in praise of tools

I am at home for the weekend. This is very exciting. I’ve done some lovely everyday things: I put my left hand through it’s kneading paces, and baked a loaf of bread. I sat with Tom and Jesus (cat) on the sofa, listened to JRR, and knitted a little. I pottered about. Just like usual, then. That I am here at all is due to some carefully focused physio and OT, my own dogged persistence, and the great tools that I’m using to supplement my physical abilities. Over the past four weeks I have been inspired by the simple design of some of these tools, and filled with gratitude both to their designers and to the tools themselves. In the days immediately following the stroke, my body was extremely weak and had no idea how to manoeuvre itself : how to accommodate or deal with its own weakness. Initially, the nursing staff had to use a giant hoist to haul me out of bed. This device was time consuming for them (requiring two bodies to move my one body) and demeaning for me. To get to the bathroom, I had to first plan my functions some time in advance, before being rolled about, lifted, and suspended in a giant sling. Covered with blankets, lolling helplessly, with my bare arse exposed through a convenient fabric window, I would be wheeled in mid-air down a busy corridor to the loo. I had no idea how to get my body to work with me or how to use the tools that were available to maximise my independence. Then someone introduced me to the Sam Hall Turner.

How I love the Sam Hall Turner! This ingenious device enables someone with weakness in one part of their body, but a little strength somewhere else, to successfully transfer from one seated position to another. Its design is simplicity itself: an upright handle and two heavy circular plates, the top one of which rotates. While sitting, with my right arm, I could position my left leg and foot onto the plate, grab the handle, lock my knees securely, and rise to a standing position before someone rotated me to the angle of a waiting wheelchair. It is brilliant for the nurse because it involves no heavy lifting, and it is brilliant for the patient because no-one has to lift you. Through your own volition, you rise upright, and are simply whizzed round into place. Here is an illustration. You must picture me in the place of the woman with the specs.

I am told by experienced nurses that the turner is a relatively new invention, and that it has, in some contexts, revolutionised patient handling. I don’t know who Sam Hall was, why his name is colloquially attached to the turner, or precisely when this device first came into common use, but it really is an invention quite brilliant in its ease and simplicity.* It has also played a significant role in my recovery, since it was through repeated attempts to aim for that handle that I told my brain to “find” my left arm, and taught the arm to reach again.

I’ve now spent a month on wards with folk with a range of neurological conditions, and am constantly impressed and fascinated by the many ingenious methods of transferring different kinds of differently abled bodies from one surface to another. The most basic methods and devices –those that, not coincidentally, involve the least amount of carer intervention– are definitely the best. A simple sliding board is not just a device to get you from A to B, but a tool that you use, reinforcing the fact that your body is doing something. This is incredibly important. The role of simple tools in enabling personal independence is perhaps the first premise of Occupational Therapy, and something I’ve always been very aware of. Many moons ago, my mum was an OT, and my childhood was spent in the light of her enthusiasm for the many great devices that enhance mobility, ease, and function. I never thought I’d experience this enthusiasm from the other side, as it were, but I am so very grateful for it. Within days of my having the stroke, my mum had whipped herself up to Edinburgh with a bath board and a handy-grabber, and was making plans with Tom to make our flat accessible. Thanks to the simple tools that she thought of, and some others that my physios have equipped me with, I can now haul my wonky ass around the rooms in which I live both safely and successfully.

(please excuse mucky shoe and blurry photo)

Quite unbelievably, given the floppy and broken state of my body four weeks ago, I can now rise to my feet without the Sam Hall turner. In its absence, my gratitude and awe are now focused on two other brilliant tools: first, the humble shoe horn. Until my foot and leg were transformed into unmoveable lumps of flesh I had no idea how amazing a tool a shoe horn was. Without a shoe-horn, I would simply be unshod. With the horn, I can put my shoes on myself. And finally, the most wonderful tool of all: my toe-up leg brace (pictured here). Over the past few weeks, I’ve tried out various walking aids –frames, crutches, braces — and this brace is a real miracle. The zimmer frame was terrible for my posture, balance, and gait, and I was completely useless on the elbow crutches, because of my weak left arm. After four weeks work with the muscles of my trunk and chest, I now have reasonable upright balance, and there is a little left side movement coming through my hip, buttock and quad. Yet, despite the fact that my leg below my thigh is still basically just a huge hunk o’ useless meat, thanks to the incredible stabilising, swinging, and springing effects of this brace I can actually walk about without a wheelchair. This brace — a miracle of simple, flexible engineering — enables me to stimulate the muscles and joints that will eventually enable me to walk unaided, and also helps me to achieve the most natural gait I can under the circumstances. Next time I’ll try to write about the particular challenges of learning to walk. . .

In the meantime, you may be interested to know that, after watching my friend Mel’s deft demonstrations, and four days of frustration and persistence, I have finally managed to work my hair into two rudimentary plaits. These plaits are not neat. Indeed, they are so untidy that I fear they may merely enhance my current rather institutionalised appearance. But they are plaits, and I plaited ’em. I am pleased.

Unfortunately, I am returning to institutional life this evening in order to get the best out of my intensive physio and OT. If you felt like sending a cheering card, then please do, but there is no need to send anything else — what with Tom baking me pies etc I really have everything I need at the moment. If you include your address somewhere on the card, I can write and say thanks when I’m up and about again.

So here’s where I am for the time being:

Kate Davies
Ward 2
Charles Bell Pavillion
Astley Ainslie Hospital
133 Grange Loan

thanks everyone. More progress next week, I hope.

*if anyone has any information about the provenance and invention of the Sam Hall turner, I’d really like to know more about it. And if you are involved in mobility and independence either as patient, therapist or care-giver, I’d also be really interested to hear about the tools and devices that you find indispensable.