Preventing Infections

I was lucky enough to be invited to the annual Biopatch Infection Control Symposium again this year, as a patient representative. I was even paid to be there, which was quite a bonus. I haven’t, however, been asked to write about the experience. All views here are my own.

The symposium really couldn’t have come at a better time for me. I’ve been finding it increasingly difficult to find the motivation for anything, especially medical things. I’m just about coping with the most essential daily tasks, but not much more, and I’m certainly not being a good advocate for myself or others. Spending the day yesterday with a room full of people who want to improve IV line care and patient experience has given me a top-up of motivation and interest, and gave me a glimpse of ‘old Jo’ – it’s been a long time since I last felt knowledgeable and connected and worthwhile.

The symposium is organised and sponsored by Ethicon (part of Johnson & Johnson), who make Biopatch. Biopatch is a small circular sponge with a hole in the middle that is designed to fit around IV lines. The sponge is impregnated with freeze-dried chlorhexidine gluconate (CHG), which is basically an antibacterial disinfectant. It’s policy at my local hospital that all central IV lines (those that end up in or near the heart, regardless of where on the body they’re inserted) have a Biopatch dressing with a clear dressing on top, so I’ve been using these little sponges for three years now.

The research is pretty impressive (HUGE randomised controlled trials and other high-quality, well-designed studies, published in peer-reviewed journals), showing that Biopatch has a significant impact on infection rates.

You can find the data and recommendations if you’re interested (start with the CDC and SHEA guidelines in the US and Epic3 guidelines in the UK – they link to lots of the studies).

That’s not really what I’m writing about.

The biggest take-home message for me was that we know lots of very good ways to reduce infection risk for people with central lines. Best practice guidelines around the world recommend ‘bundles’ of interventions, at the time the line is placed, and for long-term maintenance. None of these interventions alone is enough to keep people safe – it’s only when they’re all implemented, all the time, that the marginal benefits of each one combine to give impressive results.

Standardisation and checklists are popular at the moment, with good reason. There will always be people who have poor techniques, mavericks who think the guidelines don’t apply, and people who are good, but distracted, exhausted or overwhelmed. Checklists help to make sure that every patient receives the best possible care from every clinician, at every hospital, every time. One of the reasons, I think, that I have had such good experiences with my central line, is that I don’t take shortcuts. I was taught well, and I still use the techniques that I was taught every time. It isn’t at the front of my mind, but I’m fully aware that people die from central line infections (septicaemia), so although I am extremely grateful for my Hickman line and the medical stability it has allowed me, I try to keep a healthy fear of infection. Every time I have any contact with my line I am taking my life in my hands. I know that sounds really melodramatic, but I don’t think it’s an exaggeration.

It’s so important that patients are given the opportunity to take ownership of their line (and their treatment, more generally). I think this should be included in the best practice ‘bundles’ – the patient is the one who suffers when mistakes are made, so we really have a strong interest in ensuring that things are done correctly every time. It can be hard to criticise consultants or other senior clinicians (the balance of power is very much in their favour, after all), but I try to think of it as a teaching opportunity rather than a complaint!

I say to myself over and over, NO SHORTCUTS! It doesn’t matter how tired I am, how late I’m running, how much I want to be doing something else. An extra minute or two in order to do things properly could save me from a tedious hospital admission, or worse.

And with that, it’s ‘life in my hands’ time again.

Until next time…



As if I didn’t have enough to update, I’ve just had a couple of days away at the Costa del NHS.

Nothing major, but I had a high temperature on Monday, which is one of those issues that means, ‘Go straight to hospital. Do not pass Go. Do not collect £200.’ You know the score, I’m sure.

It turned out to be an infection of the skin around my Hickman line, plus a UTI (bladder infection). The team looking after me could not have been better – they performed a really thorough ‘sepsis screen’ which involves checking for the most likely cause of infection. My Hickman line and j-tube sites were both swabbed, and blood was taken from both sides of my line (it has one lumen reserved for nutrition and one for medication) as well as peripherally (from a vein in my arm). A urine sample was checked, and I had a chest x-ray to rule out a chest infection and to check the length of the Hickman line for infection. The chest x-ray was perfectly clear apart from a dislocated shoulder, which was no surprise to anyone.

My team liaised with the microbiology team and prescribed some heavy duty antibiotics (Co-Amoxiclav and Vancomycin). Once the results started to come in, I was started on Flucloxacillin – the Hickman line swab grew staphylococcus (staph.) aureus. This is the same bug as in MRSA, but mine isn’t resistant to any antibiotics, thankfully.

I’ve been home for a couple of days now, continuing with the IV antibiotics. Fluclox is my least favourite antibiotic because it’s given every 6 hours, and almost all my other medications are given every 8 hours, so it messes up my system. That’s not a complaint – well, it is, but anything that allows me to be at home with Husband and Feline is a Good Thing.

I’ve been feeling pretty wiped out, from the hospital stay (security guards helping to convince my roomie not to use violence when interacting with the doctors and nurses, at 3 am), as well as the infection and the medications to treat the infection. Every day has been a little better, though, so I’m sure I’ll be back to normal in no time.

Today is a lovely sunny day, so I’ll be hanging out with my loved ones. I’ll make sure I find time to take the pics I promised, of sketches and sewing.

Thanks for being patient with me!


I’m Still Here


Remember me?!

Sorry it’s been so long. Several reasons, but the main one is that I have been miserable. I tend to pull away from people when things are not going so well, so I’ve been ignoring phonecalls and text messages, email, and most other forms of communication. I currently have 15 voicemails, 4143 unread emails, and 12 other (Facebook/WhatsApp/Viber/text) messages.

I really hope that hasn’t caused any of you to feel as though I don’t care about you. I really do, but I am just finding it hard to make connections at the moment.

Part of the problem is that I am still processing some recent medical stuff. It’s hard to respond to the, “How are you?” questions (honestly) when I don’t know the answer. I also feel a certain amount of responsibility and guilt for sharing miserable and negative stuff with people, making them feel sad. I like to work out how to put a positive spin on things before I share them with others.

Another problem is that I haven’t been well. No one thing in particular, but lots of little things in combination have meant that I have been spending the majority of my time in bed. There have been some wonderful exceptions to that – film marathons with friends (this counts, even though I was technically still in bed – sofabed in the sitting room), a few trips to the park, to the local gelateria, and even a trip up north to see Husband’s family at Easter. These exceptions make me feel more human, and remind me of who I am, once the veneer of medical-badness is stripped away, and I cling to the memories of recent adventures and plans for future adventures; little lights in a tunnel that is sometimes very dark and very unpleasant.

I haven’t been able to bake or knit much recently (I haven’t even picked up knitting needles for almost 2 months), which hasn’t helped my mood. Those two things made me feel as though I could contribute something to the world – I love to give things to people, as well as enjoying the process of making them. It’s been hard not to feel like a waste of space, and a colossal drain on NHS resources, when I’m not able to make anything tangible. I get to the end of the day and feel as though I’ve accomplished nothing. Watching box sets and reading Dickens doesn’t really count as a worthwhile contribution to society, does it?

I’ve been trying to find other interests and other ways to feel productive within these new limitations. I have been drawing and painting a little bit, and trying out several other craft techniques. As part of my New Year’s resolution this year, I have been keeping a creative journal, in which I write, draw, design, plan, collage, doodle, etc. I suppose it’s a Smashbook of sorts.

One of my long-term goals, when I left hospital in November 2013 (after a 3-week inpatient rehabilitation programme), was to sign up for a course to learn new skills or improve old ones. That hasn’t been as easy as it sounds. Early mornings are out, for reasons that I explained in my previous post; evenings are difficult because I’ve usually run out of energy and run in to pain; at the best of times, I struggle to sit for more than a few hours, so each session/class would need to be relatively short and/or close to home. Mondays are generally a write-off after the weekend, when I use all my energy in order to spend quality time with Husband; likewise, I try to rest on Fridays, to conserve energy for the weekend. All these factors limit my choice of courses quite considerably, and that’s without even thinking about whether the course interests me, or if it would be physically possible. With all those limitations, it’s taken a while, but I’ve found a course that could have been made especially for me: Experimental Pattern Cutting and Design (intermediate) at our local adult education centre, which is a 15 minute ‘walk’ (in the electric wheelchair), or 5 minute drive, from home: 2 hours on a Tuesday afternoon, for 8 weeks.

Frustratingly, the course was cancelled at the last minute due to lack of interest, but I met with the tutor, who went through some of my sketches, photos of previous projects and patterns I’ve drafted, and gave me lots of helpful advice and criticism. One of her suggestions was to put together a more formal portfolio and apply for a course at the London College of Fashion, Camberwell College of Arts, or Central St Martin’s. It hadn’t even crossed my mind that I might be good enough for anything like that (I’ve spent my whole life being nudged towards the sciences, and firmly put in my place – Not an Artist – by art teachers), so I felt really encouraged, if somewhat shocked! In addition to giving so much of her time to meet with me, the tutor emailed me with lots more information and guides for further reading/projects to try, and offered to meet me again to talk about the projects, and any stumbling blocks I encountered.

I don’t think my body would handle the travel to and from any of the above colleges (except perhaps Camberwell, which is pretty close to home), let alone the physical demands of even short courses, but it has certainly given me food for thought. I’ve signed up for Craftsy courses (online video-based) on couture sewing techniques and drawing, and have been working my way through those, as well as a couple of books and lots of blogs.

This has all come at just the right time, and has given me such a boost. I have something exciting to occupy my mind, and so many hands-on projects for when my body is feeling cooperative. I’m currently sewing a dress and a jacket for myself, making adjustments to the patterns, and using the couture techniques I’ve been learning. If they go well, I’ll be looking for volunteers for my next project. I’d really like to sew/design things for other people, but I’m not terribly confident yet, and I’m quite slow – a combination of actually being slow (tactfully, I’m a meticulous detail person) and spending a lot of time in bed. I’m very happy, but am trying not to let myself get too excited about these fun projects – it seems as though the more emotionally invested I am in something, the more likely it is that my body will find some way of sabotaging it!

I’ll post photos of some of my recent creations soon. I know I still owe you posts about my bladder operation, a medical update (sigh) and photos of the garden (Husband has been doing wonderful things!) and the cat, who is ridiculous and hilarious, and is still a ray of (sharp and spiky) sunshine in my days, but those posts will have to wait for another day – my sewing machine is calling to me.

Until next time…


** Love life; Dream big; Be positive **
Rina Goldberg



When Experience Counts for Nothing

Many of us with long-term health conditions, whether common or rare, come to know an awful lot about our conditions and our bodies.

In many ways it’s a little like the experience of a car that my grandparents used to drive. She was known as Little Yellow, named for her external colour; her replacement, many years later, was known as Little Vomit, also a reflection of the external colour, or at least my grandmother’s opinion of it. Anyway, Little Yellow was a teeny little thing with slung canvas seats, perennially filled with grandchildren and sand. One thing that Little Yellow didn’t always like was starting. It took a great deal of experience with the 2-stage choke (perhaps I’m showing my age, or at least Yellow’s age) and knowledge of just how much coaxing on the accelerator pedal was enough and how much would just flood the tiny engine, at which point it was best to go for another swim, or to get another ice cream, rather than continue to try to start the car.

My body, similarly, does not always like to start. I used to describe myself as a ‘morning person’ – now something that gives rise to a slightly cynical chuckle. My blood pressure tends to be very low in the mornings, making me feel quite wobbly. My joints are also sore in the mornings (oh, hellsticks, what am I talking about? My joints hurt all the time). My joints hurt in the mornings because they slide in and out of socket, or can ‘hang’ out of socket for extended periods while I am asleep and all my muscles are too relaxed to hold my joints where they should be held (in the absence of competent ligaments, which do this for you, ‘normal’ people). Trying to get up too quickly is basically the same as saying, “I feel really optimistic today, so I need to collapse onto the floor to reconsider my attitude.” It’s the Ehlers-Danlos equivalent of time-out on the naughty step.

At the best of times, I take a lot of medication. I try not to count how many I take at the worst of times. Currently, I take somewhere in the region of 25 different medications on a regular basis. In the mornings, with low blood pressure that clouds my thoughts and keeps me lying flat for fear of enforced lying down (fainting), and joints that are weak and painful, it can take two hours just to unhook IV fluids and tube feed, hook up to daytime IV fluids (same fluids, just in a separate bag; no idea why), prepare and administer various IV, injected (with a needle), stuck-on, rubbed in, liquid (via j tube), dissolved in the mouth, or inhaled medications.

If I need to have a shower, it can double the length of the getting up process. Low blood pressure plus hot water is not a good combo (hot water makes the veins dilate, so they allow more blood away from the brain and heart), and I no longer feel safe showering when I’m alone in the house. It’s one thing to be scooped off my own kitchen floor at 3 am by paramedics because I got dizzy, fell over and dislocated my shoulder and wrist; it’s quite another thing to have that same scenario repeated when I’m half-clean (or half not, depending on your particular way of seeing the world), covered in soap, wet and naked.

For reasons that I hope are now obvious, I try not to schedule morning appointments. I’m due to have an operation in a few weeks, and I have to be ready to leave via patient transport (up, showered/dressed, and appropriately medicated) by 5 am. That means I need to get up at 2 am, optimistically. If I didn’t go to bed so early, I’d say it was hardly worth it!

I didn’t mean to write any of this extra detail (sorry). My original point, in case you’ve forgotten, was that people get to know their own particular idiosyncrasies, and learn to modify their environment accordingly. Needing several espressos before anyone can talk to you (or you’re capable of responding) is a common ‘normal’ world example, with coffee-related paraphernalia in the house (or choosing a flat above St*rb*cks) a related environmental adaptation.

Hospitals are often designed to meet the needs of as many people as possible: staff, patients and visitors, and sometimes end up suiting nobody perfectly. In this system, it can be really hard as a patient (often viewed as the person who knows least about their condition) to be assertive about their individual needs.

Many of the nurses on night shifts like to try to get tasks done in order to lighten the load for the day staff who replace them. The intention is admirable, the reality sometimes less so. In reality, ‘getting things done’ can involve putting all the lights on at 5 am and waking patients in order to check their blood pressure and stick pins in them to see if their blood sugar is ok. Quite apart from the fact that many people have low blood pressure at that time of the morning (resulting in lots of scared nurses when they check my blood pressure at that time), it’s not very helpful for people recovering from illness to have their precious sleep interrupted. Additionally, shaking me awake (I sleep with headphones in or my non-deaf ear in the pillow when in hospital) can dislocate or otherwise injure my already-sore joints.

I’d love to see a health system in which patient experience – human experience – is truly valued. I would love patients to be able to choose what time they want to sleep, eat and drink. I would love options for those with dietary restrictions to be more widely available. I would love it if there were some way of making it easier for patients and their friends and families to make the hospital environment more amenable to their own needs, whatever those happen to be.

I’m delighted that so many hospitals allow me to display (LOTS of) photographs and cards, delighted that they sometimes allow me to use my own pillowcase, and bring my own herbal teas and proper-ish coffee. I’m thrilled to report that in the 3 decades that I’ve been an NHS ‘frequent flier’, many hospitals have made great strides in improving patient experience. I remember having an operation when I was quite young (not my first surgery, but I was still under 3 years old) and remember that my parents were not allowed to stay with me outside visiting hours (which used to be pretty much just that – an hour or two once or twice a day), and I remember being intimidated by the long ward and high, narrow ‘big girl’ bed. Things have come a very, very long way since then!

Now, I’m often allowed to administer my own medication, sometimes even intravenous medication, without a huge fight (that seemed like an impossibility back in the ’90s). Not only that, but many of the nurses react with pride that I’ve been taught to look after my own care so well, and encourage me; sometimes they even ask me to talk them through the techniques that I use (I use a sterile technique of Both Hands Clean, as opposed to the more commonly used Clean Hand/Dirty Hand – more on that in another post) or ask to watch me prepare and administer my medications, to learn, rather than supervise.

Every time something like this happens, I’m so grateful to those nurses (and sometimes doctors and pharmacists) who are willing to look beyond the hospital stereotypes and see the things that I do well, or the things that I know about myself, or even the things that make me who I am.

You may have read about Dr Kate Granger’s remarkable positive campaign in the NHS, Hellomynameis – it’s a simple way to remind busy medical staff that they usually know a lot more about the patient than the patient knows about them. By offering their name at the start of any interaction, staff can make patients feel more confident, more human and less alone. This campaign was launched in 90 hospitals and NHS trusts across the UK yesterday, and I’m so proud of Dr Kate and all those who have supported and encouraged her.

I spent yesterday in my local A&E department (another other post), and almost everyone greeted me with a smile and offered me their name, from domestic staff to consultants, technicians and porters, junior doctors, nurses and admin staff. It makes such a difference. One doctor even asked how I’d met my husband (I try to throw out little reminders that I’m not just a rare disease in a bed, so she was responding to that). It pretty much made my day, along with the fact that she let me look at my own blood test results and talked to me like an educated human. She gave me the tiniest of ‘looks’ when her more senior colleague (who has met me numerous times and should have known better) tried to explain to me what blood pressure is. Having studied both medicine and physics, I know a bit about blood, pressure and even both together. I could have hugged this doctor, who didn’t know about the education, but had picked up that her colleague had pitched his ‘little talk’ at the wrong level. I don’t know if it’s that my expectations are too low from a whole life spent in close contact with the NHS, or if those tiny little changes really can change our perceptions so drastically.

Maybe this calls for a wider social experiment: smiling and being kind and aware of our fellow humans in order to change the world. I don’t know. Maybe I’ll try it. For now, though, I’ll continue to be a cheerleader of #Hellomynameis (the Twitter stream from this hashtag is inspiring and heartwarming, if you’re interested, as is @grangerkate herself), and continue to try to pluck up the courage to advocate for myself when necessary.

More soon, I promise!

Things have come a long way since I was this age (this is about the age I was at the surgery mentioned above)



France Part 1

So much to say, so I’ll start with facts.

Richard and I, along with 7 of our friends, spent a week in Chamonix, over New Year.

We stayed in a 1st floor flat, along with another couple, and the others stayed in the same building, but 2 floors above us.

I gained a huge amount of experience and confidence from this trip – our first holiday outside the UK in the almost 3 years that I’ve had a feeding jejunostomy and Hickman line. Logistically, that meant a LOT of stuff had to come with us; not just the supplies that I use routinely, but also the things that I would need if things went wrong. I spent a lot of time thinking about what could go wrong, and how I would handle each potential problem. While packing, I decided that I would plan for the more probable problems and leave the rest to chance. This sounds reckless, perhaps, but it’s how most people plan their lives.

My probable problems:
– infection
– asthma flare-up
– minor problems with feeding tube or Hickman line (blockage, leaking, minor infection)
– damage to supplies in transit, including electric wheelchair

I really, really wanted to avoid a trip to the local mountain hospital (or even a longer trip to one of the large hospitals in Geneva). I didn’t want to spoil my holiday (or anyone else’s) and would have questioned the sense of future holidays if I’d ended up in hospital, or put my health at risk in order to avoid a hospital admission. I was also extremely conscious that this wasn’t just my holiday, or husband’s.

My health really does dictate almost every moment of every day, but I didn’t want to make other people uncomfortable, make them change their plans significantly in order to accommodate me, or put a dampener on the mood of the group.

In general, I think things went pretty well. There was an early incident, when our hire car got stuck in the snow. On the driveway of our apartment block, of all places! We almost had a collision with a snow plough, as we were trying to get off the road, which was unexpected. Of course, everything was fine, and our friend came and helped us dig some of the snow away from the wheels, so that we could drive the couple of metres onto the heated drive. Picture this: Friend digging at the snow with a paint tray, at 1 am, a French snowplough driver shouting about snow tyres, and our car resolutely spinning its wheels. Much funnier in retrospect!

We didn’t get to bed until 4 am, by the time we had done the necessary medical stuff. That is past my bedtime by a considerable amount.

I developed an infection later in the week, for which I was well prepared. It felt good to be able to do all the right things without having to go to hospital.

The final problem was the flight home: we had booked flights back to City airport, which is an easy taxi ride from home, but hadn’t realised that the plane would be smaller. It was absolutely full, and there was a bit of a kerfuffle trying to find space for the wheelchair.

Apart from those fairly minor incidents, it was a wonderful holiday, and I look forward to more adventures in the not-too-distant future.

There are several things that I would do differently next time, and some that I want to remember, as they made life so much easier. I’ll post them on here at some point, more as a reminder for myself than anything else, but they may be useful for others.

Until next time…




Whistle While You Work (or The Benefits of Cheerfulness)

I really want to tell you all about my trip to France over New Year. I wanted to write all about it before I left (especially to show you the difference between my medication suitcase and my ‘everything else’ suitcase) but decided it would be unwise to advertise my empty home in advance.

There are some things that we got absolutely right, some lessons that I learnt, and some things that I’d do differently next time.

Save yourself for those upcoming posts!

For now, I’ve just been reading a blog that I love (Love, Joy, Feminism over at Patheos Atheism) and really wanted to share my own experience. Libby Anne was brought up in a large family, was homeschooled, and was taught to be conservative/fundamentalist Christian, with all the baggage that goes along with such things. My upbringing was less extreme, but I still find that Libby Anne and I have much in common. I have spoken to some of you, my trusted friends, about the changes in my religious beliefs, and the reasons for them, but have generally not trumpeted my internal debates.

One of the things that seems to attract attention and comments, as I make my way through life, is that I maintain a generally cheerful outlook, even in pretty horrible situations. Part of that is due to my natural pragmatic optimism, but this was certainly encouraged at home, at church and at the ‘homeschool’ where I spent the last two years of my primary education. I was taught to believe that I should be joyful in all things, and that one of the ‘fruits of the Holy Spirit’ is joy. If I had the Holy Spirit dwelling in me (as was taught and encouraged), this would be evident from my demeanour; I would display supernatural Love, Joy, Peace, Patience, etc.

In many churches, joy is distinct from happiness or cheerfulness, and I was taught that joy is not an emotional response, but a spiritual gift. Christians are expected to be joyful simply because they are Christian. I was taught that my response in all situations was to praise God (yes, really) and that I should look to God to give me joy under all circumstances.

If I didn’t feel joyful, or remotely thankful, my general tactic was “fake it until you make it.” I would smile and think of positive things. It’s possible to find them, even in the darkest of situations. One problem with this supernatural joy was that I had no outlet for the grief that I felt about my physical condition. I have had so many brushes with almost-death, serious illness and disability, over the last 30-odd years, and each time I was expected to take all my problems (still praising) to God. If I outwardly expressed grief, shame, or anger, it was seen as evidence that my faith was weak. Almost a sign of failure. Not only was my body failing, but if I expressed anything other than joy, my spirit/character was failing. This was the only thing over which I had any control, so I did my best not to fail.

Additionally, my physical illness was seen as a sign that all was not well in the spiritual realm. I have been told that my condition is because of my sin, my lack of faith, because I don’t pray hard enough. I have also heard that god is testing me, that he has great plans for me, that he never gives us more than we can handle.

I no longer describe myself as Christian, which has been a great relief in so many ways. I no longer feel judged for my body’s failings, or for my response. I feel that I am allowed to feel what I feel, whatever that may be.

I’m grateful that all my emotions are validated, and that I no longer have to cover up my ‘negative’ emotions. And yet I still enjoy finding the best in most situations, looking for laughter and fun despite everything. There are times when that’s impossible, which is ok, but endless negativity takes its toll, on me and on those around me. I value my close friends, and am so, so grateful for all that you do for me and Husband. Because I value you, I sometimes choose to censor my negativity, because I don’t expect you to have unlimited strength to deal with my sadness. An hour away from the harsh realities of my medical world can sometimes give me the perspective that I need, or the strength to continue smiling even when things are hard.

I no longer feel that I’m being untrue to myself as I express my emotions, and I no longer feel that my spiritual state is under constant scrutiny. But I am an adult, and am responsible for how I choose to express my feelings. What I say, and how I say it has an effect on how I feel, as well as having an effect on my friends and family. If I spend all my time complaining about how much I hate my feeding tube, for example, it makes it much harder to spend 20 hours per day with a pump and bag of nutrition connected to it. While I try to acknowledge and validate my feelings, I still have the power and responsibility to choose how I use my time, my words and my thoughts. Giving time to the things that make me feel happy and positive is good for everyone, and pretending can go a long way towards making something less difficult.

Thank you for not judging me, whether I choose to ignore the bad things, or sob on your shoulder about them. Thank you for sharing your strength and energy with me. Thank you most of all for being there – on the other side of the Interwebs, on the phone, or in person.


What Not to Say to Someone with a Disability: A Suggestion

*** Not a Rant ***

I didn’t intend to write about words today, but I spotted a word that bothered me, so I thought I’d share it with you.

Most of the time I try to maintain a positive attitude about my life, my body, my future. I have so many good things (and good people) in my life, which really do outweigh the negatives most of the time. So I find it hard when people describe my body or my life with words such as:


Today’s example comes from a website that sells products for people with disabilities:

The transmitter button can be operated by people with limited dexterity, Arthritis victims etc. Powered by 1 x A23 battery. Transmitter range 120M.

So, just FYI, I’m not a victim.