Sunday, June 02, 2013

Strategic compensating

Relatively early in my stay at the rehab, during a "family meeting," my physical therapist, Joanie, commented on the fact that I was good at "strategizing"when it came to formulating solutions to my physical limitations. That was a nice way of saying I compensated well.

I'm periodically asked --out of kind curiosity -- about  how I manage to do as much as I do with one hand and limited balance, speed, and mobility.

So I thought I'd take a little time to document some of my most common strategies. If I were more ambitious, I would make videos of me doing all these things, but it would probably just frustrate you to watch.

The recent brain injury conference I went to often tossed around the word "survivor", a term I'm looking to replace, since it feels too immediate. It's certainly better than "victim", but what do you think of these alternatives?

  • Recoverer (too awkward?)
  • Survivalist (invokes images of a bunker filled with quad canes and Ginkgo Biloba?)
  • Healee (also awkward and touchy feely?)
  • Changeaphile (captures the necessary mindset but awkward?)
  • Recovery Stylist (watch the clip)
  • Strategist (coming full circle)

While I think my nature as a problem solver serves me well, there's more to it than that. I recently came across this book, which I think summarizes nicely three basic priciples of doing more with less:

  • Body Positioning (to which I would include mastery of basic laws of physics, like counter-balance, leverage, and inertia).
  • Four fingers and a thumb (I think the author does well to highlight that "one hand" is more than a singular assistant, but I would say, "Four fingers, a thumb, and a mouth".
  • Gadgets (certainly something I relish and utilize and expand my collection)
To these I would also add:

  • Guile and vigilant intention (early in my recovery, I was actually put on a medication called Provigil to aid my energy and focus, since you  never know when a ninja might leap out and push you over. But seriously, folks, attention to potential consequences is pretty critical. Looking at typical right hemisphere brain injury problems, I once again have to count myself as pretty fortunate when it comes to the limited extent of my cognitive deficits.
  • Patience (years of computer work has, unfortunately, trained me to be more patient with inanimates than people).
  • Help from others (while it took some time to get past the "proud handi-capable" stereotype, I've tried to take on the philosophy imparted to me by an amputee patient of one of my therapists  -- that allowing others to help me is in some fashion a gift I'm able to give them.
  • Self assistance (my right hand and foot often pitch in to help my left.
Now to the nuts and bolts:

I work from the bottom up

  1. Socks
    1. Jamie says it's now easier for me to put my own socks on than for her to do it for me.
    2. My technique is basically to stretch the opening into a snake's mouth with my right hand  and then swallow its prey whole (see The Little Prince).
  2. Underwear and pants:
      1. left leg, then right (don't ask why -- that's how I was taught), often lying back on the bed.
  3. Brace
    1. Depending on the weather, I may wear my KAFO under my pants (the plastic can offer a cooling effect) or over (though jeans get a little bunchy).
    2. In the winter I often wear silk long johns for a thin, warming layer between my skin and brace or else just put the brace over chinos.I get many comments regarding the faux denim shell on those days.
  4. Shoes
    1. As I described on Facebook, after months of wearing the same sneakers, I recently purchased a new pair of appropriately-business-casual shoes, which required my going from a size 8.5 to a 10 Wide (in order to accommodate the brace's foot bed). 
    2. My right shoe, on the other hand, is stuffed with three insoles to better fit my still-8.5 foot.
    3. Squeezing the shoe over the brace can still be a challenge and probably wouldn't be possible without my Shoe Lip, which acts as a shoe horn and keeps the back of the shoe from folding over. Depending on how much attention I feel like drawing on any given day, I may also put a thin sleeve of nylon hose between my brace and shoe, to cut down on squeaking.
    4. Elastic laces are pretty essential for turning any shoe into a slip on, though I'm intrigued to try out this one-handed tying technique.
  5. Shirts
    1. Depending on the weather, I often wear t-shirts under sweaters or button-downs.
    2. If it's a long-sleeve button-down, always button the cuffs first (no one can button his/her right cuff with his/her right hand after the fact).
    3. Then, left arm in sleeve (sometimes guided through by the right hand), over head, then right sleeve, then pull down the back. I have been known to get quite spectacularly tangled up, at which point I have to dial 911.
    4. Button from bottom up, being careful not to misalign.
  6. Vests and jackets
    1. It's starting to get a little warm for these, but having decent pocket space is pretty important to me, so a fleece vest with zip-up pockets has been a must.
    2. I prefer a vest with a cloth tab on the main zipper, so I don't have to pre-zip and go over my head; the zipper tab allows me to align the two tracks, hold it taut with my right hand, and then zip up with my teeth.
    3. Jackets and coats are a little harder than vests and consequently require the tried-and-true flip  (though since I can't bend over and put both arms in the holes or lift my left arm over my head, it's a little more like this (though with less flair).

  1. Breakfast usually consists of a yogurt, which I use to take my morning pills.
    1. Stirring a yogurt with one hand requires the Thighmaster Gambit (I hold the container between my knees and then stir with a spoon in my right hand). I've found this tactic can also be used when opening jars.
  2. Lunches are generally pre-packaged, microwave-friendly offerings from Healthy Choice or Trader Joe's. 
    1. Last year, I had an entourage of helpers from my department assist with carrying. This was emblematic of their generosity and also provided good social interaction.
    2. This year, I decided to fly solo on lunch, using my NERHP messenger bag (SWAG from my exceeding expectations honor). Doing so still gives me a bit of mid-day exercise, plus the satisfaction of inching open and closed my lunch bag zipper (therein lies the physics lesson), and the hope of getting a hot lunch back to my desk without spilling sauce all over the inside of my bag.
    3. Any meals requiring cutting call upon the Knork or straight edge of an ordinary fork, since I can't yet hold a fork steadily enough in my left hand while slicing with my right.
    4. Food packaging -- even that at the rehab -- is rarely one-handed friendly. Opening therefore requires counter-balancing (such as with diner creamers) or teeth (sugar and ketchup packets).

  1. Brushing my teeth is the one regular time I put my left hand to work, holding the brush steady while squeezing paste with my right. It's a good reminder to not neglect or totally write off my left hand, but mostly I got tired of my toothbrush tipping over.
  2. I still mostly shower sitting down and use a long-handled scrubber (Yes, Wilk, I wash myself with a rag on a stick)
  3. Putting on deodorant in the morning is one of my favorite things to do:
    1. I can lift my left arm enough to reach my left armpit with my right hand.
    2. Applying to my right pit with my right hand requires what I call The Orangutan 


Carrying things from on place to another is probably my biggest frustration. If I don't have my bag, it's a slow process of repeated trips, during which I mostly leave my cane in one room, carry a drink (or whatever) in-hand to another room, and then retrieve my cane if I can remember where I left it. Making a pot of coffee, for instance, takes about six treks between the sink and the percolator, and I'm not exactly a speed demon.


Now that I'm driving again, I can make myself useful by once in awhile stopping at the supermarket on my way home from work. My first rule there is: no matter how short the list, always get a cart --it can carry my purchases and my cane, and it can act as my cane (something they used to have me do once in awhile at the rehab, just to see if I'd knock paintings off the wall ). I've greatly improved my precision and am proud to say I haven't taken out any store displays.

Online shopping is my friend. Between Amazon, Cafepress, and Etsy, I can cover all gift-giving needs, whether traditional or personalized.

All of the above strategies have helped make my not-so-normal life feel a little more mundane. Why, this past weekend, Jamie took the boys camping and left me to fend for myself. While it was too hot to make me want to do much of anything (except write this), it did feel like stretching my wings a bit. Not a day goes by that I'm not posed with some kind of new challenge, so it was nice to bundle them up with quiet time.


  1. Brilliant, Ken!
    Off the chart problem solving!
    My single biggest frustration is getting the "prove you're not a robot" right

  2. You are explain in a perfect way to live a person in this world. You explain in right way about the eating and hygiene in day to life.

  3. Eating is important thing and we must following in a perfect way. Lots of people are following the unwanted food diet system.

  4. Eating a nutritious diet is a very important thing about improving health. So, make a healthy diet plan and follow them!! You can add nutritious food in your diet plan.