Deadly Curb Cuts

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.

Sidewalk Construction Material Transitions

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.

Shoelaces

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.

Autonomic Dysreflexia and the Sweat Towel

A short time into my stay in rehab at Saskatoon City Hospital I began having a regular problem of sweating. Of course, my first instinct was to cool down because, obviously, I was too warm. Being that my stay was during the winter months it was easy to go outside and try to cool off. What was bizarre to me was that I already felt far too cold and I very seldom felt comfortably warm since my injury. However, after going outside with only a light jacket, beads of sweat freezing on my face, the only way to stop it seemed to be to get out of my borrowed wheelchair. With no answers from the physiatrists, nursing staff, occupational therapists or physiotherapists it was up to us to find the problem and solution. It's nothing new to have to be your own advocate for your healthcare, but to a newly injured quadriplegic this was a little bit frustrating to have no suggestions from the professionals who were caring for me and specialized in my circumstances.

My dad, a heavy duty mechanic with very little computer or Internet experience – this was 1996 with the Internet being still somewhat exclusive – used his access at work to search for the cause of this problem. It was a good day when he called me from work, on my cell phone, another technology still with a degree of exclusivity, and told me to, "Take off that leg strap!" Because I was in an average sized wheelchair borrowed from the hospital it was a couple inches too narrow for someone as tall and large as I was. This necessitated me to strap my legs together at the knees, which narrowed my hips, so that I could use the narrower wheelchair without wearing holes in my pants or skin from the rubbing of the wheels.

It was the pressure area being caused by the prolonged use of that strap on my legs that caused pain I could not feel which manifested itself as profuse sweating. This condition is known as autonomic dysreflexia, an autonomic nervous system response when a signal sent from an area lacking sensation reaches the spinal cord lesion, cannot make a connection to the brain, and bounces back. This results in a sharp increase in blood pressure with symptoms such as tingling in the face and head, sinus congestion, flushing of the skin, a general feeling of anxiety, slow or rapid heart rate, profuse sweating and throbbing headaches. At worst, the potential for high blood pressure related conditions such as stroke, aneurysm or heart attack are real and the reason it should always be taken seriously.

Autonomic dysreflexia typically occurs in people with a spinal cord injury above T6 but it may vary, along with the symptoms individuals may experience, and is not limited to people with a spinal cord injury. People with multiple sclerosis, or other neurological disease or disorder, may experience this and their symptoms can vary just like they do for anyone else who experiences it.

Medical professionals are better than they used to be about being aware of this condition and its potential seriousness. When I was in rehab I was warned to make certain that anyone about to perform anything that may cause pain below the level of my sensation use standard anesthesia procedures. The pain caused by being cut open without appropriate anesthesia could easily be one of those times that causes a bout of dysreflexia which could cause one of those life altering conditions mentioned above. If the pain cannot be removed something such as nitro spray may be required in an emergency circumstance to lower the blood pressure and prevent the potential consequences.

My model and good friend, Paul, pictured above, described his typical autonomic dysreflexia symptoms as the pounding headache, flushing which makes him feel flashes of heat, combined the sweating which makes the air feel like ice. He is a prime example of how much dysreflexia can vary. Paul still has much of his sensation, his motor function below his injury is fully impaired, yet he still experiences dysreflexia when he is in pain below the level of his normal sensation.

As serious as autonomic dysreflexia can be, being aware of it, the level of severity, and the areas in my head and face that I can feel the tingling and sweating, make it much easier to determine the location of the discomfort and alleviate it. Some doctors will overreact to the point that they insist blood pressure medication be taken on an everyday basis just because of the minor bouts that occur from entering the freezer section at the grocery store, feeling the urge to drain my bladder, or even pass gas. Unfortunately, that doctor lost all credibility with me by thinking I should be lightheaded and woozy all of the time from the blood pressure medication because of minor tingling in my forehead when I need to pee! For the record, there were other ways that doctor believes quads should compromise living for the sake of a longer life, which also lead to his lost credibility with me.

As unpleasant as it might be, bowel care, performed by digital stimulation, well lubricated or not, and the application of a micro enema, causes dysreflexia in many. It has to be done, isn't pleasant, but I still do not believe it warrants blood pressure medication (we take enough, already), unless it were to become life-threatening. If it were that serious I imagine there would be alternative methods to consider beyond putting a bandage-medication over something that escalated.

Knowing that when I feel tingling or perspiration at the top of my cheek, below my right eye, means that my left foot is bothering me makes a world of difference in easily managing the condition. That is one example of where I know the resulting cause of pinpoint dysreflexia. The same can be said for when I experience dysreflexia anywhere else in isolated areas in my face, head or neck. Sometimes, though, I just do not know where the source of the pain is and it is trial and error to find it and alleviate it. A good friend of mine, Heather, had problems with dysreflexia for a long time and could not seem to find and solve the problem. Finally, someone suggested that the rods in her spine may be causing her problems. An x-ray revealed that they were broken and were clearly the cause of her prolonged problem. Her story is much deeper than just what I've said and you will find enjoyment digging into her very well written posts.

Regardless of the cause, most people get the profuse sweating and have their designated sweat towel. Mine is pictured above and is employed during most bowel cares and the occasional time that I need it until the cause of my sweating is determined and resolved. At worst I have had to take a second towel as the first had become completely saturated and was dripping sweat more than I was. Thankfully that was years ago, and only very seldom since the cause of my problem was surgically resolved, just as Heather's required a surgical repair.

If you are someone with a disability who may be susceptible to autonomic dysreflexia, consider it before undergoing even a small procedure, getting that next tattoo, or any other time you will be knowingly experiencing pain below your level of sensation.

Solutions: Determining and removing the source of pain, pain killers or if it is serious enough, something as strong as nitro spray may be employed by medical professionals to reduce your blood pressure until the pain can be resolved.

Eye Drops

It's not that eye drops are necessarily a common need for quads, it's that administering them is difficult to do independently for a few reasons.

First is simply the dexterity needed to control the bottle with two hands in order to squeeze it gently and precisely enough to apply just a drop or two. Both hands are occupied so forget using one, or both, to hold your eyelid open.

Second is the complication of the reduced range of motion in our necks. Many of us have had neck vertebrae fused as part of the treatment after our injury to prevent further damage by stabilizing the neck with hardware. This reduction in our range of motion makes it more difficult to tip our heads back far enough to administer the eye drop. As much as we become good at compensating for lost range by bending at the back or waist, being in a properly fitted wheelchair holds us in an upright position quite well. This struggle to overcome limited range can be eliminated by administering the drops while in bed, but many eye drops call for more than the two times per day when you'd definitely be in bed.

Holding the bottle two-handed, without dropping it in your eye, keeping your eyelid open, all while maintaining your balance is no small task. But practice makes perfect. Of course, I do not take for granted the times my wife has taken care of the application leaving the balance and eyelid to me.

Solution: Look away from the bottle to prevent blinking and back up to a wall or corner and lock your wheels then use the wall to lean on to help with balance. These tricks may help with or without someone else's help.

Curb Cuts

If I am fortunate enough to find a parallel parking spot, or an angle spot at the right-side end of a row, that doesn't obstruct my ramp or lift with a planter or bike rack, and it has a parking meter usable by me, I might be able to access the amenities of downtown. That is, if I am not stuck wheeling multiple blocks one direction or the other searching for a curb cut as seen above. Crossing in the middle of the street because there is a curb cut/driveway for an alley is not unusual for me.

Unfortunately, once you get beyond downtown Saskatoon, curb cuts become a rarity. Old "character" areas of the city have few curb cuts, very high sidewalks, very few driveways, and sporadic back alleys. Any time I have tried to enjoy a photo walk with friends in those scenic parts of town I have spent more time searching for places to cross the street than actually enjoying the neighborhood, the scenery, and the photography. Newer areas are usually fairly good about having curb cuts but they are notorious for losing their smooth transition between the sidewalk and the road after one winter. That is, the concrete sinks and the asphalt heaves making for a large lip at the bottom of the sloped curb cut; ideal for doing a headfirst dive out of my chair if I am not very careful.

Speaking of winter, as we plunged back down into the -30°C range, everything but fresh snow becomes as hard as concrete and, ironically, makes it easier to wheel through and over than when it is warmer. A recent respite from the cold had us enjoying slightly above 0°C weather in January. However, the streets are a jagged, rutted mess now that it has refrozen and when it was warm the gritty, wet, slop that I would have to wheel through to cross a street makes for an utter mess. I restricted my parking to being on the same block as my destination. This did result in passing up three coffee shop options before settling on one where I lucked out to find a usable parking space.

I do not know what the answer for this problem is in winter. Anything but the most thorough snow removal would make for similar problems, but I do believe that improvement is possible. As for the limited parking downtown and the dangerous ridges where a curb cut meets the heaved asphalt, there are simple solutions. Firstly, remove the planters and move the bike racks. When the springtime pothole repair crews come to the neighborhood, the transition at the bottom of the curb cut could be made much safer for nine months out of the year for anyone using a wheelchair, stroller or other mobility aid, by evening out the ridge with the asphalt equipment they use to fill potholes. Regarding the complete lack of curb cuts in older neighborhoods that require me to spend much of my travel time on the street searching for a place to get back onto the sidewalk, that is simply an unacceptable discrimination.

On a positive note, the snow build up at the edges of roads, and medians in parking lots, often makes for the perfect transition between the lower and higher surfaces. Under the right circumstances, including a temperature of about -15°C or colder, everywhere is a curb cut, or should I say ramp. Aside from the bumpy surfaces, at least we are lucky enough, on occasion, to have easy access to small height differences.

Source and Solution: The only way to improve the situation is through organized petition of your city council.

Parking Meters

By now it is no secret that dexterity limitations of quadriplegics are possibly our biggest struggle, directly or indirectly. Putting coins in a parking meter is one of the ultimate tests. I have lost more than a few quality cups of coffee worth of coins to the gutter over the years. Every time I go to the University of Saskatchewan for photography, exercise or whatever other reason, I feel like I am part of a cruel experiment. Why do I feel like this when using the designated handicap parking meters at the University? Because of the way they face.

Follow along with my reasoning, if you will. As you will notice, the coin slot faces the street. If the individual with a disability is driving they cannot reach the meter from the driver's side as they will be on the street. Once they get out, the meter is too far away to reach from the street by wheelchair or walker which means they will need to get up and onto the sidewalk to deposit coins, just like a standard meter. However, the space between the meter and the edge of the curb is only between 30 and 45 cm, between 12 and 18 inches. The photo above distorts this distance because of the wide angle lens I chose to use, but believe me when I say it is less than 18 inches between the post and the curb.

This short distance between the curb requires the individual to back up to the curb to deposit coins while facing the coin slot. This introduces the risk of falling backwards off the curb, regardless of the disability in question. If you add some improperly cleared snow to the equation, creating a cone of snow around the meter's post, you make it even more difficult for the user to get close enough to deposit coins. For these reasons I avoid the designated spots whenever possible. However, with parking at the University being at a premium, often the only spots available are the designated ones.

I would greatly appreciate understanding the reasoning used by the person responsible for designing the meters this way. All of the designated meters at the University are like this so I know that it was not just a coincidence. There are no designated meters or spots around the city of Saskatoon so difficult meters are not a problem. But angle parking, with end spots blocked off by planters or other decorations, which make the use of a van with a lift or ramp impossible, are a problem.

The city of Saskatoon and the University of Saskatchewan used to have pay-by-cell phone but, for whatever reason, it is no more. Other payment methods, such as a card-based system, are enabled but this is useful to me only on a very occasional circumstance when I visit the University so I have not pursued that option.

Despite my criticism of the city of Saskatoon's lack of access, they have done one thing very well. They have implemented an annual $20 fee that provides disabled individuals with a sticker that is adhered to their parking placard which allows a free 36 hour parking limit at any standard meter in the city. Of course, you have paid your $20 annual fee, but the convenience makes it completely worth it at a very reasonable cost, in my opinion. The only thing we need now is for them to make a deal with the University, St. Paul's Hospital, Innovation Place and private lots throughout the city so that we can easily use those, as well.

Parking access varies from one city to another. It may have been costly to park in downtown Vancouver but they had a very easy to use smart phone app that allowed you to pre-enter your credit card information, enter the meter number you are parked at, and choose your length of parking. It also allowed enabling notifications to let you know when your time was running low so that you could apply more time. This was not just for accessible parking, it was for everyone and was a brilliant system that eliminated the need to carry change with you. In Seattle, any accessible parking placard approved in North America provided you with free parking at any meter. Period.

Solutions: Explore the options available in your city for accessible parking, don't be afraid to speak to your city counselor and, when traveling, examine what is available in the locations you will be staying.

UPDATE: Smart meters are finally coming to Saskatoon! This pay system was enjoyed by us during our trip to Vancouver and Seattle in 2013. The option to pay with a card, a smart phone app, and still pocket change, made quicker, easier, more precise and exactly what works well for the disabled community.

Winter

Until now I have focused on the positive. Solutions and helpful technology. The barriers exist, be they man-made or natural and unavoidable.

I used to enjoy icefishing, hockey, tobogganing and a lot of other sports that take place only in winter. But, that has all changed since my injury. I still enjoy icefishing, when the amount of snow on the ice, more likely depth of the ruts to get on the ice, is scarce enough that the minimal clearance of my lowered floor minivan can navigate without getting hung up or damaged. It has been a number of years since I have been able to get on the ice and I do really miss it.

However, that sickly photo above that encapsulates my view of winter is the utter truth. Last winter was brutal. This one is starting off in the same way, having just emerged from a bitter three-week streak of regular -30°C or lower nighttime lows with both snow and wind. The cold makes it dangerous for anybody, especially someone with reduced circulation and who cannot feel their legs freezing. But, when you can get where you are going is not such a big issue. When someone like our neighbors two blocks away don't shovel their snow all winter, and you have over 60 cm of packed snow on a public sidewalk, it makes it dangerous and almost unusable for anyone. They have refused to shovel the sidewalk again, this year. You chose to buy a corner lot. Shovel your snow!

I try to restrict my excursions to essential outings when it is that cold and I tried to arrange to have someone with me, just in case. If I get stuck it would not take long for my hands, protected only by the gloves, to begin to freeze before someone came along to give me a push. The cold is hard enough on all vehicles but the adaptations to my van are already something to respect as fragile. The kneeling of my van and the ramp have performed flawlessly even in the coldest weather but, when possible, I turn off the kneeling and park side a curb or accept the push to reduce the moving parts and hopefully save something breaking.

Finally, if I have to choose winter weather, I will choose no snow and colder than -15°C. Why? Because ice melt substances do not work below -15°C. When they do melt it clings to my tires and push rims, making them wet, slippery and gritty, not to mention the mess they cause me to track in. I am also aware of the potential toxicity to pets some of them have. When it is nice and cold everything is as solid as concrete and much easier to traverse by wheelchair if the snow is hard packed or properly cleared. Living in Saskatoon has taught me not to hope for the later.

I have considered starting up a site to shame cities for their disgraceful inaccessibility but I fear that it would be focusing too much of my energy on the negative, instead of the positive. As well, peers of mine who have lobbied for years spent much of their energy and put much of their heart into what resulted as miniscule improvements and the civic government of the time patting themselves on the back like they had moved mountains.

Solutions: Choose outdoor activity for less cold days, when possible. Plan activities, hobbies or projects for the worst of the winter months. And, unfortunately, complain when neighbours, cities and businesses do not make reasonable attempts at their legal and moral duty to clear snow.

Sparkles! Sparkles Everywhere!

I am thankful that the number of barriers featured on this website is, and will be, fewer than the number of solutions and technology to aid individuals in their daily lives. However, there certainly are a few hidden barriers that are less obvious than you might think and worth bringing to the attention of people.

I will be the first person to admit that I really like the glitz and glamour, lights and shimmery decorations, and almost all things cheap and tacky when it comes to Christmas decorations. I'm quite aware of the places that most of these decorations come from, the pollution belching foreign factories and underpaid workers. But, as a photographer who loves all unique light sources, I can't help but get a little bit caught up in what would be considered classless and cheesy the other 11 months of the year.

It was with personal hardship that this photo was made for, as you'll read, the problem I'm about to talk about affected me briefly after handling these decorations. For, you see, many of the decorations, including greeting cards, are heavily laden with sparkles. Sparkles that often fall off. When the sparkles get on your clothes, on your hands, in your hair, and stick unpredictably to wherever they make their way, it can become a danger. How, you may ask? Many of the technologies that keep us alive involve inserting a device in a place that is typically reserved for exiting.

Most common, for me, is if sparkles should make their way onto my hands or onto my shirt they can become difficult to remove and may inadvertently make their way into a private area when using pant hooks to gain access for the purposes of catheterization. If sparkles make their way from my hands or shirt onto that catheter, and become deposited inside my bladder, the resulting discomfort, urgent urge to urinate, and potential incontinence is nothing short of miserable until you see those sparkles make their way out of my body, through the tube into the leg bag, finally ending up in the toilet.

My friend, Paul, has said his daughters' love of cosmetic glitter is a similar fiend.

So, this year, when you are choosing your Christmas cards or decorations to gift to a disabled individual who has similar invasive needs as mine, try to avoid the glitter. They will appreciate it.

Here is the Behind the Scenes video.

Exam Gloves

*Snap!*

Has anything pleasant ever come from the sound of an exam glove being snapped into place? Well, it may not be pleasant but, it is very necessary for the well-being of many people including the individual wearing the glove and the individual being helped by that person. These gloves are very necessary in the life of a quadriplegic as well as most persons with any type of neurological disability.

Latex exam gloves are becoming far less ubiquitous than they used to be because of a significant increase in latex sensitivity to outright allergies in people. I know that I become quite congested when exposed to latex, be it exam gloves at the dentist or latex therabands. Thankfully exam gloves are available in different materials such as vinyl.

They come in powdered and unpowdered. The powder is only on the inside of the gloves but they are in a boxes of 100 together so the powder inevitably gets spread around. It can cause dry skin for the user, it gets on and in everything, as well as being a potential irritant to both the wearer and the care recipient, but they are easier to apply to sweaty or moist hands. As such, the unpowdered variety are more common. They are more difficult to put on moist hands, but avoid the potential problems introduced by the powder.

The downside to vinyl gloves over latex is that they can affect dexterity. For many things the reduction is not a problem. For procedures such as dentistry or surgery that precise tactile feel is critical. The unavoidable wrinkles in vinyl gloves, which demonstrate their lesser elasticity, can be seen in the photo. Other factors where latex outperforms vinyl is their puncture resistance, again very applicable to the two aforementioned professions.

Latex and vinyl are not the exclusive materials used to make examination gloves but they are the least expensive. Those materials are accompanied by gloves made from the more costly polyisoprene, nitrile and neoprene, all with varying qualities including strength, fit, chemical resistance and environmental impact. The full chart I used for my research can be found here. Not all types can be found in individually packaged, sterile packaging for uses such as surgery, or more commonly, a caregiver catheterizing a patient. For those specific uses your choices may be more limited.

Exam gloves keep the user safe and keep the messy business of life with a disability a bit more contained and a bit more easily cleaned up.

Source: Drug and department stores, but for bulk pricing, medical supply companies.