Pacing Yourself

The moderator of the Garbo archives, Timo Salmi wrote a program called ``enough''. It shuts your computer down after a time period that you select! That should get your attention! Not to worry, the program is harmless. But it makes you do soft reboot at each break time.
    The program is in a package of FREE utilities, in a file called something like tstsr4.5.zip (where ts stands for timo Salmi and tsr stands for Terminate and Stay Resident Programs). On the web you can find this file at: http://www.cdrom.com/pub/garbo/garbo_pc/ts
    The same package contains some more moderate alarms and time keeping programs --- all for the IBM PC (running dos), and all free.
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Topical Pain-Killers

On the subject of pain and sensitivity to drugs, I'd like to suggest a topical pain-killer called Pain Doctor (it's OTC as far as I know) which contains capsaicin. I've used it when I'm desperate (right before I take Aleve, which in my opinion works far better than Motrin (Ibuprofen) for wrist pain), and it seems to work best if used 3 or 4 times a day. If you do try it be sure to wash it off after a couple minutes since it can make your skin feel like it's burning if you are sensitive... it's distributed by ABC Pharmaceuticals, Inc. (1-502-237-5555).
    The other thing I use for pain (before I turn to Aleve, which I avoid if I can because it numbs my brain) is ice, quite frequently, until the skin is numb and red (not till I have frostbite!).
    Something I have done at night when I'm in constant pain is get a pillow (or a few) and use them to prop my arms up so my hands are up in the air, which seems to reduce the chance of nighttime swelling (and hence pain).
    I've also worn splints at night, though I have stopped recently since the hot weather and covering my wrists at night like that only made the swelling worse, so I'm in search of splints that do not actually cover the inside of the wrist itself. Excess heat notwithstanding, it's helped everyone I know who has wrist RSI's to wear them at night.
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Build Your Own TENS Unit

Date: Fri, 2 Aug 1996
I was looking into the following projects, which I hope to build, thought I'd pass along the info for anyone else who has a do-it-selfer around with a hot soldering iron . . . .

(Forwarded)
We published two designs for TENS units, our most successful projects *ever*. Back issues/ copies of articles are available for a small cost directly from the Publishers in the UK. Project info. and ordering details gladly sent by email upon request, please contact the undersigned. Thank you for your enquiry!

From Everyday Practical Electronics Magazine (U.K.)

TENS Projects for electronics constructors
-------------------------------------------
We've received many requests for more details of our magazine's projects concerning TENS - Transcutaneous Electrical Nerve Stimulation, or pain killing by electronic means. This message directs any interested readers towards the relevant back issues of our magazine which are readily available from the Publishers in the United Kingdom - see later. I've also given a few basic details of the projects themselves, which have proven to be the most popular projects we have ever published.
    Firstly, about ourselves - Everyday Practical Electronics magazine (EPE) is one of the U.K's best known electronics magazines for hobbyists, constructors, education, technicians etc., we're now in our 25th successful year.
    We regret our policy is not to disseminate copyrighted project schematics and constructional projects by electronic means, such as email or in a newsgroup, because this is unfair on our subscribers and regular readers who pay cash for their monthly magazine. We do however offer a comprehensive back issue service covering most of the past five years' issues, often further beyond! Costs are given later.
    One of our regular designers, Andy Flind, has produced two fully-worked TENS units as constructional projects. The magazine articles written by Andy include all circuit schematics, interwiring diagrams and printed circuit board foils - everything you need to build the projects successfully. *NOTE* we can also provide the printed circuit boards too, from our PCB Service. This saves you having to originate artwork etc. yourself.

SIMPLE TENS UNIT by Andy Flind
(EPE Magazine May 1994 issue)
--------------------------------------------------------------------------
This design is based on a 3-chip 4000-logic pulse generator, outputted to a voltage multiplier circuit. This provides a normal output of 75uS wide pulses at around 90Hz, with a maximum potential of about 80 (eighty) volts peak. It also has a "pulse" output consisting of groups of eight of these pulses repeated at a frequency of about 1.4Hz. The only available control is a switch for selecting Pulse or Continuous mode. It runs from an ordinary 9V battery, and is pocket sized (the prototype measures 145 x 80 x 34mm).

ADVANCED TENS UNIT by Andy Flint
(EPE Magazine June 1994 issue)
-------------------------------------------------------------------------
This is an improvement on the simple design in that the logic pulse generator has been expanded (5 chip) to offer greater degrees of controllability. It incorporates potentiometer controls for setting the frequency, amplitude and width characteristics of the pulse, which is then fed to a voltage multiplier network as before. Again it is battery operated and the article includes all the details you need to build it.
    Both projects look as though they use standard off-the-shelf parts which you can buy in the USA - but you may need to source adhesive electrode pads from a medical supplier, or improvise, and you may need to substitute some transistors for equivalents available in your own market.

BACK ISSUE SERVICE

**** PLEASE NOTE ALL COSTS ARE IN POUNDS STERLING AND WE CANNOT ACCEPT PAYMENTS IN OTHER CURRENCIES ****

The May 1994 issue is still available from the Publishers. The June 1994 issue has sold out. We can provide a photocopy of the Advanced TENS Unit project, (*NOT* the entire magazine) for the price of one magazine issue. Back issue are available by writing a letter or sending a fax to the Publishers in the U.K., or e-mail to editorial@epemag.wimborne.co.uk
    Back issues of Everyday Practical Electronics Magazine cost Stlg 2.50 P&P paid in the UK only. Overseas: Stlg. 3.10 each by surface mail, or Stlg. 4.10 each by airmail if you wish. Payment is accepted by bank draft or cheque drawn in Sterling on a U.K. bank, or by Visa/ Mastercard. **The minimum order value for credit cards is Stlg 5.00** An approximate Exchange Rate is, One Pound = US$ 1.55.

Back Issues Dept.,
Wimborne Publishing Limited,
Allen House,
East Borough, Wimborne,
Dorset,
BH21 1PF.
UNITED KINGDOM

Phone + 44 1202 881749
Fax + 44 1202 841692 - due to the high cost, we don't reply by fax overseas

Credit card holders, please include the number and expiry date, it will be charged in Sterling which will be converted by your card company at the prevailing rate.
    The (glass fibre & roller tinned) printed circuit boards for the above units are also available from us, they cost Stlg 5.84 (Simple) or Stlg 6.56 (Advanced) plus Stlg 1.00 (one Pound) per board for airmail outside of Europe. Subscription rates are also available, Stlg. 47.50 airmail per year.
    We hope the above will answer any queries but please don't hesitate to email us if you have any more questions. Our new WWW site opens soon, http://www.epemag.wimborne.co.uk
Best regards --Alan Winstanley, email: alan@epemag.demon.co.uk
Views are my own.
- Everyday Practical Electronics Magazinee -
Wimborne, Dorset, BH21 1PF, United Kingdom

(End Forwarded)

paul marxhausen ```` ``````` `````
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Using a TENS Unit

>I also had a TENS unit for awhile. If I remember correctly, there are two
>kinds of controls on it. One is for the amplitude and one for the
>wavelength. In other words, one setting for the frequency of the pulse, and
>one for the intensity. Be careful with that intensity setting, you can flare
>yourself up worse by setting it too high (I learned the hard way). Don't ever
>set it so high that your muscles are tightening up or jumping in reaction.
>Start with a low setting and the steady pulse, and if you have specific sore
>points, put the electrodes on either side of the point, not right on it (this is
>what I was told to do for my trigger points).

Krista makes some good points about TENS use, i.e. don't put it directly over the painful site, don't increase the intensity to the point where you flare up, etc.
    In my experience TENS can be more effective than it usually is because patients are not properly instructed in its use. In order to block pain the electrodes must deliver current to the correct nerves. Different sensory modalities are conveyed over nerves of different diameter. The type of current required to stimulate a large diameter nerve is different than that required to stimulate a small diameter nerve. If the nerve you need to stimulate has a large diameter and your stimulation parameters are set for a small diameter nerve the TENS will be less effective. There are several variables which need to be considered. It is best to make a chart and record the set-up vis a vis these variables in order to find the best set-up for you. The chances are that the PT is not going to be able to guess the optimum set-up for you in one TENS instruction session; you will need to determine that by trial and error. That is how I have gotten the best results with my patients.

Variables:

Intensity: This is the amount of current.

Width: This is the duration of each pulse (many per second). The wider (longer) the pulse width, the "stronger" the sensation.

Rate: This is the number of pulses per second. Slower is "stronger" and more likely to cause a muscle contraction.

Mode: Most modern TENS units have modes which will control the presentation of the current, e.g. modulation: continually changes the rate and width, burst: periodic increases in current/ rate, etc. If the nerves accommodate to the TENS (after a couple of weeks) changing the mode can make the TENS more effective.

Electrode placement: The patient needs to experiment with placement (under the guidance of the PT) to find the best locations. Sometimes one channel at the spinal nerve root level and one channel at the site of pain is effective. Sometimes crossing the painful area "X" style with both channels works well.

Duration of treatment: The time left on is a variable.

Activity: What you are doing can alter the effectiveness of a given set-up.

Some people do well with the "brief-intense" protocol, i.e. high width, low rate, high intensity to contractile level for no more that 15 minutes. Others do best with settings which can be left on for many hours, e.g. low width, high rate, low to medium intensities.
    Only by making a chart keeping track of these variables and of pain levels before, during and after treatment can optimum TENS set-ups be obtained.
    Of course TENS is not a cure, only a treatment of symptoms but, for those with functional impairment because of RSIs, it is well worth the inconvenience of TENS if it can decrease the pain enough to enable the patient to function better and I think TENS would be more effective if PTs took the time to explain all the variables of TENS treatments to their patients and the patients were methodical in determining the optimal settings for them. --Dean, a P.T.
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Winter Warning

This may not mean much to sorehanders in Arizona or Australia, but for those of us in the north whose weather maps have icicles on the isotermals, it's time to plan ahead.
    How about starting in the morning by scraping ice off your windshield? Using a credit card can bankrupt your wrists and fingers. I went to the local friendly auto parts store today and bought a couple of long-handled, two fisted ice scrapers. Good strong handles, and using two hands is so much easier on the system than one! You can even wrap the handle in pipe insulation or tennis racquet tape for a custom grip.
    If you can't park under cover at night, and you don't think scraping is quite your style, how about carrying a single bedsheet or sheet of plastic with you? Place one end under the wipers, trap the sides in the doors, and use magnets on your trunk to hold the rear down. In the morning, pull it off, shake off the snow and frost, and drive off humming. Even a sheet of cardboard on the windshield will keep ice from forming on the glass.
    While you're out in the cold, how about protecting those long-suffering hands with a *good* pair of gloves? Sporting goods stores have a wide selection for skiing and other outdoor activities. Find a pair that are not too loose and not too tight. Insulation is a wonderful thing in winter gloves. Down is light, but bulky and doesn't work when wet. Thinsulate is great stuff. Layering also works very well. I have had specialized skiing and motorcycling gloves, but my all time faves are a pair of inner liners worn inside a large pair of black buckskin overgloves. The liners are woven of some stuff NASA developed for space clothing (keep the heat in the glove), and the gloves are nice and flexible, but waterproof enough that I can make snowballs without freezing my pinkies.
    Just a reminder that now is the time to prepare for the inevitable. --Craig
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Jar Opening

When there's no one else around to do the jar opening, I depend on an inexpensive gadget called a JarPop (about $2 at our local Wal-Mart). It looks kind of like a large, thick, slightly curved, heavy-duty plastic churchkey. It releases the seal on a jar through leverage. I have to sit in a chair, brace the jar between my legs, and use both hands on this implement, but it really works, and it only takes gentle, steady pressure. Then I use the Good Grips wedge-shaped opener (the one with the handle) to get the lid unscrewed.
    This device might not work on every type of lid (such as those on Tabasco sauce bottles), but I think it should work on any lid with a vacuum seal.
    The wedge-shaped, cabinet-mounted jar-opener devices with teeth never worked for me. Either they don't grip well enough, or I don't have the strength it takes to hold the jar in there firmly enough.
    I've seen this gadget in catalogs at absurdly marked-up prices (e.g., $12.95 for something that sells in discount stores at 1/6 the cost). People should check their local stores before resorting to the catalog rip-offs. --Marilyn
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How to Ski Hands-Free

Date: Wed, 27 Nov 1996
As a child I discovered I'd accidentally learned to ski hands free after out-growing my ski poles. I had the poles in my hands, but I wasn't planting them because they were too short.
    Just ski as if you had phantom poles. It's good for your technique anyway. Go out on the bunny slope a few times without poles.

Date: Wed, 27 Nov 1996
i'm also in the Northwest, and looking forward to the season...
    definitely enlist the aid of a friend - or friendly stranger - to help with those horrid ski boot buckles. also, check out your bindings - some styles will be easier for you to manipulate than others. since you might have to adjust them by yourself on a far-flung slope, it makes sense to invest in bindings that are easy to use (according to your own personal symptoms).
    the best thing to do about poles? ditch them altogether. when i was taught to ski in the late '70s and early '80s, the method of the time involved skiing your first 15-20 days of instructions with no poles at all. it's still fairly easy (and will deliver you from the temptation of overusing your hands/arms on the slopes). it may feel strange, or a little embarrassing, but one season of pole-free skiing could make the difference for many seasons to come. and you'll certainly get your thighs and glutes in shape, sidestepping up to the chairlifts without poles to help.
    also, ski carefully if this is your first season with RSI! take mellower slopes, avoid the best moguls, etc. it's no laughing matter to take a serious fall when you have a chronic injury. i had a non-skiing fall about nine months into my RSI case, which set me back a good two months' worth of recovery. your hands will instinctively attempt to curb your fall - this can be devastating to the wrists, hands, or shoulders. --Tiffany

Date: Wed, 27 Nov 1996
I'm thinking out loud here, but what the heck! I am an avid skier, and perhaps some of the suggestions can be useful for others.
    The one time you may want poles is to go across the flats to get to a lift. Maybe you can find some of the telescopic poles used by backcountry skiers. They are light and fold up small. Don't ski with them, but keep them in a backpack for those times when skating doesn't cut it.
    I have some special poles, made by Lajos, which I got to protect a broken/sprained thumb that has become a cronic problem. The hand hold is molded such that the thumb is in its own hole on top and the four fingers go around the side somewhat like a standard molded hand hold. This grip may be usable with less muscle effort than the standard strap or molded grips. I'll pay attention next time I hit the snow.
    For cross country skiing without poles, maybe the skating stride on skating skis would be more feasible than the old diagonal style. This wouldn't help much in the backcountry, but would be useful in groomed X-C resorts. --Howie
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Page modified 20 January 1997