Relaxation Ideas

Relaxation Exercise / Repetitive Stress Injury

Frank G. Bowe, Personal Computers and Special Needs
Sybex, Inc., 2021 Challenger Drive, No. 100, Alameda, CA 94501

Sensory Aids Foundation, 399 Sherman Avenue, Palo Alto, CA 94306

There are several levels to typing. When one first learns, one has to concentrate on moving the proper finger to the proper key. But after you have been typing for a long time, you probably do not even know where the keys are, but your fingers do. The reason is that your brain is no longer the primary activating factor, but rather a reflex action in the nervous system. It is sort of like having a co-processor to your main processing unit.

Typing as fast as possible helps get the response automatic, but practicing this way too much ingrains mistakes and trains the hands to be very rigid. That is why you should practice slowly also, in a relaxed manner, and at various speeds and in various ways. When you are an expert, you will find that you use no more energy than is required to type which means your fingers move no further and with no more force than is required.

Another thing: When I type a word, I do not usually think of the word as a sequence of letters. In other words, I do not thing W-O-R-D. I just think "word" and my fingers do it in one motion, practically. The reason to practice those words with which you have problems is to train yourself to be able to type them as one fluid movement.

Also, do not worry about mistakes. It is impossible to learn to type without making mistakes. I have recently formulated all of these ideas as I have been giving my wife typing lessons. She is a very highly educated woman (advanced degree in English, French, and Spanish literature from a European university) and quite bright, but typing is difficult for her. I have to remind her that this is a mechanical skill that only can be learned by making mistakes. So do not be too self-critical, but be very persistent.

Hope it may work for someone else. (And, obviously the entire Cortez Peters' system is much more than just that one technique--he's also got a great system for analyzing the errors you do make!).

The book you want is Cortez Peters, Championship Keyboarding, Skillbuilding, and Applications, McGraw-Hill, 1989, ISBN 0-07-049635-8. There are one or two others, but this is the one you need to begin with.

Just a word, though, on the 'satisfying career' aspect of MT. I have done it both ways - I used to think it was so boring and just "typing". I would think about what I was going to do later on or something and not even keep my mind on my work. Well, it showed in my quality, of course. When I began to take it more seriously, it became more interesting. Really, to be a good MT, you never stop learning. There is always something new. You can even go so far as to really "get into" what the procedures are, etc., and get a wonderful education in every kind of specialty. Once I took that approach as well as recognizing the seriousness of a complete and accurate medical record, my job became much more interesting to me, and it still is even after 12 years.

Primarily, though, I do MT because I do have a LIFE! What freedom it is when your day is not spent as a typical "work day" outside the home. But, since I do have to make a living, I might as well do something enjoyable and productive.

However, in the past three weeks (I have only been doing this since December) I have had a multitude of incidents that interrupt my work. For example: My monitor died. Then my video card died. Then my computer would not boot up. Then our waterbed mattress sprung a leak. Then there are the daily phone calls, and the husband who says he understands but constantly finds things I need to give my attention to when I am typing, and the dog who (by freak accident) got tangled in my headset, dislodged one ear speaker and ate it! It seems like there is a neon sign that goes up whenever I sit down to type that says "INTERRUPT ME!"

Am I unusual, or does everyone who begins working at home encounter similar frustrations? I am very serious about the committments I make to others, and when a delay hinders me from fulfilling the time I have dedicated to the service I am working for, it really bugs me. Does anyone have any hints or suggestions that have helped in similar situations? I really do not want to quit, so I need a plan that helps me keep balance between work and family. Any suggestions would be greatly appreciated!! 3/20/96, from Karen Rhoda, itype@aol.com
I have been an MT for 11 years now, working out of an office attached to my home. When we redesigned, the room the contractor insisted on installing as many windows as possible and I am now very glad that he did. If you have access to windows then by all means move your equipment to the window with the best view if at all possible. I am fortunate to have 4 large windows in my office, two of which overlook my neighbor's yard. This neighbor has several bird feeders within view and I find the intermittent distraction of watching the birds, squirrels and occasional rabbit feeding to be very entertaining and a nice break from the video screen. I have set hours from 8:30 a.m. to 5:30 p.m. with an hour for lunch and two 10-minute breaks during the day. On those breaks, weather permitting, I go outside and take a short walk. On inclement days I pay a telephone visit to a stay-at-home friend or a shut-in. We both enjoy the break from our daily routines and they know I am on a set schedule and are very good at allowing just a 10-minute call. Getting up and stretching periodically is also very helpful.

I also pick up and deliver work to the physicians I transcibe for on a daily basis. Not every physician gets a delivery everyday but I hit three offices per day which usually takes an additional 30 minutes. It's nice to get to see other people, too. This routine has worked well for me. I hope this is of some help to you in giving ideas to brighten an otherwise boring situation.

From Mary Morken
I find that having some project that relates to my work keeps me interested. I can think of ideas while transcribing and jot them down for later. A midday nap helps me not to fall asleep. I too work looking out a window at woods with birds and squirrels. Sometimes a five-minute break to catch the news helps give me a window on the world. On-line communication also gives me perspective for a fresh return to work.

Summer vacation is a different story. One year, my best work time was about 9:00 p.m. to 2:00 a.m. That year, I also discovered my best sleeping time was from 3:00 a.m. to 9:00 a.m., but one can't always work the family around that schedule when school starts. I think we can sense when our truly most productive times are--it's that time of day when you can just sit down and crank it out. Try and schedule your biggest work block at that time, perhaps, then follow it with a healthy break of pursuing a hobby (drawing, reading, etc.--take advantage of that aspect of working at home) or even meditating!! I'm going to miss my art classes, but they really were wreaking havoc on my work schedule--I became one cranky unhappy camper. Follow your instincts with a work schedule and try and stick to it. I've gone back and forth with this in the past, thinking, "well, I work at home, I can set my own hours." Well, I guess the moral of the story is to SET the hours and STICK to it rather than deciding day-to-day when to work.

I have a husband and teenager in my household. They've finally been trained that when I'm in my chair I'm busy and they should deal with their needs on their own. They come running when they hear the printer start or the chair creak when I get up!

We are a two-cat family here, one on my lap and one on my shoulder throughout the majority of the day. Along about 2:00 p.m. the mewing starts for a snack and then they're back to bed!

The first few weeks at home were difficult for me, but that was over six years ago. After working in an office and being away from my daughter so much, I tried to make up for it when I started working at home. Unfortunately, sleep diminished as I was working through the night to make up for the time I didn't work during the afternoon when she was home. A little reworking and all things started to fall into place. It takes understanding from the family, which comes with setting limits and self-discipline.

The job we do is an exceptional job in that every day you have the possibility of learning something new. I like to really LISTEN when I'm transcribing residents because I've often caught errors they've made. This makes me feel good. It makes them glad someone is covering their mistakes. Keep track of how many new words you learn in a certain period of time. All of these things sound quirky, but there's something to them. After all this time, I still feel like a "newbie".

From Trisha Potter:
This has been happening to me all winter!!! I have a regular Dictaphone "U" headphone and since the weather turned cold, with the onset of the static electricity season, I've been getting shocked on a regular basis! However, I've realized that I can actually *hear* the static building up and can reach up and discharge it with my fingers rather than having it shoot into my brain (sorry for the technical jargon!). Before I learned my trick, the shocking would happen randomly, which really made me think of being in a prison camp. I used to try to figure out if what I was typing had any effect (just another way to pass the time), like "ST segment depression ... ZAP," but, no, it was just a fluke. Anyway, I know what ya mean! Sizzlingly yours, Trisha

After six years of pain which may have been caused by ulcers on my ischium bones from sitting too long, and failure of egg crate and soft pillows, a paraplegic on Compuserve Dragon forum told me of a $300 Roho cushion he used without decubiti or pain. It was instant pain relief for me! It's got hundreds of 4-inch-high, soft rubber tubes of air, something like a KinAir bed. My chair is junk but my cushions are gold!

I think a list of MT occupational health hazards would be long, not to mention functional problems from stress, and family conflict from working at home.

I transcribe for a busy neurologic practice. The physicians evaluate many patients suffering from repetitive strain injuries. I use a special board called the "Morency Board." This was designed by a man named Dan Morency who worked at the famous L.L. Bean. I met him through Lauren Emery, an occupational therapist at Plastic and Hand Surgical Associates. He got carpal tunnel syndrome and had to have a carpal tunnel release on each of his hands. Afterward, L.L. Bean sent him to school to study ergonomics and to make a long story short, after trial and error, he came up with this board that looks like a high chair and is upholstered in a soft, comfortable gray material. Your arms and wrists rest on it as you type. It relieves all the pressure from the wrists, arms, and trapezius muscles which get so sore after sitting and typing for long hours. I introduced the neurolgists to it and they, in turn, often send me their patients to give them a hands-on demonstration. It has helped many people become productive again after repetitive strain injuries. The cost is in the $80 range and pays for itself thousands of times over in money saved in medical costs.

The Morency board is an arm rest. It attaches to the work station directly in front of the keyboard (picture an upside-down U). The shape of it makes it look like you are sitting in a baby's high chair and your arms rest on the arms of the upside down "U." The chair height should be adjusted so absolutely no pressure is put on the median nerve and the typist should be seated so the body is at a 90-degree angle. The size of the board depends on the shoulder width of the individual. Three different sizes are available. These are sold by R&D Ergonomics here in Maine, email rdergo@aol.com, telephone number is (207) 865-6445.

I use an ergonomic keyboard by Kinesis which is truly an experience and a joy on the hands. It feels as if your hands are floating. I have been using it now for about a year, typing 10-12 hours a day, and notice a tremendous difference in the way my hands feel at the end of the day.

One stress that most people don't think about is the stress of sitting for hours at a time. Sure, many people would love to have a "sit-down" job, they say, but not for the amount of time we have to, in the positions we have to remain in! If you took somebody and made them sit in a room with their foot out in front of them going up and down, their arms outstretched, and their fingers tapping rapidly and made them stay that way, they'd call it torture! Of course there are many options to help relieve this stress. Different kinds of chairs and keyboards, advice from experts on getting up and stretching, etc. It's especially easy at home since nobody is there to give the MT a dirty look for not pounding away every moment. So a person can certainly adapt. It's just that most people don't think about sitting being hard work!

Special attention needs to be given to the height of the computer monitor. If it is too high or too low, neck strain will creep up on you. I used the simple method of putting some books under the monitor to raise it to eye level. The center of the screen is directly at eye level. My computer is in a tower cabinet, so the monitor does not sit on the case.

Periodically while working I do some very simple exercises, generally when I'm proofreading. The first is to drop my arms and hands to my side and let them totally relax a few moments. Then stretch the fingers as much as they will go for a few seconds extending them. Next clinch the hands into a fist and hold for a few seconds. Then the stretching of the fingers is done overhead and a fist made with the arms held overhead.. This contracts and relaxes the carpal tunnel area and helps keep the tightness out that constricts this tender area.

I originally had my workspace arranged so ergonomically that I could reach everything, computer, transcription machine, printer, etc. without leaving my chair, but soon made some changes that would cause me to get up at least once an hour. It's too easy to get involved with working and find yourself in the same position for three or four hours at a time.

Within the first year of doing medical transcription at home, I was experiencing a bit of carpal tunnel syndrome symptoms and even some cubital tunnel symptoms. The cubital tunnels symptoms were caused by resting the "funny bone" area of the elbows on the hard wooden arms of the chair and caused more problems than the carpal tunnel symptoms. Since making the changes to my my chair, desk, monitor height, and doing the exercises the symptoms has stopped and I have had no problems after six years of medical transcription.