Sunday, May 20, 2018

Sunday Stroke Survival: Adaptive Gardening Revisited

Adaptive gardening can only take you so far. If you are like us, we depend on the production of our garden to supply us for the whole year. We use a variety of planting methods. Some are adaptive and some are not.

This year we are focusing on building up new sections of the garden area. We laid wood chips in a thick layer. Then, we laid down cardboard. On top of it all, we placed straw bales. Hopefully in a season or two, we'll have a foot or more new, rich, composted soil over the hard, compacted red clay and granite rocks in which to grow vegetables in.

Straw bale gardening is another adaptive gardening technique. But for us, I'm not talking a dozen straw bales. I got fifty of them. As I said, our garden needs to provide a year's worth of vegetables for us. Each row around the perimeter of the garden took 10 bales a side in a trapezoid shape. This is all new ground for the garden. It was previously a rough driveway of sorts. Now, with the new driving areas graveled in, we've got a definite borders to the garden besides just a fence.

While planting or transplanting these bales, would be a classic adaptive or handicapable garden, the interior of the garden is the standard row planting. Unlike the previous year where I misplanted some crops in low raised beds that should have been elevated, this year I'm actually mapping it out before I plant. I know what I need to plant where.

I'm also not listening to Mel this year. Her idea of walkways between rows and mine are feet apart . Her ideal walkway between tomato plants is 2' when actually with the sprawling growth, tomatoes really need 4' between rows. I just really have difficulty managing to weed and harvest in that narrow of a row spacing. My toy box won't fit between the rows once the plants reach full maturity. We are still growing potatoes in tires. Old tires are easy to manage. It's upcycling although there is some concern about toxicity of old tires. We roughly get 50 lbs of potatoes a year and that is just about right for the two of us to consume. I just throw another tire on the stack and compost as it rows. I usually stop mounding tires and compost when I get five tires stacked. That's roughly 5lbs of potatoes for each tire. We usually do two tire towers for 50 lbs. To harvest, it's simply removing the tires one by one and pulling the potatoes out. The soil can be mixed with new compost and it's recharged for the next plants.

After the initial potato harvest, I'll stack and fill the tires two high for sweet potatoes or onions. Some of the tires I'll leave as singles and plant spinach or lettuces in them. I do like my gutter planters for lettuces though. I can pick micro greens to my heart's content. Gutter planting works best on quick harvesting like salad greens. They aren't deep enough for standard crops. They also tend to dry out quickly so close and careful monitoring is essential. I've wated videos on using this technique for strawberries, but when I attempted it I found the soil depth too shallow for an abundant harvest.

If you are only raising two or three tomato plants a raised bed is dine, but this year we'll be plant a minimum of 25 plants between Roma paste tomatoes and Cherokee blacks. The same goes for other vegetables too.  For seedling planting or seeds, I carry two sticks. One is 6" long and one is 3' long. Can you guess why? The 6" stick is for elevated raised bed planting. Out beds are only 3 1/2' wide. It's an easy reach to the center of the beds. The 3' stick is for ground level planting. It's also a substitute cane if I need it. I use a lot of different things in the garden that can substitute for my cane; a rake or hoe works wonderfully. I can get pretty creative when it comes to my mobility issues and doing what I want/need to do.

 I say that living post stroke has been an adventure. In a way it has been a great blessing. A blessing?! I hear y'all now wondering how anyone would consider surviving a stroke is a blessing. "Jo, you've stepped off the ledge and are free falling into the crazy zone!" My response is still, it's a blessing. Hear me out.
  • I have met many wonderful and supportive people since my stroke. Ones I may not have met otherwise.
  • In spite of all that I lost in abilities, I've found new and creative avenues to enjoy that I may not have tried if it weren't for my strokes.
  • I'm thinking more outside the box to achieve what I want out of life. Admittedly, I've always thought outside the box, but now it's extreme and I love it.
  • Through the frustrations in attempting to live my life post stroke, I've developed a more patient attitude. See, God, it's working.
  • Through my pain, I have a deeper compassion and empathy for others than I had before. I can relate more on a one by one basis.
  • Through my limited ability, doors or windows open that were closed shut before.
Every experience is an opportunity for learning. You can either embrace it and get on with your life, or stew in despair. I never would have thought that adaptive gardening was a way to be self sufficient before my strokes. My strokes opened my eyes to a new way of being self sufficient and productive that I wouldn't have thought of before.

Sure, adaptive gardening techniques are for small time gardeners. But sometimes, the end results can be greater than you first thought. I'm still trying to get back to the production levels here as I had on my old property. It will happen. It just takes time. I'm patient. Hear that God! I'm being patient.

Nothing is impossible.

Tuesday, May 15, 2018

Neurosurgeon Update

At long last,  I had my consult with the functional neurosurgeon. I've only been trying to get in to see him for 8 months! If you remember I had to go through Emory's Stroke team first.

I spoke at length to his assistant. He in turn spoke to Dr Boulis before he came in to see me. Dr Boulis and I reached common ground very quickly. I could see the gears turning in his mind for the best possible outcome. His assistant had already performed the spasticity assessment and preliminary exam. To nobody's surprise, I was ranked severe. I've been this way for months. I'm now 10 months since my last Botox injections.

I simply said, "I'm broke. Fix me." In my mind, I was doing my Austin Powers imitation. "I want it all. Yeah, Baby!" I wasn't afraid of the pain of recovering from surgery, nor hard work entailed to get what I wanted. I never have been.

He nodded his head and asked me which was more important pain relief or recovery. I answered back
with both. The only way to fight spasticity is to strengthen the weak muscles and I wanted a fighting chance. He said he was impressed by this answer. It proved to him that I had given this a lot of thought. I explained to him that I'd read almost every report on spasticity in the past three years including some of his. I even mentioned his TEDMED talk in Washington, DC. It was about the battle that goes on between the neurosurgeon, the patient, biotech, and the FDA. Pretty interesting stuff, but I digress.

The thing about the rhizotomy is the prolonged recovery time, at least a year between the surgery and  reteaching the body. So if he did a dorsal rhizotomy to my lumbar spine, it would be a year or two before he could do the cervical/thoracic one and vice versa. Especially since I'd already spent six years in this fight. I had confessed to him that I was tiring of the fight for recovery post stroke. I'm still in physical therapy and looking for answers after six years post stroke, for God's sake!

He first did the "do no harm" speech and explained he didn't want to make it worse. I lifted my affected arm the 4" away from my body for emphasis. That's how much voluntary movement I have in my affected arm with the spasticity. "Worse than this?"

He had to admit that it couldn't get much worse. That left the leg. While I've lost the ability to dorsey flex and evert my foot at will because of the spasticity, it still keeps me ambulatory. Sure, I'll stumble over invisible lint, or fall, but I'm still moving under my own power. The new new AFO is correcting my odd gait issues. I again imagine I'm seeing the gears move in his brain and the light bulb goes off. A Baclofen pump for the lower limb would work better than the oral medicine. Both surgeries could be completed within a year.

Then I dropped the bombshell. First one, and then the other. I told him about my aneurysms and about how my heart reacts to anesthesia. I half expected him to run out of the room screaming, but he didn't. Now, it was my turn to be impressed. No sense in doing the rhizotomy before the aneurysm is fixed. If it blew, I'd be dead. That would have to wait until after cardiology gave the all clear for me to be off my blood thinner for three weeks. But the Baclofen pump trial could be done to see if it works on my ankle and foot spasticity. I would only have to be off my blood thinner for a week prior to that surgery. I would also have to be cleared by the Emory heart team prior to the rhizotomy. It's just Emory covering their butts, but I understand it. They don't know my cardiologist or my vascular surgeon.

Tomorrow, I'm calling my cardiologist first thing. It's time to get this ball rolling. My hope is renewed and very much alive after this appointment. At the very least, it's a positive action plan.

Nothing is impossible.

Sunday, May 13, 2018

Sunday Stroke Survival: Caring for a Spastic Hand

Now,  I'll admit that my spasticity is severe. Most stroke survivors do not have spasticity as bad as mine. But for those who do, this post is may help you.

Even with my severe spasticity, the therapist , with electro-dry needling and working her hinny off, can stretch my fingers out to almost full extension (straight) and my wrist to almost neutral position (straight). The electro-dry needling is my word for it. I imagine there is a technical word for it. I just can't remember the term right now. A battery operated device causes the muscles to contract and relax through a sequence electrical shocks. The electrodes are attached to the various acupuncture needles inserted into my muscles. It basically saves the therapist time, and wear and tear on herself. It can tire the muscles in ten minutes versus an hour of manipulation by hand.

At times, the spasticity in my hand is so bad my nails will bite into my palm enough to draw blood. As I said my spasticity is severe and most severe spastic sessions can last hours (think spasticity on overdrive). Yes, it's very painful. I've described it here and other places as a cramp on top of a Charlie horse.

Grossness Alert, but it's honest

The normal shedding of skin cells pile up in the palm, creases in the wrist, the crease in the elbow, and between the fingers. As you can imagine this with normal sweating...the smell of this dead skin is awful. The old saying of it will gag a maggot fits perfectly to this. While many therapist will say that ice reduces spasticity, but remember I'm the Queen of Abby Normal. It takes moist heat and a lot of it. I've got a 40-gallon water heater and when I bathe, it takes every drop of it to reduce the spasticity enough to relax the muscles enough for me to marginally wash these places. Most times, it's by brute force shoving the washcloth in there. At times, I've even resorted  to a Scotch-Brite green scrubber part that the sponge has worn off to exfoliate my hand. Yes, I'm sold on Scotch-Brite as I said in an earlier post. A simple washcloth just doesn't do the job. The worn out green part is thin enough that it will fit wear a loofah will not. Even with all of that, there's still dead skin left in the nooks and crannies. I know because I can feel the slimy mess when I dry off. My spastic, inverted foot isn't as bad because the skin is exposed for the most part.

All this slimy goo building up on my arm, besides the smell, can cause skin break down if not removed. Most days, I can manipulate my fingers by myself, but with my wrist in a fixed 90 degree flexed state makes it impossible to cut my nails as I once did. So what do I do? I pick at them. Yes, they aren't pretty, but most of the time they are curled into my palm anyhow. My nails, from constantly being in a warm, moist environment, are now thin and soft. For this, I'm thankful. Madge, from Palmolive dish detergent fame, be hanged. Notice she only puts the finger nails into the Palmolive to soften them before a manicure. Yes, I know. I'm aging myself referencing a 1960-70s ad. By hey, I'm an older person. Get over it. It's hard to imagine that with all that goo constantly in my hand I still have dry skin to boot, but I do.

Now my hand isn't always spastic in a fist closed fashion. Since the fingers will move, sometimes I become spastic in a witch's craw. Every joint hyper extends in the opposite of normal. Yes, I had the ability to do this before my strokes at will. Every couple of months, the hand will relax as pictured like this morning. Although the spasticity will persist in the wrist, the fingers are pliable and I can voluntarily move them a little. Oh happy hours~ because at the most that's how long it will last. It's a mini spa day at the Murphey Saga house. I'll break out my soft loofah and being careful not to touch the center of my palm, I'll scrub everywhere else. Touching the center of the palm reflex will cause the hand to close into a fist. I am also careful not too extend my wrist too much because this will cause the spasticity to return. It will be awkward trying to get at places but it sure beats a closed fist. I'll immerse the hand in warm water to rinse the dead skin and sweat away. Oh heaven! The hand is actually clean!

Next, after drying the hand, I'll apply lotion. I'll put a big dab on the back of my affected hand and up my arm so I can go to it easier than trying to squeeze it out of the bottle every time I need some more. I know time is limited before the spasticity curls the hand shut again. As I apply the lotion, I'm using a massaging action. At the base of the fingers where they connects to the hand, the tendons are usually tight like piano wires. I'll massage these first and make my way up each finger with a kneading motion, it's a reflexology massage stretching them out one by one. I hit all the trigger points pictured. I save the center palm and the crease of the wrist for last. I know the reflexes and spasticity will return with the manipulation of these areas so I work quickly until I can no longer access the area. But, it's heavenly while it lasts.

I have mentioned several fields of study in this blog. I'm an expert of none of them. I do watch, read, question, and learn what works and what doesn't as it pertains to me. I've been in occupational and physical therapies for over half my life with this or that ailment, or it seems like it. I've never stopped and added up all the hours. There's also a limit to what I can do for myself with one functioning hand. I'll do what I can and ask others for help if needed. The other more questionable practices like acupuncture, massage therapy and reflexology have is garnered knowledge from licensed, holistic healing persons over the years. I say whatever works, do it. It really can't hurt. Even my PT follows my suggestions because it alleviates my pain and helps with my range of motion while she works. Now that's team work.

Nothing is impossible.

Thursday, May 10, 2018

My New New AFO

Well, after spending three hours at Hanger yesterday, I came home with my new new AFO. Instead of being that clearish white tone it's almost beige except for the straps. Instead of five straps it only has three. As you can see, my foot is in perfect alignment. It's actually more comfortable than my old one.

I'm still in a new "breaking in" period so I'm wearing it for two hours a day for the next week, and then three, etc. The foot strap that controls the spasticity in my toes is the reason I can't leave it inside my shoes like other AFO wearers.

Today, for my two hours of wear, I'm going to put it through it's paces. I've got to harvest the wheat grass from our straw bale gardens, pick clover, dandelions, and succulent grasses (weeds) for the rabbits and feed it to them. Yesterday we hung the fans so they would be more comfortable. The daytime temperatures are almost 80.

I've also got 40 tomato plants (32 Roma, 4 Cherokee black, and 4 beefsteak) to plant. It may have to wait until tomorrow's allotted time for the brace. We do love our tomato products. I've also got some herb plants to get out of our growing porch. Next seeds to start are my watermelons, okra, and oriental eggplant. I found some turmeric, ginger, and horseradish roots to plant into pots. It just gets too cold here to over winter them in the garden. The English peas and the bush green beans are already showing green leaves. It's springtime and our busy time.

I hope the new new AFO works like it's suppose to. If not it's another appointment with Hanger. But it may be a moot point because I have an appointment with the neurosurgeon before then. I'll let you know how it goes.

Nothing is impossible.

Sunday, May 6, 2018

Sunday Stroke Survival: Donning an Apron One-Handed Style

One of the things that I miss most living post stroke is wearing an apron to protect my clothes while cooking, washing dishes, and cleaning.My shirts bear the stains as a badge of honor for completing all of these chores without one for the past six years.

The major drawback for donning an apron now is the ties. Most have ties at the neck and the back. While I've gotten pretty adept at tying shoes and my shorts, or anything that ties in front of me, I just find it impossible to tie things tight behind my back and neck. Trying to tie them in front and making it fit are two woefully different things. I prefer a full apron because, being well endowed, everything lands on my nature made shelf if anything is above it.

I found a fix for this at a local farmer's market late, last summer. A cobbler's style apron. I could tie it while it was on a flat surface in front of me. I could even double knot the side ties so they wouldn't come loose. I got to talking yo the seamstress who was selling her creations. While the price was a bit steep at $25 a piece, but when you look at the cost of all the shirts I've ruined since my cooking videos started airing on YouTube, it was a bargain.

The apron was nice, but in the north Georgia summers, the temperature can reach 100 degrees. Besides, I needed more than one unless I washed it every day. Anyhow I was talking to this woman about tying an apron with one hand. She only had one cobbler style apron available, but she could make new ones in the coming week. I really wanted an apron like I wore in commercial kitchens. They were heavier fabric and durable. I also wanted some that were cute for the videos. After all, these videos were viewed by hundreds if not thousands of people. I wanted to look fairly presentable. The back piece of material was just too hot for summertime cooking. Plus it raised the cost of the apron more material= more cost, it makes sense or cents depending on your point of view.

The woman asked if there was any fabric and style the was in her aprons that I liked. There came the dilemma. There was too much to choose (50 plus) from and the styles, oh my! I settled on two fabrics. Both were cotton duck cloth or thick broadcloth. One was actually the fabric she used as a table covering. The other resembling pillow ticking. Thick like an old railroad engineers cap.

The style needed to simple and feminine, but not too fru-fru because that's not me at all. Think utilitarian meets Cosmopolitan. It had to present well on camera. I pulled several styles that had things I liked and disliked to illustrate what I meant. In my years of sewing, I knew how to alter patterns to incorporate what I liked and didn't like. I figured she knew how too. She got a good idea of what I wanted and she said give her two weeks to figure it all out. If I style had two working hands to play with scissors, I could have designed and made my own. I figured it would cost more, but it was in fact only $15 a piece for the two I custom ordered from her. I gave her free rein to make them the way she wanted.

What I ended up with was gorgeous! I couldn't have done a better job myself. They were worth every penny.

The first one was made out of her table covering. Attention to the little details such as a large pocket on the left side of the apron for ease of access with my functioning hand. Velcro closure at the neck covered by a pretty button.
Green toile print with mini pleated bib

The blue pin striped one  has a bow that came untied. The neck tie was tied to fit and double knotted. That one tying has lasted through several laundry trips. Again the placement of a large pocket on the left side of the apron.

 To replace the ties, she came up with an ingenious solution. D rings. So it still has one tie but I can adjust it once the apron is on. I'll fasten the tie in the D ring, don the apron, and cinch it tight. Voila! A snug fitting apron. I guess if I didn't have such a stroke addled brain, I would have thought of this fix too. If you had a favorite apron before your stroke, you can now alter it so  you can wear it again. Just be sure the D rings are on your functioning side.

 I can now happily cook and clean to my heart's content. AND, not destroy my shirts doing it.

Nothing is impossible.