Brand matters when arthritic hands administer COVID tests

Until this weekend, I had only personally administered two brands of COVID-19 home tests on myself or my children. All of my earlier home testing experience was with:

I wrote a detailed review of the Cue Health product a few months ago for those who can afford a more accurate, but much more expensive home test.iPhone running Cue App next to Reader device with COVID-19 test plugged in

Both the Abbott and Cue coronavirus tests were easy for me to use, had straightforward directions, and required only moderate hand strength and dexterity. I highly recommend either of these brands to those with less-than-average manual abilities.

I say this as a person living with a diagnosis of mild, seronegative rheumatoid arthritis whose small joints do not always cooperate with my intent. Those with profound disabilities may require assistance for even these tests, and near-normal eyesight is necessary for every COVID-19 test I’ve tried.

That said, if you can still brush your own teeth effectively, you can probably manage either Abbott or Cue home COVID-19 tests.Open COVID-19 test box with post it note reminder to test twice, 72 hours apart

In our busy household of five, we keep all of our coronavirus test kits on a dedicated table at the side of the living room, stacked up in order of expiration date.

Having flown cross country in March to visit my father, I consumed several tests in quick succession upon my return, and we quickly worked through our locally purchased Abbott test kits to the more recent Roche branded ones we received free from the United States government.COVIDtests.gov offers free at home COVID-19 tests to Americans

Every home in the U.S. is eligible to order 2 sets of 4 free at-⁠home tests. Click here to order yours if you haven’t already.

We test my younger child—the one who attends high school in person—every weekend before he goes downstairs to visit his paternal grandfather. Дедушка lives downstairs in our home, but he has his own dedicated space, kitchen, and a separate entrance. Still, age and health status leaves Deda especially vulnerable to a severe case of COVID-19.

We feel grateful to have the means to protect him from an infection we might unwittingly visit upon him by going about our own public lives.

On Saturday, we used one Roche COVID-19 At-Home test kit from a box of four. Fortunately, it was conducted by my hale and hearty teen, administering his own test. I did not anticipate how difficult this test would have been for me, had I been taking one myself, and I was happy to be merely an observer and reader of directions.Roche COVID-19 test instructions, box, cartridge

Steps five and six of the Roche process would have stymied me, but my healthy child had no real issue with them or with the test in general. There’s a lot of firm pinching involved in those steps, which would be beyond my arthritic fingers.

Our older home educated teen took a test later the same day, and I asked if he wouldn’t mind trying the fourth brand in our personal arsenal: the ACON Labs FlowFlex test even though this meant using test out of expiry order.

I was curious if it would present similar issues. It did.

FlowFlex was the brand sent out by our health insurance via its preferred mail order pharmacy, Express-Scripts.8 FlowFlex COVID-19 antigen tests

We are entitled to eight “freei.e., included with our employer-provided health insurance COVID-19 tests every month for each covered member of our plan. I ordered those for the two household members going to work/school as soon as the benefit was published on the website, and they were delivered about four weeks later. In the meantime, I’d ordered a batch of tests each for the other covered members of our household.

If I order directly from the preferred prescription provider, I don’t have to wait for reimbursement. Paying nothing out of pocket seemed like the best option. Now I know better.

For our household, in the future, if I’m the one who requires testing, I should go to a local pharmacy and purchase Abbott’s BinaxNOW tests instead of accepting the option available via mail-order without any out-of pocket expense. This will be a smarter choice given my manual limitations.COVID test tube in stand awaiting insertion of swab and drop-dispensing cap

I believe it is highly probable that Abbott’s BinaxNOW, Roche’s COVID-19 At-Home test kit, and ACON’s FlowFlex have similar probabilities of correctly detecting the novel coronavirus responsible for the chaos and societal disruption of 2020-2022. That said, I doubt the ability of the latter to work for me, with my limited hand strength.

Both the Roche and the ACON FlowFlex test require a user to firmly pinch the included vial between one’s fingers for an extended period of time to get an accurate result. I doubt I could do this reliably, repeatedly, for accurate test results.Fingers squeezing plastic test tube for COVID test

I did experiment with my teen’s FlowFlex vial post-test to determine that I’m capable of dispensing the mixed drops with that product without too much discomfort, but dispensing four drops into the test cartridge is less effortful for some of us with weak phalanges than holding tight to the tube while spinning the test swab therein.Hands squeezing to dispense drop of liquid for COVID test onto cartridgeI felt compelled to compose and post this particular piece as quickly as possible to share my experience with the world. Had I only tried that first test brand, that I happened upon at my local pharmacy last fall, I would have no idea how tricky other versions of COVID-19 tests might be for those of us with more limited mobility.

It is worth reporting that, if I did not have such limitations to my dexterity, I would prefer the more compact packaging offered by Roche and ACON Labs over Abbott’s fairly bulky box, especially for travel. The Roche multi-pack uses far less packaging for four tests than two boxes containing two each of the BinaxNOW. Roche/FlowFlex’s volume will be decidedly less if packed in a suitcase.

Aside from the need to firmly grasp a plastic tube for steps five and six (Roche)/step 2 (ACON’s FlowFlex), I would not have such a distinct preference for Abbott’s BinaxNOW over the competitors. That being said, my limitations have settled in as a near constant over the past decade, and I no longer expect my own normal to return to a more median average.

From my perspective, if you require an at-home COVID-19 diagnostic test, and you have limitations to your manual dexterity, you should try to get an Abbott BinaxNOW antigen test or a molecular one from Cue Health.

If your hands are crippled by arthritis, and you must use Roche or ACON Lab’s tests, ask a fully able bodied friend for assistance, if possible.


Disclosure: The author of this post owns 51.044 shares of ABBOTT LABORATORIES (ABT) stock at the time of writing. Abbott Labs makes the BinaxNOW test kit product.

I find written directions easy to follow and actually enjoy the step-by-step process of assembling LEGO toys and IKEA furniture kits, so my experience may not reflect that of average people.

PDX airport renovation poses new challenge for those with mobility limitations

This post will benefit those of us who fly in or out of Oregon’s major international hub, PDX. The airport, it is a-changing, and if you think you know it and how to navigate it, but you haven’t traveled much during the pandemic, think again!

Until now (December 2021), perhaps my favorite thing about PDX was the elegant simplicity of all airside (post-security) amenities being accessible to each other. There used to be a connector between this airport’s two sides. Adding 150 feet of space inside the terminal is displacing the old walkway.View of construction at PDX from Lounge

R.I.P. airside connector!

The good news is that this generally sensible airport will regain such a connection when the major construction is done. The bad news? That is scheduled for 2023.

As of 2021, travelers need to exit security and re-clear the TSA checkpoint to go from the B/C side to the D/E side. That’s a bummer, and a change, but it makes PDX similar to many other poorly designed airports.

Note: Crossing from B/C to D/E always has been a long-ish walk, and those with difficulty walking should get assistance or allow lots of time here even when the option comes back. Fortunately, most domestic connections don’t require crossing the airport in this way.

Here’s something that had an even bigger impact on me, a person who travels with some mobility limitations due to chronic illness: the walk from check-in to gate before departure, or from gate to baggage claim upon arrival, has grown from manageable to torturous according to my abilities.

This update may also affect families with young children. Little legs on very tired, very young people may also find the new trek difficult.

If you think you already know you can comfortably handle the walking distances at PDX, please look at updated construction maps and reconsider before travel if it’s been awhile since your last transit of this normally pleasant airport.PDX airport winter day - 1

I flew into PDX in the summer, visiting my dad, and the modern “one way valve” security exit didn’t seem so very different from before. The walk was longer, yes, and around to the side whereas one used to enter and exit the secure area from a central location, but at that point the airport still felt familiar with a slight redirection.

Landing in early December, 2021, however—after an, admittedly, much longer-than-average flight time due to a fierce jet stream—walking from arrival gate to baggage claim felt like personal judgement by a cruel god. I thought I might have to stop and rest at one point. I regretted failing to ask for a wheelchair escort before I was halfway out.

Checking in, just before the New Year, to fly home again, I asked an Alaska Airlines representative if the way in was now as convoluted as the exit route had been.PDX airport Alaska Airlines gate C11 - 1

“For the next four years,” she chirped. I opted to visit the special assistance group over by the windows and take a ride to spare my feet.

If you struggle with walking long distances, I strongly advise electing wheelchair assistance at PDX until its renovations are complete. Arrive very early, and accept the help that is available.

As it happens, there was no free assistance agent to help me at 07:30 on New Year’s Eve, though someone was present with the flock* of empty wheelchairs checking boarding passes and explaining the process.

Lucky for me, they gave us the option of having one of my able-bodied kids push me in an airport-owned chair, so we were off within five to seven minutes. An elderly couple traveling on their own who’d arrived before us was still waiting as we left.

I didn’t ask for an official estimate for how long the process of being assisted might take, but I’d add at least half an hour to one’s airport dawdling allowance if traveling alone with special mobility needs requiring an airport-provided wheelchair and attendant.

It goes without saying that one’s teen may not steer a wheelchair as expertly as an experienced, paid professional. Then again, I’ve had my feet bashed by at least a couple of strangers in the past, so a strong kid who loves you isn’t the worst option at an airport.

The “traffic cop” airport employee who directs passengers into the correct TSA security line did cause us some confusion by pointing to the “Express” lane when we were actually eligible for the “PreCheck” lane.TSA Precheck logo

It’s worth knowing that PreCheck trumps Express as far as convenience goes, so use that lane if your boarding pass indicates you are eligible.

Travelers transiting the airport from one no-longer-connected terminal to another are eligible for “Express” lane priority, which did have a markedly shorter line this December morning when compared with the standard security queue. PreCheck, on the other hand, allows one to leave shoes and light jackets on one’s body, keep liquids and electronics inside one’s bag, etc.

Fortunately, the split between Express and PreCheck was very close to the body scanners and X-ray machines so we backtracked only 15 or 20 feet.

It is possible that simply being in a wheelchair caused the “traffic cop” airport employee to direct us to the Express lane. In the past, I’ve noted that wheelchair assistance often allows one to skip the security queue. If this policy is universal, that could shave off a bit of the time “wasted” waiting for an assist. Then again, I didn’t stop to interrogate the employee in question, so don’t count on cutting the line due to mobility limitations without consulting a higher authority than me.

When I make use of airport assistance in the United States, I do tip any wheelchair attendant $5 per ride.

This is not a mandatory fee—services for travelers with disabilities are the responsibility of places of public accommodation—but it does seem to be expected, particularly in the northeast region. In foreign airports when I’ve relied upon similar services, I’ve gotten baffled looks from employees less accustomed to our tipping culture, with gratuities being politely refused in New Zealand, for example.

If you only occasionally need an airport mobility assist, and haven’t typically taken advantage of one at PDX, reconsider your habits there for trips from 2022 to 2024. If your toes are anything like mine, they will thank you!Red walker on hardwood floor in home

Airport assistance is a public good meant to serve all of us who travel; don’t be ashamed to take advantage of services designed to allow everyone equal access to the world.

*What is the correct plural noun for wheelchairs, I wonder? If I get to choose, let’s go with a “roller” of wheelchairs.

RIP memorial demitasse, or the perils of living with autoimmune arthritis

Assessments used to measure the progression of autoimmune disease—like the one I live with—often include questions about how symptoms interfere with daily life. When arthritis afflicts the small joints of the hands, sufferers like myself experience the perils of managing common fragile objects.Starbucks wish you were here ornament demitasse - 3

Case in point: the demise of a demitasse cup I used every day.

This cup was a gift from my mother who passed away in 2019. Today, I fumbled it while loading the dishwasher. It cracked when it hit the counter, one corner crumbling to bits, then continued on to finish shattering against the tile floor.

R.I.P. Starbucks “You Are Here: Oregon” demitasse cup!

Starbucks wish you were here ornament demitasse - 1

My favorite vessel for my daily shot of espresso joy is hardly the first victim of my less-than-nimble MCP and PIP joints.

There’s a particular glass pitcher I use to refill my beloved Zojirushi countertop hot water boiler.

Because my hand slipped perfectly between the pitcher’s handle and body when my joints weren’t swollen, it was my yardstick for physical manifestations of arthritic flares. Swollen, the knuckles—where the base of my fingers meet my hand, or, less often, even the middle joints of my fingers—were too thick to slide into that same space. It made me feel less crazy to have confirmation that my symptoms were real,* physical, and not “all in my head.”

One clumsy morning, I bashed the handle off the pitcher as I maneuvered it between faucet and kettle. Somehow, I managed to rap the fragile handle against the edge of the counter as I lifted it out of the sink.

The result is a far less useful, slightly sharp nub on an otherwise pretty jug:Patterned clear glass water pitcher with top stub only of broken off handle

It was such a lovely pitcher, I still use it—though with even more care—for the same task. The vessel just can’t serve its secondary medical alert function anymore. Also, it is rather trickier to keep a hold of, so I tend not to fill it full to keep the weight manageable.

In the grand scheme of things, these are trivial losses. My hope in sharing this story of small failures is to illuminate—for those fortunate enough to enjoy fully able bodies—another of the small daily battles waged by someone living with even minor infirmities.

They take a toll. They have a cost.

Living in a world designed and built to be adequate to your needs—which is the happy reality healthy people inhabit—is extraordinarily convenient, yet easy to overlook until some change in one’s own status lays bare every discrepancy.

* For many patients with conditions that can’t be definitively diagnosed by simple tests like blood work—especially when the complainant is a woman or a person of color—it is common to feel, if not to be, dismissed as a mental patient instead of acknowledged as the unlucky sufferer of a valid physical ailment. A recent BBC story describes how even physicians with disabilities are greeted with suspicion by the medical establishment.

Roasting vegetables is the right recipe for pandemic winter

  • Hate to cook?
  • Trying to shop less frequently because of a pandemic?
  • Know you should eat more vegetables, but enjoy almost every other food more?
  • Spending more time working and/or learning from home?

If, like me, you tick all these boxes, you should start roasting root vegetables as soon as possible. Best of all, you will have an excuse to purchase a rutabaga. If there’s a vegetable that’s more fun to name, I have yet to hear of it.

Say it out loud: ROOT-uh-BEG-uh! You’re smiling now, right?

Plate of oven roasted carrot, beet, turnip, sweet potato and onionYou will need access to an oven or a toaster oven to cook veggies this way. Beyond that, all that’s required is about one hour and:

  • a sheet pan or other wide, shallow, oven-safe cookware
  • oil
  • salt or other, more sophisticated seasonings
  • vegetables
  • cutting board or plate and a sharp knife

Primal Kitchen avocado oil and Kirkland Himalayan pink saltYou can roast many other things, but the long storing properties of most root vegetables make them ideal for a COVID-19 era menu. Broccoli comes in little bunches; potatoes are sold in great big bags. Shelf life is the main reason for the discrepancy.

Root vegetables in storage boxes and bags: carrot, beet, turnipHere’s a nice resource discussing healthy root vegetables and their nutritional characteristics.

In normal times, many people rush home after work and need dinner on the table within minutes. Roasting is a long, slow process, ill-suited to that kind of lifestyle. Now that a greater* proportion of us are working from home due to the pandemic, however, this kind of “prep it, put it in the oven, then ignore it for an hour while you get back to work” recipe is a lot more accessible.

I was introduced to the concept of roasting root vegetables by a functional nutritionist to whom I was referred by my primary care physician. I suspected that my diet affected the symptoms of my autoimmune condition, but I struggled under the burden of cooking every bite of food for myself given my near total lack of enjoyment of time in the kitchen. This was the best idea the nutritionist gave me from a fairly wide array.

Before I started roasting vegetables, I didn’t buy turnips, rutabagas, or parsnips. Now, I usually keep at least a couple of each on hand because it is so easy to prepare them this way, and the results invariably taste good. Note that these are not vegetables I typically enjoy otherwise.

If you’d like a professionally produced set of step by step instructions, feel free to carry on with Epicurious instead of my low budget advice. Otherwise, here’s my 2 ¢ as the laziest possible chef.

Recipe for roasted root vegetables

  1. Pre-heat your oven to 450° F if you remember; if you don’t, allow more cooking time. This is not a fussy recipe.
  2. Wash all your vegetables, and peel if you prefer.
  3. Chop vegetables into uniform, small-ish pieces.
  4. Pour—or brush with a pastry brush or a bit of paper towel—a thin film of oil onto your baking sheet, lined with foil or a silicone mat first if you prefer.
  5. Spread vegetables in a single layer on prepared baking sheet.
  6. Drizzle with a little oil, and sprinkle on salt and/or pepper, Borsari, or other dried herbs or spices.Borsari original seasoned salt bottle
  7. Roast vegetables, lowering heat to 425° F for about 20 minutes. Check at the 20 minute mark, stirring and flipping pieces over. Continue roasting in 10-15 minute increments until you think they’re done. Look for some darkened edges, or note when the sharp odor of raw vegetables is replaced by the sweeter scent of cooked ones. If in doubt, a total cooking time of 45-60 minutes is probably about right, and most vegetables won’t hurt you if raw or under-cooked, unlike meat.

Roasted vegetables on Silpat lined half sheet panVeg roasting tips from an unseasoned cook

My most often roasted vegetables are sweet potato, carrot, beet, and parsnip, but I use turnips and rutabagas pretty often, too. I have yet to regret roasting any vegetable, but, in my experience, the watery ones seem like extra work for less deliciousness.

Unless you’re cooking for my husband or a similar philistine, always include one small onion with your other vegetables. Caramelized onion is just so tasty unless you hate onions, and maybe even then, and even a small amount lends tons of flavor to the entire rest of the tray of vegetables.

Chop up your vegetables to the size you like to eat. I make little pieces that look like breakfast hash for myself; my husband prefers heftier chunks, a bit larger than dice. I can cook both in the same oven for about the same amount of time with no ill effects, so I’d say the size is purely a matter of personal taste.

Don’t crowd the pan! I always do, and the results will be softer, more “steamed” vegetables with less of the really yummy, caramelized, crunchy bits. Use a larger pan than you think need, and you’ll get the tastiest results. If, like me, you prioritize getting that last dish into the dishwasher instead, just recognize that a smaller batch might turn out better.

Proper chefs on the internet tell me I would get crispier, more delicious vegetables if I used an unlined baking sheet. I use a Silpat non-stick silicone mat anyway. Again, I prioritize easy clean up, and the food ends up good enough for me either way.

Try roasting vegetables you don’t think you like. You may feel differently about them once roasted! I do not normally care for beets or parsnips, but I like them roasted. I like raw carrots, but hate them cooked moist say in a soup; I love them roasted. You can see where I’m going with this. Your experience could differ, but this is a wonderful way to try eating unusual produce that might not normally appear in your diet. Most of us benefit from the addition of greater variety in this category.

Offer roasted vegetables to your kids, possibly not mentioning exactly what they are until they’ve rendered a verdict on taste. Make sure the distinct varietals are different colors so you can identify favorites for future reference. Encourage your kids to eat a whole rainbow of foods. Let them select spices from your cupboard and try roasting with them, possibly by sniffing each bottle until they find one that smells tempting.

My favorite is Borsari Original Seasoned Salt. This is the only “mixed” seasoning in my spice cupboard. It is delicious on duck… and everything else I’ve tried it with. A Whole Foods employee recommended it to me c. 2003.

* 7% of Americans reported being able to work remotely prior to the pandemic; as of October 2020, one third of us are working from home all the time, and 25% report doing so some of the time. More than half of Americans have worked from home for at least part of the pandemic.

Trampoline exercise to ease chronic pain & stiffness

A mini trampoline probably won’t solve your chronic pain issues. My JumpSport 550fi rebounder* has not cured my autoimmune disease, nor did I expect it to. What it has done is offer me is an opportunity to rise up from my seat and move in a way that doesn’t aggravate my sensitive joints.Hardback library book on JumpSport fitness trampoline to show relative size

JumpSport 550fi specs

I ordered my fitness trampoline from Costco.com and received it in mid-July, 2020. I believe the JumpSport 550fi model sold by Costco is simply the manufacturer’s 550f model with the optional Handlebar accessory included.

Here are the specs if you’re interested in the same rebounder I have:JumpSport 550f/fi specs including price, size, weight

My JumpSport 550fi came with two workout DVDs and a one year subscription for additional streaming content. The former was at an intensity too high for someone with my health issues, and I never attempted to access the latter. Watching the instructor led exercises on the disc was helpful for getting ideas about how I might adapt moves to my own level, however.

I wouldn’t go so far as to say I’m “bouncing my way to fitness,” but I am getting up off my backside and moving vigorously more often than I did without the trampoline. When even common, everyday tasks present you with physical challenges, this feels like a big win!

Recent studies suggest that even very sedentary people gain massive improvements in health and longevity from fairly small amounts of exercise. My personal goal is to always—every day, no matter how bad I feel—get my blood pumping on purpose for at least ten minutes. During pandemic lockdown, my fitness trampoline has become a key component in achieving that.

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