Kitchen POTS and pans

How do I stay on top of everything while I am dealing with so many medical issues? I get this question a lot. Some of it comes down to my stubbornness (or perseverance, whichever you want to call it). But some of it comes to structuring my activities to maximize my efficiency.

The thing about chronic illness is that it can make some of the most simple tasks seem like climbing a mountain. Some people struggle to get out of bed, some struggle to shower, some struggle to clean their house, some struggle to write with a pen or pencil. Some people have all of that covered, but just can't quite manage to use a proper swimming stroke, or run around a bend in the road without tripping.

When you need to rest after each of these basic life tasks, it can leave little time in your day for the things that are truly important to you. Whatever tasks you struggle with, the key to improving quality of life is to make these tiresome tasks more accessible.

As a physical therapist, I am trained in what we call "task analysis." I always think about my time as a gymnast and, later, as a gymnastics coach when it comes to task analysis, because doing drills for a new skill is a perfect example. The simplified idea is to break down a task into each of its component parts, troubleshoot each piece, and then put it all back together.

So I can tell you which muscles world champion gymnast Simone Biles needs to activate during each part of her new vault, named the Biles. Using the same methods, I can also take out some of the strain of basic household tasks by analyzing the components, seeing where I struggle, and finding solutions. The fun part is, the same task might hold a completely different challenge for a different person, and therefore the solution will be different.

For example, here are some tasks I struggle with and how I address them:

Example 1: Kitchen Tasks

• The problem: kitchen activities such as washing dishes, chopping vegetables, and stirring pots on the stove are very challenging for my body. On many days, I wind up needing to lay down after these tasks.
• The basic analysis: all of these activities require prolonged standing at the kitchen counter, which results in my heart rate going into tachycardia because of my POTS. I get lightheaded during these tasks because of my cardiogenic syncope. My knees lock out because of my hypermobility, and my flat feet don't help matters either, causing pain through my legs, hips, and back. My poor muscular compensations result in improper posture, that causes soreness and stiffness in my upper back. 
• The solution: I bought a tall kitchen stool, so I can sit down during those tasks and keep my body functioning for longer throughout the day. 

Example 2: Laundry

• The problem: moving laundry between basket, washer, and dryer, then folding it, is exhausting and often painful.
• The basic analysis: bending, twisting, standing, pushing, and pulling all strain my back and shoulders, and the quick position changes affect my dysautonomia symptoms. 
• The solutions: use that booty! Squatting rather than bending while picking up items can protect my back, prevent the position changes, and squeeze in a functional workout. Moving just a couple items of laundry at a time, especially while they are wet and heavy, can protect my shoulders from too much torque at the joint that risks subluxation. Sitting while folding smaller laundry items can help save my energy for the bigger items that I need to stand to fold. Wearing my back and shoulder braces can also help protect my body during laundry.

Example 3: Drying my Hands

• The problem: drying my hands on a towel has been causing my finger joints to sublux recently. It's painful, and I need my hands for basically everything throughout the day, so I would rather avoid the constant subluxations. 
• The basic analysis: the pulling and twisting motions involved in drying hands on a towel tend to sublux the hypermobile base joint of my fingers (metacarophalangeal, or MCP joint).
• The solution: taking the extra time to dry my hands slowly, gently, and cautiously, using more of a patting motion than a rubbing motion, can keep my joints in place and keep my hands working better for other tasks.

Every person is different. Something that seems impossible for me may not even warrant a second thought for you, and something that I don't struggle with at all may be your most challenging task. But with little modifications in activity, your day can be more productive, with more energy conserved for the things that are important to you.