Lessons from Occupational Therapy

To retrace my progress, with the new Medicare Advantage HMO plan I have, I learned I could get home health. REAL home health... which included physical and occupational therapy. GOOD QUALITY physical and occupational therapy.

I've been dealing with issues of pain in my right arm, wrist, and hand for over 30 years. With this last flareup of Spondylolisthesis, I aggravated it all by supporting my body weight on canes and my walker. After the fact, I found out it is not a good idea to use the canes at all or the walker as a wheelchair, but the damage was already done. I could no longer do even simple self-care tasks using my right hand/arm.

Occupational therapy would hopefully assist with troubleshooting movement challenges with my arm and teach me other living skills I needed to learn. I had four somewhat productive visits.

First, Brian informed me that my manual wheelchair could be lowered so my feet touch flat on the floor. All this time I've had it (got it from a donated equipment room at the local hospital), I had no idea. No wonder I didn't like it very much. Lowered, I can use my comfy seat cushion and backrest as well as pull myself along with my feet... and because the chair has brakes, it is less risky (less of a fall risk) to use the wheelchair at home vs. transferring on and off office chairs on wheels.

I told Brian where it hurts on my right shoulder when I lift my arm. He explained how the nerves connect, checked the alignment of my collar bone and other structure, and observed that my shoulder was out of alignment due to weak scapula muscles and possibly a rib dislocation. He gave me an exercise with a band for pulling back and strengthening these muscles.

On another visit, I told him when I raise my arms to reach for something, I get pain in my arm. He asked me to show him how I reach. I reach with my palms down. He told me to always reach up
higher than my elbows with my thumbs up. Palms down rotates the (right) shoulder in and pinches nerves. I don't know if my arm will get better, but at least I know how not to make it worse.

We also discussed during the four visits the many kitchen tasks I was having trouble doing and what adaptive equipment I could get to achieve these tasks. One major one is cutting things. Another was when my right arm hurts a lot, I needed to be able to do everything with one arm. Don't one-armed people have adaptive equipment they use?

I have ordered this cutting board because the posts will secure something round like a bowl for mixing, a jar for opening, or food to cut up, is off to the side, and the board also has (not shown in this image) spokes to put food on to hold it in place so you can cut it:

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Out of the different types of knives available, I chose this one. I won't have to rotate my hand to grip it nor will I have to push down from above.

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Note: Adaptive equipment is expensive because the manufacturers know people will pay more to have them. I balked at first, but then just ordered it all. I would really rather have someone who did all these tasks for me so I could save all my energy to do the exercises that will strengthen my body and do things I enjoy (like writing). Food prep, cooking, cleaning up after cooking, cleaning up the floor after cooking when I spill stuff, doing laundry, and cleaning, in general, have never been tasks I enjoy doing. Ask me to organize something, and I'll have some fun.

For more about how I adapted to trying to get the base on and off my Vitamix, go the previous blog post about Difficulty Swallowing.

An additional website Brian gave me (the one he looks for all his adaptive equipment on) is performancehealth.com.

And if I continue having trouble swallowing after 30 days on Proton Pump Inhibitors (PPIs), it may be a muscular issue. The GI doc had already told me this but couldn't tell me what to do about it. Brian told me speech therapists are trained to help with this. Thankfully, this same home health agency has speech therapists, too.

Postscript to the post Lessons from Physical Therapy: Tie a piece of stretch band to the outside of the door handle. Stretch band will not slip off like the last thing I tried. As I leave with the mobility scooter or wheelchair, pull the band over my shoulder which will close the door behind me.