Out of Seat

May 26, 2009

I must confess that I have not been good at real time updates about my recovery, or for that matter, any updates about my recovery. My excuse is that I have been very busy recovering. In addition to trying to earn a living, I have been attending multiple physical therapy sessions per week, various doctors appointments, oh, and then there’s being a husband and father to two boys.

Anyway, as this blog is mostly about wheelchair use I feel it only fair to announce that I no longer have it. The rental company collected it today!

To cut a long story short, here are the main milestones of my progression to out-of-seat status:

3/18: Started physical therapy on right foot (left leg still in cast)
3/25: Wore shoe on right foot for 1st time and used to lightly propel myself in wheelchair
4/08: Left cast removed. Given two giant braces to wear on each leg. Left brace has three wedges to raise my heel to accommodate shortened Achilles tendon. Told to ramp up to full weight bearing over two weeks. Took 1st full body bath since accident
4/09: Walked for 1st time with assistance of physical therapist and walking frame. Freakin’ weird! I’m taller than her and never knew it. Oh is it good to be vertical!
Next two weeks: Walked for 10 minutes, three times per day with a walker or crutches
5/06: Given permission to transition to regular shoes on my right leg. Already reduced wedges on left brace to two. Not using walker or crutches any more.

Since then I have only used my wheelchair at the end of the day when I’m exhausted and cannot tolerate the brace any more and in the last two weeks I have not used it at all.

So it was that I said goodbye to my trusty wheelchair today. I must say that I have become somewhat attached to it over these months.

I will be following this post with a summary of the things I discovered while living in a wheelchair.


Gluteus Ex-Maximus

April 1, 2009

The other day I was complaining of some discomfort in my back injury to my physical therapist. I asked her why the area seemed to be raised or sticking out more than usual. I’m referring to my sacrum bone – the largest bone in the spine, attached to the pelvis. This had its bony protuberances sheared off by a rock at some point on my unconscious descent of the mountain. Anyway, her answer took me by surprise.

“You don’t have a butt any more.” she said.

I looked in shock at my wife. She shrugged and smirked in silent confirmation. It was like a light just turned on. It explained a trend of increasing discomfort over time while performing certain non-changing activities. I grabbed what used to be a butt cheek and felt that it was no longer a bulge above my rear leg muscle – there was no change in contour. And to make matters worse, my leg muscles have withered due to lack of use. She was right. My sacrum appears raised because my gluteus maximus is no more.

So what could be more ironic? I am confined to sitting but my sitting equipment – the padding that provides comfort – is disappearing. Here begins the relevance to wheelchair life – at least for me. So I sit in a wheelchair a lot. But in order to live I have to make many transitions between this wheelchair and other objects. I have already mentioned the transition to toilets in an earlier post. It turns out the surface most used in this operation is my butt, bum or derriere. I must say at this point that I am very lucky – while I cannot weight bear on my legs yet, they do work and I can actually use them a bit for motivation. To continue, in order to get into the car I have to wheel out onto the porch, get out of my chair and descend about ten steps on my bum (I’m from England, the country where “fanny” means vagina). Somebody else needs to carry my wheelchair down the steps and place it at the bottom. I then have to get into it again and wheel down the pathway to the car. I then get into the car and somebody needs to put the wheelchair in the trunk. Then they need to drive to the destination and more transitions follow. I know I digress.

Another transition. I’m now taking baths, but one leg is in a cast so it cannot enter the water. But its more complicated than this. Our only bathroom with a bath won’t let me and my wheelchair in – the door is too narrow. I have to wheel to the door, transfer to a small office chair with wheels placed by somebody else in the doorway, scoot across the 4 feet of floor to the bath, remove my clothes, place a plastic garbage bag over my cast, transfer to the edge of the bath. Here we go; bum meets very hard and narrow surface. To cut a long story short, there’s not many ways a bum sans glutes can comfortably sit on a bath edge. Next there is a slightly scary descent into the bath ensuring that the leg cast does not also take the plunge and remains on the narrow bath edge. Now imagine exiting the bath – its the reverse but add wet bum and change descent into ascent. Yes, the other day I slipped and fell back in.

These are just two examples of bum/inanimate object interfaces. Just to expand a bit, the other day my wife and I went to view a Montessori school. So much for ADA compliance – I had to ass-end one flight of external terra cotta steps and two flights of internal carpeted steps just to get into the place. This does not include the landings made of beautiful hardwood.

Where am I going with all this? Hard, cold, hot, rough, wet, slippery. These are all words that can be used separately or in combination to describe what my bum has to feel these days – a bum that has diminishing insulation. And so to wheelchair accessorization. My workaround for steps and some floors is a 3/4 inch foam pad that I keep underneath my cushion (the cushion is not waterproof). I use this as a little bum relief for every other step. Its hard to use it for every step. I have considered attaching some straps that would allow me to wear it while traversing steps. Not sure this is worth the hassle or dramatic drop in street credibility.

Portland Airport Restrooms

February 17, 2009

We are waiting in the airport lounge near the gate and I need a leak. I’m getting into this wheelin’ around lark now so speed off to the restroom. Funnily enough, from my height the restroom sign is occluded by a whole bunch of other signs, but a quick inquiry of a food court server confirms I’m on the right track. I enter the restroom and immediately hear straining. What’s more, its coming from the disabled stall and the pair of socks and shoes responsible for the straining noises seem very fit or un-disabled. As a regular user of disabled stalls in commercial buildings I have never prevented a disabled person from using the restroom, or have I? I so rarely encounter disabled people in restrooms that the disabled stall’s semantics have been redefined in my brain. This is a place:

  • where there’s more space, so you can bring bags and jackets with you
  • that usually only has one adjacent stall (its normally in the corner of the room), so only one other person straining next to you
  • where the toilet is further away from the stall divider so your neighbor is less likely to be able to see your feet and hence, be able to recognize you as an ex-stall-neighbor

In short, the disabled stall is more comfortable and offers better privacy than the regular stalls (for me). My model has just been shattered! I no longer care about comfort and privacy – I just want to take a leak! And Mr. Maroon Socks is preventing me from doing this. Considering my options I decide to relocate to outside the restrooms until I see Mr. Maroon Socks depart. The idea of just hanging out inside the restroom is not that attractive to me.

A few minutes later I recognize my target. He’s in a hurry. I just hope that he was not in too much of a hurry when he cleaned up after himself in the stall. There’s a lot of surfaces that I now interact with these days. Thankfully, he had cleaned up well. I maneuvered my chair around so that I could back into the stall and reached forward to grab the underside of the door so that I could pull it closed – the right hand edge and handle mechanism are too far away to reach. As I’m sitting doing my thing I focus in on an information sticker on the stall door. It actually describes the features of the toilet flush mechanism but its diagram and proximity to the stall locking mechanism make it appear to describe the features of the lock. Perhaps its my pain-medicated state, but it doesn’t seem implausible that the position of the lock on the door should define what kind of flush will occur when you flush the toilet.

Toilet flush options sticker too close to stall locking mechanism

Once I’m finished I approach the sink area and make note of the locations of soap dispenser, sink and paper towel dispenser. There is a small wall separating the sink from the towel dispenser, but by positioning my wheelchair so I’m straddling the small wall, I am able to soap, wash and dry my hands without moving my wheelchair. I’m learning.


February 16, 2009

Two weeks ago I had a serious snow boarding accident resulting in multiple broken bones (in my legs), brain contusions, damage to my tailbone, a lost front tooth and various bruises and lacerations around my body. Basically I’m lucky to be alive and also lucky not to be permanently physically or mentally disabled. My recovery, for at least the broken leg bones, requires that I not put weight on my legs for 3 months – in other words, I’m wheelchair bound.

I have been wheeling around for about 8 days now, but only in my room at hospital or at my brother-in-law’s house in Portland. This means that I am able to make transitions between the following things in any order:

  • Bed
  • Toilet
  • Sofa
  • Car

That’s it! Not a lot of pushing the envelope so far. Also, accomplishing all these things, while awkward and often painful, felt fairly obvious with no unexpected requirements or outcomes. Once you master the basic rule – don’t attempt any transition without applying the wheelchair brakes or things are going to end up more painful than normal – and given that I was lucky enough not to break any arms or shoulders, I’ve been able to do most things without being manhandled by someone else.

Well, something changed today. It was my appointment with my surgeon to remove stitches, generally clean me up and determine if I can go back to California. His office is at the Portland Legacy Emanual Hospital near the Trauma unit where I was previously staying, so the surroundings were familiar. We arrived a few minutes early and I needed to make a restroom stop. I told my wife I would join her in the waiting room and headed off to find a restroom. I found one, used the button on the wall to open the door, managed to maneuver myself and the wheelchair into the disabled stall and do my business. None of it was easy but then I didn’t expect it to be easy. There are lot of micro adjustments to positioning to allow doors to close around wheelchair parts and so on. However, once I exited the stall and headed for the sink things got surprising. The soap dispenser and sink were co-located so no problems there. But next I needed to dry my hands. Looking around I discovered that the paper towel dispenser was on the opposite wall from the sink. In order to get to it I had to maneuver my wheelchair, which meant grabbing the grips on the wheels with wet hands. Doing this felt very disjointed and somewhat unsanitary. I was immediately struck by the apparent lack of consideration for wheelchair bound patrons of this restroom within a hospital. Was this a one-off oversight or would this turn out to be a pattern that I would discover over the course of my recovery? It was at this moment that I conceived the idea to keep a log of my experiences while in a wheelchair. As a designer I am used to gaining insight into other peoples’ lives by observation and interview techniques but here is a perfect opportunity to learn by actually doing 24/7. It doesn’t get any cleaner than this. There are no cheating options. I can’t just say, “Oh screw that! I’m walking around this obstacle.” I can’t walk! I can hardly crawl.

So here marks the beginning of my blog. I intend to list my experiences here. I hope that some of it will be entertaining and light hearted. I hope not to offend anyone, especially people who have to reside in these contraptions permanently, but if I do, I apologize in advance. I ultimately hope that the outcome of this could be some new product designs, but if nothing else, I would like to raise my own awareness of the lives of a group of people that in the past I have politely acknowledged and sometimes offered help, but never sought to REALLY understand how their life plays out on a daily basis.