Motorized Wheel Chair Source

Actual human being says:

though I are not to be To walk without walking.. I DO can know to walk with legs not To Daylight. Your eyes slowly open.

The familiar texture of the ceiling comes into focus and you realize, even though you’re still half asleep, that you have a lot of things to do today. You take a deep breath, swing your legs over the side of the bed, and. . . .

Nothing.

Your body, from the waist down, refuses to move. Just as you start to panic, your brain comes fully awake and you remember the accident—the overwhelming pain. Reality settles over you like a nightmare. Your legs are numb. You can’t walk.

That period of emotional adjustment—which can last from weeks to months—is a fact of life for the more than a quarter-million Americans who suffer from spinal cord injuries, and for the approximately 11,000 new cases expected to join their numbers this year.

But as devastating as such a severe injury is, the vast majority of people gradually adapt—through guts, determination, and the surprising flexibility of the human nervous system—so that going about their daily activities in a wheelchair becomes second nature.

BECOMING A “CIVILIAN” AGAIN

“A big part of being disabled is just coping with a series of physics problems,” says UAB engineer Preston Scarber Jr., Ph.D., who’s 34 years old. In many ways, he is typical of spinal-cord injury survivors. Like 82 percent of them, he’s male. And his injury, a diving accident, happened when he was a teenager; some 56 percent of spinal-cord injuries occur before the age of 30.

Physics problems, he knows well. After earning a Ph.D. in engineering from UAB, Scarber now works as a simulation research engineer in the materials science and engineering department. He fell in love with the subject of science during high school, and he remembers the one-two punch of chemistry and physics as “a life-changing experience. The idea that you could calculate things exactly was like suddenly seeing the universe in a completely different way. I was hooked from then on.”

His first love had been music, and he envisioned a future of touring the country as a jazz saxophonist. But that dream dissolved one summer day in 1985, when he dove into an East Lake swimming pool and his head struck concrete. He remembers that he hit the pool floor and then bobbed to the surface, gulping for air. “I remember my lip hurting, because I had bitten it when I hit bottom. But all the rest of my body was just a slight tingling sensation. You know, when your arm or leg is asleep? That kind of tingling.”

The diagnosis was a level C-4 to C-5 incomplete spinal-cord injury. He had lost the use of not only his legs, but his arms, as well. After the initial trauma surgery, weeks of rehabilitation followed at UAB’s Spain Rehabilitation Center and also Lakeshore Hospital. It was during that long summer, he says, in a transitional-living program to help wheelchair patients become what he calls “civilians” again, that he planned out his new future: “I was the only kid there,” he recalls. “Everybody else was in their 30s. And I was taking mental notes the whole time, seeing how grown-ups handled these things. Finally I said to myself, think about how much ambition you had before this happened. What are you gonna do with that?

“Well, I decided not to conform. I said, I’m not going to a nursing home, and I’m not going to work for a charity. I’m going to be a burr in society’s behind until I get what I want.” He punctuates the declaration with a hearty laugh.

Back in high school (a new one, incidentally, because his old one had three flights of stairs and no elevator), he found that being in a wheelchair, ironically, simplified much of the usual turmoil of adolescence. “When you’re a teenager, your whole mindset is ‘How can I fit in? Am I different?’ For me it was, ‘Yep, you’re different. Next question?’” The laugh, again. “It really made me look beyond the small problems. Compared to not being able to breathe and not being able to sit up, the actual schoolwork was a breeze. I mean, a no-brainer.”

DEFINING ABLE-BODIED

“Coming through! Coming through!” a voice shouts amid the crowd of runners.

It’s not a warning you normally hear near the end of a grueling 13.1-mile race. But athlete Kevin Orr, of Pelham, had good reason to sound the alarm: He didn’t want to knock anybody down. As he finished up the Mercedes Half-Marathon in a manually propelled sports wheelchair, he knew that his vehicle—on a steep downhill grade—could reach almost 40 miles an hour if he didn’t use the brake to nudge it back to 25 or so for safety reasons.

Unlike Scarber, Orr says his process of adaptation to a life without walking was not sudden at all. He was born with a rare (about one in 3,000 births) disorder known as arthrogryposis, which prevents muscles and joints from developing normally.

But a wheelchair was not always his preferred method of locomotion. “When I was a kid, I used mostly crutches and braces,” Orr says. “I’d only use a wheelchair when a brace broke or something. The chair seemed almost like a toy, by comparison.” As he got older, though, the chair became second-nature. Then he discovered the phenomenon of wheelchair sports, which is when he decided to make a career of helping children with disabilities. Today he’s a recreation therapist at the Lakeshore Foundation, using exercises such as aquatics to help rehabilitate kids whose conditions range from spina bifida and muscular dystrophy to amputations and traumatic brain injury.

For wheelchair users such as Orr and Scarber, mastering the perils of gravity, exertion, tight spaces, and uneven terrain are only half of the struggle. An equally daunting obstacle is the attitudes and misconceptions of other people.

“I like to use the phrase ‘temporarily able-bodied’ when referring to people who can walk normally,” says Ellen Dossett, Ph.D., director of Life Projects at the UAB Civitan International Research Center, “because we all need to be reminded that we could lose that ability at any time. And since people are living longer than ever before, the percentage of us who use a cane, a walker, or a wheelchair is certain to increase dramatically.”

That fact has yet to penetrate the awareness of most Americans, though. In general, Dossett says, “people tend to make a great number of assumptions about someone’s abilities just because that person is sitting in a wheelchair.

“The most frequent complaints I hear from wheelchair users are, ‘Strangers come up and start shouting at me like I’m deaf,’ and ‘People talk to me very slowly, in short sentences, as if they think I’m mentally retarded.’

“Misconceptions about disability are even part of our language. How often do you read about somebody who’s ‘confined to a wheelchair’ or ‘trapped in a wheelchair’? Or even that someone is ‘dependent on a wheelchair’? Well, I’m dependent on my legs. So what? The wheelchair is just that person’s best method of mobility.”

PROBLEMS OF PERSPECTIVE

UAB physical therapist Carolyn Sherer, who collaborated with Dossett on the award-winning book Just As I Am: Americans With Disabilities, says that the “psychosocial” adaptations to a physical disability can be just as daunting, if not more so, than learning all of the new physical skills necessary to navigate the world.

“For many people, it’s a huge adjustment to get comfortable with going out in public in a wheelchair and doing all of the activities you need to do,” says Dossett. “With a disability, of course a lot depends on the age of onset. If you’re born with a disability and have never experienced anything else, then that’s your reality. As you age, of course, you become aware of the ways in which other people are different, but it’s a far more gradual process.”

Cases such as Scarber’s, in which a disabling accident strikes suddenly, are “highly individualized, very different from one another,” Sherer says, because each patient brings his own biological wiring and his own emotional makeup to the situation.

“It took me about a year,” Scarber says, “to completely get over the habit of trying to move around like I did before the accident—to start thinking like a person in a wheelchair. For one thing, your whole center of gravity changes, so you have to get over constantly feeling like you’re on the verge of falling.”

Phillip Klebine, the assistant director of research services for the UAB Department of Physical Medicine and Rehabilitation, describes his own spinal cord injury, in a 1984 automobile accident, in much the same way: “In the first place, for a person who’s newly injured, it takes a long time just to get some basic strength back. Plus, you generally have blood-pressure problems, and just sitting up straight for any length of time makes you feel like you’ve done a day’s work.”

That point is when the real-life problems begin in earnest, says Dossett. “It’s one thing to do strength training so that your arms are able to push a wheelchair, but it’s quite another thing to get your brain to reprogram all the visual cues that you’re accustomed to having from a standing height. Seen from a wheelchair, parts of the everyday landscape that were once essentially invisible suddenly loom large and threatening.” Or, in some cases, small and restrictive.

“Doorways are probably the biggest problem,” Scarber says. “So many of them are just not wide enough. Stairs are out, of course. As for your office and your kitchen and your bedroom and your living room and so on, it’s a matter of carefully planning your existence so that you can reach everything you need.

“Every object I deal with has a place, and it’s all arranged in a certain way so that I can live my life at full speed without having those ‘accessibility moments’ of ‘Oh, no! This is too high, or too low, to reach. Is that thing going to shift and fall on my head when I move this thing?’ If you take care of all that beforehand, then when you’re in a rush you don’t feel those shortcomings as much.”

NAVIGATING SOCIETY'S ARCHITECTURE

When the subject turns to going out in public, most wheelchair users—along with their friends and families—seem to have a stock of stories about absurd encounters that have become, with the passage of time, funny.

For Kevin Orr’s wife, Stephanie, one particular incident stands out. About 13 years ago, when the two were dating, they went to a local fast-food restaurant for lunch. “Kevin was with me in line, in his wheelchair,” Stephanie remembers, “and the girl at the cash register looked at him, and looked over at me and asked me, ‘What does he want?’

“I just shrugged, like, ‘Beats me. You’ll have to ask him.’”

She’s also found that the term “handicapped accessible” is used very loosely, especially when it comes to housing. When the Orrs were looking for their first apartment, they saw a newspaper listing for a unit that had just been completely remodeled for that purpose. When they arrived, the manager proudly showed them the new accommodations: wider doors, lower cabinet heights, the whole nine yards.

There was only one problem. To get to the apartment, they had to go down a short flight of stairs. Stephanie says, “We asked him, ‘Where’s the wheelchair ramp?’ He thought for a minute and said, ‘Well, I guess we’ve still got some work to do.’

“It’s not as easy as just nailing some kind of ramp across the steps, because the safety standard for an access ramp is one inch of rise for every 12 inches of length. So if you’ve got steps that are three or four feet high, that adds up to a pretty long ramp, horizontally. It’s something you need to take into account up front, when you build.”

In fact, that realization is the basis of a new architectural movement known as “universal design,” which is basically about making any new building—including houses—accessible to the disabled, from the drawing board on up. Dossett says the approach has two big advantages compared to retrofitting existing buildings. “One is the cost. People in business talk about how much it costs to remodel facilities for accessibility, but if you do that from the very beginning, from the design stage, sometimes it doesn’t cost any more at all to allow for wider doorways or kitchens and bathrooms that have cabinets and counters at a lower height. The second factor is that, if all of this is done right, it’s invisible. It’s just as attractive as any other house. When you go inside, it doesn’t occur to you that all of this is tailored to a person who uses a wheelchair or a walker.”

And though most people assume that the landmark Americans with Disabilities Act (ADA) fixed all of those problems with public accommodations, experts in the field—including wheelchair users themselves—say that the reality is quite different. “The ADA was a very significant first step,” Dossett explains, “but the problem is, it’s one of those pieces of legislation that’s not government-funded. It’s up to the business owners, the policy makers, and so on, to comply with the law. If they don’t, somebody can take them to court, and that’s a good thing. But the fact is, most people are not going to file a lawsuit. They just live with it.

“I think the next big hurdle is public awareness. We see the curb cuts, the wider elevators, the automatic doors, and we assume the problems have been fixed,” she continues. “But it’s amazing how many buildings have met the ‘letter of the law’ but are still tremendously difficult for people with chairs to get around in. Either the aisles are narrow, or the wheelchair entrance is positioned so that you have to go much farther than other people to get in the building, or the ramps have no covering against the weather, so you have to juggle an umbrella and the wheelchair.

“Bathrooms remain a big issue. Is there room to transfer from your chair to the toilet? Is there room to turn around? Is there privacy? Each of these, in itself, may not seem like a gigantic problem. But when you add them all together, every day, it’s a major source of discomfort. All of us, wheelchair users or not, choose where we go based on convenience and comfort,” Dossett notes. “I hate restaurants where the music is way too loud, or the tables are too close together. I choose to go somewhere else. I hope more business owners will realize there are a lot of people with disabilities, and they make choices too.”

ADJUSTMENT AND AWARENESS

Even after wheelchair users master balance, rough terrain, maneuvering in tight spaces, and personal interaction with the public, their medical problems still aren’t necessarily conquered—and the difficulties have a way of transmuting themselves, over the years.

After the 1974 automobile accident that damaged her spinal cord, Shirley Estill, a co-worker of Phillip Klebine in the Department of Physical Medicine and Rehabilitation, used a manual chair. But she recently started having severe problems with her hands and wrists; the diagnosis was a combination of carpal tunnel syndrome and a condition commonly called “trigger finger,” in which the finger joints lock open or lock closed.

“It started affecting not only my ability to move my chair, but everything else I did during the day,” Estill says. Her doctor recommended a motorized model, which made daily activities much easier. She also learned about a minivan conversion that allows users to drive from their wheelchairs, rather than going through the cumbersome process of transferring in and out of car seats. “My van came from the factory with a lowered floor and a ramp. The driver’s seat rolls out of the way and a lockdown device secures my wheelchair in place. I can strap on my seat belt, and I’m ready to go. Plus, the driver’s seat can be returned when my husband drives. It makes my life a whole lot better.

“In the big picture, I’m fortunate that my shoulders are still in good shape. A lot of people with paralysis develop shoulder problems, which really interferes with normal daily activities, like showering and getting dressed. The only problem with the motorized chair is that since I’m getting less exercise, it’s easier to gain weight.” She laughs. “But hey, nothing’s perfect.”

The ongoing problem with public perceptions of people with disabilities is one that will never be solved by engineering breakthroughs. But Klebine says he’s increasingly hopeful in that regard. “Most of the uncomfortable interactions I see are with older adults,” he says. “And that’s understandable, because in their day, people with disabilities rarely got out in public, much less had regular jobs. So it’s still kind of strange for some senior citizens. They’ll come up to you and say, ‘It’s so nice to see you doing something with yourself!’ Sure, it gets tiring, but you can’t fault people for how they were brought up.

“Kids, on the other hand, seem to adjust better to new things. So it’s a visibility issue. The more the public sees it, the less of a novelty, the less awkward, it becomes.”

Kevin Orr agrees. “Kids are naturally curious about anything that’s different,” he says. “I encourage them to ask questions, and when they know the facts, they’re like, ‘Okay, that’s cool.’ I guess what it comes down to is that we don’t just educate people in the classroom or in a rehabilitation facility. We do it every time we go out in the world.”

Return to the Table of Contents

Print This Page

* © 2005 University of Alabama at Birmingham
* Birmingham, Alabama 35294
* 205-934-4011
* Disclaimer
* Abo
I are not bot Ii do does know this without google engine