For over two years now, I’ve navigated an off-and-on, recurrent (or remitting?) knee injury. I’ve gone through rolls of CVS and Synergy brand kinesiotape (and a half roll of KT tape which I swear does not adhere as well and has since been relegated to other tasks). I’ve seen a sport medicine physician. I’ve iced and compressed and elevated. I haven’t gone to physiotherapy because I lack insurance, though that sort of rehabilitation is likely in the works. This has brought me to trialling the SmartCrutch…

Photo on 2018-01-09 at 11.26 PM #2

…but more on that in a moment!

The technical-non-technical background on my knee

If you don’t care about the suspected mechanics of my injury and want to get to the SmartCrutch jump ahead to the next header. 

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Here’s a screenshot of my x-rays from a couple years ago which I posted on Instagram, recently (somewhat poorly) labeled, and sent to a friend. 

It seems the issue is my patella is being pulled medially (toward the “inside” of my leg), and causing some sort of tracking-type problem. Likely, this is because my legs are different lengths—yes, many people’s are, but unlike many people’s, mine are actually clinically significant, to the tune of about 68 mm. This stems from my right hip being super screwed up, also known as severe hip dysplasia. I have an orthotic but because of muscle tension in my quads preventing my hip from fully extending, combined with the other stuff, I still limp.  

The theory here is the malalignment has messed with my quads, has pulled my patella over to a slight angle, and this results in a degree of pain and the feeling like it’s going to give out. My limb length discrepancy is visually apparent (limp), and these symptoms further exaggerate my limp to one that is not-normal-for-me. Doctor, x-rays, then the assessment became that this is all due to my biomechanics and it didn’t seem to my doc that exercises would help this, at least not then. A year and a half ago or so, there was nothing he could really do (especially given my lack of insurance coverage). My pain isn’t terribly severe, thankfully, but feeling like I’m going to possibly fall over combined with that and my general imbalance is a tad disconcerting. Walking longer distances, as well as snow and ice suck (I don’t encounter that many sandy beaches which might also suck after a couple dozen feet). The injury actually started when I was working at tennis clubs, weaving around uneven back areas of courts. So, uneven things remain a problem: cobblestones in Zurich, snow here in Winnipeg, as well as long distance walking, and abrupt stops. 

It was a mostly annoying problem until one night about six weeks ago when, after a fair bit of standing/walking, the only way I could really move about my kitchen was by holding onto the counter. Awkward. 

The question of crutches…

Well over a year ago, a friend asked if I’d considered using crutches. I had, sort of, but related to my hip dysplasia (as they both stem from a staph infection resulting in multifocal osteomyelitis as a neonate, AKA a bone infection affecting multiple joints), I also cannot fully straighten my right arm. This caused significant issues when I had knee surgery (on the other knee) 14 years ago and had to use axillary crutches. My orthopaedic surgeon said forearm crutches might help, but other mobility aids were more easily accessible—I eventually used axillary crutches for a very short period post-surgery when I was semi-weight bearing. Thus, axillary crutches still didn’t seem a great option. A year following the injury, I did check out options and discovered the Smart Crutch, but wasn’t ready to make the mental—and financial—investment into crutches. 

Well, finding myself leaning on my kitchen counter to stabalize myself changed my mind pretty quickly. Within 12 hours of my e-mail to Smart Crutch that night, Kirsten at Smart Mobility had replied, and agreed to send me a pair of crutches for review. (It turns out Kirsten is also trying to find the “right fit” in a Canadian distributor, so while being Canadian is always a win, it was definitely a win here.)

Enter disclosure: I didn’t pay for these, but regardless, promise a thorough and honest review. Because that’s what we agreed on. 🙂 (Formal disclosure at the end of the post.)

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Getting to know SmartCrutch

I contacted Kirsten on Monday night, we discussed by e-mail Tuesday/Wednesday, connected by phone on Thursday, and she shipped the crutches out same-day from Colorado. I was impressed. FedEx had them in my hands in Manitoba on Monday, well before 5 PM as promised. Again—impressed! 

The uniqueness of SmartCrutch is in their adjustability. For me, that’s key. SmartCrutch transitions between a forearm crutch to a platform crutch. As my right elbow does not fully extend (and my wrist also has limited extension, though not as significantly), being able to adjust and carry weight across my full forearm, I thought, would be of significant benefit to me.

SmartCrutches are are a bit of a custom fit, with more customizations out of the box. They have three sizes currently available (with a fourth on the way!). While the upcoming size, Kirsten lamented after I provided her my measurements and we chatted by phone, was likely more appropriate to people my size, we settled on the Petite-Midi crutch. 

Needless to say, in the pre-crutches and starting out phase I was curious: will the SmartCrutch(es) help manage my knee issue? Will it help relieving the lower back pressure I often get when walking and mostly consider normal now? (Oops.) Will there be things I never realized were totally off that are helped? Will I even notice a difference? And the pessimist: Will they just be a pain in the ass? Is the way things are now just the way things are and will be?

And… so began my SmartCrutch trial.

Unboxing SmartCrutch.

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How about a break from this for a video, yeah?
Because, unboxing videos! Yay!

Also apologies for the video quality. I should learn not to record using PhotoBooth and why I didn’t plug in my good microphone which was right beside me is a mystery.

Beginning the SmartCrutch Trial

When I wrote this part, I was 4 weeks into using the SmartCrutch. Within an hour of unboxing, I headed out the door with my SmartCrutches for a board meeting, which was almost rescheduled due to snow/bad weather (which says a lot in Winnipeg). A fresh layer of powder on the sidewalks, I trekked out to the bus stop, a ten minute walk away. 

My first SmartCrutch story is of a “problem”-not-problem. After leaving home, I heard this strange sound. Living near train tracks, I didn’t think much of it. As I continued on, it followed me. Not even halfway to the bus, I realized the odd whistling sound was the wind blowing through the adjustment holes in the crutches—similar to blowing over the top of a pop bottle, except times the four open holes. Quite musical, but not ideal. 😉

Easy fix: Once I got home, I stuck some purple glitter washi-tape over the open holes. Problem solved: no more whistling (though an amusing story!).

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The next issue I came across was more of a fit issue. As mentioned, Kirsten mentioned this when we chatted, that I am somewhat between SmartCrutch sizes. One thing I LOVED about Kirsten from the get-go was her honesty. My forearm measurement is “between” cuff sizes—a little short for the petite/midi crutch. Kirsten mentioned that this could be a problem, but likely workable, and sent the crutches out. She also suggested some great workarounds, and super prompt replies to my e-mail questions. (Again, beyond impressed with her customer service!). One such workaround was modifying the angle of the crutch to closer to 90*. Another was to “close up” the cuff so the opening was essentially non-existent—I accomplished the latter in a few different ways. More on that in a bit.

And before it gets pointed out, yes, I realize the cuff opening is for safety so that if I fall the crutch falls off, but given the crutches make me more stable, I’m willing to take this risk.

SmartCrutch: 4 Weeks Later 

I would say that I continue to grab a SmartCrutch (sometimes two) about 90% of the time I leave the house (and 97% of the time I’m walking farther than say around a small store). I love that they’re small-ish even fully set up so that I can tuck them in between my knees on the bus, keep my backpack on my lap, and only take up my designated one seat. 

In the past few weeks I’ve also “styled my crutches”, both with fun contact paper and by closing the cuff as Kirsten had suggested was helpful, I attempted this a few different ways, starting with shoelaces and a combo of duct tape and KT tape, moving on to a thick bright green ribbon (hey, it was Christmas!).

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I’m still working on other ways to keep the cuffs closed, as the above methods were decent but not terribly long lasting—I just tried Command strips for picture hanging, too, and the velcro-like closure didn’t stay securely closed to the force of the cuff opening trying to separate. So, back to the drawing board!

This was a dual solution, resulting in less forearm friction and also solved the issue I was having of the crutches almost falling off when I reached up for something with them on, AKA every time I went shopping, only saved by the fact I was wearing a puffy jacket.

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The pink chevron contact paper is a mod I am loving. I still have to get the right crutch finished up, but it’s a two person job! Pretty template + idea from Jennifer Peacock-Smith (Facebook group for template here).

I’ve not experienced any arm pain while using the SmartCrutch, although of course some muscle soreness is to be expected (and experienced!). As well, I haven’t noted any lower back tightness/discomfort as I’d often get pre-smart crutch when walking faster than a saunter for more than 10-15 minutes some days. Win!

Another thing about being a person who generally limps and has their whole life, random strangers always seem to need to ask if I’ve injured myself. Usually, the answer was no. Even post-injury, the answer was no, since I limped anyways. 25 years in to my life, I finally got annoyed with these people. Particularly one totally random man when I was just trying to walk across a parking lot with my earphones in and I had to take my earphones out to hear “What happened to your leg?”, and then I just said “Sorry, I’m busy.” and booked it out of there. 

Guess what? Since wandering the world with a crutch or two, no randoms have asked. It’s been quite refreshing.

As well, I find the SmartCrutch is easy to stow in a variety of locations beyond the bus. I’ve yet to take them on a plane (coming in March!), but thanks to their design, I’m set at archery and while pushing a shopping cart! 

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Final thoughts on SmartCrutch

Bottom line here: the SmartCrutch is comfy. Seriously, that layer of foam lining the bottom of the platform is delightful, and comfy whether you’re wearing long sleeves, a jacket, or no sleeves. The adjustability has been crucial for me, and I find the ability to adjust, adjust, and adjust again has been so helpful—you don’t have to get a measurement right the first time, because you can keep tweaking it until you get what works for you. And if you have weird biomechanics like me, that’s super helpful. 

I find I have generally less knee pain at home when I use my SmartCrutch. Actually, today I used my SmartCrutch inside the house for the first time after coaching without it, and my right quads were just feeling unstable and not stellar: it was so nice to not have to repeat that situation from a month ago using my counter to navigate my kitchen—I grabbed a SmartCrutch instead!

As the hashtag goes… #ilovemysmartcrutch!

 

Disclosure: I received a pair of SmartCrutches from Smart Mobility, Inc. in exchange for an honest review. I was not required to write favourably, and I have done my best to give my honest opinions. (Of course, bias does come with free stuff. It’s sort of in the box. ;))

It’s #BellLetsTalk Day, which here in Canada is the one day of the year that people—for better or worse, and sometimes to just bash Bell—stop to talk about mental health. I’m not getting into the Bell thing—it’s a thing.

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What I am getting into is this country has taken the time to pause and reflect. This is awesome. I have seen so many of my friends on Facebook share their struggles and triumphs and stories of living with anxiety and depression; of going to therapy and of choosing to try medication. People who have dealt with these things since childhood, or who are navigating mental health concerns for the first time as adults. To all of you who have shared your stories—today or any other day—I am so proud of all of you. Thank you for being bold, embracing who YOU are, and sharing your journey: I hope that it makes people in your world see “mental illness” differently, and see you just the same, because you are. You are important and your story is important. Every damn day, not just today—the highs, the lows, your story is important. Every. Freaking. Day. 

I am right here with you.

ADHD is a neurodevelopmental disorder, but one that is also considered by some—including the Canadian Mental Health Association—a mental illness. Like depression and anxiety, ADHD is caused by an imbalance of chemicals in the brain, specifically neurotransmitters.

And I’ll be honest, there are days that I can’t believe that. There are days that I see attention deficit disorder as a blessing or a gift or whatever cheesy, cliche thing people say and how could that be a mental illness? How could it be something that isn’t awesome? Days that I am on my A-game, that I have witty remarks that come out the right way, and that words just fly out onto the page in front of me, and days that my energy is exploding out of me in a way that actually feels good.

Except, more often, there’s the flip side to ADHD. The self-doubt, the feeling that I can’t do things right because I have failed to meet expectations so many times, the times I cannot focus enough to figure out the simplest of things—or even when I can focus, there is information my brain simply can’t process. There are the times that not only can I not understand why I am reacting to things the way I am, but also that it is a tidal wave: my feelings just crash over me and I can’t figure out how to just stop this and react how I know is “normal”. It helps—a bit—knowing that this is common for kids and adults with ADHD alike, that we legitimately feel things more intensely and for longer than other people do [1]. But it only helps after the fact. There are the times I hyperfocus and fail to get anything done that I actually need done and only let myself down; others that I again feel like I’ve failed someone else. The words “I forgot,” or “I’m sorry,” are not less true when they come out of my mouth: I mean it. But I get it: it’s hard to accept, again, when you’ve heard it before, because it looks like carelessness. I don’t blame my ADHD—I blame myself, because ADHD and I coexist. I am not my diagnosis, but I cannot separate from it, either. ADHD isn’t just about academics: it’s about life. And it sucks when your failures or shortcomings are not for lack of trying, they are just because my brain is not wired that way.

But here’s the thing. It’s so much better than it was. It’s better knowing that there is a reason why some things are like they are. ADHD is not an excuse, but it is an explanation, if even just for myself sometimes. It’s better knowing how to figure out strategies that work rather than just feeling like I’m stupid. It’s better knowing that this is how I am wired, and that is okay

My first appointment with my psychiatrist back in 2013, she did not say it but she clearly made a note that I appeared anxious. I started medication for ADHD the next day. When I met her again a month later, early in the appointment she commented that I seemed less anxious even just on a very low dose of Concerta, and asked if I had felt anxious before. I told her that I hadn’t, but that things just “felt better” inside me. It was hard to describe—she understood. Every appointment I have seen my psychiatrist she actually asks about side effects. She asks how things are going. She asks how my mood is. Every time. Because she knows the statistics.

Research states people with ADHD are at increased risk for mental health issues: nearly half of people will experience an anxiety disorder, well over a third will deal with a mood disorder like depression, and 15% will develop a substance-use disorder. [2] However, if ADHD is managed correctly, be it through whichever combination of exercise and therapy and medication and eating well-ish, these things can either be caught early and treated early—maybe even be prevented. Maybe.
I am fortunate, I do not currently have any co-existing mental health concerns. That doesn’t mean that it hasn’t, won’t or can’t happen.

ADHD medication doesn’t give a person with ADHD any special ability to concentrate. I probably still focus less well than most non-ADHDers on 72 mg of Concerta a day. I don’t know because I’ve never had a non-ADHD brain. But do I feel better? Yes. Even though all of the above that I still struggle with. Part of it is because of medicine, but part of it is simply knowing what I am working with, knowing that other people experience this, knowing other people get me.

So, Canada.
You spoke.
I spoke.
We “talked”.
Now, don’t shut up just because Bell does.

Because we need this conversation. And we need the conversation to go further: to ensure mental health care is easily accessible—and affordable—for all Canadians. To make therapy with high-quality therapists affordable and accessible*. To ensure that services are available on demand, when people need them—weeks, or months, or years later. As a Canadian, healthcare for your body comes with the package—its a right. But care for your brain? It’s still on the table. (Which is closer than it’s been for a long time.) Stories are important, but so is access to care.

We need this conversation because we need every Canadian to feel confident they can be supported when they choose to share what they are facing.

Because my diagnosis is NOT about whether or not you believe it exists or not. It exists.

And we are living, breathing, singing, dancing proof that WE EXIST.

*Affordable and accessible therapy, to me, means to make therapy that is not income dependent or not something that is dependent on (awesome) charitable organizations like Aulneau, or educational institutions like the University of Manitoba Psych Services Centre. I’m uninsured, and if I can’t afford insurance, I can’t afford a $150 an hour therapist: which doesn’t mean that I should (or in some cases can) just wait longer.

Part of having ADHD is not only does it often feel like we don’t live up to others’ expectations of us, we often don’t live up to our own expectations of ourselves. This challenge is one such example of that—yes, I am getting all the posts done, but this entire week has been catching up posts. I’ll get the last day in on the last day, well, probably anyways. I set the bar high-but-doable for myself, and then—despite proclaiming it for the whole Internet to see—fell behind. Despite my best intentions, what happens always happens.

This is why the reward system works so well. Guess what? 99% of the time, my work gets submitted on time because there’s a financial incentive. That isn’t a bad thing. If I’m not on a deadline, my client knows at least a day or two in advance when I notice things are getting tight. And if they said “No, I need that in.” guess what? I’d be staying up all night to get it done for them. School was the same—the extensions I was given were due to legitimate things—ER trips, emergency surgery, and my grandpa passing away. It was never ADHD. Grades, like money, are enough of an incentive. 

Personal goals are a bit different though. There are all kinds of systems to make personal goals work. I’ve actually done surprisingly well this month, believe it or not. I’ve meditated in some fashion every day (even if I still haven’t made morning meditations a thing. November.), and caught up quickly where I got behind on the planking. Although I got a bit tripped up with the app because I finally “failed” a day—didn’t make it the length I needed to—and then what happens is you have to redo the day. So that brings me in behind, too. I’ve tried the accountability partners but that’s proved to not be so successful, which is fine because I get it, people got their own stuff. I have to work, somehow, on the use of rewarding myself for reaching personal goals, I think. Except—other than like, a 3D printer pen—there’s not a lot of stuff I want. (I mean, I did go out and buy noise cancelling earphones yesterday, which are more of an investment, honestly…) I mean, I am the person who takes 3 months to make an Amazon order because I just want the darn free shipping.

There’s a lot of self-forgiveness that goes on with ADHD. I set plans, I start to follow through with them—and somehow I start strong and end up behind. It’s not a unique thing—non-ADHDers and ADHDers alike do it—but I feel like my track record for actually finishing something according to the plan i’ve made or dreamed up is about 20%, maybe. To date, I’ve finished no larger-scale writing projects that I’ve started in like, over ten years. We’ll see if NaNoWriMo 2016—coming up in November—will change that. It feels great to finish stuff: every time I hit submit on that last post or wrap things up and submit an invoice to a client, I feel like I’ve accomplished something, and it’s a bonus that I love what I get paid to do as much as I do. 

So many things though that I don’t finish, I shrug off. Yes, I’d love to finish them. Resistance, however, is there, between me and the checkbox for each step or each project that I’ve started. Resistance is all of the reasons. And yet, self-forgiveness is a necessity in life with ADHD and a byproduct of that Resistance. Overcoming Resistance is easy—do the thing you are being called to do. And while self-forgiveness is required to coexist with my ADHD brain, it wouldn’t be required if I just did the shit I intended to.

Self-care in terms of self-forgiveness? Yeah I haven’t quite got this figured out yet.

Challenge Update

Plank: 3 minutes 15 seconds accomplished successfully after failing it yesterday.

Meditation: 10 minute Breath and Thoughts meditation on Smiling Mind.

I got distracted by a floor tape roller last night. I am rocking this ADHD awareness month challenge, seriously.

Kind of like mindfulness in general, meditation with ADHD is hard. Even with a guided app. I did a 3 minute meditation just now with Smiling Mind to prepare myself to write this post, and it was all “Count your breaths up to 10 and then start over. If you feel your thoughts pulling you away, start again at 1.”

Clearly I was like Seriously, Smiling Mind? And then started counting again at 1.
And then I thought about going for grilled cheese after my meeting tomorrow. And then I started again at 1. And then once I eventually got to 10, the app man told me now to stop counting and focus solely on my breath. And I kept counting, because seriously, why are you making me switch gears like that?! 

I claimed at one point in high school that I used to meditate, in the days before I had such an app to guide me. I think I honestly did not actually meditate and just did deep breathing until I fell asleep—more of a relaxation exercise than a meditation. They are not synonymous. Also I really liked the blog post I linked there, but I totally missed reading the point where it said to “take a moment now to just notice”. 

For me, meditation is not easy. Smiling Mind (or other guided meditation apps) makes it easier, but it is not easy. But I do know that the more regularly I meditate, the more I feel that I want to meditate, the more I take that second to just notice. I am more likely to incorporate a midday meditation, or early evening like I did tonight before writing this. A couple weeks ago, I did a walking meditation while walking to the bus, which was kind of cool except I did not do the pacing thing as recommended because I was trying to go from point A to point B and not from A to B back to A in six steps.

What am I getting from it? I’m not sure. A pause, at the very least, which is important with the 800 kilometers an hour ADHD brain. I use meditation to help me unwind a bit before I go to sleep. I think I notice more things in my daily life, like the sound of leaves blowing along the sidewalk behind me.

Focus? Yeah I’m not sure if it helps there. In fact, I just realized now probably part of the reason I struggle so much with not letting my thoughts drift too much during my evening meditation is because my meds have worn off. But if it can help with curbing my impulsivity even a bit, or assisting me to pause before I react to something, then hey: the practice is worth it.

And of course, there are reasons it is called a practice. I’ll never master it, especially with this quirky ADHD brain.

And that’s okay—it’s about practicing being non-judgemental about my own thoughts, and then deciding if that’s what, or how, I actually want to think—and having the power to change it, rather than regarding it as inherently good or bad. (Read more about non-judgemental awareness here.) ADHDers can be ridiculously hard on ourselves (on top of often struggling to be mindful!), and I think this is a really important thing for me to be working at… A definite self-care piece.

I think the reality is that mindfulness, meditation, being internally non-judgey is hard
Self-care is hard.

But it’s also extremely necessary. And if meditation can help guide me to those pauses, those right choices…

Well, I’ll keep trying.

 

Day 16 Challenge Update

Meditation: Check.

Plank: Repeat. 2:05. Getting easier (for now), at least with music on ;). 

I started this on Sunday. You know, ADHD. Point is I am finishing it and I still did the plank and meditated. BOOM. (Mostly.)

The thing with ADHD is that unless you have it, it’s hard to totally understand. Or as the folks at ADHD U say, “If you don’t got it, you don’t get it!”. While ADHD is variable and no two of us are alike (like, of course, with just about any diagnosis), community helps.

The ladies—especially our team of administrators—at Smart Girls with ADHD are equally good at providing empathy and laughing at ourselves for the things we do… At volumes that only ADHDers seem to do those sorts of things. Even when I am not posting or responding frequently, if I do something that the other ladies will relate to—usually funny, sometimes frustrating—I will most often pop over to the group and share it! It’s fun to see the comments come in of other girls’ stories from the preceding few days saying “I get ya!”

Community is important to know that you may be different from most people around you because of ADHD or LD, but that you are not alone. I shared a blog post earlier this month, and I always don’t know how to feel when I get a response like this:

Mostly, I am overjoyed that someone knows that we get it. However, there’s still a part of me that still hurts because we are so enthusiastic to find people that get it because of all those who don’t get it. This, though, is why community is so important—and for me, an important part of self-care, one that I can choose to access more when I need it, and less when I don’t. Because when nobody gets it? The ADHD community—whether that’s our Smart Girls (or the Smart Girls admins), the #ADDcheckin tweeps, or just sending off a message to a friend who I know gets it, like Aaron or Jess if I’m needing to be a tad less public about the whole thing.

I’ve said it before about chronic disease, but it really applies to ADHD too. Find your people, your community. The ones that get you. Even if they’re halfway across the country or the continent or the world, my little neurodiverse, ADHD community is so important to me to have—to know that even in my brain’s quirks, other people have the same variation of normal that I do. And just having that safe space to share or rant or whatever is so important, and often reminds me that yes, patience is important and that applies SO MUCH to being patient with myself, too.