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

Snow Shoes for a Stroke Survivor

Since my stroke I am careful about venturing outside when it snows, but I am not trapped inside until spring.  Once streets are plowed and sidewalks shoveled, I wear boots over my shoes to give me better traction when icy slush is left behind.  Boots also help when my car is covered with snow.  Dragging snow off my car dumps snow on my boots instead of my shoes.  Boots I tried on at a shoe store would not fit over my leg brace.  My leg brace does not allow me to point my toes which is a pre-requisite for donning boots.  On-line I found the Neos overshoe with a Velvro opening that goes all the way down to my toes.  The Villager model is lightweight and designed for occasional use which is perfect for me.  I walk more slowly with boots on, but that beats not being able to get to the grocery store or keep important appointments, like a doctor appointment.

Notes-to-Self.  1) Make the ankle straps long BEFORE I take the boots off.  Long straps make it easier to unsnap and snap the plastic buckles. After snapping the buckle closed, pull the end of the strap to make it tight.  2) Begin by opening the boot ALL the way to the toe so I will not have to wrestle with the nylon fabric to get my toe in the boot. 

A video at www.overshoesonline.com shows how to don this boot.
Warning #1: I do not put the boots on while standing as the video shows because I do not have good standing balance.  My boots go on safely while I am sitting.  Warning #2: The first set of boots I ordered was too big so they flopped around when I walked.   homeafterstroke.blogspot.com

Donning Socks Can Make You Crazy

At 58 years old I wanted to go home instead of going to a long-term care facility.  I live alone so I was motivated to learn how to don socks with one hand.  When Joyce complained about getting her sock crooked in The Tales of a Stroke Patient I understood her dilemma.  She reminded me of the tortuous process I use to do this task.  Pulling a sock up one-handed requires me to pull one side up, then the other side, repeat, repeat, and repeat.  However, holding my leg completely still in the air for that long a time is impossible.

I bend my knee to pull my leg up on the bed to keep it still and avoid leaning over to reach my toes.  My repeated pulling is not always symmetrical so I watch to see if my sock is twisting.

To prevent the heel from ending up on the side of my foot, I go back down to straighten the toe if needed.  When the toe is straight, the heel of the sock ends up on the heel of my foot.  homeafterstroke.blogspot.com

On-line Grocery Shopping

Janet is a dear friend who can speak truth with kindness.  She gently talked me into paying a grocery store employee to shop for me during the winter.  Thanks to Janet, I did not become hysterical about being stuck in my house with no grocercies because of a blizzard.  When weather reports became dire, I ordered groceries on-line and picked them up before the snow storm hit.  This photo shows I was right to worry.

The designated parking spaces I have to use for on-line grocery shopping are too narrow for me to put a shopping cart next to my car to unload groceries.  So I put groceries in my trunk.  I am glad I put boxes and a cooler in my trunk before my 1st attempt.  I do not want to use my cane to fish around for cans and round produce that could roll to the back of my trunk.  homeafterstroke.blogspot.com

Painful Lesson About Falls

Linda wrote a post in Leading a Healthy Life about dislocating her hip when she bent at the waist instead of bending her knees while reaching down to pick up something.  She screamed when her hip slipped out of its socket, when family members helped her sit on a chair, when the EMTs moved her to a transport chair, when they carried her up the basement stairs, when they put her in the ambulance, etc.  I also take chances when I reach down to pick up an object.  Even though I know better, it is frustrating to not be able to move the way I used to as an able-bodied person. 

I am grateful that Linda shared her painful experience.  Her description was so vivid it has changed my behavior.  For example, I put heavy bags on the top step (red circle) so I can I load them first into a rolling cart inside my front door.  I do not want them to crush fragile products like bread.  When I leaned way down to grab lighter bags on a lower step I thought "don't do this."  Now I use a safer strategy.  I expend the energy to walk down to a lower step (green circle) before I lift the lighter bags up to the top step.    

A few days later I felt my heels come off the floor while I was struggling to maintain my balance as I squatted to pick up an object under a chair.  Again I thought "don't do this."  I moved the chair.  In the coming weeks I will look for instances when I put my body in a precarious position.  Linda, thank you for reminding me to be careful.  homeafterstroke.blogspot.com

Community Ambulation Falls Thru the Cracks

Stroke survivors have to figure out how to walk safely in the community.  Walking in PT gyms and on deserted sidewalks in my neighborhood did not prepare me for walking in community settings.  

I had to teach myself how to maneuver around carts and people in a grocery store, squeeze past closely placed chairs and tables in a restaurant, and deal with children in a shopping mall who do not look where they are going.  PTs do not know walking requires divided attention because they walk clients in wide empty spaces that provide no cognitive challenges.  Equally unfortunate, OTs who are trained to address cognitive issues do not assess community ambulation because walking is PTs domain.  So community ambulation falls through the cracks. homeafterstroke.blogspot.com

Staying in My Home is Not Easy

The independent living facility I hope to go to has a heated underground garage.  Until I move, I need 5 snow strategies because I have to park my car on the street.  When snow is forecast my 1st strategy is to go grocery shopping.  When we get a dusting of snow I use my 2nd strategy.  I use a child-size shovel to push snow onto my lawn.  I sprinkle Ice Melt on my walkway and in front of my car.  The big container is heavy so I use a funnel to pour Ice Melt into a small container sitting in my bathroom sink.  My sound hand lifts the big container.  My affected forearm under the big container controls the degree of tilt.  

New Jersey often gets above freezing after a snow storm.  When the weather forecast says this will happen I use my 3rd strategy.  I wait a few days for the sun to free my snow-covered car.  However, the street has a low spot that captures water as the sun melts the snow.  I need a 4th strategy to cross this small pond.  I place a thick rubber matt over the water so I can to get to my car safely.  

When the weather forecast says New Jersey will stay below freezing after a snow storm I use my 5th strategy.  I pay two teenage boys to clean my car, walkway, and snow that the snowplow has pushed against the side of my car.  They also shovel snow in front of and behind my car so I have a clean parking space.  Old people in my neighborhood are nasty when someone takes the parking space in front of their house.  homeafterstroke.blogspot.com

The Only Cutting Board That Works Great

I had a 2nd stroke so I got serious about a low salt diet.  Unfortunately, food does not have much flavor without salt so I started adding aromatics like onions.  The standard cutting board for one-handed people shown on the right is not that helpful.  Impaling food on 1 nail allows the food to swivel.  Two raised edges on the left back corner holds food still ONLY if you push the knife towards the corner.  Food like peanut butter gets smeared on the raised edge.

A cutting board that works much better is the Swedish cutting Board (1). The part I use the most is the adjustable vise (see red knob) that can be taken apart to be washed.  The vise makes it easy to spread food on bread and slice a thin English muffin, a soft tomato, or a whole head of lettuce.  Instead of 2 nails, I impale meat on 9 prongs.  This small section lifts out of the cutting board so I can put it in the dishwasher.  See the empty space in Figure 7.8 below.



For safety I cut food by using my palm to push down on a large chef's knife.  This lets me keep the ends of my paralyzed fingers away from the blade (see arrow in Figure 7.8). 

This cutting board is more expensive than a regular board but I think it is worth every penny. It makes food preparation safer, faster, and less frustrating.  homeafterstroke.blogspot.com


1. Dutton, R. My Last Degree: A Therapist Goes Home After a Stroke, 2nd ed. 2013; Booklocker.

My Pain Got worse

My central pain became intolerable at night.  Central pain is constant pain created by brain damage.  Symptoms include pain caused by normally non-painful stimuli, constant burning, 

electric shock-like pain, and a stinging, tingling, or pins-and-needles sensation.  These abnormal sensations are usually localized to one body part, especially the hands or feet.  I have a constant burning sensation in my hemiplegic foot.  Three strategies give me relief.

Initially (1) taking Tylenol and (2) raising the sheet off of my foot helped me fall asleep.  In the photo I placed a ball outside the covers to show you what the ball under the covers looks like.  The ball keeps the covers off the end of my big toe all night long.  When these two strategies were not enough to help me fall sleep I added a 3rd strategy.

(3) Gel packs heated in a microwave oven.  WARNING: Gel packs heat up very quickly and are deceivingly cool at 1st touch.  I heat the gel pack for only 25 seconds on High because a stroke took away my ability to tell the difference between hot and cold in my leg. To safely remove the gel pack from the microwave and transport it to my bedroom, I put it on a stiff paper plate.  I place the gel pack NEXT to my foot. The gentle heat gradually extinguishes the burning sensation in my foot so I can fall asleep.

 Two sensations can cancel each other out.  This is why you rub a painful body part that has bumped into an object.  Ben Gay cream works because it has Capsaicin that produces a mild burning sensation that cancels the awareness of muscle pain.  homeafterstroke.blogspot.com

Home Programs Are Like Dieting

Home exercise programs are like dieting.  Both are "shoulds" that make me feel guilty when I do not do them.  As an OT I know exercise is important, but home exercises get boring after a few months.  I am still doing home exercises because each one is anchored to something I want.
For example, avoiding pain is a powerful anchor.

After I felt my OT massage a painful knot out of my shoulder I was determined to stop it from coming back.  The painful knot formed because I was repeatedly using my shoulder (see photo) to lift my hand. 






I start with my arms down at my sides and raise both hands to the middle of my chest using only my elbows.  This put less stress on my shoulder muscles when I lift my hand.  I do this movement 3 times before I take my pills with yogurt each day.

I set out the yogurt, spoon, and pills before I start exercising.  I am afraid I will lose the sensation of what normal movement feels like if I stop to gather supplies.  An anchor turns "I should" into "I want to."
homeafterstroke.blogspot.com