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Friday, January 11, 2013

Working with FlyLady or a Similar Program When You're Disabled

*In advance, I want to warn you that this is quite a long blog entry.  I have a lot of info to share with you.  I hope at least some of it will be helpful, though.  I will continue to update this blog entry with additional information, as available.  Some of these probably ought to be posted as their own article, but for now I'm just going to leave them all in one place.  As always, I welcome comments and feedback, as well as any thoughts on what you would like to read about in the future from me.*

FlyLady's program can be good to follow for those who suffered from a disability because she has a designated activity for every day of the week.  This eliminates some worrying about "what to do and when".  I think that the structure this program provides can be a much-needed boost to getting things done and feeling good about yourself (something every disability can take away from).  You don't have to do what FlyLady does on the day she says to get things done- adapt what she says for your own life, schedule and physical condition.  I have fibromyalgia and osteoarthritis in several joints.  This makes how I feel changeable from day to day.  Lots of different things affect it- weather conditions, barometric pressure, how much sleep I got (or didn't get), what my previous day's activities were, etc.  Following the FlyLady program or doing something similar to it provides motivation while also spreading out activities which must be performed for lifestyle and home maintenance over a week's time instead of jamming everything into one or two days.  Does it work for every single person, all the time?  No.  Life is insane and sometimes our routines break down over the insanity.  I've taken the framework she provided and (hopefully in keeping with her message), I soared above the chaos with it.  Not all of the time, but more and more with every passing year, my life is under control.  That's a feeling many of us want to have, especially when a disability is tossed our way.  FlyLady's program provides a valuable template from which you can draw ideas, a schedule and perhaps even some focus.  Monday is Weekly Home Blessing Hour, Wednesday is Anti-Procrastination Day, etc.  (Please go to www.flylady.net if you're unfamiliar with her program, but want to check it out.)  Essentially, she sends out a free daily email that's easy enough to subscribe to, in order for us all to get motivation each morning when we check our inbox.  The digest format of FlyLady's daily emails means you get everything in just one email a day, which for minimalist & simplicity purposes is what I recommend choosing.  This program focuses on getting our houses & lives organized in baby steps, which is sometimes more than enough to do for those with chronic pain, exhaustion and/or disability.

The power-cleaning adventures of youth, where we could spend hours at a time without a break cleaning house, is totally out of the question for those of us with considerable physical disability.  Set small, realistic, achievable goals but ones that are important for you to meet each day. Write out a to-do list or email yourself via an online calendar to serve as a reminder of when to do these activities.  I actually do a little more work every day towards cleaning my home than I might have done pre-disability, because letting things pile up for a whole week now is unthinkable.  But despite doing somewhat more work daily, it's actually easier because I don't burn myself out with intense weekend cleaning.  There's no more heavy layers of dirt and dust to get through anymore.  Simple techniques really do work!  I went from not even noticing an unmade bed to despising one left that way. 

Every day, make sure that you have something that you want to get up and accomplish.  Your mental attitude will have a lot to do with what you get done.  You can either think that it's going to be a good day ahead or a bad one.  Logically speaking, why would you even want to go into the day thinking that it'll automatically be a bad day?  Even people stuck in bed may still be able to write letters, knit, sew, talk into a tape recorder, play chess, work on the Internet, take online classes, write in a word processing program to author material or do other similar tasks.  Never assume that people don't want to hear from you or talk to you.  No matter what your age or disability, you will always have something important to contribute towards society.  Keep yourself- and your mind- busy & productive.  Surround yourself with youthful, positive, energetic people in as much as possible.  Reach out to others in order to help them whenever you can.  If you're still alive, it automatically means you still have something great to offer to the world!  Never let anyone tell you otherwise.  If you're still here, it's for a good reason. I promise that if you'll be open to finding out what good you can do even as a disabled person, somehow all of your needs can and will be met.  Having a grudge against the world won't change matters and will probably just make you (plus everyone around you) feel worse.  No matter how bad off you are, someone out there has it worse.  It's perfectly natural to have periods of self-pity and mourning, but that should get less frequent with time.

These are concrete things that I suggest to ponder & try out:

1) Accept what you can no longer do or what tasks that you must modify.  I now get a load of laundry out of the dryer and because of my back pain or a lack of energy that day, I may have to sit down to fold or lay out the clothes before hanging them up.  At one time I could stand up and work for hours, but it's just no longer possible for me to do so because of my pain level many days.  Place a chair nearby and lay your clothes out neatly over the back of it if you're not strong enough or pain-free enough at the moment to hang them up after removing them from the dryer.  You can always hang them up in a few minutes after a brief rest, after all.  Listen to music or watch TV while folding clothes or doing other housework in order to make it more enjoyable.  Place your clothing which is folded up in a dresser or a linen closet instead of hung up on a rod, if you have trouble reaching high places and/or lack upper body strength to put things on hangers.  Or put clothing on a lower rod (like a double rod that's hung about halfway up a closet wall) instead of the higher one.  Elfa from The Container Store has cool mesh closet drawers that are an informal (and fairly inexpensive) "dresser" option for storing clothes, shoes, handbags and more in closets:

http://www.containerstore.com/shop/elfa/bestSellingSolutions/drawerSystems?productId=10014851&green=A012EC3C-27DA-5D63-A408-4696E4701B4C

Don't be afraid to try out new ways of getting things done and don't compare what you can do to what others are capable of. Just do the best that you know you can do each and every moment.  You should keep an end-game rule, though, to avoid clutter.  No matter what, for example, make sure your clothes get put away from the dryer somehow.  What FlyLady says really does work best for many disabled people- do a load of laundry a day.  Sort, wash, dry and put away every single load, every single time.  I know some people prefer to do all their laundry one or two days a week and if this works for you, that's no problem.  If you have a small household, you may be able to get away with just doing one load of laundry two or three times a week.  Some people may have to share laundry facilities or go to a laundromat and that can create challenges, too.  But disability makes doing several loads in a day and hanging them or folding them all up difficult sometimes.  You may not be able to do it as quickly as a non-disabled person or work standing up.  It's okay to bend the rules- but try not to break them too often!  Accept that it may take you considerably more time to accomplish a task than someone without any disability or physical issues.  I don't always like that my pace is slower than a lot of other people- but it's the end result that counts, not the speed at which you work!

2) Ask for help from others, even if you have to pay for some of the services.  I realize that option may not be available to everyone, but be sure not to make assumptions about how expensive a service might be or how much paperwork might be involved.  It's really easy to make a mountain out of a molehill and think procuring a service will be harder than it actually is.  Look into help from professional organizers and housecleaning services that may accept bartering for their work or those that do "pro bono" work.  You'd be surprised how many businesspeople actually like bartering or are at least willing to try it.  Perhaps you make beautiful quilts, can alter clothing, know how to hem items like a professional seamstress or you do something else that a professional organizer or housekeeper could really use your skill set for.  Delegate any services that you can to family or friends.  Review your skill set carefully to see what you can offer to others as a payback for their help.  Maybe you're good at balancing checkbooks, paying bills, editing rèsumès or writing business letters.  If someone loathes a task that you find quite easy to do, offer a barter!  They may be absolutely thrilled to vacuum the house for you if you'll write out their checks to get bills paid.  Many people are super-busy and would love to pass off certain tasks to another (particularly ones they dread), but are afraid to ask for help.  People do this in the business world all the time.  Don't feel like you've got to do everything yourself and let others know you want to help them, too!  Meals on Wheels can provide you with dinner to eat nightly and even other meals for a relatively small donation every month.  Many housecleaning services are out there with bonded, insured maids that do a fine job of cleaning house.  Not every person you hire for a service may do things "perfectly" or in the exact way that you'd do the task, but they can get things done for you which are impossible to continue doing yourself.  Accept that sometimes, especially with disability, you may have to hand over the reins to someone else taking over a task.  If you're used to controlling and/or doing everything, I know that this is tough.  But it's often necessary and you must be thankful for the good help that you do get.

Always thank someone if they help you out, even if they didn't do it quite up to your standards (especially when they tried hard & did the best job that they could).  However, keep this delegation of activities in balance.  Try to do what you can yourself, even if it takes you longer than someone without a disability, so long as it's safe.  This will help keep your fitness level and your spirits up.

3) Carry a phone with you at all times.  Buy and use a cell phone or home phone clip to wear on your belt or waistband daily.  (Most cordless phones are sold with belt clips already in with the packaging nowadays, too.)  Make it part of your routine to put this on as soon as you get dressed and don't take it off until you're charging it and/or removing your clothing for the night.  Right after it's charged, put it back in the clip and keep it close to you.  Alternately, consider wearing a necklace like one from Life Alert in order to speak with emergency services if you fall or otherwise get injured.

4) Time how long it takes you to do activities NOW, including on "bad" days physically.  Adjust old standards to suit your new capabilities.  Pre-disability I could clean my house (usually without taking a break) in 90-120 minutes, assuming it was straightened up first.  Now I must take a ten- to fifteen-minute break about once an hour, more on a really bad day.  I also move a little bit more slowly, cannot lunge or squat down like I used to and can't kneel down on the floor for very long.  I've had to adjust my time for total housecleaning to about three hours for my two-bedroom, two-bathroom apartment.  Not easy to admit, for some reason.  But I'd rather acknowledge that it takes me twenty minutes to dust and accept that I'll need a ten-minute break than lie to myself and think I can get it done in ten minutes.  I don't move that fast and I now just work with this knowledge.  I prefer to do the housework in small increments each day rather than face a whole house to clean at one time, but sometimes my home just needs a good overall deep cleaning.

5) Alternate between periods of "active rest" and physical work.  Example- spend fifteen minutes standing up to wash dishes, then go sit at the computer and balance your checkbook or pay some bills.  Spend five minutes wiping down the mirrors in your home, then spend five minutes sitting in prayer. Do homework for forty-five minutes, then go run the vacuum for for the same amount of time.  You get my drift.  Do this all day long and you'll be astounded at what you can achieve.  Looking at things in terms of little chunks like this makes life more manageable mentally, as well.

6) If applicable, take your medication(s) and allow them to begin working in your system before starting chores.  This is especially true if you take pain, heart or lung medications.  It takes anywhere from 30 to 120 minutes for medication to kick in, depending upon your weight and how much food is in your stomach.  The more food in your stomach and/or the more that you weigh, the slower it will likely be before you start to feel positive medication effects.  Keep this in mind when planning outdoor activities, too.

7) Wear protective clothing, an apron, joint pads and a nose/mouth mask (3M makes these, for example) when cleaning, if needed.  If you're outdoors, you may need a sun hat and a cooling bandanna.  You may sweat more than you used to when doing any physical labor- wear a bandanna around your forehead to mop up sweat before it drips down into your eyes.  Special cooling bandannas and cloths are available that you dunk in cold water for a bit, then put around your neck to prevent overheating.  If cleaning product chemicals, dust and dirt affect you negatively, wear a disposable mask over your nose and mouth to keep offending particles out.  I only wear rubber gloves if I've got a really nasty cleaning job, such as cleaning the oven, because I can't stand how hot and sweaty rubber gloves make my hands feel.  But if your skin is sensitive or there's a lot of nastiness to clean up (such as vomit), use them while cleaning.  Keep hand sanitizer, antibacterial soap, disinfecting spray and anything else on hand that you can to prevent spreading as much bacteria and viruses as possible.  Wash your hands and/or use sanitizer frequently.

My mother's diabetic problems really drove this home to me, as she was near death last year due to an infection she caught after visiting someone else's very dirty house. For those that have a compromised immune system- and many disabled people do- there's no such thing as having too clean an environment. I know that some people will disagree with me on this, but once I saw my mother fall into a diabetic coma over what was probably once one little microbe of bacteria, I got really serious about germ-killing.

Be super-careful when cleaning on or around wet floors.  I recommend that you always wear rubbed-soled shoes with good tread while cleaning.  (Slip-resistant shoes are available from many vendors, including Amazon.)  No open-toed shoes, not just bare feet, nothing with a slippery sole.  You can always change into fancier clothes or take the rubber-soled shoes off when you're done cleaning- but you can't immediately fix a broken toe that got smashed because it hit a vacuum while exposed bare!  Safety first and good looks second, no exceptions.

8) Read Jeff Campbell's book entitled Speed Cleaning. I don't recommend it so much for speediness as I do for the fact that it really teaches how to clean in a very thorough (but not obsessive or overworking) manner. If you follow FlyLady to the letter, such deep weekly cleaning may be unnecessary, but it really depends upon your household.  The more people, pets and activities that are in your home, chances are the more cleaning your home consistently needs.  Depending upon your household, you may be able to get away with only doing "heavy housework" once every couple of weeks or you may actually need to clean house twice a week.  The more pets you have (and the furrier they are), the more kids, the more dusty or dirty a geographical area you live in...well, chances are the more often you'll have to clean.  Some people like a cleaner home than others, too.

Constantly review your cleaning product arsenal to see what can be slashed from the list.  Research never stops for me in this regard.  I'm always on the lookout for ways to cut cleaning time and make the housework easier while still getting great results.  This isn't laziness, just an attempt not to waste time.  Don't get out the furniture polish & dusting cloths if a quick feather-dusting is all that's needed.  A small, cordless vacuum (either stick or handheld) can be a good thing to own if you get pet or kid spills and little messes here or there.  I own a carpet sweeper that only cost a little over $20 and it works well to get up that daily layer of dust and cat fur my household so lovingly produces.  It's lightweight and since it's a sweeper, never requires batteries or plugging in.  Use whatever tools will be the lightest and easiest to employ while still getting the job done- you'll automatically make the job a little safer to perform.  If you wipe down your shower tile and tub with a clean white hand towel after every shower plus run a small fan in there every day for awhile, I can almost guarantee that you'll never need to reach for a cleaning product to clean the shower or tub again.  Yes, it adds a minute or two to your daily routine- but isn't that better than scrubbing the bathroom for fifteen minutes with bleach or some other noxious chemical every week or two?  Choose environmentally-friendly products without fumes or fragrance for cleaning whenever possible.

9) Write down what you achieve each day right after you're done performing the task or check it off on a to-do list.  You'll be amazed at what motivation this provides to keep going forward day after day.

10) Break chores you used to do all at once into "chunks".  At one time I could polish every piece of wood furniture in my home without stopping.  Now I can usually handle a room or two & need a short break, at least if a lot of standing is involved.  So what if it takes a week to get the whole house thoroughly dusted?  There's no Olympic competition we're in to see who gets their house cleaned the fastest or best.  Do what works and drop the rest!  Don't lose precious moments of your life worrying about a little dust or dirt.  But don't put things off until it will take hours and hours to clean, either.  There's a point in everyone's house where dust goes from just being an annoying little powdery finish on furniture to being a heavy-duty allergen.  The more dust that is on a surface, the longer it'll take to clean and the more frequently you'll have to change your dusting cloth or shake out your feather duster.  Balance and moderation are the biggest words a disabled person has to live by.

11) On days when you feel better, do a little extra work in or outside the home.  This will help make up for days when you're out of commission.  If the cleaning's done, use the energy to finally clear out a junk drawer, a messy closet or pull out some weeds in your garden.  Work with your natural cycles, not against them.  If you're a night owl, accept this and use the time to your advantage. If you're an early bird- same advice, different timing. I get a metabolic boost at night that some people don't- this is very common with "night owls". Left to my own devices, I actually have my highest-energy time between around 10 p.m. and 4 a.m. Working during your own "peak hours" can make even difficult tasks feel less draining and painful physically.  It makes doing routine tasks feel a little bit less boring, too, I've found.  Many people are like this. Some doctors consider it a problem and have named it Delayed Sleep Phase Disorder.  However, I think it's merely an example of different people just being built for different work in life, not necessarily that it's some kind of flaw.  If you enjoy getting up early and going to bed early at night, great.  But if you're a night owl, seize the energy you feel then and use the time after dark to get things done.  Just because you don't rise with the sun doesn't mean you're lazy.  Many people get this label if they experience this in their school years or because they work a day job (otherwise known as first shift).  Being this way also can lead to getting an incorrect label as an insomniac, when in fact this is not true.  Again, left to my own devices- meaning no activity, work or school forcing me to rise early- I'll not go to bed until sometime around one a.m. in the morning. I then sleep fine for six to eight hours & get everything done that any normal person does while I'm awake.  But there is often a stigma attached to people who don't get up early in the morning, especially in more Puritanical societies which always believe that kind of lifestyle is the only correct way to live by.  If you can never get to sleep at any hour without some sort of intervention, okay, then you have a problem with insomnia.  If you just have a different sleep cycle than others, that's not insomnia.  You may indeed have problems with what people see as living by normal circadian rhythms and such, but that's a totally different issue from never being able to get to sleep at all.  Sleeping pills are often prescribed for these delayed sleep phase "problems".  I'm neither for nor against that treatment, but feel I must speak up about this so-called problem here.  Look carefully at this issue if it has affected you or someone that you love.  Advanced Sleep Phase Disorder is when someone goes to bed very early in the evening, around 6 p.m. for example, and wakes up extremely early in the morning for good, like at 2 a.m.  Again, it's up to you whether or not this is viewed as a problem.  Some people also love the quiet that comes with the world late at night and into the wee hours of morning- I'm one of them.  It can be a terrific time to focus without myriad disruptions from the outside world.

12) Don't procrastinate about doing things, especially if you're feeling well enough to accomplish something that day which needs to get done. The time we spend procrastinating can be better spent working.

13) Keep your reading glasses or eyeglasses on an eyeglasses cord and wear them all the time, if applicable. This way you won't sit down to read a book or watch TV only to realize your glasses are in another room. Alternately, keep your glasses by the spot in a caddy next to where you always use them (i.e., next to your recliner) and discipline yourself to clean and return them to that caddy every night before going to bed. I put an eyeglasses cleaning cloth and a spray bottle of eyeglass cleaner in the caddy with my eyeglasses to make this chore even easier.

14) For frequently used items such as pens, tissues, scissors, Scotch tape, etc., keep a caddy with these items in areas of your home where you use them all the time.  For example, I have a caddy like this with similar items in each by my bedside, on my dining room table and in my living room.  I also keep these supplies at my computer desk and some of them are also in my Office in a Bag.  (At my desk, I put them in a school supplies zippered bag, then put this in a drawer).  While it may go against minimalism somewhat to have multiples of these items all around, it does help with simplicity when one is disabled.  Yes, this means I own five pairs of scissors- but it sure is nice not to have to get up after I've sat down just for one little item like this all the time!  Again, keep this in balance- I'm not trying to encourage laziness and/or overspending.  But people with deteriorating joints and other body issues experience levels of pain enough to warrant this, I know.  In my younger years, all of this was unnecessary, but I definitely understand how important it is to have items close at hand now that I experience many days of a painful disability.  Write a list of each item in your caddy to keep in it, so that when you run out of these items, you can check the list and see what needs to be replenished the next time you go shopping.  Alternately, as soon as you see you're close to running out of something, put it on your shopping list, along with a brief comment as to where the item should go in the house once purchased (if needed).  Otherwise, buying the replacement's likely to slip your mind when you go shopping.  Be sure to put things back when you're done using them.  Even with having multiples, you still want to be able to put your hands on what you need in the room you need it in every time.

15) Study every medicine, herb, spice, therapy and surgery available to help your condition(s).  Be prepared to look outside the box and consider unorthodox viewpoints.  Read reviews whenever available by doctors, nurses and patients who used or had the treatment/drug.  Make sure to carefully look into both the positives AND the negatives of every single option you're reviewing.  It's important to be open-minded but skeptical about any treatment you receive and medication available.  Many people do whatever society or their doctor dictates and suffer for it, unfortunately.  Also watch for contraindications and what medicines should not be used together.  Herbs also have these issues, so don't assume an herbal remedy is 100% safe no matter what.  Side effects are not to be taken lightly and neither are withdrawal symptoms, and both need to be reviewed with a very wary eye before you take a medicine.  Other patients on medication forums can often be your best source of this reality.  Nothing against doctors or nurses, many of them are hardworking and well-intentioned, but they usually don't suffer from the condition they're treating.  Unless a person has been through a condition (or been on a particular medication) all they will have is "head" knowledge of the subject, not "body" knowledge.  And there is a huge difference.  But keep in mind that there are a lot of "addiction scares" out there, some of which have merit, but many of which do not.  So many people are afraid of medication, even when it makes a positive contribution to a person's life and the person legitimately needs the medication to live.  And dependence upon a medication, when you need a prescription to manage a legitimate medical condition over time, is completely different from addiction!  Addiction means you are taking a medication you either don't need at all, you're using it to get a high (or to zonk out) and/or you're taking it in amounts WAY beyond what it's prescribed.  It's my personal opinion that the medical community and the government needs to stop making people who take normal, properly-prescribed medication to live in some level of comfort and normalcy feel like they're all potential addicts!  

Many, many medications are said not to have withdrawal symptoms (at least when they're first introduced to the market), but actually induce a horrible reaction if medication is suddenly stopped.  Doctors and nurses are also not always aware of this potential for withdrawal or are willing to acknowledge it when a patient brings it up, either.  Pharmaceutical companies do a lot of marketing directly to doctors and their staff, which almost certainly colors the viewpoint of those who listen to the presentations, so please be your own advocate in all cases.  Do your own research and don't rely on others to automatically know what's best for your body.  At least in the U.S., remember that pharmaceutical companies are also often allowed to test new drugs out of the country, which could mean that we don't get all of the information we might have years ago about new drugs on the market.  There are many reasons for the frequent drug recalls that occur today and that is one of them.  Drug companies often advise the FDA (Food and Drug Administration, under U.S. Health & Human Services) as to what their products can treat, only for the public (and the FDA) to find out the results were exaggerated or just plain false.  Don't necessarily buy into those TV advertisements and definitely not into celebrity endorsements of medications alone. 

On the other hand, don't let fear keep you from trying a potentially helpful medicine or surgery, especially if that's been well-studied in several different medical researchers.  Sometimes you have to weigh the benefits of a medication against the side effects, and the advantages are such that it's worth any downside of the medicine(s).  When other people have good things to say about a medication consistently and can provide specifics on how it helped them (and how they were suffering beforehand), pay attention.  Act as early as you can on pain or problems, too- it is much easier to treat a condition before it gets to a severe stage and is possibly life-threatening.  Never, ever let a doctor, nurse or insurance company bully you into or out of getting a procedure or medication!  A lot of nonsense and fearmongering goes around the world of pharmaceuticals, herbs and supplements.  Sadly, government officials, businesspeople and those in the medical industry can and do manipulate data to serve their own purposes- and this comes at the cost of effectively treating patients.  Many times, people don't need to be in nearly as much pain as they're in, but those in power keep treatment (including medication) from those who desperately need it for a legitimate condition.  We all have to be educated, outspoken and guilt-free about our disability and the treatments we need.  Don't let prejudice, miseducation or hype keep you from getting the best care.

Pay attention to how any new medications or supplements affect you. Look for any cardiovascular, mental or weight changes and don't let them get out of control. Also, don't overdo it on any pills, including supplements. A person's liver can only take so much. If you've developed persistent abdominal pain and you've been taking six different supplements, for example, it can be a sign that your liver is overworked. Taking a break from supplements may be needed if you're experiencing any problems. Slowly add them back in one at a time once side effects end- if any pain or problem reoccurs, cease taking the supplement at once.

16) *The following information is generally only going to apply to people within the U.S. It is not to be regarded as official legal or business advice, but as a primer for assisting you on understanding the complex world of health insurance as it is currently administered. These rules & regulations won't apply to everyone & can change at any time.*

Don't let a lack of insurance knowledge, a low income or financial woes keep you from seeking out important & necessary self-care as a disabled person. Even if you don't have insurance, you'd be amazed at what is potentially out there for you at no or little cost. Pharmaceutical companies have myriad programs to assist low-income people with paying for prescriptions. Most of the time all that's needed is a recent copy confirming your proof of income (such as from a W-2 form), a written prescription from your doctor, a form the doctor fills out (usually only a page or two long) plus a short form that you will need to fill out. It is well worth a trip to the doctor to get them to fill this out for you, considering the potential savings it could yield you, assuming you meet the income requirements. If it's a prescription you've been on before, a doctor may be willing to just let you drop off the paperwork they need to fill up & sign off on. If they're willing to, have the doctor's office fax in the papers to the pharmaceutical company's number (this # should be listed on the forms you fill out). If not, mail in copies of the completed info to the address the pharmaceutical company specifies. Keep copies of every single document you send in for each prescription, in case it gets lost in the mail or they don't get the fax. Never, ever send your original W-2 or proof of income papers in; send copies of this only. Unless it's required that you provide it, black out your Social Security number from any forms you send the company, too. A Google search will yield you the same of the pharmaceutical company that manufactures your prescription(s) if you don't know who it is, and you can also search this way for the specific form that company uses for requesting this aid to begin with.

Teaching & research hospitals often provide no- or low-cost services for a variety of conditions. Doctors will usually just charge a flat fee for those without insurance to come in for a routine check-up; depending upon the area you live in, it's usually around $75.00 to for them to do this. Remember to check into every available government program that there is, too- Medicaid, Social Security, Medicare, etc. Your family doctor may be able to steer you in the right direction if you've had trouble applying for benefits or are intimidated by the breadth of available aid out there. Not every doctor's office employee is knowledgeable or helpful in that respect, but many people are- remember, a lot of these folks deal with insurance day in & day out, giving them an inside eye on things you may not possess. I know that this is a lot of information to take in, but it's vital you do everything to help yourself stay strong, safe & comfortable.

Keep up with getting your vaccinations, going to the doctor & dentist. In the United States, preventative care should be free in most (if not all) cases, so long as you have health insurance. Even for the uninsured, flu shots only run about $30.00 & that is peanuts compared to what a hospital stay would cost if you got super-sick with the flu. While I had to swallow some pride to accept it, my mom paid for me to get the flu shot this past year & I'm grateful that she did this for me. Don't let pride keep you from taking care of yourself. Not everybody has a helpful parent or other hand to reach out for, I know- but if you do, get over your ego & take the help when it's offered. Pneumonia shots are also important to get for those who've had multiple bouts of it (or bronchitis) in the past, if you are are elderly, have a compromised immune system or regularly work around many people who get that illness. Pneumonia vaccinations, unlike the flu shot, aren't required yearly. Tetanus shots & the related boosters should be received as well.

Getting your teeth cleaned by a dentist twice a year is typically covered at 100% of eligible expenses by most American insurance companies, though sometimes you'll have to pay out-of-pocket to the dentist first, send in the claim to the insurance company & then get reimbursed. There may be a small fee the insurance won't cover for supplies or X-rays (usually $6-$10 each time, sometimes a little more if you have more complex X-rays done). But following this regular schedule of dental maintenance is vitally important. It costs approximately $100 per cleaning, so even a lot of uninsured people can afford it. If it prevents far more costly and painful procedures down the road such as root canals, bridges, crowns or dentures, then to me it's worth the price. No, doing this is not an absolute guarantee of resolving all future dental problems, but it sure doesn't hurt your odds, either. Look online for reviews about local dentists and/or oral surgeons to get the lowdown on who's best to see.

If you have health insurance, know your coverage guidelines backwards, forwards & sideways. If you're insured, you should get what is called an "EOC"- otherwise known as an Evidence of Coverage. If you don't get a paper copy, one should still be available to view online by either your employer or your insurance company. Review this EOC carefully & thoroughly. It will usually explain exactly what is covered & what is not under your insurance, what your out-of-pocket cost will be, if you have a deductible or not & much more. Don't be afraid to call your insurance company's customer service phone number (it should be listed clearly on your medical insurance card) & talk to a representative when you have questions about your coverage. Many companies are open 24/7 to their customers & also have online customer service available these days through a webchat format. I worked in insurance on the phones for over five years & educated many people about their coverage availability & options. Many times they'd say, "Wow, I wish I'd called you all sooner. I had no idea such-and-such was covered!" If a request for a service authorization or a claim is denied, you & the applicable medical entities both have appeal rights. Ask the insurance company EXACTLY what is needed before getting a surgery done or a prescription if you're unsure of whether they'll approve payment for it or not. Never assume that the hospital, surgery center, doctor or dentist's office has done all of this homework for you, either.

Look into home health care services that would be paid for by your health insurance company if needed. While normally custodial or cleaning help won't be covered by insurance, home health care is usually covered in the form of help with day-to-day activities only a nurse (or someone similar) can do. If you're talking to a rep & they seem disinterested or not very knowledgeable, call back to get a different person or ask to speak to a supervisor instead. Don't ever let someone tell you that they can't send you information in writing as a confirmation, either- anything they tell you over the phone CAN be sent to you via fax or mail if you request it. A representative may not be able to do this, but it should be available through the automated system, printed online or can be mailed to you by a customer service supervisor. Depending upon the document, be advised that it may have to come directly from your employer (or the Office of Personnel Management for Federal Government employees/retirees) & not the insurance company itself.

If you're insured & your insurance company uses a network of participating providers that you must choose from in order to get maximum financial coverage, be aware of your provider's in- or out-of-network status before seeing them. Not every insurance plan uses networks- if you don't know whether or not your insurance coverage does use there, find out. These days, you should be able to view online which providers of services are in-network prior to getting treatment (assuming it's not received on an emergency basis), but you can always call the insurance company to double-check instead. The rule of thumb is this- if your provider is within the insurance network (in other words, they have a contract with the insurance company), they must submit any prior authorization or notification requests for services that the insurance company requires (such as for a gastric bypass surgery), they have the right to collect a co-pay at the time of service if one is to be paid per your coverage outline & they must submit all claims for you. An out-of-network provider, on the other hand, can charge you in full for services at the time you receive them, is not under obligation to submit either notification requests or the claims (meaning that you are responsible) & you may have less financial coverage from the insurance co. when seeing a non-network provider. An example? Many policies will state that in-network providers can charge a $30 co-pay at the time of service, and then all other charges which are covered under the EOC will be paid at 100% of the provider's contractually-agreed-upon payment by the insurance company. But under the same policy, out-of-network providers are only reimbursed at 80% of the eligible expenses. This can be a tremendous difference in what you'll pay out, so be informed before you go to see any provider for help.

In-network providers usually have anywhere between 60-180 days to submit a claim to the insurance co. after services are rendered, while out-of-network claims typically are allowed one year from the service date to be received. A denial of "untimely filing" will automatically be applied to claims falling outside of the allowed time limit, so be conscious of claims getting filed promptly whenever you receive treatment. With in-network providers, an untimely filing denial will be on their heads- they have a contract telling them their timely filing limits & are expected to be honored. They cannot bill you above & beyond what your normal responsibility would have been, had the claim been filed in a timely fashion when it's a contracted provider involved. However, with out-of-network providers, the financial burden will be yours to bear if the claim's not filed in time. The only common exception to this rule will be if an auto accident (and therefore, auto insurance) is involved, in which case the time allotted is usually increased. Different states have different guidelines & laws or contracts are always subject to change.

When in doubt about any aspect of your coverage, research it until you get answers & make records of anyone you talk to. If you find the information online, I highly recommend that you print it out & keep it for your records instead. Most providers & insurance companies are not out to cheat people- but back yourself up with hard copies of facts whenever possible. Health abuse & fraud do exist, so you must take measures to protect yourself and/or your loved ones in this regard. If you ever see a claim for services sent in to your insurance company that you did NOT receive at all or for a date of service when you did not get any treatment, report it at once to the insurance company. Providers can & do make honest billing mistakes, so don't automatically assume they're attempting to commit fraud- but it is imperative to report these incidents as soon as you spot them. The insurance company will research this for you regardless of the provider's in- or out-of-network coverage.

Also keep copies of all receipts or cancelled check copies (front & back) of any payment you make for ten years from the date payment was cashed. I keep a manila folder for each year of these receipts that I've paid. CLAIM ALL MONEY PAID FOR THESE SERVICES, AS WELL AS ANY PRESCRIPTIONS ON YOUR TAX FILINGS EACH YEAR! While you may have to keep receipts in order to record this, some pharmacies (like CVS, for example) have viewable & printable prescription records that can be printed out for the prior year to prove exactly what you spent on medications during that time. Depending upon the amount of money you paid out for these services, it can affect your Federal tax return to your benefit. Usually it takes about $3,000.00+ spent to get anything back, but claim all money spent even if you think it won't do you any favors. It never hurts to claim this info & it might just help you. As with any info you use to claim on your taxes, keep a paper copy of these records for seven years.

Make sure that you keep every single copy you ever get of the document called a "Certificate of Creditable Coverage" (COC) given to you by an insurance company, usually sent out after your coverage terminates due to a job loss, change of employment or in merger/takeover situations. This document is written proof that you were insured between a certain date range and that knowledge may be needed by your next insurance company or to prove you had health insurance someday in a court case or other important matter. As always, I recommend that you keep this in a file folder. Mine is filed under a hanging file folder labled, "Insurance Coverage", and I have a manila folder within it labeled "Certificates of Creditable Coverage". Never, ever throw out mail from your insurance company without examining the contents- I cannot tell you how many times I had to send out a duplicate refund check, COC or EOC copy again because our insurance co. customer disregarded the original envelope, tossing it in the trash.

Any time that a claim is paid or denied by an insurance company, an Explanation of Benefits is the document that's produced by them for both you & the provider of service to look over. It explains what the insurance co. paid, denied, needs additional information to consider whether further payment is warranted on a line item & what your patient financial responsibility is. View all of this carefully & make sure that you understand what you owe to the insurance co. and/or to the provider of care (be it a hospital, doctor, dentist, etc.) If additional information is requested from you (and not the doctor's office), either provide the document ASAP or contact the insurance co. if you think this item should not be needed. Certificates of Creditable Coverage copies are frequently required if your insurance is rather new & is subject to what's called a pre-existing clause. The insurance company is within it's rights to ask for this document copy, in that case. Never fax or mail in your original document- make a copy & send them that.

17) De-clutter, de-clutter, de-clutter.  Remove all obstacles from doorways, stairs, entry halls, garages, basements, furniture, etc.  The less you own, the less you'll have to clean. The fewer your items, the less that can get lost or stolen.  The wider your pathways are, the less of a chance you'll take getting seriously injured.  Keep small items like magazines, dishes, cat toys and other such things that can trip you up off of the floor as much as possible.  Never keep these items in dark, tight spaces.  Purchase a grabber/reacher with a magnetic tip (they're inexpensive), so that you can pick items up from places too far away to grab with your own hand easily.  Slips and falls aren't always preventable, but clutter makes both the accident itself plus the pathway for emergency services personnel much worse.  Some professional organizers specialize in helping chronically disorganized, disabled and/or elderly clients.  Ask anyone you consider hiring for help in de-cluttering a variety of questions to see how much they can help you in your particular situation.  Be honest!  Whether dealing with family, friends or someone in a professional setting, tell the truth if you need help.  When you need something, say so.  Be clear and consistent.

18) Use bad days physically to tackle "mental" tasks instead- such as paying bills, balancing your checkbook, de-cluttering your file folders or setting up a filing system, adding written events and stickers to your paper calendar, clearing out old files or backing files up in your computer, culling through magazines and catalogs, setting up your Office in a Bag, cleaning out your purse, etc.  And vice versa- use days when you have brain fog but feel okay physically to polish wood furniture, wash dishes, clean lamp or other glass parts with glass cleaner, vacuum upholstered furniture, wash slipcovers or curtains, clean your car's windshield and outside windows- any mundane physical task which takes little mental acuity to get done.  Let me tell you, minimalist or not, I always have plenty to do around my house.  When watching television, use the time when you're sitting down between commercials to write letters, read a book, study owner's manuals for household items, fill out forms or other paperwork-related tasks.  I often use "commercial time" to handle things like making a bed, swish-and-swiping a bathroom, unloading or loading the dishwasher, washing any dirty pots or pans, changing towels in the kitchen- any quick task.  This makes me feel less lazy while still enjoying my TV time.  Most of us actually have plenty of time to get done what we really need to, but we don't manage our time well.  I don't always recommend multi-tasking, but there are times when it should be your philosophy.

19) Do everything in your power to keep your home and anything you put in your body clean through proper filtration or treatment.  I cannot stress how important it is to keep exhaust fans clean, air-conditioning filters free of excessive debris (whether they're the replaceable kind or not) and your water pure.  Even the absolute highest-quality replaceable air filters last a maximum of about six months.  Take canned air and/or a vacuum attachment, cleaning computer hard drives, behind or under appliances and on any portable fans to suck up as much dust as can possible.  Doing this generally adds years to the life of your appliances or electronics, too.  Join FlyLady and follow her emailed advice if you need help with general cleaning.  Tackle a room five to fifteen minutes at a time at least once daily.  Julie Morgenstern refers to this as "equalizing your space".  I love that phrase.  Be determined to clear any clutter until it's gone.  Research any cleaning supplies you buy and read reviews on them in advance- especially with expensive purchases such as vacuum cleaners or carpet-cleaning machines.  It may sound painful or overwhelming at the outset, but it usually takes years to get completely organized if you didn't learn the skills as you grew up.  It took me around six years to really become fully organized & it's still always a refining process.  Call in a housecleaning service to come in once every week or two, especially if your home hasn't been cleaned well in awhile.  Buy a water filtration system for your kitchen sink or any other faucet that has water coming out of it possessing a heavy chlorine scent.  Even if only one pot is dirty in the kitchen, wash it.  Don't let tasks pile up.  A dirty house weighs on the mind, body & spirit. It lowers the desire to get things done in all aspects of life.  It can make you feel self-conscious about your home.  Make sure your home gets dusted & vacuumed once a week.  Any hard floors should also get a washing with a sanitizing cleanser once a week- a Sh-Mop works best to easily get this task done.  A Sh-Mop requires no bucket (in other words, less weight to carry and strain on your back!) & unlike a Swiffer, doesn't use cloths which must be thrown out.  It is sold with washable cloths called Sh-Wipes that fit around the mop.  You just wet the Sh-Wipe in the sink, pouring an appropriate amount of cleaner onto that cloth as well, and you're good to go.  Clean your bathroom basin & toilet at least once every few days.  Keep Lysol Disinfectant Spray or a similar product around to sanitize toilet handles, faucets, door handles & more surfaces that are gathering areas for germs.  Wipe down your tub or shower enclosure free of moisture after every bathing (I just use a fresh white hand towel for this task each day).  Pick up after yourself as you go along.  If applicable, attach a basket or caddy to your walker or wheelchair, gather up items not in their right place throughout the home & then distribute them in their rightful place instead.

20) Take good care of yourself every day & keep body maintenance up.  Don't focus on how time-consuming self-care is.  Get up every day, bathe if you can, style your hair, brush your teeth, put on some makeup if you feel better wearing it, adorn yourself with some jewelry, dress in clean & attractive clothing.  If you can, dress to lace-up shoes each morning.  At the very least, I suggest putting on socks or indoor/outdoor slippers.  My Granddad was a man that I never saw in pajamas.  Every single morning, as soon as he got up, he groomed himself & dressed to his lace-up dress shoes.  I never saw him wearing anything less casual than a long-sleeved collared shirt, well-ironed trousers with a belt on, his wedding band & watch, dress socks & shoes.  He wore this even to mow the lawn or clean the house.  On Sundays, when it was time for church & dinner out somewhere, he dressed up even more.  He always wore a suit, tie, overcoat & fine hat on Sundays.  What a dapper, handsome gentleman he was, timelessly elegant & well-groomed.  And he never got out of his clothes or shoes until he went to bed.  I firmly believed that my Granddad accomplished so much in his life in part because of the discipline he showed in this area in many others.  He was doing what FlyLady taught long before there ever was a FlyLady!  It took me learning the rule from FlyLady to put two & two together regarding Granddad.  He was a remarkable example to me in so many ways & this one is no exception.  I guarantee that you'll get more done if you groom & take care of yourself before the inevitable insanity of each day begins.  If you're like me, you may just want to "hit the ground running" from the minute you wake.  Self-care may seem like an annoying waste of time & energy, especially when one or both of those things are limited.  But cutting corners on self-care, either in the morning or at night, is just not worth it.  Get your hair cut, colored or permed regularly- whatever is applicable & enjoyable to you.  Looking good will help you feel a little better, no matter what your physical condition might be.

21) Every night after dinner, I recommend that you set aside a clean bottle full of water for yourself to drink from the next day.  I just put mine on the fridge door & grab it the next morning before I start on my household chores.  I prefer a reusable stainless steel water bottle to a plastic bottle or using a glass.  The water bottle is portable, doesn't sweat & keeps the drink colder much longer.  Keep fluids nearby at all times & if you aren't already in the habit of doing so, train yourself to take sips from the bottle throughout the day.  Dehydration is easy to bring on & can take awhile to recover from.  It's many side effects include constipation, headaches & fatigue- something no disabled person needs added onto their body.

22) Live a healthy life, as it'll give you more energy, even with having a disability.  Most women instinctively know that living healthy during pregnancy creates a stronger, healthier, happier baby. We should look at our own bodies & treat them as carefully as if we were carrying such precious cargo on board all the time- because you are important! It will show up physically in your eyes, face, skin, memory & posture if you're living healthfully or not.  Take your medications on time & at the right dosage, using a pillbox & possibly a timer to remind yourself if needed.  Email reminders can be used for things like this, too- so long as you check your email often enough.  Eat clean- Tosca Reno wrote a great book about this subject, but info on how to eat this way is all over the Internet.  As much as I love desserts, I long ago learned that high-gluten foods (such as Panera bagels) & high-sugar foods greatly aggravate my stomach problems, especially when eaten more than once a week.  Try to limit yourself to one serving of dessert, one day a week only, if eliminating sweets entirely is impossible for you.  It's perfectly natural to desire something sweet after an evening meal, but try to satisfy the craving through a small serving of fruit, lightly-sweetened yogurt, a piece of crystallized ginger or 1 oz. of dark chocolate.

Drink purified water, high-pulp no-sugar-added unpasteurized juices (I prefer orange juice) & the type of milk that agrees with you (dairy, goat, soy, almond, coconut).  Cut out soda- I can't even recommend drinking diet ones, because they're full of chemicals.  Sometimes I squeeze fresh lemon juice into my plain water with a spoonful of raw sugar to make a quick "lemonade".  Sparkling water can be a nice change of pace, too.  I know that drinking water can get old, but it really is essential, especially as we get older & our system slows down a bit.  Constipation can usually be treated by drinking plenty of fluids, eating raw foods, a bowl of old-fashioned oatmeal & "good" oils.  Green & black tea are superb for a change of pace, but they can make you more thirsty. If you drink tea, keep sweetener to a minimum.  When I'm under the weather, I like adding powdered ginger & fresh lemon juice to my green tea.  Ginger & garlic are both cleansing agents for the body.  Garlic is superb for the heart & should be eaten daily, if at all possible.  Ginger, turmeric & a few other spices can help with inflammation & arthritis pain.

Don't drink alcohol if you take tranquilizers or any other medication/supplement that states such a warning on the bottle.  If you like to drink alcohol, wine is still considered the "healthiest" of alcoholic beverages, especially red wines.  Even if you choose to drink, having more than one or two drinks a night isn't really good for the stomach, liver or brain.  Stop smoking cigarettes if you currently do so.

Include extra-virgin, preferably organic olive oil & coconut oil in your meal plan.  Cold-pressed oils are always best.  Avoid any oil which has been bleached or degummed, which is sadly something that's done often to oils that aren't cold-pressed or extra-virgin.  Avocados also provide healthy fat- if you don't like them, you can still try using avocado oil instead.  I love avocados because they add moisture & texture to sandwiches & Mexican food.  These days, most grocery stores sell convenient ready-to-eat guacamole that is sealed to prevent spoiling.  These packages typically serve two to four people.  Consuming sources of these healthy fats are absolutely essential to the proper functioning of the brain, appetite satisfaction & lubrication of the joints.  Chia, sunflower & pumpkin seeds are great for you & also provide healthy fat- make sure that you buy the unsalted version seeds.  Eat unsalted raw nuts if you're not allergic, about 1 oz. a day.  Nuts mixed in with dried fruit (again, look for no-added-sugar versions) are a terrific snack mix.  You want a ratio of 2:1, nuts against dried fruit.  A 1/3 c. serving of this snack mix is a good portion for women, 1/2 c. for men.  Eat fresh, local and/or organic produce consistently.  Aim to eat a salad with lots of dark leafy greens daily- a serving size for greens is two cups.  Also experiment frequently with new vegetable recipes, cooking greens, squash & other veggies from scratch.  If you lift weights, taking in adequate amounts of protein at regular intervals is essential- skinless chicken breasts, fish, beans, natural nut butters, eggs & protein powders made without artificial coloring or sweetener are superb sources of protein.  Brown rice, millet, Bulgar wheat, old-fashioned oats & other whole grains should be eaten at least once a day.  Eating such a diet will keep you regular, satisfy many of the nutritional needs of the body & brain, plus help keep your weight stable.  Many people find that they need to eat a small meal about every three hours, five to six times a day, especially if they exercise a lot.  Some people are a three-meals-a-day, no-snacking person, and if that works for you, great.  Experiment to see what your particular cycle of needing food is.  I highly suggest reading the book, "Firm for Life" by Anna & Cynthia Benson, for even more detail on this subject of consistent proper nutrition.

For items that need a little sweetening up, I recommend using Stevia, raw blue agave nectar, coconut crystals, unbleached raw sugar, coconut palm sugar, brown rice syrup, raw honey or molasses for sweetener instead of artificial sweeteners or white sugar.  Most if not all of these better sweeteners can be found at www.vitacost.com, if you can't buy them in your local area stores.  That site also sells all of the organic beans, natural nut butters, oils, unsalted nuts, unsalted seeds & no-sugar-added dried fruit that I wrote of earlier in this paragraph & often at far cheaper prices than anywhere else.  When you have dessert, make it something you really enjoy & keep the portion size small.  Don't keep large amounts of any food that you can't control yourself from eating too much of in your house.  For some reason, Oreo cookies are that huge downfall for me, so I never buy them (though I'd still like to!)  A bowl of old-fashioned oats with a little raw sugar, honey or molasses & a splash of milk is a great "sweet treat" that's still healthy in the evening- I usually eat a 3/4 c. portion of oats (uncooked), personally, though most people eat 1/2.  This particular food helps create healthy cholesterol levels, as well.  There are also tons of recipes out there using nuts, seeds, raw oats & other healthy foods to create snacks even kids will be excited about eating.  In this day & age, almost every craving you have can be satisfied in a healthy way without sacrificing much taste or texture.  It may take some experimentation, but it can be done.

A good multi-vitamin/mineral supplement is something almost everyone should take, because even eating a high-calorie diet may not provide you with all the essential nutrients.  You'll have to experiment to find the best one for you, but I can recommend the supplements sold at http://www.mdr.com as being of very high quality & potency.  Flex-a-Min glucosamine/chondroitin/MSM is an absolutely necessary supplement for my knees, just to give you some anecdotal advice, if osteoarthritis affects you.  I purchase it on www.drugstore.com, as they have the cheapest price I've found for the volume (and it's always been sent to me with a long expiration date on it, which is extremely important).  Without this supplement, I'm reduced to feeling like I need a double knee replacement within days.  With it, I'm no teenager again, but I can manage climbing steps, squatting, walking & moderate exercise easily enough.  Not everyone is the same- but this one supplement is my desert island pick.  Aspirin & cold packs are essential when inflammation is acting up on me due to my fibromyalgia.

Below is a good daily medication checklist which will help you write down what dosage you took & when you took it, making relying solely on memory a thing of the past (and this is free to download, save & print):

http://www.printabletodolist.com/preview/Daily_Medication_Checklist

23) Do a minimum of fifteen minutes of exercise five to six days a week.  Even if you're not able to walk or engage in traditional aerobics programs, find ways to work out in an alternative manner.  If you sit in a chair & do some light dumbbell or rubber exercise band upper body exercises, you can regain a lot of strength & flexibility that's been lost.  Light resistance bands, all kinds of dumbbells & other equipment can be found at www.amazon.com.  Chair yoga poses can be found online.  Exercise DVDs have been made for those who must sit in a chair to work out in recent years.  If you can handle more exercise, do so.  If you have knee problems, I'd suggest removing lunges, work done where you have to get on the floor & using an exercise step with a height more than 4".  In women, knee problems are often exacerbated by weak hamstrings and/or inner thighs.  Strengthening these areas with resistance bands or weight-training can help immensely in that case.  You can even do leg lifts and hamstring curls in bed!  Wrapping the knee(s) with an Ace bandage or a brace will also give stability to this vulnerable area, preventing the joints from locking out on you or going out of place.  Back problems are so different from person to person that it's hard to make general suggestions.  But sitting around all of the time will make the back pain worse in the long run, not better.  Gentle yoga, Pilates, abdominal work (such as crunches) & spinal erector work can improve your back pain.  I'm not saying that you should go out & run a marathon- but keep your fitness up now and you'll borrow less trouble later!  Everyone is different, so please listen to your own body's needs, take a rest day at least once a week from exercising & consult your doctor if any new problems crop up.  Chronic problems sometimes require the assistance of a physical therapist- it's not a bad idea to at least consult with one to see what exercises would be best for you to do on a regular basis so that your particular condition treated better through movement.

24) If applicable, do your grooming rituals sitting down.  While it will burn a few more calories to stand up & blow-dry your hair, apply makeup or do other grooming rituals, it uses up vital energy you'll probably need to apply towards your day later on.  I recommend buying a vanity table & chair set if you've noticed standing for long periods while grooming has become painful.

25) Wear clothing & shoes that support your body appropriately plus keep you comfortable.  Natural fabrics usually feel best- it's important that you allow your skin to breathe as much as possible.  Support hose can make a big difference in the way your legs feel, especially from the knee down.  It is absolutely essential that you wear shoes which are appropriate for your type of arch & gait.  Good shoes sold nowadays also address overpronation or underpronation issues, so watch for that, too.  Bad shoes affect absolutely every part of the body, not just the feet.  Make sure the shoe you buy is supportive but not so thick in the sole that you can't feel things like your gas pedal in the car easily.  Running sneakers generally provide more support & padding against your walking surface than simple walking shoes, but it really comes down to personal preference.  Running shoes generally are more expensive than walking shoes, but I've found the extra cost to be worth it.  My favorite brands are Clarks, Drew, New Balance & Saucony- keep in mind that I have relatively flat arches, a low instep & overpronate somewhat.  Women with high arches often say they love Asics, which I personally cannot wear.  Pay very close attention to online descriptions & reviews of the shoes before buying.  A good place to determine what type of shoe might be best for you is www.footsmart.com, as they allow a search for shoes that addresses physical conditions, type of arch, gait, etc.  Fashion is great, but staying mobile & comfortable is something no disabled person can afford to disregard.  Quality shoes with good tread also prevent the chance of falls & tripping.

26) I think that having an Office in a Bag is a must for the disabled.  In mine I have a two-page document which explains my entire medical & surgical history, as well as contact information for my family.  I highly recommend that you create such a document for yourself & put it in your OIAB.  Other important documents include a Durable Power of Attorney or it's equivalent for your region/state, directions to the nearest hospital, a "How to Do Laundry Chart" if you are incapacitated & need someone else to do the laundry for you, how to care for your pet (if applicable), plus a list of the daily & weekly chores which should be done in your home.  I think everybody should have these documents prepared, not just the disabled.

27) Keep a well-stocked first-aid kit at all times in your home, car & workplace (if applicable).  You can buy travel & purse-sized kits like this, as well.  If you take prescription medications, refill them on the date first available to do so & pick them up as soon as they're ready.  You never know when emergency will hit- having these medications on you is a must.  There is no such thing as being too prepared for emergencies.  Survival rations should also be a top priority to have on hand- plenty of extra water (in case your source is compromised or stops working) non-perishable food, a can opener, a non-electrical cooking apparatus such as a camping stove (if you have a blackout) along with plenty of fuel for it, lots of batteries, an NOAA radio with a cell phone charger that is powered by cranking it, flashlights, waterproof matches, emergency candles, plenty of blankets & towels, an LED lantern, paper plates, plastic utensils, plastic or paper cups, a bucket (preferably one with a lid), a bandanna (which can be used as a tourniquet or many other things if needed), a loud whistle, portable fans that run on batteries, a battery-run clock, an oil lamp, a poncho or strong umbrella are what I consider bare minimum items.  If your structure could even possibly be compromised (via a tornado or earthquake, for example), keep a portable tent, a tarp, plastic sheeting, waterproof duct tape & emergency sleeping bags on hand (one for each member of your family).  If you have frequent long-term blackouts & have the space to do so, purchase a generator to keep your power going.  Full refrigerators & freezers maintain their cold temperature better than ones with less stuff in it.  Keep plenty of ice (bagged if needed) in your freezer at all times.  Also place important documents such as your birth certificate or will in a waterproof, fireproof safe or in a lock box at your bank. Keep some cash in different denominations & coins on hand in case ATMs are out.

Keep your vehicle(s) no less than half-full with gas at all times, as FlyLady suggests.  My mother was in the hospital four times last year, all but one time were unexpected, and I was glad she had kept her own vehicle gassed up.  All vehicles should have some emergency supplies in them, too, in case you have to evacuate your home.  These supplies include a folding shovel, an emergency triangle, a camping stove with fuel, cooking/eating supplies (a couple of camping pans, a metal spoon, plastic cutlery, paper plates, etc.), a pry bar, a pocket or folding saw, items to change out a flat tire, extra water, motor oil, antifreeze, an ice scraper, a tow strap, a paracord that will support up to 550 lbs., a safety vest (in case you have to get out of your car at night and/or in foggy conditions), an escape hammer, some flares, a waterproof flashlight, blankets and/or emergency sleeping bags, a tarp or emergency tent, travel-sized pillows, a fire extinguisher, a cell phone charger, jumper cables, an NOAA radio, a compass, a can opener, a loud whistle, a map of your local area, sunscreen, a headlamp, baby or sanitizing wipes, waterproof matches and/or a lighter, a multi-tool, a bivy & some non-perishable food (granola or protein bars, nuts, seeds, dried fruit, etc.)  Some of these items may not be needed due to your particular climate, but you get my drift.

You may ask what this has to do with disability. Well, having these items on hand will give you peace of mind, first of all. Knowing that you're prepared for all eventualities (to the best of your ability) provides an automatic sense of relaxation even in times of great stress. The disabled are usually more vulnerable during times like this than the non-disabled & experience more discomfort. Having the items on hand to cook meals, bathe, get in enough fluids, listen to the radio, keep a cell phone charged & sleep in as much comfort as possible even during a time without power is just plain practical.  Never assume "It won't happen to me" when talking about emergencies.  ALL of us in some way or another have unexpected emergencies crop up.

28) In addition to trying out the FlyLady program, continue to periodically peruse books and videos on household management, de-cluttering, minimalism & organization.  There is always more to learn.  I highly recommend checking out reviews on Amazon to pick from the best of the many books on the subject.  There are a couple of books that I consider essentials, particularly for people who- like me- did not learn in childhood how to keep up daily routines easily.  I also think that literature of this nature can provide the immense motivation that it takes to stay on the organized path.  If you're really ready to pare down your life to bare minimums, read Elaine St. James' book, Simplify Your Life. It's in many libraries & is available for purchase on www.amazon.com.  While I didn't do every single thing that she suggested, the book provides one hundred different & very practical immediate ways for getting life back-to-basic.  I consider it a must-read for anyone trying to unearth themselves from rampant consumerism & attempting minimalism for the first time.  It gives superb food for thought along with excellent, succinct actions to take towards leading a simpler life.

29) Your mind will be either your greatest ally or your worst enemy.  One has to make a deliberate set of decisions over & over again to choose doing what they know needs to get done even through pain, exhaustion or just plain ennui.  If you think I'm a naturally motivated, energetic & disciplined person, think again.  I'm one of the laziest people by nature physically (not so much mentally) that I've ever come across.  Choosing to be lazy, not to do my chores, not to do homework, etc.- these were patterns that haunted me for the first twenty-six years of my life & still have to be overcome today.  I've been following FlyLady since 2007 & while I do know what needs to get done in my home now mostly off the top of my head, I still have to make a thousand decisions a day towards either laziness or excellence.  I wish I could tell you that eventually you'll run on auto-pilot & the upkeep of your home will feel 100% easy, joyful & simple.  If you suffer from chronic pain and/or mobility limitations, though, this is much less likely to be the case.  Being on a proper eating, supplementation and medication regimen can make things better, but all of us still have bad days.  For your sake, I would hope following FlyLady (or something similar) becomes immensely easy & you'll have none of the internal fights that I do.  But I feel I must raise the warning flag.  I struggle, I still fail sometimes & there are also times when I just feel outright rebellion towards doing housework or cooking.  I know what to do now to maintain my life & home in an excellent manner, but choosing to do that is an entirely different matter!  But you know who it hurts when I don't perform my chores?  It hurts me.  No one else is really harmed by it, though it potentially makes things more challenging for them, too.  It makes me feel overwhelmed to see a kitchen full of dirty dishes, several piles of dirty laundry, an entire house covered in dust.  It doesn't help my health to breathe in accumulated dust, dirt or cat fur. I don't feel good when I don't make meals complete with protein, whole grains & vegetables.  There's nothing political about it.  My mother (whom I live with) helps out as much as she can & I appreciate that.  But otherwise the work falls to me- it's just the way things are.  I may not like it a lot of the time, but I have to overcome my temporary feelings & go with my knowledge.  And what I know is clear- while it's not always or even often easy to follow the FlyLady plan, my life, home & body function a whole heck of a lot better for doing so.  Granted, I've never gone near the hoarding lifestyle & in fact I actually love to de-clutter.  That is my natural strength & it's probably what made me even latch onto FlyLady's program in the first place.  But I probably created about fifty different control journals before I finally stopped rebelling & actually decided to stick to the program!  I'd write out brilliant control journals only to find my lazy streak win the internal argument of the day & determine my control journal + the whole program was bunk.  So off the control journal went to the Recycle Bin of my computer, over & over again.  I didn't make an easy start of things & I'm still so far from what I wish I could be many days that it gets tempting to give up once in awhile.  I, too, struggle with sticking to a workout program, shining my sink, washing the pots & pans after every dinner- all the same stuff everybody else periodically encounters.  I have off-days where almost nothing gets done.  Disability is often unpredictable & compounds this.  But I refuse to give up.  The on-days do outweigh the off-days by now & that is what always gives me hope & determination.  Like a baby learning to walk, I stumble & fall quite often, incredibly frustrated at times with myself.  But I get back up, dust myself off & try, try again each morning.  The reason I may have been granted any ability at all to write of things like this for you is because I know just how difficult it is at times.  I can't write to you very well about things I didn't have to struggle with or learn the hard way firsthand.

30) If you can, move taking your shower or bath to the evening instead of doing that in the morning.  Standing in a shower for awhile or going through the motions of bathing & grooming can be tiring to people who have a disability.  While not true for everyone, this energy can often be better spent on getting some other physical work done earlier in the day.  It also saves some time in the morning getting ready.  For those who run hot anyway, taking a morning shower when your metabolism is at it's highest point can just make you sweat more afterwards from the warm water & steam in the air.  I sweat very easily and am going through early menopause, so I know what this is like- hot flashes are no fun!  Taking an evening shower or bath when you're naturally cooler & your metabolism's going slower can reduce or eliminate this post-bathing sweating.  (Be aware this probably will not apply to true night owls who get a metabolic boost at night.  You'll know it if you're one of these people. I personally get a metabolic boost nearly every night between 9:30 & 11:30 p.m., which keeps me energized until approximately three in the morning.)  Also, a warm shower or bath can be very relaxing at night, washing the day away, so to speak.  Again, I know this doesn't apply to everyone- some people feel refreshed by taking their daily shower or bath in the morning.  There are usually advantages & disadvantages to every choice you make, and that's true even in small decisions.  Some need morning bathing because they work out in the a.m., for example.  Just do whatever works for you personally after some experimentation.  This is just another suggestion to consider if you're looking to get more energy into your daytime hours.

31) Always carry a small back-up supply of your medications (if applicable) & something to drink with you when you leave home.  Carry your medication in a pillbox or pill fob.  If you'll be away from home more than four hours, carry two doses of medication just to be on the safe side.  You don't want to be stuck in traffic, face a longer-than-expected waiting period (such as when you are stuck at the doctor's office) or some other emergency & have nothing to drink on you.  If your blood sugar runs low due to a medical condition, you'll be away from home for more than two hours and/or you must eat something when you take your medication, carry a small and non-melting snack with you.  A granola bar without coating or chocolate chips, crackers, a baggie of dry cold cereal like Cheerios or some unsalted, shelled sunflower seeds are great for this purpose.  Lock & Lock makes little storage containers which are about 3" around that hold a 1 oz. portion of nuts, seeds or dried fruit well, and can be bought on www.amazon.com.

32) Avoid infections as much as possible, both internally and externally.  They take down your immune system, lowering what you can get done in a day & then put you at risk for even more serious systemic problems.  Use antibacterial or anti-fungal soap in the shower, anti-fungal spray or cream & medicated body powder if you tend to get skin infections.  Desenex, Johnson's & Tinactin all sell various anti-fungal products.  Dial and Safeguard brands make antibacterial bar and liquid soaps.  Anti-fungal shower gel can be bought on www.amazon.com.  A healthy diet which includes copious amounts of antioxidants, vitamins & minerals taken in will help fight infections, too.  Read up on purifying agents that exist in nature (elderberry, fresh citrus juices, green tea, ginger, garlic, etc.) and take them regularly.  Carry a mini-bottle of antibacterial gel or Purell wipes with you everywhere.  Keep a can of Lysol disinfectant spray in your work desk drawer, in your bathrooms at home and anywhere else that germs spread like wildfire.  Unfortunately, many of us have to go to a job where employers force workers to come in even when they're very ill.  Cuticle-based jobs, where dozens of people are in close quarters without any doors between them, are notorious for this.  While you cannot prevent every possible infection from coming your way, do your best to purify the air around you and the surfaces you have to touch.  Don't count on others, including any cleaning staff, to do this on your behalf.

33) Read Julie Morgenstern's book, Time Management from the Inside Out.  In this book, the author explains in depth what many of the aspects are which prevent us from spending our days wisely.  She does so in a very non-confrontational, gentle but effective way.  It's an inspiring read that doesn't engage in blaming the reader, while also providing loads of viable strategies for running one's life more smoothly.  I've been simplifying, getting organized & de-cluttering for many years.  Time management isn't something that I could even deal with taking on until the clutter was gone, and that clutter for me was mostly mental.  Perfectionism is perhaps the biggest clutter mentally that a person could ever carry with them.  And it has to go right out the window if you ever want to be a true time manager who lives with peace of mind, isn't rushed and doesn't feel like a chicken with it's head cut off.  I must look at my calendar daily to see what I have to tweak, cut out, add in or put off (if possible).  Developing priorities + sticking to them is something that comes when clutter is clear from your space and you start trying to manage your time better.  And I can assure that even experts in organizing or housecleaning are constantly learning new techniques in their trade, reviewing new products & eliminating any clutter more easily- myself included.  Different times in our lives will demand alterations in our schedules, too.  If you think that having a clean house will finally magically fix your schedule, I'm here to tell you it just isn't so.  Yes, de-cluttering and keeping a clean home certainly frees you to live a better life.  But unless you live a very quiet, uninvolved life, you're going to have to possess a calendar and it's something you'll have to look at daily.  That is way more involved than I could ever get into with a blog.  But trust me- if you feel like you never get to do what you want, that you're involved in things you no longer care about or time seems to constantly slip away from, Julie's book is a must-read.  But be aware that reading a book and even buying or using a calendar isn't enough- you'll have to be willing to look honestly at your life, cut out what's not working and start doing what does work.  Every single time that a change in life occurs- going back to school, having a major illness occur or a happy event like getting married- you'll have to alter your habits and scheduling somewhat.  Or alter them a lot, depending upon the situation.  I recently started college full-time after many years away from school and I can advise that while it's wonderful, I must manage time with magnifying glass now.  I simply cannot live a free-for-all existence and succeed as a college student in an Honors program.  It takes tremendous discipline, especially with a tiring disability.  You can expect that if you're disabled, things which others take in stride may be more difficult for you.  But accept that, move on and keep moving forward.

34) Pick easy-care surfaces that hide dust or dirt well (within reason). I used to have these awful off-white, unsealed laminate countertops in my kitchen.  (Off-white and white were popular kitchen colors at the time, but we didn't choose the finish ourselves.)  Every single crumb, speck of dust and drop of oil or sauce showed up so terribly- in a kitchen, not exactly a winning feature for a finish. Not only that, but because of the type of surface it was, only scrubbing with Comet or a similar product would get stains up, which meant many more minutes of rinsing, too.  Blueberry juice could reduce me to tears.  (How do you keep stains from occurring on kitchen countertops unless you just choose not to cook at all? Whoever designed that old countertop should be burned at the stake...)  We switched over to a speckled brown/beige/tan/grey countertop surface that was sealed several years later and I wanted to just kiss every inch of those counters when we did.  Not only do I never have to dig out the Comet ever again, but a day's dust doesn't make my kitchen automatically look like I'm the worst housekeeper to ever live.

Similarly, pick wood furniture (if you have a choice) which is light- or mid-toned in color. White, off-white, pastels (when painted), honey tones, light oak, pine- all good colors for wood that won't show dust in a nanosecond. While they are beautiful and look admirably modern, dark cherry, mahogany or other dark finishes on wood furniture or flooring shows every speck of dirt extremely fast. Just keep this in mind when making the investment in furniture or flooring, particularly if you're disabled and can't dust or vacuum every day.

35) Keep bed-making simple.  Actually, I hold this rule for those who aren't even disabled, as it really goes well with a minimalist lifestyle.  While they're pretty, I'm not a big believer in having those little throw pillows, lots of blankets or bedskirts on beds.  I have one 100% cotton blanket that's long enough and thick enough to serve as a bedspread over my sheet set and pillows, and that's it.  No shams, no decorative pillows, nothing fancy.  I'm not known for my military corners, either.  I simply tuck in the fitted and flat sheet as needed each morning, bring the blanket and flat sheet up and then fold them back after straightening my pillows up.  My bed is always ready to get into easily at night, but looks finished enough during the day to make me happy.  My bed is still made, it's just done the easy and simple way!  Many Europeans and Canadians have a duvet with a duvet cover that's made of the same fabric as their fitted sheet or something else equally smooth against the skin and therefore don't even need a flat sheet.  This can cut back on some expenses- many sheet sets are broken up piece by piece for purchasing online these days.  With a duvet and breathable duvet cover already in place, only pillowcases and fitted sheets are needed.  Those who run colder or who live in a chilly home may prefer a down comforter with a down comforter cover made of flannel or cotton instead.  The website www.thecompanystore.com carries these types of products along with Primaloft comforters, a down alternative that I personally like a lot (it's in my fall//winter comforter that I use on my bed instead a blanket sometimes).  Their catalog is a good resource and I actually prefer browsing through it as opposed to the website to actually locate sheets, towels and other items they sell.  I also love www.macys.com for bedding and bath towels.  Macy's has great bedding and bath sales on a fairly regular basis, too.

36) Organize, organize, organize!  Not everyone can afford to do this constantly, but what you keep in your home after the de-cluttering is done needs to be stored in a beautiful and functional way.  Lately I've been watching YouTube videos and checking out the website below for further inspiration and product cues from a great professional organizer named Alejandra.  She has lots of really innovative organizing tips for free on her YouTube account and a nice list of product links:

https://www.alejandra.tv/shop/best-home-organizational-products/

37) Celebrate everything that you get accomplished, no matter how small it seems!  Fully expect the journey to go one step forward and two steps back at times, but keep your eyes on the forward motions.  Pain colors the brain & so does feeling on top of the world.  The closer and more frequently that you can get to the latter feeling, the more you'll accomplish in life.  I don't suggest that you live in a bubble, but I do suggest that you search out ways to give of yourself to others, which will automatically increase your happiness.  Do things that bring you peace and take your mind off of the disability as much as possibility.  Be charitable to others.  Eliminate things that cause you stress and aren't essential to living your life well.  We all have bills to pay, a home to clean, meals to prepare and other beings to be there for- make it your priority to embrace and enjoy each of these responsibilities.

Here's to being an organized minimalist,
Liz

1 comment:

  1. Wow Liz, that was indeed a long post!  I actually came across your blog as part of a Google search regarding FlyLady - I have been following her for about 2 years, but not as successfully as I would like.  I have to say that I am both inspired and embarrassed by this post - embarrassed by my lack of success with FlyLady when I do not have any of the health issues you have.  However, I found your writing incredibly inspiring and informative - I will use that inspiration to start making changes immediately, and I have saved this post in my iPad Notes for future reference as I am sure it will prove even more useful in the future when I will be dealing with ageing and/or illness.  Thank you once again for writing this post, although it is more like a book - I think you should look into self-publishing on Amazon!  I cannot believe the amount of care and detail you put into this writing, especially in view of your health issues.  Finally, can I just say what pleasure it was to read a blog post with correct spelling, punctuation and grammar, all of which are sadly all too rare on the Internet.

    Thank you once again for reaching out in this way to help other people.  I do hope to come back and read more of your writing, but I suspect that I will be very busy cleaning and organising for some time to come!

    From your new disciple Vivien.

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