Rehearsal Saves Me Again

My moving company will keep my belongings in storage containers for 2 to 3 weeks until there is a truck heading to west to Michigan.  The facility I am moving into will put a few pieces of furniture in my apartment so I will have a place to stay while I am waiting.  However, my car must be filled to the max because I need supplies to take a shower, do laundry, and make breakfast until the moving truck arrives.  I turned to rehearsal to make sure I can pack what I need in my car.  

The purpose of rehearsal is to make me feel awesome when I tackle a new task.  My 1st attempt shows me what I have to change.  My 2nd attempt lets me test new ideas to fix problems I discovered in step 1.  My 3rd attempt gives me an opportunity to combine and test the steps from attempts 1 and 2.  My 4th attempt gives me an opportunity to get faster.  Here are two examples of learning how to pack stuff in my car so I can stay calm on the day I leave for Michigan.

I need a rolling cart to take my clothes to the laundry room.  I need to know: 1) if I can lift the rolling cart into my car with one hand and 2) if it will fit in my back seat. I could not lift it straight upwards to put it in the car because it is too heavy.  However, when I leaned down and moved my hand close to the wheels, the weight of the long handle swung the cart horizonal. That made it easy to place the wheels on the floor of the car and then tilt the cart upright.  I was surprised to learn the small front wheels nested nicely under the driver's seat.

I also need to know if 2 clothes baskets packed with bed linens and nested waste baskets will fit on my back seat.  I slid the 2 empty clothes baskets down my front steps and transported them to my cart using a small cart I keep on my patio.  I put them on my back seat and learned I could close the car door with room to spare.  The height of the basket raised the handle of the cart, but not enough to obstruct my vision in the rear view mirror.

There were so many constraints to take into consideration!                I would be a nervous wreck if I had not rehearsed these tasks. homeafterstroke.blogspot.com

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

Bathing When I Travel

I am traveling at the end of April.  I have not used this shower stool for 4 years so I practiced using it home before I left.  Rehearsal always gives me confidence. 

Caution.  This stool may not be safe if you need assistance to stand up or sit down or are heavy.

It is not safe for me to stand in the shower.  When I travel I use a folding shower chair.  This adaptive device allows me to visit with family and friends and present at conferences.  I bought the stool at a local medical supply house. Before I bought it I wanted to see if I could open it myself and sit on it to feel how sturdy it is.    It is too big for anything but the widest luggage so a luggage saleswoman suggested I transport it in a nylon garment bag.

When I travel I cannot count on towel racks being close to the shower.  Before I get in the shower I check to see if the toilet is close to the shower.  If it is far away I drag a chair from the bedroom and place it close to the shower.  Then I open a towel and put it on the closed toilet seat or chair.  This gives me a clean place to sit after I get out of the shower.  I also put a folded towel on the closed toilet lid or a chair so I can dry myself.  After I am dressed I take the stool out of the bathtub.  I fold the stool and place it on the towel covered toilet seat and use the ends of the towel to wipe off the water.  homeafterstroke.blogspot.com

2nd Hardest Challenge to My Independence

Learning to drive a modified car is the hardest task I had to master after my stroke.  The 2nd hardest is dealing with the New Jersey ban on stores providing and selling disposable plastic bags.  Reusable bags sold in stores and on-line are big.  They hold a lot so they are too heavy for me to carry up my front steps.  They also do not nestle together in the rolling cart I use to transport bags from my car to my front door.  Section 1.18 of the law allows customers to use disposable bags so I reuse bags I have saved until they rip.  Going to a long-term facility because I cannot get food in my house is a severe consequence.  Meals-on-Wheels supplies only 2 meals a day Monday to Friday.

Solution # 1.  I carry my plastic bags in a canvas bag from LL Bean.  The small canvas bag was not tall enough to let the plastic bags hang down fully.  The large canvas bag sags.  The medium canvas bag with short handles is just right (see photo below).

Solution # 2.  I pre-bag a few items like a half gallon of milk and packages of meat that tend to leak.  I bring extra bags to shake open.      I place one handle over the metal arch shown in the photo.  Then I drop the item in the open bag.  This allows me to work at my own pace before I get to the check-out line.

Solution # 3.  When thin plastic bags are nested inside each other, the friction between bags makes several bags pull out at once.  Hanging them side-by-side vertically stops them from sticking together.  However, when I strung the handles of the plastic bags over the handles of the canvas bag it created a messy pile (see left handle).  I had trouble finding a handle that paired with its mate. 

So I weigh down one handle of each plastic bag with a big key ring.  I hang these key rings over the side of the canvas bag where they are easy to grab.  This strategy lets me quickly find one handle so I can pull the bag open, fill it, and lift it out of the canvas bag.

Solution # 4.  Bulky items like a box of cereal and a pack of toilet paper are hard to put in a small plastic bag.  I put a cereal box on the belt last so I can put it in the empty canvas bag which stays open because it is stiff.  For a pack of toilet paper, I make a hole in the top with my car key after I take it off the shelf.  I stick my finger in that hole to put the toilet paper on the belt and in my cart.

P.S.  I am grateful to a kind cashier at Shoprite named Michelle.  When no one was behind me in line Michelle waited patiently while I made numerous mistakes during multiple shopping trips.    The ban begins on May 4th.  I am glad I had all of February to find the solutions listed above.  Rehearsal saved me again.  homeafterstroke.blogspot.com

Hard to carry over skills acquired during exercise

  

The transition from exercise to functional tasks can be difficult.  Functional tasks require clients to divide their attention between thinking about what their body is doing and watching what objects are doing.  For example, I kept dropping a tube of toothpaste until I realized only my thumb and middle finger contact the tube of toothpaste.  The photo shows this precarious grasp.  Dropping an open tube produces a splatter of sticky toothpaste on the floor.  So I press the end of the tube against my stomach to hold it still while I watch my sound hand remove the cap.   

Fortunately I have a strategy for dealing with my negative emotions when I fail during functional tasks. The first time I try a new task, one or more steps are difficult or impossible for me to do.  This means I cannot finish what I started.  To help me persist in the face of failure I call my first attempt a rehearsal.  The purpose of a rehearsal is to discover solutions that will make my second attempt awesome.  Waiting until the next day also gives me time to think of new things I can try next time.    homeafterstroke.blogspot.com

Walking in a Barren Environment

Walking in wide, empty spaces did not prepare me for tasks that force me to stop concentrating fiercely on my hemiplegic leg while I am walking.  In-patient PTs walked me in gyms with equipment and people sitting around the periphery.  When two clients who are walking approach each other the PTs look at each other and decide who will stand still while the other person moves first.  Home health PTs walked me around the block in the middle of the day when nobody was outside.  PTs work in a barren environment that does not make them aware of cognitive demands.

Stroke survivors need to walk sideways between tables at a restaurant and go down stairs that have a railing only on their affected side.  At a store - walk in circles around racks of clothing and stop for people who are not watching where they are going.  At a hair salon - sit down in the chair without tripping over the big metal footrest.  Using a public toilet - turn around to sit on the toilet regardless of which side the grab bar is on.   Clients and family members need to understand that walking requires problem solving as well as physical mobility.  

Football coaches do more than have players throw and catch footballs and do foot agility drills.  Football players eventually have to stop concentrating on their body and start thinking about their opponents' strategy as they move.  Athletes and musicians have rehearsals to make the transition from practice to function.  Why are stroke survivors not getting the same kind of help?  homeafterstroke.blogspot.com

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