Thursday, March 31, 2011

Skin Care The End

          Let’s see, where did leave I off? Oh yes I remember, my daily skin care regiment. Well, I’ve already given you the meat and potatoes so I will now share with you the sides, desserts and appetizers.
·        I am a mouth breather so my lips are CONSTANTLY chapped. I use Blistex lip moisture in a tube.
·         I also have very dry sky and I use Malibu Hemp Skin Firming Bronzing Moisturizer or Jergens natural Glow Firming Moisturizer from my shoulders to my toes.  
·        I use L’Oreal Lash Serum once at night to lengthen and thicken my eyelashes. This stuff is worth 3 times the 12.95 price. It will actually grow new lashes where you have lost them!
·        Always keep your skin moisturized, it’s healthy for your skin and gives you and your attendant a chance to look over your body for any signs of breakdown. Use YOUR favorite moisturizer.
·        Since my hands are paralyzed, my finger joints are contracted and my hands curled I wear my nails fairly long. My attendants keep them polished and filed for me. (thanks Michelle and Kristi!) I also use my fingernails as tools when trying to open things ect.
·        TIP – I HONESTLY BELIEVE that the foundation to ANY skin type routine is good exfoliation.
No matter what skin type you have, I suggest St. Ive’s Apricot Scrub as your basic skin care exfoliant.  If you have problem skin you need to get a product called Serious Skin Care for problem skin. You can order it on line at If you have normal or combination skin I would suggest a product containing Retinol. Such as ROC.
Be certain to always do your pressure releases in your wheelchair as well as in bed. Tilt your chair back whenever you have the chance and if you are strong enough, lift your bottom off the chair several times a day. If you are male be sure you are never sitting on your testicles. This could cause autonomic dysreflexia and be very dangerous. Shift position as often as you are able and be mindful of your fellows.  
The rule of thumb is to check your body for any signs of pressure sores twice a day in bed when you are naked but I think once a day is enough. The decision is ultimately yours.

Wednesday, March 30, 2011

I Really Need Your Computer Help Friends PLEASE!

Can someone,  ANYONE, help me with a problem I've had with my blog since I started it in Sept.
It seems that somehow the settings for my comments got screwy somewhere down the line and It wants to show comments on a white background with white text which in essense makes them invisible.
Anyway, I put a bandaid on the situation by making my blog background slightly gray but for the life of me I see NO setting for blog OR text color.

P.S. Happy Spring everyone!!!  

Tuesday, March 29, 2011

Skin Care Part 4

        It is true, the sun is not very good for your skin but it is wonderful for your brain, body, and soul. The sun’s rays are absorbed through your skin and converted to vitamin D which helps your body’s immune system, hormone functions, and helps keep your bones and joints healthy. Plus, the white light from the sun’s rays helps reset your internal clock for better sleep, happier more productive days and the ability to fall asleep faster, stay asleep longer. It’s also the same kind of light prescribed by psychiatrists for SADD (seasonal affective depressive disorder) so it cheers you too. But the best asset about the sunshine on your skin is…it’s FREE! I believe everyone could benefit from a little sun bathing, unless of course you or someone in your immediate family has had a history of sun related cancer. Then by all means, protect yourself but still get a doctor approved white light lamp and sit in front of it shining on your face.
        Now I will divulge MY skin care ritual. Can I have a drum roll, please! Seriously though, I am that vain. It’s one of my biggest character defects but I simply can’t help it. And it’s gotten twice as bad since my injury because being relegated to the wheelchair used to make me feel invisible. I certainly never noticed people in wheelchairs when I was able bodied. But I digress once again so without further ado let’s begin…
·       I shower every other day so I use a facial cleanser (Oil of Olay PRO X or Regenerist Facial Scrubs) put on an exfoliating scubby pad and used all over my face and neck in circular motions. After shower I moisturize my face AND neck with Oil of Olay Pro X eye cream and day cream
·       On off days and every night I wash my face and neck with filtered hot water with a wash cloth and moisturize with Oil of Olay Pro X eye cream and either Pro X day or Regenerist Microsculpting cream for day and Pro X eye cream and night cream for night. Don’t forget your neck!
(to be continued)

Monday, March 28, 2011

Skin Care Part 3

After choosing a method of pressure release and weight shifting, and practicing it for a few days ask you three questions. “How does my skin look?”and “Are there any marks on me?” then “Should I call the doctor about this?” just remember what I told you in my last post, press down gently on the red area and if turns white it’s alright, if it stays red, call the doctor instead.
Now, let’s talk about skin care for the face. I will begin with healthy face care tips for all skin types and later talk about each type of skin and how to treat it, Let me tell you friends, I’m in my 40’s and I’ve had people guess low 30’s!  First, if you use soap on your face, STOP NOW! Only plain warm water, exfoliating scrub, or specific facial cleanser should EVER touch your skin!
If  you are a sun worshipper, such as myself, PLEASE use a cream or lotion that contains an SPF of 15 or greater on your face. Don’t think “oh well, now it’s late the damage is done.” Because any little bit of improvement to your skin is certainly better than none. Be careful, though, and pay particular attention to your face to be sure you’re not allergic to the sunscreen in the face cream you’re tanning with. Even if you tan easily and darkly as I do, you need to start to throw out the baby oil and iodine mixture and use nothing less than an SPF 2 AFTER you’v etablished a base tan. (about four 1 hour sessions in the sun using an SPF of 4)
(To be continued)

Friday, March 25, 2011

Skin Care Part 2

 Unfortunately though, the damage was already done in BOTH our cases. There is no way to reverse paralysis, YET, I was still depressed enough to feel like nothing was working; not the meditation, the exercise, the good healthy diet nor Eric’s attempts at being more attentive. My mind kept thinking the worst and my mouth kept saying the worst at the worst possible times that I ever could have. I didn’t mean to sabotage our time together, it just happened. I tried to always act upbeat and pay special attention to everything Eric was saying, that way I couldn’t be accused of not listening and interrupting when he was trying to speak to me. But like all humans I sometimes fell short of the mark but Eric seems to thinks he is above making mistakes. In 17 years I can recall him apologizing half a dozen times. And they were for BIG mistakes. Nonetheless, I am rambling again so now I will get back on topic and give you the information I promised.
        We put the air topper right over the craftmatic’s softest foam top and set in on 3 ½ . Even my recurring tailbone callous healed sleeping on my back all night on the air topper on my craftmatic! Eric’s feet and legs were less painful because he getting more sleep, even if it was an hour or two or maybe even three. It WAS helping! Now, the recurring callous and scab that I’m talking about on my tailbone came from my stay at Select Specialty in Latrobe, PA after spending 4 weeks in Mercy Hospital in Pittsburgh, PA where I got 2 stage two bedsores on my sit bones and 1 stage 3 on my coccyx (tailbone). It took 4 months to heal them BUT the tailbone never completely healed; it always had a hard scab on it that was a defense mechanism against the hard surfaces of the chair, bed and shower/potty chair.
        The easiest way to examine your skin is before, during or after an shower and in the am and pm when your attendant has undressed or before they have dressed you for the night or day. If you are able to dress and undress yourself, keep a long handled mirror near or under your bed so you can see every inch of your skin. Keep your skin well moisturized with a good over the counter body lotion. If you find a red spot or area gently depress the area with your finger or knuckle; if it turns white you are probably alright. If it stays red it’s time for dread. Call your doctor right away so he or she can have a look at it. In the meantime, remove ALL pressure from area for as long as possible. Apply some skin prep with clean hands to affected area to protect it until you can get to the doctor unless otherwise directed.
        Area that are especially vulnerable are heels, sit bones, tailbone, ears, elbows, and any particular joint you may repeated sleep on for example your shoulder or hip. The best way to avoid bed sores is to MOVE throughout the night and change positions at least once. Or do what a friend of mine does; she uses the bed to shift her weight. She has a craftmatic just like mine and raises and lowers the head and feet to shift her position in the bed.
(To be continued)


Tuesday, March 22, 2011

Skin Care Part 1

       Please let me tell you how I keep my skin so healthy and youthful appearing. I never reveal my true age, even on this blog.
But seriously, all quadriplegics and paraplegics must be concerned and vigilant about their skin. Bedsores and skin breakdown can happen in matter of hours, but takes weeks or as long as months to heal. It’s especially important if you can’t roll yourself over onto your side or stomach.  Like me, my injury is so high in my neck ( c- 6 complete) , which means my spinal cord is severed a the 6th cervical (neck) vertebrae,  that the triceps muscles in my arms are very weak and I am unable to roll myself over or sit up. So I used to have Eric come in and turn me on my side about 4am every morning but it was uncomfortable, my shoulder, hip and elbow got extremely sore, and it was another break in Eric’s sleep. But I finally came up with a solution.
       Although I already sleep on a craftmatic mattress, I added an air topper so I wouldn’t need to be moved during the night. This not only saves my joints but saves Eric precious sleep time.
( to be continued)

Monday, March 21, 2011

Bowel Routine Part 2

I use the vibrator in the same way as an old yoga trick for sluggish bowels. After your attendant has placed the suppositories high up into your rectum, place the vibrator just inside your right hip, turn it on and keep moving it SLOWLY up the right side of your stomach until you get to your ribs. Then move it ever so slowly across the top of your tummy, leaving it sit where you can digitally feel stool in large intestine. Which runs all along the outside of your belly as shown.

Simply follow your large intestine with the vibrator for about 30 minutes. Make certain you are sitting on a blue pad! You know your body better than I do, it may only take you 10 minutes with the vibrator before you need to get out of bed and onto the potty chair. However, if you start to move your bowels BEFORE you have a chance to get on the pot, don’t panic! Simply have your attendant take the vibrator, lay you flat, roll you off the mess, clean you up and onto a clean blue pad until you can get out and on the potty chair.
After getting on the chair you will probably need the vibrator to complete your bowel movement and if you’re like me, you will need to be digitally stimulated at least once to ensure completion and no accidents. TIP: if you DO need stimmed tilt your potty chair forward as far as is comfortable. This will make sure your body releases ALL mucous and gas. For a sore bum I use Tucks pads and to freshen the little lady between showers I use Summer’s Eve wipes.

Friday, March 18, 2011

Bowel Routine Part 1

         Some may find the next subject distasteful, but it is a crucial part of any spinal cord injured person’s routine. The area I will be discussing is so subjective and completely personalized that I will simply be talking my routine and how, why, and to what extent it works for ME. I will share my tips, time saving tricks and ways to be more comfortable and clean. Including tips on how to eliminate accidents, speed up a sluggish metabolism and go when YOU want to go. So let’s talk about my bowel routine.
         I move my bowels every other day. But I’m treating and caring for my bowels every day. Since I take narcotics for pain, I often had trouble with hard stools, constipation and incomplete bowel movements. So to counteract this I eat a diet rich in fibers, (soluble AND insoluble)I exercise EVERY DAY and I take herbal supplements instead of harsh laxatives to stimulate my bowels. Also, I am lucky enough to be prescribed a medication that helps to empty my stomach and aid in the digestion of my food. I also use a supplement after I eat called a multi-enzyme. It is formulated to help with digestion of all food groups and even helps your body use the micronutrients in the foods you eat.
 I get all my vitamins, mineral, herbals and supplements from one on line store called Puritan’s Pride. They also have a catalog which is how I began ordering from them. That’s how long I’ve used their products and would recommend them above all others. The cost of their products has only risen slightly over the years and the shipping is still only 4.95. There is one product I use that P. P. doesn’t sell. It’s called Colon Clenz ,manufactured by Golden Blend and costs around 10.00 for a small bottle and 20.00 for a large one. On the day I move my bowels, I take 2 tsp. Benefiber with my breakfast smoothie, ½ reglan after each meal and 1 colon clenz at around 6:00pm.
On the day before I do my bowel program, I take 2 tsp. Benefiber with my morning smoothie, 1 reglan after each meal, I colon clenz and I cascara sagrada between 2-3pm and again between 4-6pm. If I’ve had a lot of protein or my stools have been very hard I may add 1 TBS milk of magnesia. Then the next morning at around 10:00am I have my attendant insert 2 dulcolax suppositories into my rectum and then we stim my stomach muscles with the NMES machines or use a vibrator like one you might use on your back.
( to be continued)  

Thursday, March 17, 2011

Catheter Change Part 2

Inserting your fresh catheter
1.  Test the new catheter for imperfections such as holes, tears or bubbles. Just use the syringe and inject a little saline into it to inflate the bubble so that you can see what condition the bulb is in. Be sure to aspirate the saline back into the syringe.
2.  Next, open the packet of suri-lube and squirt it in the bottom of the empty tray. Roll the end of the catheter that will be inserted into the bladder in the lube, coating the tip generously.
3.  Gently feed the tube into the catheter opening until you feel it “pop” through the bladder, then only push it in another ¼ “ or so.
4.  Use the prefilled syringe to inflate the bulb with 8-10cc’s of saline depending on your comfort. ( I get lots of bladder spasms so I only use 8 cc’s)
5.  Open your irrigation kit and fill irrigating bottle with body temperature water. Pull up large syringe full of water and fill bladder using open end of catheter and let drain into tray. Repeat once or twice more depending on how much residue is in the bladder.
6.  Use alcohol pad to clean betadine solution off the belly.
7.  Attach whatever type and size bag you wish to wear.
8.  Dress catheter opening as described earlier if you wish.
As I stated earlier, a well trained spouse, attendant or caregiver can do this procedure properly, cleanly, and expeditiously. As a matter of fact, I recently had my five year cystiscope exam and the results were so good that my urologist told me I need not come in once a year which is the norm but my catheter care was so outstanding and my bladder so healthy I didn’t need to be seen for two years!

Wednesday, March 16, 2011

Catheter Change Part1

        Now let’s discuss changing your suprapubic catheter. There is absolutely no need whatsoever to go to your urologist or have a visiting nurse do this procedure for you. All you need is to have your catheter supplies (I use Bard) delivered to your home once per month through a medical supply company and get approval and  perhaps a little training from your doctor IF you don’t trust my instruction. Or you could print my instructions, discuss them with your urologist and see what he or she has to say.
        At any rate, here is what you will need:
1.  1 insertion tray – 3 packets betadine, 1 packet surgi-lube, 1 saline filled syringe, draping gauze, sterile gloves
2.  1 irrigation tray
3.  An 18” length of tubing
4.  A leg bag or night bag ( any size)
5.  1 catheter ( find out what size you use from your doc or nurse)
6.  1 graduated collection container
You will want to fully train your attendant in the proper procedure of changing your catheter at intervals given to you by your physician. I have mine changed every two weeks or twice a month because I am prone to bladder stones. Changing more frequently has alleviated that condition completely.
First, have your attendant WASH HIS OR HER HANDS thoroughly! You will want to remove the old catheter but before you do the bulb needs to be deflated and emptied of any remaining saline. If this is your first solo catheter change you may not have an extra syringe lying around and may need to cut the catheter at place where the saline is injected. Be careful your attendant doesn’t cut into the plastic but cuts the rubber and the old saline will drain out deflating the bulb thus allowing the catheter to be removed comfortably.
Drape the area around the hole and open the betadine packets one at a time.  Swab the hole in a circular motion using all three packets making a larger and larger circle until you have swabbed about a 4” diameter around the catheter opening. The area is now completely sanitized.
(to be continued)  

Monday, March 14, 2011

Catheter Care Part 1

         I have a indwelling suprapubic catheter which is what I opted for when I was in rehab because I was still in my 30’s and in a relationship. So naturally I assumed we’d still have a physical part to our union. Besides, the idea of neat little whole in my belly seemed much more sanitary, comfortable, and easier to care for then a messy, uncomfortable tube hanging out of my urethra.
         First, let’s talk about cleaning the area and catheter. In the six years I've been injured I might have had eight bladder infections. So I must honestly say my routine is excellent in preventing such infections. Each morning when I change from my night collection bag to my leg collection bag, after thoroughly washing his or her hands my attendant will remove the band aid that was placed over my catheter opening the night before and alternate between saline solution and peroxide sprayed onto a cotton ball and then a q-tip to clean the area around the opening and the tube itself. Both will have build up of a combination of triple antibiotic solution and bodily secretions which may include blood, fluid, or pus. Be mindful of what you cleaning every day; too much blood or pus could indicate a problem and you should call your urologist immediately.
         After cleaning, my attendant then switches out the bags making certain the leg bag has been cleaned and rinsed in a solution of 1 part chlorine bleach to 4 parts warm water. When cleaning the bags make certain to rinse with warm twice before adding bleach solution and then make sure to shake solution into every corner and hose of bag. Finish with one more last warm water rinse. Then we can remove the tape that was holding my cath in place, use a SMALL amount of triple antibiotic ointment around the catheter opening and on the tube. GENTLY pull the catheter tube all way until your attendant can feel it tug. Then push it back in ¼ “. I cover my cath opening with white pads I order from a medical supply company. They have a slit for the hose to move and keep things clean and dry. But you needn’t cover your catheter at all or you can use a band aid as I do at night. The choice is personal.
At night we remove the white pad, clean with bactine, use a little triple antibiotic, set catheter and cover opening with a band aid. Then we switch back to night bag after cleaning it.  
(to be continued)                                 

Sunday, March 13, 2011

Skin, Bladder, and Bowel Routines Part 1

Now that I’ve told you my diet, herbal and exercise secrets, I suppose I could let in on my catheter, bowel routine and skin care tips, tricks and musts since these are also very essential parts of a healthy quad or paraplegic’s lifestyle.
One syndrome that is exclusive to those with an SCI is called autonomic dysreflexia. It happens primarily with T-6 injury or higher but can happen to anyone with a spinal cord injury or disease such as MS. There are three causes we like to call the three P’s: they are PAIN that can’t be felt because of little or no sensation, a bowel obstruction, full bowel or constipation (POOP), or a full bladder that is being blocked from being emptied due to a plugged catheter, a full leg or night bag, or a need to self catheterize (PEE). All of these situations let go too long will cause the blood pressure to rise to dangerous levels. High enough to cause a stroke or brain hemorrhage. So it is vital to find the cause and take care of it as quickly as possible.
When symptoms are an intense headache, profuse sweating above the level of injury, a red face, nasal stuffiness and blood pressure 40 mm Hg over baseline AD should be suspected.
(to be continued)

Thursday, March 10, 2011

Daily Routine Part 5 Evening

Since beginning my daily muscle stimulation and nightly meditation/ exercise( meditercise as I like to call it), some of muscles have” woken up” and “remembered” what it felt like to be used. Even if I can’t get up and walk around, I can flex various muscles throughout my body; I have more trunk control, and I  regained control over and sensation in my private and anal areas which helps immensely with my bowel routine. I have, since 6 months after my initial injury, had most sensation throughout my body but never had sensation in or around my anus, very little on my legs or feet, and not much in the way of sexual organs. Until, I started my nightly routine and became more in tune, more in touch, more mentally connected with my body.
       Let me continue: After my 100 reps flexing my lower buttocks, I move to abdominal muscles where I know with every fiber of my being I am moving because this is one muscle group that we stimulate regularly so I’m familiar with the feeling of contractions and can reproduce them at will. So I will contract my tummy 100 times. Then it’s on to the middle butt. Another muscle group we stimulate. Flex and relax, flex and relax, visualizing my bottom getting rounder and firmer with every rep. Of course you will start with 10 – 20 reps because doing the meditercise correctly is more important and with your full concentration and all your physical might then a lot of reps done incorrectly or half-heartedly.
       Finally, I arch my back pushing my head into my pillow, cross my arms over my chest and try to lift my hips off the bed by flexing the uppermost part of my bum cheeks together as fiercely as possible for 100 reps.This also works muscles in your lower back and obliques. Lastly, I hold hand up at the elbows and try to separate and straighten each finger, seeing it happen in my mind, watching with real glee as my contracted knuckles open easily and smoothly an my fingers that have become almost closed fists separate and wiggle individually. And by the time my program is complete, I’m so relaxed I usually fall asleep before it’s finished and if this happens to you don’t fret; you can finish your routine anytime you are awakened during the night or in the morning before you get up.
The important thing to keep in mind is that it is YOUR routine. Whatever you need to think about to motivate you and whatever higher power you can put some faith into to help heal you is what YOU must do to make this routine work. And it is worth the $150.00 or so investment to get started with a good NMES machine to stimulate those paralyzed muscles that simply lost connection with your brain both physically AND psychologically!    

Daily Routine 4 Evenings

Evening Routine
       Even though I’ve already talked to you about my bedtime meditation/exercise/relaxation program, there’s much that I’ve added and I want you to get the full benefit of a complete and concise description of my routine.
ANY Lean Cuisine, Healthy Choice or Kashi Entrée
Lori’s Cappuccino Protein Milk Shake
·       Large plastic mug
·       Blender
·       2 small scoops vanilla or chocolate ice cream
·       2 TBS cappuccino powder
·       1 scoop protein powder
·       1 TBS Benefiber
·       ½ cup skim or 2% milk ( start w/less, add more if needed)
Have attendant get ingredients into blender for you and blend until thick and creamy yet thin enough to drink through straw. Check blood pressure, this meal will definitely lower it. Take all evening vitamins and supplements.
Vitamins & Supplements
·       Vitamin C – 1000 mg
·       Vitamin E – 400 mg
·       Soy isoflavins – 750 mg
·       Red clover – 430 mg
Bedtime Muscle Flexion/Relaxation & Meditation

After getting tucked into bed for the night I begin my muscle flexion/relaxation meditation routine. My attendant makes certain my body is straight and my hips level. Also, all of my ranges of motion exercises have been done and my catheter site has been cleaned and dressed.
I begin with my feet and toes and as I imagine and visualize my feet straightening and toes spreading wide apart, I try with all might to actually make these movements happen. And after a few moments, I can actually FEEL my toes moving! And they really do too, because I’ve shown Eric and Kristi and they both see small movements in my toes AND feet!
Then I move my flexing and relaxing up my body in a somewhat orderly fashion by next flexing my quads ( upper thighs) as tightly as I can while thinking about how hard and strong they used to be. I do 100 repetitions on every muscle I work on. Then I go on to my inner thighs pretending to move to squeeze my heels together until I swear I can feel them touch. Then relax. And once again squeeze, 100 times. Next I think about spreading my legs against heavy weights over and over again. Finally I will push down with my toes to flex my calves and hamstrings. I do this one last because I need to have my feet up to perform all the exercises before it.
Then I move on to my mid-section. Tilting my hips up, pulling my abs in, and trying to lift my knees off the bed; I flex my lower buttocks muscles together as tightly as I can. You are probably asking yourself how can she “tilt her hips, pull in her abs, even think she could lift her knees off the bed let alone flex her buttocks muscles being paralyzed from the chest down?
(to be continued)    

Monday, March 7, 2011

Daily Routine 3 Exercise Routine II

Exercise Routine 11
Check BP (I use a wrist BP cuff) as shown. Have attendant strap on your weights. Tilt chair to your comfort level.
1.    Begin by lifting arms bent at elbow up and out to the sides and then bring fists together. Repeat up to 35 reps
2.   With arms still in the lifted position, push elbows backwards remembering to keep your elbows lifted. Repeat up to 35 reps.
3.    Rest for a moment always keeping hydrated with water. Tilt chair to crunch position. Do your starting reps or whatever you’ve decided on not forgetting your oblique muscles. Do same amount of reps for your obliques.
4.    Tilt chair entire way back; make certain you are not too far reclined. Do chest exercise as shown in photo or as described as followed. Starting low do flies and in 5 parts work your way up your chest until you are even with your chin. Flies are exercises in which you start with yours arms down and lift as if you are hugging a barrel and bring your fists together. Work up to 15 reps each movement. Depending on your triceps strength lift your arms as high above your chest as you can. REALLY push yourself. It’s worth it!
5.   Now do your presses and bicep curls. 3 sets each. Alternate between exercises and do up to 40 reps each.
Keep in mind if you haven’t worked out before or not for awhile start with light weights and low reps and build up over time. A good rule of thumb is this; if 25 reps are too easy, you probably need more weight. Then, if your workout becomes less challenging, add a pound to each weight and so on. So you will have enough weight for a long, long time. That is why it so important to buy adjustable ankle/wrist weights. These are easily found for reasonable prices at Wal-mart.






Sunday, March 6, 2011

Daily Routine Part 2 Afternoons

Afternoon Routine
        Lunch – 1 large apple or pear ( any variety) sliced, 3 – 4 ozs. Of  sharp cheddar, swiss, or Monterey jack cheese, sliced and  whole grain crackers like Trisckets
1 Green Giant veggie meal and a Dole fruit cup
Peanut Butter and Banana Sandwich on whole grain bread with 8 oz. milk or 8 oz. of  V-8 fusion ( depending on what you drank at breakfast)

Afternoon workout
        For my workouts I use two 5 lb wrist weights and workout 6 days a week alternating between two routines. Since I have so few muscles that actually work, I’ve had to become pretty creative.  Although, since we began muscle stimulation, I can do several exercises now that I could never do before. Everything seems to be coming together.

Make certain your blood pressure is at least 110 over 70 or you will be too weak to get the best exercise possible. Wait at least 1 hour after lunch and 1 hour before dinner (try not to eat later than 7:00pm). Invest in a set of adjustable 5 lbs wrist and/or ankle weights. Start with the 1 lb and add another lb to each weight every time a set of 35 is too easy.
Workout 1
        Have your attendant strap your weights to wrists tightly. If you’re like me and have skinny little arms, you may have to slide a little of your hand inside the weight. Ask your caregiver to tuck your thumb into your hand so you can have a tight fist. Tilt or recline your chair a little to make up for the added weight that will be trying to pull you forward.  Once you feel comfortable begin your routine in the following manner. Between each exercise give yourself a few moments and drink plenty of water throughout workout.
1.  Hold your arm straight out in front you and lift straight up thumb first. Repeat up to 25 reps. Repeat exercise on other arm.
2.  Next hold your arm out at the side of your body and lift straight up thumb pointing up. Repeating on other arm. Up to 25 reps.
3.  Place both elbows on arm rests of your chair press both arms upward as close to your head as you can. If you are like me your triceps are very weak and you will not be pressing above your head but slightly out in front of you either way as long as you do 35 reps you are working a different part of your shoulder.
4.  Tilt your chair back a little more so you can do your crunches and side crunches. Make sure your chair is back far enough that you have to use your stomach and oblique muscles, but not so far that you can’t do the exercise at all. Hold your arms up near your ears and begin your crunches. Start out doing 30 reps straight up, 30 reps one elbow pointing right, lay back, lift with elbow pointing left, for obliques.
5.  Tilt chair all the way back and work on chest by holding arms out to the side as low as possible. Start with 5 reps each exercise building up to 10. After doing your first set move your arms slightly up your chest do 5 more reps. Keep moving your arms a total of 5 time until you above your head or even with your eyes. Make certain one set is directly across your chest. Rest for a few moments. Drink some water. Then start at the top of your chest doing 5 reps each until you’ve worked your way back down to starting point.
6.  Start with 20 reps and do military presses alternating them with 20 reps of bicep curls. When doing your curls hold your arms as high as you can so you can involve your triceps. Rest between each set and drink plenty of water. Do a total of 3 sets each.
7.  Depending on the level of your injury and how much triceps strength you have you will have to slightly alter this exercise. Lean to one side so you can lift your arm using your triceps muscles straight up, slightly out or out. All of these will work you’re your triceps and try as hard as you can to lift higher than you’re supposed to be able.