After struggling for a long time with personal needs, I discovered that there is a whole world of assistive devices that I never knew about. Since others may have similar difficulties, I thought it an important topic to post for people after surgical fusions. First of all, some things can be improvised so there may be no need to buy expensive items from supplisers. However, it is also important to know that are suppliers that sell all kinds of assistive devices that can really help, if needed. After full back fusion, I had difficulty cleaning myself after using the toilet. Being a guy, I didn't have the courage to talk about it, so I struggled. There are also a variety of commercial items available from suppliers, such as pattersonmedical.com and other places: reachers that hold a wad of toilet paper, mirrors with extended handels, toilet-side water systems for washing, etc. For me, extended tongs that hold toilet paper works best. I found a 3-foot long stainless steel shoehorn on Amazon.com, but they're available elsewhere. I can easily put on take off slip-on shoes, and I use the opposited curved end to pick up dirty socks off the floor. I bought a long dowel, screwed in a coat hook into one end, and use it to help pull up or push off my pants. Of course, one important tool is a sock puller, which can be purchased from some drug stores, but they're also available in wider sizes from medical supply stores. I wear a size 12 shoe so I had to buy a wider size. Grabbers are really important when a person can't bend. They are also available from some drug stores or medical supply companies. I prefer a trash grabber available from hardware stores because they are longer and their rubber tips are much more effective for picking up anything from a coin or credit card off the floor to cans off lower shelves in the kitchen. Shop around or improvise! My latest acqisition, called the Antioch Clipper, is a nail clipper with two long vertical handles - one to hold the appliance and the other equipped with a button that can be pushed by the user to clip toenails. It comes with an attached magnifying glass to enlarge the cutting site, but it can also be removed if not needed. I haven't mastered it yet, but think it may be helpful. I previously bought a toenail clipper that worked by squeezing a handle, but it was flimsy and didn't work at all. I also tried angled scissors with an extended handle, but they just didn't work on my thin toe nails. Nobody ever talked to me about how to get around the disabilites after such an extensive full-back fusion. Once again, everyone is different and each person needs to find what works best for him- or herself. The important thing to know is there there are tools available to help compensate for most disabilities, especially after fusion.