Hygiene? Remind me what that is again...

I have finally started working on the FAQ/advice portion of my blog. The first things I have added are some tips (alright, alright, a tone of tips) regarding hygiene while on crutches. You can find it under the FAQ tab, but for convenience sake I have posted it below as well. This entire broken leg/bone infection experience has given me a lot of new experiences and warped my sense of humor a bit, so I hope you find it both useful and amusing. It is super lengthy, so the are no obligations to read it, I swear!

Having a leg injury may seem like the perfect excuse not to shower. At first you might revel in the fact that you can throw social convention out the window and sit in your pajamas for days on end, binge watching Netflix in your mom’s basement (because let’s be honest, you will probably need way too much help in those first weeks post injury to be able to live alone), while other people bring you ice cream and cater to your every whim. Trust me, it is not worth it.

First of all, while your friends or relatives will likely be more than willing to help you out, you don’t want to take advantage of this. Remember, they are your friends (or family), and they like you (be it due to mutual interests or familial obligation) for a reason. And that reason is not because they enjoy bending backward to your whims, like bringing you bonbons and a super frappe latte whatever at three in the morning.

Second, your family/friend/significant other will start resenting you pretty quickly if you’re sitting on their coach in your stained sweat pants with your greasy hair and smelly armpits yelling for more hot chocolate and bacon at 6:45 in the morning while they scramble to find a clean dress shirt for work and beat the morning rush. Your job is to get better, not to be somebody’s adult child.

Third, you might have thought it would be nice to let your hygiene slide for a day or so when you were able bodied. Everyone wants the occasional day off to break up the monotony that work can be, and that is easily done by calling in sick, donning your flannel sponge bob pajama pants, letting your bed head be, covering your self in orange Cheetos stains, and leading Mario to his princess all afternoon. But being dirty is not so fun when you lose the ability to wash up for weeks on end. When I am dirty, I am cranky and my whole world outlook changes. I feel like a shut in and start resenting the rest of the world. I lose any desire to get out of the house and more significantly, my perspective of my situation changes – my world becomes a black hole; I focus solely on my leg and worst case scenarios and lose sight of everything else going on in my life. A lack of personal hygiene can definitely have a negative impact on your psychological wellbeing in this already trying time. When I am clean, I feel better and more optimistic about my situation. I am also more prone to testing my independence, which will further your confidence and help ease some of the resentment you incurred from your friend/family member/significant other because of your never ending demands for more bonbons.

Fourth, I waste more energy thinking about my hygiene than it actually takes to shower, brush my hair, etc. Plus, sometimes piping hot water in the tub is the one thing that can actually make me feel better. A bit of thinking ahead and creating a new routine based around you being on crutches can make taking care of personal hygiene simpler, less time and energy consuming, and almost enjoyable. It will definitely be worthwhile.

Obviously, personal hygiene is pretty important. I am a firm advocate that it shouldn’t be thrown out the window just because of an injury. That doesn’t mean, however, that there aren’t allowances that should be made for someone recovering from an injury or surgery.

At the end of the day, you have or someone else has somehow managed to hurt your leg so badly that you can’t walk without crutches and now your mobility is drastically impaired. From personal experience I know that the first weeks after injury/surgery are the hardest. In those first few days, even the simple task of lifting your leg off the mountain of pillows it resides on 24/7, like the royal monarch of body parts it is, may be a daunting and virtually impossible task. The pain can be overwhelming and the psychological prospect of pain upon moving even more so. Once the pain (and likely the shock of the stupid thing you did to get injured) has worn off after a few weeks, your crutches will become your number one foe regarding hygiene – they are cumbersome, slow, and consume about 100% of your energy. But no matter what, there are many ways you can help hygiene win what seems like a losing battle. And that is the purpose of this post.

Over the years I have gained a lot of personal experience dealing with leg injuries/surgery. And I do mean a heck of a lot of experience – from breaking both legs simultaneously in 2006, four surgeries (with more to come), and seventeen months on crutches over the years (and counting!), I know what I am talking about. During the past decade I have amassed a mountain of wisdom regarding living on crutches and with a leg that, at times, is good for literally nothing other than weighing me down. And I am going to share those nuggets of wisdom with you.

Safety

Remember, your physical mobility is greatly impaired by your inability to walk and your cognitive functioning probably is too depending on how much pain medication you are on. Crutches and grogginess together make an already bad situation worse. You are not only a danger to yourself as you stumble around, but also to other people and any inanimate objects in your direct vicinity. Before you can worry about your hygiene, you need to make sure you have a clear path to the bathroom.

You will want to move any obstacles and tripping hazards in your way. This includes rugs, shoes, dirty laundry carelessly thrown on the floor because of your inability to actually get to the hamper in the bathroom, the laundry hamper itself, your cat missprincessalicethefifth, crawling toddlers… You get my drift.

In the bathroom itself, all of the floor mats need to be removed. Crutches can catch on them, causing them to slip from under you and then you to gracelessly crash to the floor, potently causing more injuries and certainly more pain in the process. If your bathroom is small, it might be a good idea to move the laundry hamper as well.

You will want to procure a bath mat for the tub or shower. Nothing says danger to those of us with injured legs like a slippery wet surface in a box enclosed with tiles and nowhere to grab onto in case we fall. I have a super cool green crocodile bath mat from Ikea, but any bath mat will do. I’m sure adhesive rubber ducks would work just as well.

If you are really unstable or worried about falling in the tub (especially for those who are older, accident prone, or have multiple physical impairments), I recommend getting a grab-bar for the shower. Do not, and I can’t stress this enough, so I repeat, do not hang off of the towel rack. It is not designed to hold your weight and will likely rip open the wall as you desperately cling to it for dear life, leaving you sprawled on the bathroom floor. If you do this and it does happen, please don’t do it directly after a shower. There is nothing worse than your dad finding you sprawled over the bathroom floor than your dad finding you naked on top of the towel that once covered your now naked butt on the bathroom floor, unable to get up yourself.

Bathing

The process of bathing while on crutches/in a cast/recovering from surgery is a daunting task. The forethought that is required, risk of getting you cast wet or falling in the tub, physical energy required, and inevitable pain from moving your affected limb make it easy to defend your stance on not showering. As previously mentioned, however, hygiene is important. It is also very achievable with some basic planning. Before you begin on your shower adventure, make sure you have taken care of any safety issues, as discussed above.

If you are still in the early days of your injury/surgery, it might not be feasible to get out of bed long enough to shower. Not to worry. If nothing else, past experience has taught me that wet wipes are your best friend. They don’t leave you sopping wet in bed, they come in a variety of pleasant scents, and some of them even contain soap that doesn’t have to be washed off with water. If you are feeling more ambitious, you could opt for a bowl of warm soapy water and a wash cloth. Regarding the greasy mess that has become your hair, there are numerous brands of dry shampoos out there. They come in a variety of forms, from powder or lotion, to aerosol spray. The effect won’t be as great as a shower but the results are relatively good. And at the point you finally feel up to washing your hair, anything is better than nothing.

Before you shower, and it will be a shower because casts can’t get wet and surgical incisions often can’t be submerged in water for at least four weeks post op so baths are out of the questions, there are some preparations you need to make. As previously mentioned, make sure you fix any safety hazards, purchase a bath mat, and install any grab bars if necessary. You will also need something to sit on while in the tub/shower. Obviously standing on one leg, possibly in a narcotic induced fog, on a slippery wet surface is not a good idea. You will need something to sit on. Shower chairs are available at any health supply store. If you don’t want to shell out the cash, opt for something like a plastic chair or a cooler (that is what I use. I just have to empty the water out of it after each shower). A removable shower head, on the other hand, will be worth the money. That way you can control the water and rinsing your hair and back will be super easy instead of contorting your body to get under the stream of water spouting from the shower head mounted on the wall.

As you make your way to the bathroom, assemble all of the things you need. This is important. If you forget your clean underpants or t-shirt, you are out of luck. There is no point putting on your old dirty clothes that you have probably been wearing for a week and are now covered in sweat stains due to the crutches because that will undue the clean feeling you got from the shower. I wouldn’t advice crutching around naked to retrieve your things unless you are absolutely sure you are alone. This brings us to another important point. I try to only shower when other people are home and I always leave the bathroom door unlocked while I shower. That way, if anything goes wrong, someone can always get to me quickly. But back to collecting your stuff. Do your absolute best not to forget anything. This means towels, clean clothing, underwear, socks, any toiletries not kept in the bathroom, q tips, special products you might want to use, hairbrush and comb, etc. You will also want to make sure you are stocked up on shampoos, body wash, etc. There is no point going through the whole process of getting in the tub only to find out you don’t have any conditioner left. If you have a cast/dressing/surgical incision/wound that can’t get wet, don’t forget the duct tape and garbage bag or cast cover either. I kept those in my bathroom drawer, along with scissors, so they were always on hand. The scissors will help you remover the tape and bag once you have showered.

Make sure that your towels can be reached from the tub and that your shampoo/wash clothes/razors/loofah/etc. are ready in the tub/shower. Sit on the toilet to undress yourself and, if necessary, apply your cast cover or duct tape garbage bag masterpiece. For those of you with PICC lines, make sure to put on your PICC line cover or wrap your arm in a combination of saranwrap, clear packing tape, and rubber bands. It is imperative above all else that the PICC line and dressing stay dry. If you have a walk in shower, simply use your crutches to get to your shower chair/cooler/large object to sit on. If you a have tub, pivot from the toilet to the tub (if possible, or lower yourself down onto the side of the tube with your crutches), then get your legs over the side of the tube and transfer yourself to whatever you will be sitting on.

Now it’s time to shower. Hot water never felt so good! Don’t worry about water usage or how long your shower is at this point. Chances are you might only be showering once a week instead of everyday like you used to. So take your time, enjoy, you deserve it after all the effort and planning it took you to actually get into the tub. Don’t think “I will shave my leg(s) next time,” because that might not happen for another week. Do everything: shave, loofah/exfoliate, wash your hair, use body wash, whatever it is you do to get clean.

Once done showering, turn off the water and grab a towel (hopefully you remembered to keep it within reach). Dry off as much as possible, including your garbage bag clad leg. Transfer from whatever you are sitting on to the side of the tub. Then swing your legs over. Before you do anything else, dry the bottom of your foot/feet so you don’t slip on the floor. Transfer to the toilet, cut off the garbage bag or take of the cast cover making sure not to get said cast wet, and then get dressed. If applicable, tend to your PICC line. If possible, rinse out the tub, hang up wet towels, or clean up after yourself in the bathroom in any way you safely can while keeping pain and energy levels in mind. This will help mitigate some of the resentment your family member/friend/significant other has towards you because of the bonbon eating stinky adult child thing.

Congratulations! You are now clean.

At this point, you have likely been out of bed for at least an hour. Make sure the floor is dry so that your crutches don’t slip and make your way back to bed or the couch. At this point you are probably exhausted so you have earned a good break. It is worth it though because you are clean! And clean contributes to happy, which ultimately promotes healing. Go ahead, have another chocolate. Just stay away from the Cheetos for a few days until you start mentally preparing for your next shower.

In between showers, which occurred every 4-5 days when I had my cast, I regularly washed my hair in the sink and wiped myself down with wet wipes. Due to this, I hardly ever felt truly dirty. Now that my cast is off and I am waiting for my external fixator surgery, I shower a bit more often. The effort is completely worth it.

Keeping you cast dry!

If you have a cast and/or surgical bandages, you can’t get these wet under any circumstance. And when I say never, I mean never. Nobody likes the smell of wet cast, and even worse than that is the smell of moldy cast. On top of that, over the weeks (or months) the skin on your leg will die, dry out, and flake off. It will have nowhere to go but the bottom of your cast. When this skin gets wet, it clumps together, and that is truly a disgusting sensation for the bottom of your foot. And don’t even get me started on the psychological aspect of being stuck in a gross cast for weeks on end.

Duct tape and garbage bags will be your best friends. Red Green would be proud. If you get that reference, good for you; if not, look up Red Green on YouTube. You will not be disappointed and you will find a new show to binge watch as you wait for your bones to knit together. The more duct tape you use the better. You don’t want to overdo it of course, but a little extra duct tape can be the difference between staying in the shower for five extra glorious minutes and having a sopping wet cast. I got my duct tape at the dollar store because it was cheap and came in fancy colours. When that ran out, I got the biggest role of regular grey duct tape I could find. I may have broken my leg and struggle to wear anything besides pajama pants, but it’s still nice to feel sexy! And nothing says sexy like flowery pink and blue duct tape, right?

Your other option is to buy a cast cover. They are easy to find on amazon or at your local health supply store. I have never tried one of these, but I had heard good things from others who have.

Cast hygiene

Hygiene doesn’t just refer to showering and clean clothes. It also refers to keeping your cast (or wound dressings) clean. When I got my first cast after surgery number four, one of the orthopedic technicians gave me a cast shoe. This thing had been a life saver. Think about it like this – your cast goes everywhere you do, including you bed, and the hospital bathroom. I don’t want my cast in my bed after the bottom of it has touched a dirty public bathroom floor. So the cast shoe was a god send. I highly recommend it to anyone who has a cast.

Speaking of cast hygiene, I stay inside when it rains and avoid mud and puddles. After several weeks, a dried out muddy cast gets smelly and fells disgusting both physically and psychologically disgusting. Add to that all the dead skin that has probably been collecting and you will probably start to get a bit claustrophobic. I know that I did. 

On top of all that, be aware of the surfaces you stand on. You might not venture out into the big wide world during the winter due to the risk of slipping on a patch of ice or crutching through thigh high snow, but other people, like your family member/friend/significant other do. When they get home, they will track snow and slush inside with them, which will then melt and create both a slipping hazard and the perfect place for your cast to become soiled, likely simultaneously. So beware of the front entrance to your house and any other area (like shopping malls, hospital waiting rooms) that might have wet, dirty floors. If you do venture out in bad weather, wear your cast show. If you don;t have one, you can always tape another garbage bag to your leg.

Other nonsense like brushing your teeth

Aside from showering, there is other nonsense like brushing your teeth that needs to be taken care of. It might seem like a good idea to forgo brushing your teeth while you recover from you injury or surgery. It can be frustrating trying to balance on your crutches while you reach for your tooth brush and toothpaste and then spend several minutes vigorously brushing away as the muscles of your good leg start cramping, your armpits start complaining as you lean on your crutches for support, and you start teetering like a log caught on a large rock at the edge of waterfall. If you find holding onto your crutches while doing all this too difficult, you could always set them aside and clench onto the bathroom counter for dear life. But given your narcotic induced stupor, this might not be the best idea. Despite difficulties, not brushing your teeth is not an option. First and foremost, you need to consider the impact that not brushing will have on your teeth. I have already been on crutches for two month since my last surgery with at least six more months to go. Not brushing for that long is not an option; I don’t want cavities or gum disease! Second, no matter how much you shower, you will still feel disgusting if that layer of plaque starts accumulating on your teeth. Nobody likes that peach fuzzy feeling as they run their tongue over their teeth. Third, I feel better about myself and less self-conscious around other people (like my doctors) when I have clean teeth and a minty fresh breath. This last point goes back to the psychological aspect of being clean. Do not underestimate this! If you can’t stand long enough to complete this task, my best advice is to either place a small folding chair in the bathroom that you can sit on while you brush your teeth and that can easily be stowed away when not in use or to put the toilet lid down and sit on that. If your toilet is too far away from the sink, have a small basin and a cup of water with you so that you can rinse and spit while sitting down.

Clean clothes!

I have always loved the smell of fresh laundry. It just smells so… clean!

There is no point in putting all that effort into showering if you are just going to put on those smelly dirty sweat pants you have already worn for a week. You might not think clothing gets that dirty if all you do all day is sit on the couch, but think about it. You are still wearing something 24/7. Sitting in one place, especially on an office chair, is going to bring you right back to your college days of three hour nonstop lectures on hard plastic chairs. I don’t need to explain what will happen. Plus, all that crutching around is going to make you sweaty, and sweaty equals smelly. Add to that, your clothing will get frumpy and covered in crumbs. And smudges… because you probably forgot napkins or paper towel when you decided to grab that bag of Cheetos. So clean clothing = good. Even if it is just another pair of clean pajamas, at least it is clean. Changing clothes will likely be difficult for the first few days as your struggle with pain management and/or a bulky cast, especially if it is the most evil thing ever devised by man… a full leg plaster cast. But pretty soon you will get the hang of it, so it will be worth it.

Changing out of your pajamas into other clothing (even sweat pants or a track suit) will do wonders for you psychologically. Getting dressed will help bring some purpose into your life (because binge watching Netflix all day every day is not that fulfilling) and help regulate your time. It will also make it easier to go out at some point and interact with other people. Nobody wants to be seen stumbling around outside in smelly Cheetos and sweat stained worn out pajama pants.

I recommend comfortable clothing, like pajama pants a few sizes to big (but not so big they become a tripping hazard), baggy sweaters and t-shirts, and slipper socks with anti-slip thingies on the bottom (because socks, a lament or tile floor, and a narcotic induced haze combined together is asking for trouble). Gee golly, thingies is actually a word and not highlighted by spell check. You really do learn something every day!

When it comes to clothing, choose simple fabrics like flannel or cotton. Anything that has rimples or pleats around you armpits is going to chafe as your crutches rub against you. You do not want to end up with blisters or a rash in your armpit. I have been there and done that. It was not fun.

Sometimes I find it is worth the extra energy to wear something nice and look good. Despite some initial trepidation that knee length skirts and crutches would not go well together, I found it looks quite good and, if you’re careful, you won’t end up showing your zebra print panties to the world by accident. A nice blouse or a sweater with a fancy neck line wont’s hurt either. Add some earrings, a scarf, and a cute wedge shoe (be super careful with wedges or high heels) and you are good to go! Putting effort into looking good can have a tremendous impact on your psychological wellbeing. Plus, nobody wants to see those minion pajama pants adorning your butt when you do finally get the courage (and energy) to leave the house.

You have to be really smart when it comes to clothing though. Too much clothing and you will overheat when you crutch along (crutch walking, especially when you are fully non-weight bearing, is hard work), but too little clothing and you will freeze when you reach your destination (it is really hard to keep up your body temperature if you don’t move very much). I suggest clothing that is light weight and can be easily removed, like a body warmer instead of a big old winter coat, and things that can easily be layered instead of one thick woolen sweater.

Your friend deodorant!

Deodorant is your new best friend. There is no way I can emphasize this too much. Using crutches is hard work. No matter what the weather, hot or cold, you will sweat like crazy. In the summer you will sway from your crutches on your armpits (the one thing you shouldn’t do because it can cause nerve damage) as you crutch along under the fiery sun in 40 degree plus Celsius weather. In the winter when you expect it to be cold you will have massive sweat stains and drench your three sweaters and super puffy winter coat that makes it hard to bend your arms far enough to hold your crutches properly because the physical exertion of using crutches completely trumps the wind chill.

Furthermore, you are pretty much getting a full work out as you crutch between the hospital parking garage and your doctor’s office. I swear the people who design hospital put such a large distance between parking and the fracture clinic because they know that people on crutches try to move as little as possible. I wouldn't be surprised if there is a conspiracy among doctors to get us more active.

And at the end of the day, crutches are really just two long sticks jammed under your armpits. Regardless of the weather or what you wear, this will cause you to sweat. If you don’t use deodorant, the padded parts under your arms will stink.

So, to sum it all up: crutches = hard work = sweating = smelly you! This will defeat the point of expending all that energy and time on bathing while simultaneously making your family/friend/significant other resent you because you smell like an adult child. Deodorant is you friend!

Makeup

I have never been a big fan of make up to begin with and I am even less so now that I am once more reliant on crutches. I suggest either completely avoiding it or using it sparingly until you are recovered enough to no longer need crutches. As previously stated, using crutches is physically exerting and makes you sweaty. Unless you like the look of concealer sliding off your sweaty red panting face, avoid make up. I am not saying to never use it, like a special event or party, but think carefully about it first.If you do use it, consider applying it once you have gotten where you need to go.

Whew. If you made it through all that, I applaud you. I obviously have way too much time on my hands right now. I do hope that you found this guide to hygiene helpful. I know that it can truly feel like a losing battle right after surgery/getting injured. But it will get better. As you physically start to feel better and gain experience with your crutches, you will find new ways of doing things that makes sense to you. You will find what works and utterly fails and how to save time.  And in the end, you will feel better. There is nothing wrong with letting hygiene slide a little bit after your physical abilities change. It is to be expected, but you don’t have to give it up completely, especially if you are in this for the long haul like I am. With such a long treatment plan/recovery period, life on crutches has become the new normal for me instead of a small bump in the road that will pass after a few weeks. I can’t live the next half year in sweat pants. I don’t mind some Cheetos stains occasionally, but I generally like to be clean!