In previous posts I have stated how many problems I have been having with my braces. one of the suggestions I read was to take the braces to a local expert and asked for advice. I did call the company and after a few conversations they proposed that I come over at a time when they had a national expert on RGO braces to look at the situation and make suggestions.
Two weeks ago I did that. I brought the braces over and their expert, who is well known to my orthotist and has lectured in her classes, took a good look. After a couple of hours of having him look and having me walk back and forth in the parallel bars, he came up with a long list of changes he wanted in the braces. he felt that the hips were too loose, that the feet were at the wrong angle, that some of the attachments were of an incorrect length, that some of the attachments were put on correctly which might account for some mechanical weakness that we had been having and that I should be able to balance in the braces without using crutches as long as I am not moving. This is something that I clearly cannot do at the present time.
There was also a long discussion about alternate knees. There are two options: a purely mechanical system and an electromechanical system. The purely mechanical system uses a rod to lock the knee whenever the foot is resting on the ground and to release it when the foot is raised. The electromechanical system uses a sensor and what sounds like a motor but might actually be a brake to accomplish much the same thing. I plan to come back and try one or both of these systems if it is at all possible. Problems with the knees being locked at all times are a major subset of the difficulties that I have with my current braces and I am eager to explore alternatives although I am not sure quite what they will mean in terms of my gait or anything else that I might do.
I have sent the braces back to the manufacturer to have some of the changes made and plan to hire the local company to make other changes as much as possible. This means that I will spend several weeks to a month without the braces and plan to find other ways to exercise. I am hoping that what I get eventually will significantly improve my ability to walk.
Saturday, March 17, 2012
Locked in the Van
a very curious thing happened to me a couple of weeks ago. I had coffee with a friend who has a high cervical injury and is in a motorized chair. Recently she acquired a van which allowed her to driver herself. We agreed to meet for coffee. When she got there she discovered that she was locked into the van with no way to get out.
Let me start by explaining how people spinal cord injuries drive. There are three options for ways to drive depending on the level of injury and the amount of work you are willing to do. for people with low levels of injury and good arm function, one option is to use a fairly ordinary car and after transferring from the wheelchair to the car disassemble the wheelchair and place it in the passenger seat. This is the option that I choose. When there is an able-bodied passenger the wheelchair may simply be placed in the back especially if the car is chosen with a large enough back to easily do this.
A second option is to choose a van with a ramp or a wheelchair lift. The ramp or lift requires a much larger parking space than is required for a car or even for the first option. If the person can easily transfer from the wheelchair into a seat it is possible to set up the van so that he can roll in up the ramp, part the wheelchair next to the driver seat and transfer from the chair into the seat. He can then drive the van from the drivers seat using hand controls similar to the first option.
For people who have difficulty transferring because of arm weakness and this will include most people were using motorized wheelchairs a third option is to drive from the wheelchair itself. In almost all cases this involves a motorized chair. There is no chair in the driver seat and once the chair is rolled up the ramp it is rolled into a special clamp in the driver seat and locked in place. The car may then be driven using hand controls with the person sitting in the wheelchair. When the person wants to leave the van he pushes a button unlocks the lock holding the wheelchair in place and allows him to roll backwards out of the clamp and then out of the van.
Now we go back to our story. The clamp is electromechanical and the release mechanism might fail. This is exactly what happened to my friend. The release mechanism failed to work and she was stuck with no way to get out of her car. I saw her drive up and rolled up into the van so that I could watch her get out and thus pretty much saw the whole thing. The idea of being stuck in your car with no way to get out is, as you can imagine, very unpleasant. Eventually she was able to call the company that had installed the mechanism. Luckily, someone answered and was able to give her help. He explained that if the mechanism failed there was a lever that you could pull to release the chair. Unfortunately the lever is very deeply under a large electrical wheelchair. It is impossible to imagine someone with limited arm function being able to reach that far and engage the lever. Fortunately, I was there and was able to take the call. I drove my chair out of the van and around to the driver's side. My friend never opens the driver side door. She gets in to the ramp that comes out the side of the van. She had to move the car to create enough room for me to come around to the driver side and feel around for the box locking the chair. Eventually by feel rather than sight I was able to find lever and pull it unlocking the chair.
I found the entire incident very disturbing. Even knowing how to release the chair there is no way that my friend could have done so without external help. We considered several arrangement the most promising of which is to tie the release lever to the driver side door so that opening the door would release the wheelchair. The mechanics of this arrangement are not simple because the chair would have to drive over whatever attachment was made. I am very concerned about the idea that someone could be locked in their car with no way to release themselves.
I discussed this with a friend of mine at pushing boundaries who told me a story about a man who drove into a similar van which was parked in his garage with the ramp already down. After he had driven in causing his wheelchair to lock in the car, he discovered that the battery was dead and the car would not start and, of course, the unlocking mechanism would not work. Fortunately, he was able to use his cell phone to call AAA and they were able to get into the garage and recharge the battery. If he had been unable to use his phone or summon help in other ways he might well have died of hypothermia before he was able to get out.
Let me start by explaining how people spinal cord injuries drive. There are three options for ways to drive depending on the level of injury and the amount of work you are willing to do. for people with low levels of injury and good arm function, one option is to use a fairly ordinary car and after transferring from the wheelchair to the car disassemble the wheelchair and place it in the passenger seat. This is the option that I choose. When there is an able-bodied passenger the wheelchair may simply be placed in the back especially if the car is chosen with a large enough back to easily do this.
A second option is to choose a van with a ramp or a wheelchair lift. The ramp or lift requires a much larger parking space than is required for a car or even for the first option. If the person can easily transfer from the wheelchair into a seat it is possible to set up the van so that he can roll in up the ramp, part the wheelchair next to the driver seat and transfer from the chair into the seat. He can then drive the van from the drivers seat using hand controls similar to the first option.
For people who have difficulty transferring because of arm weakness and this will include most people were using motorized wheelchairs a third option is to drive from the wheelchair itself. In almost all cases this involves a motorized chair. There is no chair in the driver seat and once the chair is rolled up the ramp it is rolled into a special clamp in the driver seat and locked in place. The car may then be driven using hand controls with the person sitting in the wheelchair. When the person wants to leave the van he pushes a button unlocks the lock holding the wheelchair in place and allows him to roll backwards out of the clamp and then out of the van.
Now we go back to our story. The clamp is electromechanical and the release mechanism might fail. This is exactly what happened to my friend. The release mechanism failed to work and she was stuck with no way to get out of her car. I saw her drive up and rolled up into the van so that I could watch her get out and thus pretty much saw the whole thing. The idea of being stuck in your car with no way to get out is, as you can imagine, very unpleasant. Eventually she was able to call the company that had installed the mechanism. Luckily, someone answered and was able to give her help. He explained that if the mechanism failed there was a lever that you could pull to release the chair. Unfortunately the lever is very deeply under a large electrical wheelchair. It is impossible to imagine someone with limited arm function being able to reach that far and engage the lever. Fortunately, I was there and was able to take the call. I drove my chair out of the van and around to the driver's side. My friend never opens the driver side door. She gets in to the ramp that comes out the side of the van. She had to move the car to create enough room for me to come around to the driver side and feel around for the box locking the chair. Eventually by feel rather than sight I was able to find lever and pull it unlocking the chair.
I found the entire incident very disturbing. Even knowing how to release the chair there is no way that my friend could have done so without external help. We considered several arrangement the most promising of which is to tie the release lever to the driver side door so that opening the door would release the wheelchair. The mechanics of this arrangement are not simple because the chair would have to drive over whatever attachment was made. I am very concerned about the idea that someone could be locked in their car with no way to release themselves.
I discussed this with a friend of mine at pushing boundaries who told me a story about a man who drove into a similar van which was parked in his garage with the ramp already down. After he had driven in causing his wheelchair to lock in the car, he discovered that the battery was dead and the car would not start and, of course, the unlocking mechanism would not work. Fortunately, he was able to use his cell phone to call AAA and they were able to get into the garage and recharge the battery. If he had been unable to use his phone or summon help in other ways he might well have died of hypothermia before he was able to get out.
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