What would Jake Sully Drive

At one point during the discussion of my therapy my doctors raise the issue of driving a car with hand controls. I would, of course, need to use a car with hand controls because my feet are no longer functional. Their jaws dropped when that when I said that I had already driven a car with hand controls and thus knew what was involved.

The story goes back to six months before my accident when I tore my Achilles tendon playing racquetball. I felt as if somebody had hit me in the back of my leg. It would later turn out that this is the most common description of somebody who has had their Achilles tendon rupture. It took about a week including several calls to my doctor my wife and another nurse practitioner before finally my wife correctly diagnosed the problem as a torn Achilles tendon. None of the providers seem to believe that I was able to hobble around while my Achilles tendon was completely broken.

I walked into the office of the orthopedic surgeon and announced that I probably had a torn Achilles tendon. I told my story. His response was to turn to the resident and say "this is exactly what the presentation of  torn Achilles tendon is like."

After the surgery I was in a cast and on crutches for a couple months. Because the surgery was on my right foot I was unable to drive during this period. This was a large handicap but I could count on the services of my wife to get me where I needed to go. Unfortunately, several weeks after I was put in the cast Verna was offered a job in Richland on the other side of the Cascades. My initial response was "no you can't go, you're my transportation".

Then I got to thinking… "Suppose I was paraplegic. Suppose I flew into a new city. I would, of course, want to rent a car and someone would be able to rent something that I could drive. My line was "What would Jake Sully drive?

Jake Sully is the protagonist in the movie Avatar and is a paraplegic.

So I called up Enterprise Rent a Car and asked whether it was possible to rent a car with hand controls.Their response was "When you need it?". Several days later I showed up and they gave me keys to a car with and controls. I had, of course,no idea or rather very little idea of how to drive a car with an controls, I drove VERY CAREFULLY around the parking lot about four times before I felt confident enough to VERY SLOWLY get out on the street and drive home by the least used route.

So what are hand controls? Hand controls consist of a bar which is mechanically hookedto the brake and gas pedals of the car. Moving the bar down mechanically pushes the gas pedal. Moving the bar away from you, toward the front of the car causes the brake pedal to be pushed. The connection to the brake pedal is shown below.

 

So learning to drive with hand controls consists of doing with one hand no exactly what you would with 1 footIt takes a little practice, but within a day or twoYou are not even thinking about what you were doing.

Freedom at last

Of all of the adaptations that I have made over the past six months, the one that has made the greatest difference in my life was obtaining a car with hand controls that I could drive and which gave me the ability to transport myself without assistance. After looking at a large number of cars, see a previous post, we ended up settling on the Nissan Cube.

We chose the cube for several reasons,first, it was less ugly than the Toyota Scion, the other car that we seriously considered. The seats are low enough to allow transfers to be made easily and yet the doors are high enough so that the wheelchair may be passed into the car. There is enough room in the back to allow the wheelchair could be stored while at the same time carrying four passengers.

In this pictureI have just used a board to transfer from my wheelchair to drivers seat. The next staff in using the car is to disassemble the wheelchair And play the place the pieces where they can readily be used to reassemble the chair when I get where I'm going.

This shows the removal of the seat cushion.

Here I am removing a wheel

Because the frame is too heavy for me to lift off the ground I clip a strap with a ratchet to the front allowing me to hoist the frame in several steps

H

Finally placing it in the passenger seat

and driving off

A Small Friend

No one at our house was more distressed at the long time that I spent in the hospital than our cat. Normally I am the person who feeds the cat and pays the most attention to it and the animal was extremely upset that for over a month and a half I had simply vanished. When I returned he was happy to give me much of the affection that had been lacking during my absence.

With time he not only became accustomed to the wheelchair but discovered the joys of riding around in my lap. As I write this, the cat is happily sitting in my lap purring and collecting affection.

 

This picture shows the cat sitting in my pal as a cook dinner.

 

The cat now comes up and mews whenever he wants to sit in my lap and ride in the wheelchair and as long as I am not at the table eating I am usually able to oblige.

Adventures traveling

Until I went to a conference last fall I had ne real idea how travel on in a wheelchair worked. I had read that you notified the airlines that you were traveling with a wheelchair and that special arrangements would be made. We did all of that. Then there followed a lot of reading.

Wheelchair passengers need to show up early and are boarded before other passengers on the flight. You stay in the wheelchair until you reach the end of the jetway, At that point the gimp is transferred to a smaller chair narrow enough to get down the aisle of the plane. In the meantime, you advised to remove as many removable parts as possible from the chair to give the airline fewer opportunities to lose parts. Ideally, you end up in a seat near the front of the plane (less distance to travel) and next to the window (you certainly cannot move to let a passenger closer to the window get up.

At the end of the flight, the airline makes sure your wheelchair is at the end of the jetway when you leave the plane after all of the other passengers have exited. On my first flights to Cincinnati, that is exactly the way the system worked,

We next took a trip for pleasure to visit my brother in law in Florida – same idea – same drill. The first flight was from Seattle to Huston. We got to Huston and there was no wheelchair. At this point we remembered the warnings we had read about the glitches that might arise – the wheelchair might be delivered to baggage claim (so how do you get there??) or worse – one person described how the wheelchair was found out at the curb – as someone else might have gotten into a car or taxi.

Needless to say, Verna read them the riot act. After some time the airline rounded up people who had helped unload the plane. One young man remembered a woman who insisted that MY wheelchair was the one the airline had ordered for her and piut herself in the chair (minus cushion or armrests) and had him wheel her from concourse C to a flight on concourse E. He then left the chair at concourse E.

Fortunately we had a good deal of time to make the connection and even more fortunately the chair remained where he left it. After that Verna made sure to get off as early as possible and stand next to the chair to guard against a repeat incident. Does the world need a Lo-Jack system for wheelchairs.

Before we travel again I will have a sign made:

This Wheelchair is the Personal Property

of Steve Lewis

It is NOT the chair the airline ordered for you!!!

Using the Shower

The Gimp and his Gizmos – D

While able bodied folks can stand in the shower, showering when disabled is more of a challenge. First of all, moving your body through a stream of water is not a real option. It is much better to install a head on a hose and move the water over your body. Placing the hose in a holder at  body level makes accessing the stream simpler.

Equally important is the ability to put stream down in a way where it is both off of the body and not spraying into the room. This allows you to get your body wet and than free up a hand to soap up. The the water can be picked up for a rinse.

In theory, the chair can be placed close enough to the controls to allow a gimp to reach over and either turn the water on and off or raise and lower the temperature. In practice there is no way to access that end of the shower in our current bathroom. This means that the controls are several feet from where I am sitting.

This shows the seat I use for taking a shower together with the bar and the hose hung on it. The use of a toilet seat allows me to wash the my nether regions. The two handles allow me to balance well as well as to transfer to and from the chair.

After considering several options we found a tool for turning on and off lawn sprinklers with valves in the ground (see below). It solves the problem for the able bodied turned 90 degrees with the distance being vertical rather then horizontal. The detail shows one of the handles (for turning on the water) with the tool in the process of turning the other handle.

 

Sitting in my chair I reach out with the tool and hook it over one of two handles on the shower control. The outer handle controls whether the water is on or not. The inner one controls the temperature.

 

 

I put the stream where it is pointed into the shower and away from me. Then I turn on the water and wait, occasionally feeling the stream with my hand until it is warm. I then reach over and adjust the temperature. Always, the water is first used on the parts of my body which have feeling and only later on the insensitive portions.

 

 

With these tools, I am able , once I am seated in the chair, to turn on the shower, adjust it, turn it off and reach for a towel. The tool  is even long enough to reach a selector valve which diverts water from the shower head into the hose. Fortunately, that action involves pushing the valve since with that tool I lack the ability to pull.

It is amazing how much independence a few simple tools can give us.

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.