Monday, April 14, 2014

Incentive Spirometer

More than a few times in the months following a spinal cord injury in which the ability to breathe normally is affected there are problems relating to the reduced lung capacity and significantly reduced ability to inhale and exhale. Our breathing depends on our trunk muscles, diaphragm, and to a small degree our shoulders. With a spinal cord injury in the neck one of the two diaphragm innervation locations is cut off as well as the muscles in the trunk. That is a lot of lost function in a critical area. The worst time after and injury is immediately following, when breathing function instantly goes from using your diaphragm and trunk muscles to just part of the diaphragm. I clearly remember the distress I was in and the offer of nearby friends to perform some mouth-to-mouth assistance which I refused, being a foolish teenager not wanting his friend placing his mouth on my own.

This reduced capacity resulted in multiple initial pneumonias, the regular need for a suction hose to extract phlegm, and a general inability to expel air with adequate force. Thankfully, I never needed deep suction, as in when the hose needs to be inserted much deeper into the throat by a trained individual, but simply the same as they give you at the dentist's office. Though I still may be considered more susceptible to pneumonia it has never been a problem for me, personally.

I still cannot cough properly while sitting up or laying on my back without a learned technique, and the satisfaction of a good sneeze only graces me about one out of 20 times that the tickle and urge causes me to inhale in preparation. If I time it just right I can apply pressure to my abdomen to execute a proper sneeze. The critical act of coughing will be addressed next week.

Thankfully, there are tools to assist in building lung capacity and strength. Pictured above is an incentive spirometer, which is designed to do just that. The hose can be attached to either side of the body of the device. One side allows you to suck air in and the other side allows you to blow air out. The idea is to increase the resistance as your strength increases so that keeping the ball at the top while the air moves through it is just difficult enough. It's no different than any other strength training.

An incentive spirometer can also be helpful to encourage very deep breathing and complete exhaling which is a very good practice in clearing congestion and preventing sickness. For we who find it very difficult to get our heart rate and respiration high enough to naturally perform this deep breathing this can be a lifesaver when dealing with any kind of respiratory illness. Regardless of illness, I try to do some deep breathing a few times each day in the interest of prevention.

Source: Respiratory therapists, occupational therapists and many medical professionals. They are very affordable and can be ordered online.

Monday, April 7, 2014

Sport Cuff

I misplaced my sport cuff many years ago because I always just use a new pair of The Gloves with strong new Velcro as my tool of choice to hold on to any sporting device with a straight handle. When I wear The Gloves I do not diminish my ability to wheel nearly as much as when I tried using the above pictured sport cuff. I also found the sport cuff to limit my wrist function which is so essential to so many sports, especially those such as badminton or icefishing where wrist movement is really essential to the technique. However, for someone who's muscles that control the wrist are paralyzed this cuff makes some sport possible where it would not have been, otherwise.

For sports such as tennis or fishing with a large rod, where the movement involves more control by the larger arm muscle groups, a sport cuff has great advantages. This one was borrowed from my friend, and former model, Paul. Though he and I have virtually the same level of function, there are a few muscles of mine that provide me just a little more function than him. Where every little bit of function counts, especially where wrist flexion and triceps come in, a sport cuff like this can mean the difference between being able to successfully participate in an activity or not being able to.

Source: Occupational therapy product catalogues, online, or custom made.

Wednesday, April 2, 2014

Parking Woes Reversed

A few days ago in a parking lot in Lisbon wheelchair users and volunteers occupied all the available non-disabled spaces to make a point to able body motorists what it is like to have their parking places unavailable to them.

On every wheelchair various notes were left like "be right back", "it only takes a moment", "I'm get something here", etc.

The above quote was from the original post. While I would love to see a less aggressive campaign, we all know it doesn't work and I commend the bravery of those who helped make this happen. One of the top-rated comments on the post on Facebook identify the fact that many people with disabilities do not use wheelchairs. Fair enough. But I think this would be the easiest way to get the point across. Maybe a cane or a walker or a crutch or other assistive mobility device would have also helped to make the point.

Regardless, I hope that a few people realized how critical the spots can be to us, even when you are just running in to grab a coffee.

Thanks for the tip, Desiree!

Monday, March 31, 2014


Without Velcro The Gloves could not be tightened enough to provide me the dexterity that they do and many of the tasks I am able to complete successfully, would either be much more difficult, or simply impossible to complete. Getting a grip on certain exercise equipment, to help with Strengthening our functioning muscles, is made easier with Velcro. It enables the design simplicity of a Universal Cuff and Razor Cuff, an alternative to the difficulty of tying Shoelaces and so many other daily applications where a tight, but adjustable, fit is needed to be possible with limited dexterity.

By no means is this list exhaustive. In many cases Velcro can be creatively added to an existing device, article of clothing or tool to make it friendlier for us to use. Many stores now carry cinch straps made entirely out of Velcro. These are useful for places that something such as a rubber band or a bungee strap is just too difficult for us to use. If you have a great example of Velcro use let me hear from you.

Next week we will look at a Sport Cuff that enables a reasonable grip on almost anything with a handle such as a fishing rod, tennis racket or even a pool cue.

Source: Department stores, dollar stores, hardware stores and sewing stores.

Monday, March 24, 2014


When your dexterity is limited tying anything is difficult. I have had my experience with weaving different knots, bracelets, lanyards and keychains using paracord but that is so much different than tying shoes. With paracord I typically have plenty of extra slack to work with, the knot or lanyard is in front of me at the ideal height on a desk or table, and they are typically knots tied tight enough that they will never come undone.

Shoelaces do not have the slack, are not in an ideal position to work on when they're on your floppy and uncooperative feet, and are knotted with the intention of being easily untied for removal or re-tying to snug them up.

Why do we need our shoes tied tight? Because often leg spasms can kick our foot right out of the shoe, properly fitting and tied shoes can assist in reducing foot drop caused by a tightening Achilles tendon, and it can help reduce edema. For these reasons I prefer footwear with a fairly high rise to them. However, hightop sneakers are more of an 80s to mid-90s thing. Hiking boots are usually what I go for when the long search for the right new footwear, that won't bother my feet or cause pressure sores, begins.

I have been fortunate enough to have someone available on a regular enough basis to tie my shoes when they need it. I do not suffer from edema like many people do, and because my feet are well stretched out each day I do not fear foot drop. Because of this I simply slip my shoes on and off each day but have not actively sought out a reliable method for independently tying shoes.

If you have a solution for this I would very much welcome your feedback!

Next week we will look at Velcro which goes far, far beyond a method of securing shoes in its usefulness and helpfulness in strengthening our independence.

Solution: Other than practice and patience, I have none that I can recommend as reliable and adequate.