Authored by BlueAngel on
Saturday, May 15, 2004
This column was written by the author of this site several years ago. The thought behind the article was attempting to show how little most professionals know about teaching others how to use certain types of mobility aids to others, particularly when they don't know how to operate the equipment correctly for themselves.
Little did I realize that the very act of retirement would thrust me into a role reversal so quickly. For years I had been trying to obtain a post polio syndrome work up which finally happened (diagnosis of post-polio myopathy with sensory polyneuropathies of the lower extremities). I had polio as a child of five in Manila, Luzon, Philippine Islands. The polio affected mostly the lower extremities with the right leg being predominately affected. The right leg is shorter and smaller than the left leg. The only time this was perceptible in walking was when I was extremely tired I would have a slight limp. As the years went by, the ability to climb or step up on curbs would diminish as did the climbing of steps without some type of assistance. Then I noticed that I could not stand up to cook and wash dishes without low back pain. I could no longer reach for dishes or cooking materials over my head without my arms feeling like leaden weights. My arms also became extremely tired with the simple act of combing my hair or brushing my teeth. With the advent of these symptoms, I compensated by getting a step kitchen chair that I could sit on while I cooked and washed dishes or used the steps to climb to get things off of the top shelves (albeit with care to prevent a fall). I also compensated by taking my time to do things and listening to my body. I also had a history of falling in my youth and middle age which fortunately has not been frequent in the so called “golden years”.
I finally got my neurology work-up which included EMG, nerve conduction studies as well as pertinent blood work. The doctor prescribed a four prong cane to help stabilize climbing curbs and stairs as well as maintaining balance. This worked for a while until the respiratory problems became pronounced. I could only walk for a short distance until I became very short of breath and the right quadriceps muscle began to sting and burn. The neurologist suggested the use of a wheelchair or a motorized scooter. Medicare nor the HMO would not approve the motorized scooter due to the fact that I would not use the motorized scooter in the house and that it would be a matter of convenience not one of necessity for mobility in the house. This decision was rather disturbing to me since I was under the misapprehension that the HMO was into the maintaining independence of the individual. I have found this all very interesting, enlightening and frustrating. I can now understand better what my patients in the past felt regarding the bureaucratic nonsense and red tape that really did not help that much.
The main thrust of this article is that no-one ever taught me either as a nurse or now as a patient how to use the wheel chair properly. People seem to assume that because you are a nurse that you automatically know the correct and proper methods of using the wheelchair. You know what assuming something makes out of you and me. Never did I realize how hard it could be to accomplish what appears to be a simple task like wheeling yourself in a wheelchair! It is a very tiring job particularly when you have unknown diminished upper body strength. (You are really “sore” after the first attempts.)
Is there a proper way to place your hands on the wheels to propel you? How do you position your hands on the wheels to turn the wheelchair in the direction you want to go? What are the proper mechanics of propelling the wheelchair? How far back on the wheel do you place your hands in order to propel the wheelchair? What is the proper method of propelling the wheelchair using both your hands and feet? What is the proper method of using just your feet to propel the wheelchair if you can not use your hands and arms for any reason? These are but a few of the questions that have come cascading into my mind. It is very daunting! I can now imagine how patients felt when they were placed in this circumstance.
You quickly learn to ask questions of other wheelchair bound people. You also learn how to ask for help in getting your wheelchair placed into the trunk of your car when you are physically unable to lift the chair. All of these things can be very depressing if you allow them to be. It is very difficult for someone who is not use to asking for assistance to ask for it. It takes a lot of “guts” to do something so foreign to you, your self-image and self-esteem. I am beginning to accept the idea that the wheelchair can, indeed, be a friend. It can be a vehicle that allows me greater independence to go outside the house and do more things. The main problem now is to get my children to accept the frailty of their mother that she can no longer do the things she use to without some help.
I could ramble on and on about the role reversal but it would get very tiresome for you. The main thing I am trying to say is that you should be aware that if your patient happens to be a health care professional (i.e. Nurse) don’t automatically assume they know and understand how to use routine equipment or how to do things that all of us take for granted. They need as much help as routine patients do. When you become a patient you automatically become somewhat of a blithering idiot and seemingly have forgotten all you ever knew about the health care field!
Thankyou for listening!!!!
Repectfully submitted by Ethel E. Killgore Taylor, RN, BSN
15 May 2004: I wrote this article for the now defunct Medical Gazette in the begining of 1990. I thought that it might be usueful now to bring attention to the same issue. This is the fact that quite a few of us do have role reversals whether it is from a healthcare professional to someone in other fields of endeavor. The aging process does bring these events to the fore.
I know that I can no longer walk except around the house in limited amounts of time. I use a rollator to elevate me enough to cook, wash dishes and sometimes sweep up the kitchen with limited success. I do have to use a power chair for mobility most of the time both insiude and outside.
The main purpose for all of this is to encourage you to maintain as much independence as you can for as long as you can. You feel much more as ease and comfortable when you do. This is documented by other Post Polio Survivors.
Ethel E. Taylor, ret. RN, BSN aka "Blueangel"
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