Monday, August 18, 2014
Spinal cord injuries can be caused by trauma, disease, infection, a tumor or a number of other things. They can be complete or incomplete injuries, incomplete injuries leaving varying degrees of sensation or even movement below the level of the injury. My injury was incomplete, but the residual below-level function is limited to barely perceptible sensation in my kneecaps and soles of my feet, along with the tiniest flicker of inutile movement in my right ring finger.
Most traumatic injuries, where broken bones were the cause of the injury, requires surgical repair. Mine was performed after a week of traction that was increased to 55 pounds over that period of time. The crushing motion of my injury required the traction to stretch my neck out so the vertebrae would realign in preparation to be fused with the assistance of harvested bone fragments, two titanium plates, seven screws and about three feet of wire.
One of the worst parts of the recovery was the first few days after the surgery. The neck muscle spasms were fighting the realigned spine. Not so different than the discomfort faced by a person with bad posture sitting or walking straight after a long time of living the way that caused the poor posture, initially. Surprisingly, neither the surgical pain nor the installation of a halo in my skull without anesthetic were not as painful as those spasms. Those first days after surgery are one of the few memories I retain from my stay in neurology. It must have been intense.
Without question, it was not pleasant. However, to preserve my remaining function, and restore strength to my neck, it was a necessary surgery and a critical early step in my recovery.
One last note, from a photography perspective, out of focus x-rays can only have so much made out of them. Making a photo out of a two dimensional image was not the easiest thing I've done and wish I would've had a better creative spark for these but at least you got a glimpse of the inside of many of our necks.
Monday, August 11, 2014
In the past we have looked at what a proper, well-maintained, curb cut looks like and how it can make crossing the street simple and uneventful. However, there are exceptions to the rules that are beyond ridiculous. Last week we looked at the consequences of using a combined variety of construction materials, such as concrete, asphalt and paving stones, to build a sidewalk and what one winter in our climate can do to the usefulness of those sidewalks.
This week we look at the consequences of some of the extreme, but far too common, examples of when those materials shift over a few winters.
I know that scale is often difficult to perceive in a photograph so let me give you a hard number. The lip you see in the photo above is located just down the street from our house and is nearly 10 cm or 4 inches tall. This is dangerous on its own to come down off the road to a drop that significant but it's more than that. You're coming down into a gutter that immediately begins sloping upward, making the perfect grove for the front wheels of a wheelchair to dig in and jolt the user with more than enough force to compromise balance which could easily send them out of their chair, or tip the chair over.
Traveling the opposite direction, you're coming down a rutted slope (I understand the importance of those ruts for the visually impaired) which introduces vibrations to begin with just before slamming into a solid wall of asphalt. The perfect example of this is downtown by Citizen Café. Descending the concrete sidewalk, the roadway has crumbled with numerous holes in the asphalt at the bottom of a very steep curb cut. Seeing what I was about to run into, I was able to stop my chair, after a bit of uncontrolled sliding down the steep curb cut, and climb back up. Thankfully the driveway to an automotive shop was close by and the street was quiet enough that I did not feel in danger jaywalking to get across to the café. This was downtown, just a few blocks away from the ideal curb cut shown in the post linked to above.
Under ideal circumstances I could, as a C5-C6 quadriplegic, very slowly navigate this lip to descend with a degree of safety but to climb up that lip would be a challenge because of the difficulty of popping a wheelie while rolling down a hill. Because of that it would need to be done by climbing it from a nearly stopped position, eliminating the much needed momentum to make the climb doable. In this instance I had not only a camera bag but some lighting equipment with me in order to make the photo. I had to find far less dangerous transitions to safely get to the location, make the photo and get home safely.
Rounded curbs with reasonable gutters would be safer than these curb cuts with terrible transitions. What I cannot understand is why the annual pothole repair crews cannot be instructed to either fill in these transitions with asphalt or cold mix when they are in the area or to smooth them out out with the equipment they have for preparing potholes for repair. I understand that either option has its problems but how can this not be a priority?
The problem with filling it in is that it could affect drainage and curb cuts like these are already notorious for filling up with sand and debris, carried to them by rain and other water draining as it should in the gutters of the street. The problem with shaving down the asphalt is that the integrity of the road in those places may be compromised. My argument to that is if it is an annual task appropriate small repairs should be able to be made easily, regularly, and without long-term damage to the road.
I know that it's difficult to predict how land will settle over time, and the soil in our neighborhood is very sandy, but when this happens it simply should be the city's duty to fix these shiftings. I would expect the amount of taxes we pay in these new areas of the city to at least provide us a safe place to go for a stroll.
I still insist that the CPA wheelchair relay take place outside in places like this. Get our Mayor and other "celebrities" wheeling across this, falling face first in the concrete and maybe that would bring a little bit of action in our city's accessibility instead of just the lip service we receive every year from them.
Solution: I'm thinking that we should be reporting these as potholes but I do not feel we are a large enough proportion of the population to garner any action from those who have the power and the money.
Monday, August 4, 2014
In approximately 1990 the city of Swift Current replaced their concrete sidewalks downtown with paving stones. Before the end of one short winter those paving stones had shifted, heaved and cracked. This resulted in difficulty shoveling, tripping hazards, weed growth, and years of regular maintenance to maintain sidewalks that were about as safe as the cobblestone streets of old Montréal.
Moving forward in time there are numerous examples of mixed construction materials being placed side-by-side in designs planned by someone who obviously has no idea what our climate does to surfaces each yearly cycle of the weather. Above you can see an example of paving stone mixed with concrete at the Preston Crossing Shopping Centre in Saskatoon, Saskatchewan.
Yes, there is just enough room for my model to wheel on the concrete between the paving stones but those paving stones do cross the entire sidewalk in places with 4-6 cm ridges which require a slow crossing or to pop a wheelie over top as you roll, if you are physically capable of doing so. Should you be traveling beside someone, why should we always be expected to switch sides or interrupt our flow because of poor design? What if I want to wheel on the road side of the sidewalk to protect my wife, who is on my right, from oncoming traffic in a most chivalrous manner? The inward slope to the grating containing a tree, weeds, and sand is not too much of a problem now. However, when this centre was built those grates were hollow below the metal and wide enough to swallow a wheel from a wheelchair or a cart. This is dangerous and, as always my common argument is applicable, here as well, what about someone pushing a stroller?
This is an example of poor design that is mostly an inconvenience. It can be seen anywhere that concrete, paving stones or asphalt meet. The gaps, heaves and ridges after one or two winters take away most of the smooth function of surface transitions like these. All of the aesthetic qualities are removed, if not worse than if one material were used, and I question how many shovels, plow blades or snowblowers have been damaged trying to clear the snow on the above sidewalks.
Next week we will look at something that is outright dangerous. I've shared about the helpfulness of properly made, maintained and implemented curb cuts. This time we will look at a failed design and failed maintenance that exceeds the inconvenience shown in this post and moves to an unexpected hazard.
Solution: Those organizations charged with the duty of informing designer and planners need to get the information in the right hands, including city officials who can prevent exclusionary designs like this from ever being made in the first place. Stamped concrete is a more costly material but has much greater longevity than paving stones, if aesthetics are insisted upon.
Monday, July 28, 2014
Continuing the series on ramps, we will take a look at one of the urban ramps I have encountered multiple times. The one pictured above leads up from the Erindale pond in Saskatoon, Saskatchewan. The path around the pond is quality asphalt, reasonably level with only a few instances of lips where the building material transitions between concrete, paving stones or asphalt. The tricky part comes when you need to climb up from the shoreline to get back to your vehicle or where you came from.
Often a photo does not accurately represent the grade of a ramp and I fear that this photo is one of those, despite my best efforts. This ramp is reasonably steep for an urban setting but it is very long and without any level portions where a rest might be appropriate. Other techniques, such as allowing a wheel to back into the landscape tie at the side of the ramp, can work when a rest is needed, however, often there are no options like this and the only alternative is to turn your wheelchair sideways to lessen the effort needed to prevent rolling back down the ramp. The biggest problem with this sideways parking technique is the energy it takes to get straightened out and resume climbing.
I mention that this ramp is a reasonable grade for an urban setting. Far too often when new strip malls or other buildings have their parking lots paved the grade of the slope leading to either a concrete curb cut or the ramp leading into the building is ridiculously steep. For whatever reason, our home builder told us that they legally could not build my ramp in the garage because it would be a grade of 1:10, 1:12 being legal for a public building. This was our own private dwelling. The number of parking lots I see with ridiculously steep slopes before you actually reach the curb cut, sidewalk, or ramp to the building's front door are ridiculous. Situations like this display thoughtless guideline compliance without any common sense.
Thankfully, regardless of a slope's grade, devices such as hill climber brakes exist and can be used to grab your wheels so you cannot roll backwards. Those will be examined in the future.
We are thankful that these ramps exist, as opposed to simply being stairs, but improper implementation makes them less effective in building a barrier free community.
Source: Urban settings and do not be afraid to contact your city counselor if there are blatant problems with a local ramp, be it the condition of the building materials, the grade or transitions from level ground to the ramp or the ramp to the surface at the top.
Wednesday, July 16, 2014
Through the winding tunnels under the University of Saskatchewan, which connect the buildings that vary in age, elevation and repair, a person will encounter many ramps of multiple different characteristics. Some are steep enough that I would not feel safe climbing or descending them independently in a manual or power wheelchair. Others are properly and reasonably gradual, with many ramps falling between those two extremes.
The ramp pictured above is one of the better ramps in the tunnel system underground. The switchback halfway up gives a person an opportunity to rest, regain strength for the next climb, and can be a place to wait for a clear path to the next plateau. This ramp would be one example of one that is too narrow for multiple people at once and when the masses are moving through here it can become intrusive to be the guy in a wheelchair blocking everyone else's way.
Unfortunately, depending on the time of day and year, some of the access points in these tunnels are often closed or locked which necessitates venturing outside to find a suitable detour. Often choosing to take the tunnels is a longer distance than going outside but it can save exposing oneself to the elements. When you hit one of these dead ends, only to have to go outside to find a detour, it results in much wasted time and energy in backtracking. Far from a perfect system when time between classes is short, transportation arrival and departure times have short windows, and when accessible washrooms are less frequent than they should be.
Thoughts: If attendance at a post secondary education institution is in your future minimize those first stressful days by having a good explore to determine the best routes for yourself. Don't be afraid to mention to the appropriate counselor the problem areas that need addressing. It may not be fixed by the time you have completed your stay but, hopefully, you will be making it better for the next person who needs proper access.