Month: June 2023

Categories
Etiquette

HANDSHAKES: Purpose, Etiquette, and Alternatives

Handshake

The handshake is an ancient greeting dating back to 900 BC to seal alliances and 500 BC to convey peace and confirm the absence of a weapon. Centuries later, the Quakers handshake communicated a sense of equality between the parties. Today, handshakes are used to welcome, accept, honor, respect, congratulate, and express peace, goodwill, or gratitude.

For people with dwarfism, the handshake also represents what little people are looking for in society—acceptance, equality, and respect. Nobody has expressed this better than Paul Steven Miller, Equal Employment Opportunity Commissioner (1994-2004):

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“Little people are looking for a handshake not a handout.”

At four-feet-five-inches, Miller was initially denied a welcome handshake from prospective employers. After graduating from Harvard law school, 45 law firms denied him equal treatment, ignored his credentials, and failed to offer him a job. One employer shamelessly disclosed fear that his presence in the law firm would cause clients to mistake the office for a circus freak show! (All this prior to Americans with Disabilities Act (ADA) protections.)

Although job discrimination is still widespread, in post ADA America, applicants with dwarfism now enter an interview room standing on solid legal ground. Nonetheless a candidate at an in-person job interview must still convince an employer that they are the right person for the position. A good handshake can help deliver this message.

According to the founders of National Handshake Day—celebrated on June 29—when two people shake hands, especially when eye contact is made, they are more likely to have a personal connection and relate positively to the other person. CareerBuilder.com adds that shaking hands, makes people twice as likely to remember you than if you didn’t shake hands. Even though little people don’t need any help getting people to remember us, our handshake must still stand up to scrutiny and not make a bad impression.

A handshake needs to strike the right balance. A firm handshake reflects a confident personality, but a tight grip is too aggressive. In contrast, a floppy handshake projects insincerity or weakness. Yet a soft hold with no eye contact is preferred in East Asian nations.

As a little person with arthritic hands and finger joints I have regularly regretted responding to a handshake gesture. The pain inflicted lingers long after the greeter lets go my hand. Consequently, as politely as possible, I reluctantly buck etiquette and decline to reciprocate. However, I avoid disrespecting the person extending their hand to me by explaining my predicament and offering an alternative greeting.

The fist and elbow bumps popularized during the COVID-19 pandemic has made it easier for people to accept alternative greetings. Other no-contact greetings include:

  • Hand over heart: placing your right hand over your heart.
  • Wai bow: palms pressed together and a small head bow so that your fingers touch the gap between your eyebrows.
  • Shaka sign: three middle fingers folded down while the pinky and thumb are pointed upward and then shaking your hand back and forth.

So what’s in vogue in your world: handshakes or alternate greetings?

You may also want to read:

    Categories
    Medical

    “STAY SAFE:” Avoid Slips, Trips, and Falls

    Safety character
    Image by succo from Pixabay. https://pixabay.com/vectors/character-security-a-notice-sign-696951/

    During National Safety Month, the National Safety Council (NSC) designated one week in June to focus on staying safe from slips, trips, and falls. This caught my attention given my being banded as a fall risk when checking into an outpatient clinic or during a hospital stay. And according to the Centers for Disease Control and Prevention (CDC), my past falls have doubled my chances of falling again.

    Did you know that falls are the second leading cause of unintentional injury-related death? According to Injury Facts®, 42,114 people died in falls at home and at work in 2020 and account for almost one-third of non-fatal injuries in the U.S. Nearly seven million people seek emergency room treatment for a fall and 20 percent are seriously injured.

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    Although falling is prevalent among seniors, this post focuses on the fall risk among little people. Although I don’t have data on how many of us are falling, I suspect the fall risk is greater than in the average population. Several factors and conditions contribute to our risk, including the following:

    1. Physiological
    • Impairment in the lower body due to spinal issues or orthopedic limitations. For example, my knees and ankles are fused so I can’t catch myself when I trip.
    • Foot conditions like pain, neuropathy, and hard-to-find well-fitting footwear.
    • Balance problems.
    • Use of mobility devices.
    • Vision problems like retinal detachments.
    • Lack of sleep due to sleep apnea or pain, for example.

    2. Environmental

    • Clutter.
    • Throw rugs or loose carpet.
    • Uneven walking surfaces, like pavers or cracked concrete.
    • Cords on the floor or jutting into the path of travel.
    • Poor lighting.
    • Stairs that are broken, uneven, or without handrails.

    3. Pharmaceutical Agents

    • Taking five or more medications per day.
    • Tranquilizers to treat anxiety and insomnia.
    • Narcotics taken for acute or severe pain.
    • Antihistamine side effects causing drowsiness and reduced coordination, reaction speed and judgment.
    • Over-the-counter medicines affecting balance and gait.

    The good news is that with appropriate interventions little people can drastically reduce the risk of falling.

    Physiological contributors can be mitigated with assistive devices like a cane or walker; sensible shoes that fit well, give good support, and have nonskid soles; grab bars for the shower or tub; a shower chair and hand-held shower nozzle. Exercise can improve strength, balance, coordination and flexibility. Annual vision checks and eyeglass updates are key to spotting and avoiding perilous situations.

    Environmental hazards can be reduced by clearing the floor of anything someone might trip on—clutter, electrical and phone cords, small furniture, throw rugs, and the like. Immediately repair loose, wooden floorboards or carpeting, and clean spilled liquids, grease or food. Install handrails on both sides of a stairway. Maintain good lighting indoors and out. Limit the need for stools by keeping things used often on lower shelves. Use stools with a handle to hold onto. Never stand on chairs, tables or any surface with wheels.

    Pharmaceutical risks can be eased by a doctor or pharmacist medication review.

    What fall prevention tips can you add?

    You may also want to read:

    Categories
    Medical

    Time to Toss and Replace BMI for Dwarfism

    Weight
    Weight, Fat, Diet by SerenaWong. Pixabay. https://pixabay.com/illustrations/weight-fat-diet-health-overweight-3949588/

    According to USA Facts, 43% of Americans are obese. And according to my Body Mass Index (BMI) fat measurement, I am obese. Now that’s a label I refuse to accept.

    The first one to tag me as obese and tell my doctor that “optimizing the patient’s BMI is clinically indicated” was the pulmonologist who diagnosed me with Sleep Apnea. He’d never laid eyes on me, but calculated my BMI as 32.08 based on my weight of 73 lbs (33 kgs) and height of 3’4” (101.6 cms). (A BMI of 30 or greater rates as obese.)

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    Some Little People have been declined surgery until they reduce their BMI. When employer wellness tests identify obesity based on an employee’s BMI, insurance can be denied or premiums increased. Anxiety episodes can be triggered and serious body image issues can develop.

    As 33-year-old Sammy said, “There’s a fine line between health information and body shaming, and I have felt like I have been balancing that tightrope my entire life.” When Kobie’s BMI classified her as overweight, she responded by exercising too much and eating less. As a result, she was undernourished, constantly thought about food, and couldn’t concentrate properly when studying.

    BMI is widely used in the medical community because it’s an inexpensive and quick method for analyzing health status and outcomes. Critiques that it doesn’t account for body composition, ethnicity, race, gender, age, or dwarfism are largely ignored. For instance, in 2013 the American Journal of Medical Genetics published a letter from several doctors—including Dr. Julie Hoover-Fong, the Chair of the Little People of America Medical Advisory Board. They advised against applying current BMI guidelines to adults with dwarfism as “inaccurate as a surrogate of body fat or predictor of health outcomes.”

    So how does a person with dwarfism assess a healthy weight? My husband Robert was denied entry into a Weight Watchers program because his doctor had no standard for calculating a goal weight!

    The weight for age charts published in 2007 for children with Achondroplasia dwarfism cuts off at age 16 and Achondroplasia only accounts for 60 percent of the dwarf population. What about adults and little people with one of the other 399 dwarfism types? We have no data to guide us.

    If I followed the weight chart for a 16-year old female with Achondroplasia, I’d be huge and barely able to walk. At the 50th percentile, I’d weigh 99 lbs (45 kgs) and have BMI of 43.5; at the fifth percentile, I’d weigh 92 lbs (42 kgs) and have a BMI of 40.

    So without an accurate measure of a healthy body weight, little people turn to alternative measurement standards, like hydrostatic (underwater weighing), skinfold pinches, waist-to-hip ratio, waist-to-height ratio, and neck circumference. But the accuracy and applicability of these measures to dwarfism is also questionable.

    Ten years have passed since it was reported in the American Journal of Medical Genetics that “Studies to address these issues are underway.” It’s time to move the BMI research needle from talk to research to results!

    Ready to dig deeper? Read:

    • Kerry J. Schulze et al. “Body Mass Index (BMI): The Case for Condition-Specific Cut-Offs for Overweight and Obesity in Skeletal Dysplasias.” Letter to the Editor, American Journal of Medical Genetics, Volume 161, Issue 8, August 2013. Pages 2110-2112. https://onlinelibrary.wiley.com/doi/full/10.1002/ajmg.a.35947.
    Categories
    FAQs

    Do You Get Your Clothes in the Children’s Department?

    Clothes
    Standing on a sidewalk near traffic lights, Angela wears an off-the-rack cropped length purple jacket over a T-shirt with black Capri pants. The jacket sleeves were altered for a custom fit; the matching purple flowering trees in the background were a bonus touch of creation.

    Most little people don’t buy clothes at kid stores. We may stand at eye level with young children, but our dimensions differ drastically. At almost 30 years old, Katherine elaborated, “I am actually built like a woman. Kids’ clothing does not account for cleavage.”

    Even if children’s clothes do fit, dwarf adults don’t want to wear them. We have enough trouble being accepted for our age without making it worse by wearing juvenile clothes. Besides, 31-inches tall Katherine observed, “for the most part, [children’s] fashion made for people my size is smothered in unicorns and puppies and Disney Princesses.” At age 31, Cat’s frustration spills over when she confesses “having to resist the urge for violence when people suggest the kids section like it’s no big deal.”

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    So where do little people get their clothes? Although it’s possible to find clothes shopping in regular stores, it takes much longer. Sofiya described it well. “I usually look through almost every section of a store, try over 20 things on in the fitting room and come out with two pieces.” And, according to Katherine, “every once in a while there’s a diamond hidden amongst all the coal!”

    And it’s not a case of one size fits all. The over 400 dwarfism types come with variations in length of limbs and torso, weight, and curves. Different types need different styles. As a dwarf with a very short trunk, I don’t wear clothes that cut me off in the middle, or use horizontal lines or large designs on the fabric. Little people with Achondroplasia have an average height torso and shorter arms and legs; their issues relate more to long pants and sleeves.

    Because it’s so hard for Little People to find off-the-rack clothes that are affordable, comfortable, and stylish, our community shares shopping tips. Facebook groups are a great resource. For example, in the private group—LP Women Fashion, Shoes & Accessories—there were 40 comments answering a query about affordable places to shop for clothes that fit. Group members not only give store and brand names, but also share pics of themselves wearing particular items. The pictures help assess the usefulness of a tip, because we can see how close the buyer is to our body type and whether the tip will work for us.

    Despite being able to buy many clothes off the rack, alterations are often needed to shorten sleeves, pant legs, and the crotch. Ideally people learn to do their own alterations or sew from scratch, but for those like me who lack this talent paying a seamstress is money well spent. Thankfully, I have been blessed with many excellent dressmakers through the years.

    The ultimate wardrobe experience is being able to shop for clothes originally designed for little people. Although the price tag is higher, the expectation is that the product will be superior to clothes originally made for people two feet taller. Although I haven’t used any of the businesses listed below and cannot make recommendations, I’m delighted to share the following list of dwarfism clothing brands:

    • It Actually Fits, https://itactuallyfits.com, a clothing brand catering to little women where they can go online and find something that fits perfectly without having to worry about alterations.
    • Kathy D. Woods, https://www.kathydwoodsstore.com/, an online women’s clothing company showcasing fashions expressly designed for Little People with an impeccable fit for a variety of body types.

    For additional reading: