The Hot Tub

The Gimp and his Gizmos – C

Ever since the accident that put me in the wheelchair I have been tempted by the hot tub on our deck. The tub sits on the deck with the rim 34 inches high. The seat of my wheelchair is 22 inches high. In order to get into the hot tub I need to raise my butt about a foot above the wheelchair and over the water and then get out reversing the process.

Initially we considered a standard Hoyer patient lift. There is a picture in an earlier blog. The problem was that the lift was designed to roll under whatever the patient wanted to transfer to (think bed). The tub sits off the deck and initially we thought that we could simply slide the Hoyer’s legs under the tub. Unfortunately a simple experiment found that there was not enough room for the legs to fit and that in any case the cuts required to roll the legs under the tub might weaken the entire structure.

What was needed was not a lift that rolled but one that stayed in one place and rotated, We tried, unsuccessfully to modify the Hoyer to rotate with the thought that the legs could easily bolt to the deck. Unfortunately the engineers who designed the lift would never allow such unsafe behavior.

I mentioned my issue to a friend and he had a great suggestion. He said he had a hoist designed to bring an engine into a pickup truck. It was very heavy duty, rotates 360 degrees and was a fraction of the price of the Hoyer. I found the device at a local tool shop.

The only problem was bolting it to the deck. My brother in law looked up the formula for torque and calculated the torque as 500 foot pounds – too much to simply bolt into a set of 2 x 4s . One idea was to bolt the lift to an iron plate and then bolt the plate to the deck. My brother in law was all for the lift but insisted on running 12 inch bolts through the mail support beams of the deck. He was doing the work so I was not about to argue.

My friend suggested a great metal market in the industrial section of town which was happy to sell us an iron plate exactly sized span the support beams of the deck. We then took the iron to my friend’s drill press and made holes for bolting the lift to the plate and the plate to the support beams of the deck. Finally we bought some 30 inch drill bits to make holes in the beams for the support bolts. By the time we had finished nothing short of destruction of the b=deck would move the lift.

Now it is time for a trial. I roll up to the liift in a house coat and swim trunks.

Next I lift while my wife places the sling under me. Then I hook the sling to the chains attaching it to the lift. The sling is the same one we got with the Hoyer patient lift.

Next, Verna pumps up the lift (really a cleverly attached car jack) to raise me.

Then she swings me over the tub.

and I am lowered in – staying in the sling and on the lift for stability and safety.

Mission accomplished.

The Lift

The Gimp and his Gizmos – B

Most of our  house has been made accessible.The houses two floors but the second was small and I was willing to abandon it.The entry however  was a much larger problem.There are three that you down to the front porch.There are two steps leading down from the garage. Using the formula that a ramp will require one foot of length for each inch of drop, this would require a ramp 16 feet long inside the house.This length was clearly unusable.

We built a ramp along the side of the house which allowed me to get out of the carand flow around to the back deck coming in through the back door.This works well enough but the back door is not really a good way to get into the house. I had to get out of the car in the rain and because the back door does not have a lock it must be unlocked from the inside.

Clearly the answer in the long term was a way to get down the two steps from the garage.After a false start which will be described in another blog entry, we bought a lift from a caterer. The lift had been used in getting food on and off of a truck, but it was of a type designed to take wheelchairs off of busses. The unit has a sturdy base which bolts to the truck floor or in our case, the concrete floor of the garage. There is a hydraulic pump which moved two very sturdy arms. The whole thing is powered off the truck’s battery.

It was clear that while a significant current was needed, a large battery was not. We found a battery assist device, something to start your car when the battery is dead. It has a battery – can deliver a large current and has a built in charger allowing us to simply leave it plugged into the wall.

When we tried the device, the motor running the pump made a lot of noise. We took it in and they said that the brushes were bad and made a fix which helped but would not last. Then as my brother in law was installing it, the top popped off as the motor was inverted for insertion and the brushes fell out. It makes noise but works and we will see how long it lasts. The local dealer knows how to get replacements.

Operation is dead simple – roll onto the lift and push the up button. When it gets to the top it stops. Down simply opens a solenoid which releases the hydraulic fluid allowing a silent descent. Able bodied folks can simple use walk up the lift and take a single step to get in the garage.

Now I can drive into the garage and get in and out of the car without sitting out in the rain.

The Cup Holder

The Gimp and his Gizmos – A

Carrying anything in a wheelchair is a huge amount of trouble. There are no good surfaces for resting packages. Laps tend not to be flat and any sudden stop can cause a package to slip disastrously to the floor. Furthermore the legs are not particularly designed to carry anything of unusual shape or weight.

The problem for carrying fluids is even worse because they can spell and in most positions for a fluid might be carried that spell is directly into your lap. Remember, that while you can sit in a wheelchair and hold the glass that action consumes one of your hands and it requires both hands to move the chair. While I was in the hospital they suggested that the best way to carry a cup was to wedge it between your legs. This worked relatively well for cold drinks and cases where the cop is not to full. It is obviously too dangerous to carry hot fluids between your legs.

When I got home I bought a thermos container with a lid that sealed well and had a hole that can be opened with a button. This allowed me carry hot coffee and tea in my lap without great fear of burning myself. It was not, however, the solution I really wanted.

Eventually I decided to look for a cup holder that could attach to the frame of my wheelchair. I wanted something that could fold up into a small package that would not be in the way when nothing was being carried. Eventually I found a holder at Mobility Aids that met most of my criteria. It is shown below on my new wheelchair holding a cup of coffee. The upper holders are adjustable and can accommodate many different sizes of cup. I do find that it does not do well with cups that are not tall enough and can slipped below the upper holder.

 

 

The holdercomes with a great bracket for attaching it to the frame of a Quikie chair. When I got my TiLite the bars on the frame were too large attachment that came with the cup holder. My solution was to go to the electrical departmentof the local hardware store and buy a series of pieces that were designed for holding electrical conduits. Two of these fit into the holes in the existing device while a therapy wired able to be drilled.Initially I tried using only two attachment points both on the same side but the arrangement proved to asymmetrical and the cup tended to lean as it was being carried. The current arrangement shown below works well enough although even then the cup has a tendency to lean.

Of course,One of the things that I discovered is that while I greatly prefer Glasses made of glass and potteryThese have a habit of falling on the floor and breaking .We are in the process of getting a good supply of plastic cups and glasses  capable of surviving the abuses dished out to them.

Fired by my occupational therapist

Today I was fired by my occupational therapist. There are two kinds of therapists that you can see a lot. Physical therapists are responsible for training you in the use of your body with all of its limitations. Occupational therapists are interested in getting you back to a normal life. This may include getting back to work but it also includes many of the changes to get around in your house, to be able to use the kitchen, the bathroom and many of the other facilities that are part of a normal life.

Ever since my accident I have been seen by both physical and occupational therapists. Now that I am an outpatient I have been seeing my physical therapist about once a week and my occupational therapist almost as often. Today my occupational therapist told me that I had mastered many of the skills that she wanted to teach and that barring major new issues I would probably not need your help in the future.

I suppose that I cannot argue. I am working, at least half-time. We have made most of the accommodations we intend to make to the house and I understand the critical issues in making the remaining modifications. We just purchased a car and it is being modified to allow me to drive with hand controls. I am cooking and helping out with many other household chores. I suppose my therapist has a point that a little over four months after my accident, while I still have a lot to learn and a lot to improve, I have established new patterns of my life and they are rapidly becoming a complete story.

Bump, Bump, Bump up the stairs

Ever since the accident I have avoided visiting friends whose houses could be reached only by stairs. When we wanted to meet people they came to our house. The last two meetings of our book club met at our house as the only accessible house in the group. Last weekend I was invited to a party for the Seattle AOPA , and flying organization that I have been a member of for a long time. I found out that the house at which it was being held was up a staircase with eight or nine steps. I also knew that there would be a large number of people at the party and while much of the organization is getting up in years there would be a number of younger and stronger folks.

So I took the problem to my physical therapist and asked how a wheelchair could be moved up a flight of stairs. I had originally thought that I would have to be taken out of the chair and carried up the stairs ignominiously using a fireman's carry. The answer is much simpler and two women demonstrated how a chair could be tilted backwards and rolled up a flight of stairs. Bump, bump, bump. It turns out that while the chair is rolling the occupant can significantly aid the process by pulling on the wheels.

Getting down is essentially the same process except that the chair is rolled forward down the stairs while being tilted backwards. Getting up the staircase went very smoothly. We used four people to get up the stairs and only three to get down. I am convinced that two would have been completely adequate for getting both up and down.

In the future as long as there aren't a few strong and able bodied people around there is no need to tell our friends that we cannot go to their house. In the future the club will meet at the hosts house and with a little help I will get up the stairs and joined.

Falling Down

I have been in a wheelchair for over four months. During that time I have been in my chair, on the bed, in a love seat that we bought so I would have some place to sit that was not a wheelchair. We specifically raised the seat four inches to make transfers to and from the love seat. All the time I was deathly afraid of what would happen if I missed a transfer, leaned too far or otherwise messed and ended up on the floor.

I had talks with the physical therapists about what was to be done if I found myself on the floor. If it happens when I am alone, the answer is not pretty and may well involve a call to 911. With two people to help, the answer is a fireman’s carry back to the wheelchair. With only one helper, we reviewed a complex technique involving laying the back of the wheelchair in the floor. Carefully placing the body in the chair with the back down and then lifting the chair up. I was not at all sure I even remembered all the steps, let  alone had the strength and skill to do them.

Eventually it had to happen. I had just gotten on the love seat and was still on the edge when I tried to roll the wheelchair away so i could see the TV. I loosened   first the near brake and then leaned over to loosen the far brake. As I was leaning over the wheelchair slipped. Normally, with the brakes set, I would be able to catch myself on the wheelchair but with the brakes released I had no support and slipped slowly to the floor. Now I was on the floor and had to figure out how to get back up. Fortunately  a couple of weeks earlier we had bought a Hoyer lift.

Normally these lifts are not used by peoplewho have the ability to transfer themselves.They are used by people whose arms are weak enough that they are unable to transfer.I had an interesting problem I was trying to solve.I was trying to figure out a way to get from the wheelchair into the hot tub on my deck. The idea of the lift West transfer me from the chair into the top . It didn't work because in order to transfer you have to slide the legs under the hot tub. We thought that there was room but were wrong. Now the lift was sitting about 3 feet from where I fell while we tried to figure out what to do next.

The answer was very simple. Verna brought the lift over to me. She slung me in the sling, raise me up and placed me back in the wheelchair. It was that simple. However,had we not bought a piece of equipment that I really did not need, I would've been sitting in on the floor with a huge problem on my hands. Sometimes life just works out that way.

The Goldilocks Car

In the story of Goldilocks and the three bears, Goldilocks attempts to eat three bowls of porridge, one is too hot, one is too cold and one is just right. The metaphor has been used for many purposes – most recently in looking for earth-like planets that are  neither too cold and thus ice balls or too hot sustain life. In the context of this essay we are looking for cars that are just the right size, not too large and especially not to tall, not too short, not too large and especially not too small.

When you are in a wheelchair there are many limitations on the card you want to buy. First, the car must be of the right height to make it easy to move from the wheelchair into the driver seat. If the driver seat is too high, it will be very difficult to make this move. The same problem applies if the driver seat is too low, although very few cars fit into this category. Secondly, there must be enough room with the driver seat set as far as the reader as possible to allow the wheelchair to be disassembled and placed in the passenger seat. This process must happen any time a driver in a wheelchair asked to enter a car by himself and drive off.

There are other features which are nice to have. When there is a passenger, instead of disassembling the wheelchair and placing it in the passenger seat, the driver will ask the passenger to put the wheelchair somewhere in the back of the car. If there is a large enough space in the back that the passenger can put the wheelchair there with minimal disassembly, the situation is ideal.

The next thing we considered was the possibility that at some time we would want carry more than two people in one of our cars. My wife drives a Honda Civic which lacks room to take the wheelchair in the trunk. This means that when I am a passenger in her car most of the backseat is occupied by the wheelchair and a third passenger may be accommodated only with great difficulty. Ideally, if there are four passengers it would be nice if the wheelchair were completely outside of the passenger compartment. It might live in the trunk if there were sufficient space or if the car were a hatchback or had other space in the rear the wheelchair could be disassembled and placed in that space.

We went four car dealers and looked at various cars. Most cars were either too high or had other reasons not to be considered. So far the car that we like the most is the Honda Fit. The car is low enough and has enough space to place the wheelchair in a back area without disassembly. We have not gone back and tested to see if there is enough space when the rear seats raised to allow the wheelchair be placed in the back area.

Within the next week or so we will look at other cars, things like the Toyota Scion and maybe be PT cruiser for other candidates for a car we might buy. In the meantime I am taking training in driving cars with hand controls. I did this once before when I was in a cast and rented a car with such controls but I suspect the permanently installed controls may be more serious and perhaps easy to use.