Walking at Work

After using braces in therapy for several months I finally summoned the courage to take them in to work. I wrote the manager of our physical plant and had him meet me in the garage and walk with me to my office. There are a number of possible barriers. First there is a door between the parking area and the elevators. The door opens on a card swipe and then is fairly heavy - requiring first a swipe from a walker - not really difficult but time consuming. Then you need to put away the wallet and open the door so it will not relock. Then the door needs to remain propped open until you can get it wide enough to get the walker through, then you have to move the walker through the door without being knocked over or jammed in the door. Getting out is another issue but I will deal with that later. Next there are the elevators. There are three elevators. Pushing the button is not difficult but after that you have no idea which door is going to open. Once a door opens you need to be able to get into the door before it closes. If you are moving slowly in a walker, this can be a big problem especially since once you are in front of the door you are too far from the button to push it again.
   After getting help with the door and the elevator I arrived at my desk. I had them lower the office chair to allow enough space for the cushion I brought. Office chairs are not nearly soft enough for the easily damaged skin of people with spinal cord injuries. The next issue is that the chair can both rotate and move. This can be a bad thing if you need to back up to a chair and getting down is essentially a controlled fall. It turns out that a great solution is to place the chair tight in the corner on my cubicle where is is effectively constrained from moving back in two directions. Once the chair is braced it turns out the ability to rotate and roll is an advantage since I cannot move the chair with my legs but can easily pull it with my arms into a good position while occasionally raising my legs if they are dragging.
   Later in the day when I had to use the bathroom I needed to get back in a wheelchair. The maneuvers in the bathroom are way too complex for braces. I had left a wheelchair in the garage and needed to get it. I then remembered that one of the elevators is configured for freight and has a separate button. That made the issue of the elevator simple. Push the button, move right next to the door and when it opens push enough of the walker inside to insure the door will not try to close. After that there is plenty of time to get in. Once the uncertainty about which door is to open is resolved, elevators are not an issue.  It turns out that the building manager called an elevator maintenance person to slow down the door close time. I suspect he left the close time longer on the freight elevator but I no longer needed it.
    So having solved the elevator problem I found myself in the basement on the wrong side of the door to the parking area. The way the door works to get out, there is a motion sensor which unlocks the door. Of course, the sensor is not timed for someone in a walker so by the time you get to the door even if it has sensed you, the door has been unlocked and then relocked. That is OK, if the sensor fails there is a button on the wall to open the door. Of course, the button is on the hinge side rather than the knob side. So if you push the button you need to walk completely to the other side of the door and try to open it before the mechanism times out. My real hope was that someone would show up and I could ask for help. After about five minutes I gave up and called the building supervisor to ask for help. Of course, there is no cell service in the basement so it was back to my desk. When I got back I simply asked for the chair to be brought up.
    When I left I simply got in the chair and went down to the garage. After getting into my car I left the chair in the garage hoping it would not roll away from a position designed so I could drive up and use it.
     They have promised me a button to open the door to the garage. That was, of course, a few months ago but the were also trying to get a button to the door to the street. In ,my chair the door to the street is a bigger issue since it is heavier and the place to swipe your card is much farther from the door. There is no way I am likely to go out on the street in my walker - everything is way too far to walk - so The street door is a lower priority. besides I have managed it in my wheelchair, usually on the second try, so it is possible they can accelerate a solution to the parking garage.
  Well I feel like I should add to the Google bomb causing a Google search for Santorum to go to here.

Segways

   Last weekend I took my first ride on a Segway. I have been wondering for some time whether a paraplegic in braced with little or no movement in the lower part of his body could ride a Segway  and, more importantly, how he might arrange to easily get off and on. I answered one of those questions. If I can get up I can ride the device.
  I found someone in town who rents Segways and is a genuine expert. Then I invited a fairly tall and string friend to help he get on and we went out to his place. I received a long lecture on Segways and how it was necessary to turn on before stepping onto the device and if you push or pull the wrong way the device will scoot off - not really good. We ended up blocking the device  with 4 2x4s. Them two men picked me up and my feet immediately swung under the Segway.  From then it was back to the drawing board.
   The eventual solution involved a shop table which could be raised hydraulically and my pushing myself up rather than being lifted. Once on the device I was able to easily ride it - In the older models you make the unit go forward by leaning and turn by twisting a know in the left of a control bar. This makes the required control of leaning much less precise since you are only controlling a single direction. Newer models use lean for both go and turn.
  The older models also have a single rigid shaft. This is really needed since i need a place to hold on and help balance. One issue is that the bar is apparently quite fragile and made of "unobtainium" . There are commercial approaches to reinforcing the bar although I suspect I am better off looking for a solution that meets my needs and maybe even takes some weight off the bar placing it in other sturdier places.
  I am now looking for places to buy a Segway and good solutions to getting on it.


My friend posted a video here.

Stairs

a day or so ago I was at Pushing Boundaries practicing with my braces. I was talking with my trainer about stairs and whether it was possible to use stairs with the braces. He mentioned that they had some stairs and back that I could test. He has both 3 inch stairs and 6 inch stairs. 6 inches is basically this has standard height for a set of stairs. 3 inches is ridiculously low. However, 3 inches and is a height that I have handled in the past and might reasonably expect to handle. I decided to give them a try.

The stairs were narrow and handrails on both sides which gave you maximum advantage because you could push all of the very solid surface in order to get whatever  leverage was needed by the arms. Once again, these conditions are fairly unrealistic because the stairs are narrower than anyone would ever reasonably make them . Is also the case that you use the rails I had to leave my crutches behind and, of course, the moment I got the top I would find that I need my right choose again.

Getting up was not terribly difficult as you can see. Getting down was another story entirely and barely worked. After thinking about this for a while I realized that what was happening was this: When going up you unweight one foot, swing it up to the higher stair and transfer weight to the higher foot. Then you raise the lower foot and move it up. All well and good and the fact that your weight is on a higher foot helps in raising the lower. Down is different. You unweight a foot and move it to the lower stair. When you put your weight on the lower foot, there is a significant force down on the upper foot. This force makes it difficult, near impossible to raise the higher trailing foot.
   I need to review videos of how people in braces descend stairs. I recall a strange gait where both feet swing as a unit and what I felt may explain why.

More thoughts on traveling to a place like Oaxaca Mexico

   First, assume the world is NOT accessible. Most curbs do not have curb cuts and in many cases the curb is followed by a fairly deep dish. It is possible to travel with the aid of an able bodied person capable of getting a chair over obstacles. There include bumping over curb cuts and up and down the few steps which often separate businesses from the sidewalk. DO NOT TRY THIS IN AN ELECTRIC CHAIR.
   The sidewalks are also relatively rough and not uncommonly blocked with a post positioned in a way which is impossible to pass on either side, a building protruding into the sidewalk which is too narrow to pass or ditches and cuts through the sidewalk.
    I can with a fairly large and experienced able bodied party and have not hurted for able bodied help. I have been told that it is possible to hire a pusher for not too much money. I have not tried this and would assume that the pusher would have at best minimal English.

     Taxis are possible and inexpensive and represent a reasonable way to get around. We would use them more if we did not enjoy walking and if I did not have skilled and willing assistants.

More lessons from travel

    We are spending almost three weeks in Oaxaca Mexico learning among other things about international travel. As I said in the previous post, the ADA does not apply down here.Almost every building has several steps to get in. The picture below illustrates a local restaurant.

One interesting observation has to do with transfer boards. When I was first injured I was taught to transfer, that is get from a chair or bed to a wheelchair or back, using a board connecting the two locations. Since then I learned how to transfer without a board with one exception - getting in and out of cars. The distances are long and there is frequently a difference in height. On other trips we have rented a car and took a board. The board could remain in the rental car until we left. This time we took a long board anticipating its use. However we did not rent a car - depending on taxis and hiring a driver. The problem is that if you use a board on a taxi trip to downtown, then you need to carry the board all day. I rapidly decided that I was really good enough to get in a car without any aid.
     The taxis in the city are subcompacts with the seats at about the same height as the wheelchair. One day we hired an SUV where the seats are about  a foot and a half above the height of the chair and where was no way that I could get in without some assistance. Even getting out was a real challenge.
      Yesterday we went to Monte Alban, a pre Columbian Zapotec site about 20 km out of town. Normally I woiuld not even try to go to a site at the top of a mountain with many hills. Monte Alban has made an effort to make the site wheelchair accessible. An elevator takes you up about 10 meters to  a plane covering most of the lower levels of the site. I was able to roll around the lower levels of the site - clearly the steep Zapotec  steps were out of the question.Also like all of the museums we have encountered so far, admission for the disabled is free.
     Of course sometimes you get what you pay for. One museum on Oaxaca is in an old convent with all the exhibits on the second floor and no elevator. The steps look like this.

Needless to say I sat on the lower floor while others went up.

Where the ADA does not apply

   For the the first time since my accident my wife and I went abroad to a third world country. We are in Oaxaca Mexico for almost 3 weeks. Oaxaca is a city we have traveled to before. We remember the city as relatively flat with a lot going on and want to use the trip as a test case for further travel we may consider abroad. It was very clear that many of the easy assumptions you could make in the US since the passage of the Americans with Disabilities act would not work. The question is how bad  could life get..
   The first issue we ran into was in the airport when the wheelchair barely was able to squeeze through the door of the bathroom. Of course the idea of a stall wide enough to accommodate a wheelchair is out of the question but the is a nicety not a necessity. The rest of the loo was at least functional. 
     The sidewalks are also interesting. While a number of intersections in the city center have curb cuts, eight blocks away where we are staying there are none and even many of the existing curb cuts are so deep it is difficult to get a wheelchair either up or down. Where we are staying there is no way for me to move more than a block or two without an assistant to help get the chair onto and off of curbs. Many buildings have a few steps to get in and few if any have ramps.
       We took a cab to town (forcing me to try for the first time getting in and out of a car without using a transfer board) This worked well but once disgorged there were sidewalks blocked with parked motorcycles, ladders and even carts as well as the curbs to climb and descend.
         At the restaurant where we had lunch, the  loo was down a flight of stairs and up two. I did not even look at it for size.
      My wife and I did explore about a mile through the city center. We found a great church with a ramp tp get in (not ADA shallow but usable especially with a companion to help.
    In the next week we have a series of trips to outlying districts scheduled and will really see what is and is not possible.

The Troubles with Braces

The braces I have been using are RGO braces which mean that they not only brace the legs but the hips. Once standing you can lock the braces by tilting the hips forward and unlock the braces by moving them to an unlocked mode and moving the hips forward again. There is a lot of hardware above the hips doing a fair number of complex things. The thing I have discovered over the past month or two is that none of it is reliable.
    The first problem I ran into (ignoring a lot of adjustment when I first got the unit) was when I went to sit down at Pushing Boundaries. The action was not gentle but neither was it that violent. There was a crack on my right leg and I found that the two screws holding the metal support to the plastic molded to my leg had pulled out - one leaving a smooth hole and the other cracking the plastic. The braces went back to the orthotist who, fortunately, had gotten the mold used to make the plastic piece from the factory. She was able to rebuild the plastic pieces holding my lower lag with thicker and sturdier plastic.
    The next week I went back to Pushing Boundaries. Jerry, the therapist who was there when the braces first broke was more careful. We inspected the braces carefully and he took care that the Velcro straps holding the braces to the leg were especially tight. This was a mistake as the thin wire loop holding the Velcro pulled out forcing us to hunt down an pliers and rebend it back into shape. We then began walking around Pushing Boundaries. After a walk around the place we went to sit down Again there was a crack in the right leg as I sat and again the screws had pulled out of the right side. This time the heads had sheared off and the thicker plastic was undamaged. The braces went back to the orthotist to replace the screws and the wires all over with thicker and heavier buckles.
    Then the braces came back there was a small issue with some of the Velcro being so long the end was under the leg making it difficult to undo. Next we took the braces back east on a Thanksgiving trip to my sister's. I was able to put them on and walk for my sister. I found that the place we were staying in had a long, straight hall - perfect for practicing walking. I walked up and down the hall for a couple of days in succession until I heard a strange sound from the left side of the brace. At first I could not see the issue. Later I realized that the upper left brace was sitting a couple of millimeters off the back brace. It turns out the screws holding that piece had become stripped. So, the braces went into their bag for the rest of the trip. In addition we decided not to take the braces on the three week trip to Mexico we had planned to take later. It was back to the orthotist to replace the two small screws with three larger ones on each side.
    After we got the braces back we started practicing around the house. After a couple of days There was a noise in the right back that after much inspection was due to the fact that a screw which was part of a critical joint had largely unscrewed. Later we would discover that there is a set screw which is supposed to prevent the piece from moving and it had grown loose. I was able to fix the joint myself and my therapist tightened the set screw.
    A day or so later my therapist and I were practicing getting up using hand crutches. For a number of repeats it was working well until I got up and the braces did not lock. With assistance I sat down and we tried it again. This time I was sure that I had made the move properly and was stable but again the braces did not lock. By now the therapist and I were sure something was wrong. With some help I got down and took off the braces. We decided to go through and try to understand the locking mechanism. It was not hard to find the problem - one one side there was a spring loaded peg. On the other an empty hole. My therapist scoured the floor and found the peg, the spring and the screw which is supposed to hold the peg in. Lacking a small enough screwdriver and deciding that it was important that the unit get a thorough inspection, we taped the parts in and sent the unit back one more time to the orthotist.