts is as important as dealing with the pain and fatigue created by physical challenges.  I no longer wonder why some people die soon after they have surgery to repair a broken hip.  Half of recovery is mental and emotional.  homeafterstroke.blogspot.com

Kalamazoo

After living alone for 18 years with a stroke I am tired of dealing with home and yard maintenence, parking my car on the street which forces me to deal with snow, struggling to get groceries up my front steps, and cooking one-handed.  In September I was going to visit an independent living site I like in Kalamazoo after the summer road repairs on I-80 were finished.  I like the information I got from the website and the sales rep, but independent living is too expensive to buy into sight unseen.  

When the delta variant sent covid cases soaring I canceled my visit.  I know the odds of catching break-thru covid are low after my 2 vaccine shots.  However, I am afraid to be alone 750 miles from home with covid.  I could be too sick to drive myself home.  Do Uber drivers deliver to the front desk of a hotel?  Would hotels allow me to quarantine with them?

Another sign that this is not a good time to visit is that the facility posted an activity schedule for May, June, and July, but not August.***  Kalamazoo county currently has twice as many new covid cases as my county which has 100,000 more people.  With the covid surge and potentially bad winter weather, my visit is delayed until spring.  homeafterstroke.blogspot.com

*** The activity schedule for September was finally published.  YEAH!  

Walking in the Dark

I need light to see if I am standing upright because a stroke stole my ability to feel where vertical is.  Unfortunately, my electricity goes out one or two times a year so I have learned to be afraid of the dark.  Instead of moving to a long-term care facility I put flashlights every place I sit (couch, computer, kitchen table).  My leg brace allows me to carry a flashlight in my sound so I can walk to a phone to report the outage.  However, when I get up to go to the bathroom in the middle of the night I am barefoot.  I need a quadcane in my sound hand instead of a flashlight.  A friend showed me her Energizer Folding Lantern.  It has a large handle so I can carry my quadcane and the lantern in my sound hand.  Thanks to a silvery lining this lantern is bright enough to light the few feet I need to walk to my on-suite bathroom.  

This lantern opens like a clam shell when I need to replace the batteries.  I need a big screwdriver to remove 2 screws (see small white circles) to open the battery compartment.  Searching for a screwdriver is maddening so I bought a screwdriver just for the lantern.

I keep the lantern, screwdriver, and replacement batteries next to my bed on an 8 inch wide rolling cart I found at Target.  It is the Household Essentials 3 shelf utility cart.  Before I get into bed, I place the cart where I can pull it close to me without getting up.  The lantern is on the middle shelf so I can turn it on while lying in bed.  In the dark I slide my fingers along the edge of the shelf until I feel the lantern handle.  This tells me where the on-switch is.   homeafterstroke.blogspot.com

I Am Feeling Better

I still wake up at 2 a.m. to go to the bathroom and have trouble falling asleep unless I listen to a meditation CD.  However, since reading The Moth Snowstorm - Nature and Joy by Michael McCarthy I have not been waking up with a sense of dread.  This book inspired me to sit on my patio every day.  The 1st thing I notice is the smell of plants.  The sun and cool breeze on my face also feels wonderful.  I am entertained by bird drama.  One day I saw hawks flying slowly in circles while they looked for prey.  A few minutes after the hawks disappeared, I saw one small bird and then two and then a trio flying in a tight triangular formation.  The trio flew to the west and disappeared.  Then they flew back to the east and disappeared.  Finally they flew to the west and did not come back.  Another day I saw 6 tiny birds land on a telephone wire with a perfectly synchronized touch down.  It was like watching a miniature version of the elite air force flying squad the Blue Angels.  Bird TV is better than being aggravated by TV commercials for car insurance that repeat every 7 minutes.  

As I sat on my patio I noticed a shadow moving on my walkway.  The two photos below were taken 15 minutes apart.  Cocooning indoors for months made me completely forget I used to know time was not one momotonous unending event.  These images reminded me I used to see each day progress by seeing the angle of the sunlight change when I went outside. 

The sound of the wind in the trees behind my house helped me remember a happy childhood memory.  My parents rented a cabin in the woods for a summer vacation.  I enjoyed a gentle wind blowing in the trees that lulled me to sleep as I lounged on a screened-in porch after lunch.  

Being outdoors has helped me pay more attention to my surroundings.  Tuning out because I am listening to stories I create in my head has decreased.  I feel joy some of the time when good things happens when I am inside.  I am getting better.  homeafterastroke.blogspot.com

Stroke Survivors Need to Talk

Research with over 1,000 stroke survivors in the UK found that one in five choose to keep their fears to themselves (1).  Major fears included having another stroke, never getting better, and being sent to a long-term care facility.  Reasons for remaining silent included not wanting to worry others and not wanting to sound stupid.

I rarely discuss my stroke issues with family or friends for two reasons.  First, the challenges a stroke creates never ends.  I do not want to see able-bodied peoples' reaction to a litany of complaints that never end.  Second, after trying to explain a few problems to able-bodied people
I found they do not understand the emotional and physical toll a stroke creates.  In contrast, a stroke survivor recently thanked me for a presentation I gave.  I showed him a simple way to hold a toothbrush still while appying toothpaste with his sound hand.  He thanked me enthusiastically because he knew how irritating it would be to clean up sticky toothpaste when a toothbrush falls over every day until he dies.  He gets me and I get him.  Thank God reading stroke survivors blogs showed me that we can get better after rehab ends and my concerns are not stupid.  homeafterstroke.blogspot.com

1.  https://thiis.co.uk/research-reveals-the-often-silent-fears-and-concerns-putting-stroke-survivors-recoveries-at-risk/

How to Empty a Bedside Commode One-handed

One problem I worried about before my knee surgery was stress incontinence.  While waiting for surgery I learned sudden knee pain can start a small urinary leak that turns into a flood after about 60 seconds.  This set off alarm bells.  I regularly get up in the middle of the night to go to the bathroom and was worried about losing bladder control if I felt sharp knee pain.  I was freaked out about having to clean urine from my carpet.  A bedside commode would solve my problem but I live alone so who is going to empty it??

I cannot carry the bucket in my sound hand because I need that hand to hold a cane.  I was saved by serendipity.  Before surgery I put a laundry basket where it was easy for me to put dirty clothes in it.  The bottom of this basket is so smooth that it slides over carpeting like it is on ice.  This gave me an idea.  I asked a friend to put some water in the bucket and put it on top of the dirty clothes.  Instead of the liquid sloshing, the bucket was cradled by the clothes as I slid the basket into my bathroom.  My sound hand carried the empty bucket to the shower for cleaning.  For safety, I slid the heel** of my affected hand along my bathroom counter to keep my balance.  I put the bucket on my shower chair and used the shower hose to rinse it rather than risking a fall by leaning down to put the bucket under the water spout.

I never needed the bedside commode.  Yet I felt triumphant because so many health professionals have told me to get a bedside commode.  I also felt humbled because I arrived at the solution through sheer dumb luck instead of my OT degree and clinical experience.  homeafterstroke.blogspot.com

** heel of hand = palm of hand near the wrist

I Need to Walk on More than Linoleum

I am glad I had PT after I came home from my knee replacement surgery for what used to be my sound leg.  The first time I walked across carpeting with a cane instead of a walker I was wobbly.  The carpeting felt uneven after waking on linoleum at the hospital and in-patient rehab.  I was glad I had a home health PT to steady me when I panicked.  Half of fall prevention is reducing fear that makes me stiffen up.

The first time I walked outside I was startled by a car that came around the corner quickly.  I did not know the hospital environment had allowed me to develop the bad habit of staring at the ground when I walked.  Again I was glad to have a PT by my side when I froze.  This upsetting experience made me realize I was staring at the floor inside my home as well.  So I began practicing walking while looking up in this less challenging indoor environment.  Walking on linoleum in wide spaces while PTs decide who goes 1st when two clients cross paths does not help stroke survivors learn to divide their attention between environmental challenges and controlling their body. 
homeafterstroke.blogspot.com