Assistive Technology — don’t forget to use it!

It seems silly in retrospect, but one of the things that took me longest to integrate into my daily experience with Lyme disease was simple devices that would increase my mobility, strength, memory, and so on. Many of these things are inexpensive or even free, and all of them helped to reduce the impact of the symptoms I was suffering from.

Here are some top things that I made use of. Please comment on this post with your own ideas and maybe we can build up a nice list of things that anyone who is suffering from Lyme disease can draw from.

  • Oven timer: This may not be obvious, but I left the stove or oven on and forgot about it far too many times before my husband and I decided that I should always turn on a timer if I was going to be cooking. Even if it didn’t seem necessary, I could always set it to 30 minutes or an hour from now. Better to have it go off and remind me that something was on the stove than to deal with a badly burnt pot or worse.
  • Cane, with SEAT!: It took me far too long to purchase this one (perhaps out of self consciousness?). Once I decided to get one, I found a geeky solution that saved me over and over and over again — the flipstick. This cane has a built in seat that you can flip out. Once I had it, I no longer had to dread those long hallway conversations when someone is kindly asking how you feel our bringing up a work issue. Instead of leaving them ready to collapse, I would pull out my cane (if I wasn’t already using it to help me walk), and have a seat. What a difference that made!
  • Parking permit: Ok, I’m an eco-geek, I’ll admit it. I was biking to work before I got sick, and I tried to keep it up after. The exercise was a good thing, and well intentioned, but far too often I ended up in a collapse either when I arrived or before the day was out when I pushed it physically. You can only ask for a ride home as a favor so many times before you have to make a change. For me that was first busing, and then driving and paying an arm and a leg in a pay parking lot far to far from my building, and finally, far far too late, a parking permit. I asked for a disabled one and had to fight a major battle to get it, but that’s another story for another time.
  • Husband: Ok, this isn’t really an assistive technology, but it sure is a great assistance. I should generalize this to anyone you’re close to, what it’s really about is being able to say when you need help. Non-trivial, but crucial.
  • Write things down: When you have cognitive impairments, writing things down is KEY. There are many ways to go about doing this, and sticky notes, emails to self, and so on are all ways of doing this. Putting notes where you will see them at the time you need to act is a trick that has been used by individuals with a variety of cognitive impairments (e.g. early-stage Alzheimer’s patients) for years. Learn from them. At least for me, anything I had to remember to look it might as well not have been written down. Some tricks of the trade: If I needed to know something first thing in the morning, I would set up a calendar entry that would txt message my phone to alert me (since I was unlikely to check my email or the calendar on my computer during the morning rush). Late at night, if not urgent, I’d send myself an email (often using my phone, which I kept near the bed), or write it big on a piece of paper next to the bed that I’d see in the morning. Sticky notes or other things right in front of the front door where I’d bump into them on the way out of the house were a big help. If anyone ever asked something of me when I couldn’t write it down, I’d give them the responsibility of sending me an email to confirm. If that wasn’t possible, I’d interrupt the conversation right then to write it down. Anything I needed to track on an ongoing basis went into a custom, known location. For example, phone calls to take care of household stuff, problems with the insurance company, and so on are tracked in a google spreadsheet that I can easily get at from anywhere. Work stuff that I might forget goes on a sticky on my laptop keyboard or on my screen where I will have to move it to start typing at work. I’ve even been known to put something in my shoes (can’t forget that when putting them on) and in a pot (where I would see it at dinner time).
  • Rubber bands: These are incredibly versatile tools for twisting just about anything. I first discovered this years ago when I had a repetitive strain injury that left me with very weak and painful hands. Put them around a jar lid (for example) and then try twisting. It’s amazing what a difference they can make. If you need to, also use hot water to help things along.

There were a couple of things I never got that I probably should have considered. For example, a disabled driver permit from the state of PA would have allowed me to park almost anywhere when the need arose. Didn’t even think of this one until it was too late to matter, but it should have been top on my list right at the beginning. Equally high on my list is a wheelchair, at least a cheap model for moving me around in emergency situations such as some of the collapses I experienced at work. Emotionally, I never managed to work up the guts to go through with this one, I guess I didn’t need it often enough/bad enough. I’m still trying to understand why I resisted this so strongly. Perhaps the same forces that caused me to wait far longer than logic would dictate for even the assistive devices I did use affected my willingness to consider a wheelchair. Why is it that we only consider using these things when it seems we don’t have a choice?

So here’s my suggestion: this year, before the holidays, take stock. Ask yourself what would increase your mobility, energy, or other things that you care about. Remember that technology does not define you, that mobility and exercise may be separate categories of activity, that spending time and energy on the things you care about most is your goal, and that wasting energy on the rest is to be avoided. Remember that spending you on things that fulfill you is part of healing, and that quality of life not defined by your energy levels or even your pain levels but by spending time with the people and activities that make you happy. And then make or buy or ask for the things that will help you focus on being happy.

Up and down, up and down

It’s been a while since I made an entry in this blog, though I often think of things I’d like to write about. A big reason for this is that I’ve been trying very hard to return to my working life (somewhat unsuccessfully). As a result I cut out from my day everything that isn’t directly benefiting the kids (computers and the kids just don’t mix) or my job. You might note that no where in that sentence did I refer to the things that benefit me, and that’s probably part of why this attempt was unsuccessful, though my illness of course also contributed. But all of that is a topic for a separate post.

Today I’m here to talk about my symptoms, and my doctors, and the frustration of how badly the two are interacting. At the bottom of this post you’ll see a very nice little diagram showing my symptoms (yellow line) and the other factors that may interact with them. Anything below the 0 line is bad. For example, I started tracking my sleep around 3/11, and you can see that for the first two days, I got *less* sleep than I should have. In contrast, you can probably see that my symptoms were better than normal around 2/12 and 2/26 but worse than normal around 1/15, 2/19 and 3/11. Details on the scales and what I was tracking can be found in the caption below the image.

Now, I made this chart because I’m a scientist and I like data, but because I’m a scientist, I also know that this chart is almost meaningless. Less meaningless than my daily symptom logs (which I’ve almost stopped doing at this point, nothing new seems to come up) but still meaningless. First of all, I don’t have anyone else’s charts to compare with. Second, it’s a lot of data, but way too little to conclude anything. Maybe after a year or so I could reach conclusions, but right now it’s impossible to correlate behavior with results.

So why am I keeping a chart? A couple of reasons.

  • First off, my memory is shot, so it’s hard to report clearly what’s happening without recording the data. At least that way I can be concrete with my doctors.
  • Second, my memory is shot, so I need something like this to prove to myself and others I’m still sick — look, this, today, is not the normal me — remember, I once lived without pain. You might think that I don’t need to do this anymore, but at this point is exactly when it seems to be necessary once again. In the last week, I had two alternative docs tell me that they had nothing more to offer me, that I just had to stop worrying so much and I would start to improve. Not quite as bad as saying I’m just imagining being ill, but not exactly the help I was hoping to get. The only doctors who are still truly checked in and helping at this point are my MD/homeopath (who still seems unsure of how to help me) and my therapist (who is great, but can’t give me a cure).
  • Third, science may not be able to draw conclusions, but sometimes you have to trust your gut. I hope that with the help of this data to supplement my memory, my gut may start to reach some conclusions about what is helpful and what is not. I have to decide whether to do yoga or not, how important sleep is, and so on. Science can’t help me, my doctors can’t help me, my intellect is running out of ideas, so maybe at least I can help my gut guide me.

So I’ll keep the chart, and I’ll keep adding to the chart, and I’ll keep waiting. The increasing numbers of days with energy give me hope. The increasing numbers of days with lots of sleep provide affirmation that I’m doing what I can to help myself. And maybe one day the whole picture will either tell me what I’m doing is working, or show me what to do.
Lyme symptom chart

Chart 1: a history of my symptoms. I track

  1. cold: whether my I had a cold or the flu (since my immune system functioned so badly when I became infected, the hope is that we will see an improvement now that I’ve been treated). Scale is -1 (sick) to 0 (not sick)
  2. symptoms: (scale is -2 (lots of symptoms like pain and fatigue) to 2 (lots of energy plus no symptoms)
  3. period: since it seemed to match up with downturns. Scale is 0 (no) or 1 (yes)
  4. hrs sleep (only tracked since around 3/11). If I get 7.5 hours of sleep (exactly enough when I’m energetic) that maps to 0 on the scale. If I get less than 7.5 hrs, I subtract 1 for each hour less. If I get more than 7.5 hours, I add 1 for each hour more.
  5. Whether I did yoga (only tracked since around 3/11). 0 means I did yoga morning and evening, -.5 means I only did it once, -1 means I didn’t do it at all.

More diagnosis … which stage was I in?

Lyme disease is multi-faceted because the lyme spirochete can attack different systems in the body. Typically, the longer someone is infected, the further it progresses, though there is no guarantee as to the order in which different types of symptoms will occur. In my case, because there was no known tick bite or acute onset of symptoms, we were not sure how long I’d been sick, though we knew it had been at least 11 months by the time the diagnosis came through. This meant that I was either in the early disseminated or late disseminated stage. A key difference in those stages is whether or not there is neural involvement or heart arrhythmia).

Also, we weren’t sure exactly which symptoms I did or did not have because many of them are quite subtle. For example, I am naturally a klutz, and a slow increase in klutziness was not immediately obvious to us. On the other hand, the week I knocked over 2 water glasses a night at dinner multiple nights in a row, we started to wonder if perhaps I was more clumsy than usual. Similarly, my memory has been bad, on and off, since my first child was keeping me up at night, multiple times per night, at 3 months of age (almost 4 years ago). Was it worse? I can’t really remember, as the joke goes.

In the end, all three of the doctors I saw, including doctors from both sides of the lyme wars, agreed that I might have neural involvement (luckily, I had no heart arrhythmia). The symptoms that seemed to concern them included: my right pupil was a little slow to dilate; I had had facial paralysis; we (my husband and I) thought I was more clumsy than usual; my hearing was worse than usual; I had occasional headaches; the reflexes in my ankles were more jittery than normal; a reflex in my elbows was unresponsive; we thought my memory was worse than usual; I had had sharp shooting pains in my arm. Some of these things (such as my right pupil) may have existed before the lyme, others (such as my clumsiness and hearing) are highly subjective, and none of the doctors sat down and explained exactly which symptoms were most important in their diagnosis. So I don’t know exactly why they came to the conclusion they did. However, they all agreed, and the suggested treatment in cases with neural involvement is IV antibiotics (this is something doctors on both sides of the lyme wars tend to agree on). Thus, the day after I saw the third doctor, I headed to the hospital to have a PIC line put in.