Polio Place

As a person with post-polio syndrome, one of the fundamental self-care guidelines that I use to conserve physical energy and avoid fatigue is to rest regularly throughout the day.

I use a vibrating silent timer to remind me when to stop and rest. I've depended upon this little timer to remind me to stop and rest every four hours, to take frequent breaks while gardening, and to get up from my 20 - 30 minute rests if I fall asleep. I keep it in my pocket and since it's silent, the reminder is private - unlike a cell phone or watch alarm. Perhaps one of the most valuable aspects of using this device is that it assures my husband that I'm taking care of myself so that he is less apt to be in a position to "nag" me to stop and rest.

Several are available, but I use the Ultrak T-5 Vibrating Silent Timer (www.bodytronics.com/p/timers/ULT5).

Bonnie Helpenstell

LIGHTEN UP - Rest, Pacing, and Timing
You probably fill your car's gas tank when it is one-half or one-fourth empty rather than waiting until it runs out of gas. Rest is the body's equivalent of refueling. If you wait until your body is running on empty, it may be difficult to get going afterward and you may be out of commission for a few days.

Many of us have coped with a disability by acting as though it doesn't exist. We ignore pain and fatigue and push on until we finish the activity or drop from exhaustion. In the long run, we accomplish less and feel worse.

Fatigue, muscle or joint pain can be a warning signal of overuse. When muscles become fatigued, they give less protection to joints and may cause increased pain and damage to both the muscle and joint. The harm accumulates over a period of time and may not become obvious until you lose the ability to do an activity which was previously possible.

Rest at least one hour a day. If you work outside the home, take advantage of breaks and lunch time. Do not use your lunch period to run errands. If possible, lie down for a nap before lunch. And use your breaks to put your feet up, close your eyes, and do some breathing exercises. If resting at work isn't possible, take a one-hour siesta as soon as you get home. It will make your evening activities more productive and enjoyable.

Lie down so your back doesn't have to support your body weight. Sitting takes one-third more energy than reclining. I find that rest is more refreshing if my eyes are closed, but if you want to read use an overhead book holder so your hand and arm muscles won't stay tense. Some people like to listen to music, meditate or do visualization exercises.

Balance periods of work and rest. Prolonged activities such as cleaning house or gardening need to be interspersed with rest breaks. Before starting, decide how long you will work at it and allow a five-to-ten minute rest break every 30 minutes. Use a kitchen timer to let you know when to stop and start again. Do not start any activity unless you can stop in the middle.

Pace yourself. Most of us have had days when we felt so good that we took on an ambitious project and kept pushing till it was completed. Since good days don't happen often, we want to finish while we can. But pain from overdoing may not show up until the next day or two and then there's a price to pay. It can take much longer to recover than if you had rested briefly during the activity. Being incapacitated for a few days afterward isn't worth it. Resist the temptation to overdo on your good days.

Split your ambitious projects into daily segments throughout the week, and stick to your plan no matter how good you feel on any particular day. Alternate light and heavy tasks throughout the week, and plan fewer chores when evening activities are on the agenda.

Use “Day-at-a-Glance" and "Week-at-a-Glance" books to design a schedule which will treat your body gently. Use the "Day" book each morning to plan your work and rest periods for that day, and the "Week" book to alternate light and heavy activities throughout the week.

Timing can make a difference in your pain and activity level. Activities which are simple to perform in the morning may be difficult later, or vice versa. For example, if cooking supper in the late afternoon is too stressful, prepare most of it in the morning, to be reheated later. If morning is your most difficult time, do as much as possible the night before.

How can you judge fatigue before overdoing? You need to pay close attention to the signals your body sends you. An activity is too stressful if:

• There is a feeling of fatigue. I know this sounds obvious, but many of us have learned not to pay attention to our body. We were taught to ignore pain and fatigue and just keep on going. The level of fatigue may be out of proportion to the level of activity, but listen to your body. The activity may be too stressful, even if your mind says it should not be, so take a rest at the first sign of tiredness.

• There is a change in the quality of movement. Notice your motions when performing the activity. Is there tremor or jerkiness?

• There is a change in the quantity of movement; that is, decreased range of motion. Perhaps you can usually lift your arm to a certain height but find that the height lessens as you continue the activity.

• You start to use compensatory motions. For example, "hunching" your shoulder when raising your arm or swinging your leg out to the side instead of flexing at the hip.

If any of the above signs occur while you are in the middle of an activity, it is time to stop and rest or modify what you are doing.

Prioritize Your Work
First question whether a task is really necessary. If the answer is yes, ask yourself if the job must be done by you or whether all or part of it can be delegated, and can it be done less frequently.

If it is essential for you to do, break it down into steps. What preparation is needed - what supplies or tools - and can they be arranged in a convenient way? What body motions are necessary to perform the job? Does it all have to be done at once? How much clean-up is there? See if any of the following ideas will help you save energy with your everyday activities.

Think about using a personal shopper. I’ve used a lot of time and energy clothes shopping from one store to another. Somehow the garments that looked good in the tiny dressing room aren’t as flattering when I get them home. I either have to take them back or live with them, which is wasteful as they seldom get worn. Many clothing and department stores offer a personal shopping service which is free as long as you make your purchases at that store. You decide your budget and the personal shopper helps you choose clothing and accessories that fit that budget and help you to look your best. I think this is especially important for wheelers, as clothes that looked great on the mannequin or hanger don’t always look the same when you’re sitting all day.

Use delivery services. I can remember when the only food you could get delivered was pizza. Now many grocery stores will take food orders and deliver the following day. Occasionally you may get a few surprises, though. Some years ago my mother (who was also disabled) and I used a grocery delivery service. One time they brought pork chops instead of lamb chops and cabbage instead of lettuce. But they were very nice about exchanging things.

Get help with the big housecleaning chores. There are several ways to get help at a reasonable cost.

• Ask your family for help. Try to be flexible, they may not do it exactly your way.

• The barter system. Offer to babysit or do a friend’s taxes in exchange for household chores.

• Offer a neighborhood youth the chance to earn some money. Granted, these kids are not professional house cleaners and will need supervision.

• Ask friends and neighbors for referrals.

• Look on Craigslist. You may have to try several people before you find one who suits you, but keep looking - there are lots of people looking for work. So far I’ve tried four people and I’m still looking for the right person. In the meantime, getting some of the big stuff done is better than nothing at all and the house does look better after they leave.

• Utilize a neighborhood youth employment service. Granted, these kids are not professional house cleaners and will need instruction and supervision, but I have had a lot of good help from teenagers who were happy to have work.

• Hire someone from a state-run employment service. Again, I have done this and had some very conscientious hard-working people who stayed with me for years.

Simplify the minor chores. In between the big cleanings you can streamline your efforts to keep your home looking good. Here are just a few suggestions:

Avoid bending by using a long-handled dustpan when you sweep. Use a lightweight mop that doesn’t need hand wringing. If you must vacuum use a lightweight upright vacuum cleaner instead of the canister type.

For wheelchair users, take a rectangular waste basket and wedge it between your lower legs, hooking a bungee cord to the sides of the footrests and across the front of your legs to hold it in place. This lets you carry the wastebasket as you wheel so you can empty the dustpan frequently. Use the same method to carry cleaning supplies; put the items in a plastic bin between your legs.

Use good work habits. Establish a slow steady pace for doing your work. A moderate pace uses less energy than rushing. Do chores the same way each time. Repetition makes you more efficient. Pace yourself. Don’t try to accomplish everything at one time.

I’m sure many of you have found other ways to do things that are simple, inexpensive and energy efficient. 

© 1997-2008 Grace R. Young