Nov 13, 2006
This morning Gary did another exceptionally good transfer while I was around the corner of the bedroom not able to see him. He said maybe the two he’s done that way have been so good because he knows he damn well better make it. ;-)
Blackjack is no longer fooled by the pills being hid in the chicken-flavored pill pockets. So now I set him on Gary’s lap and hang onto all four of his flailing feet while Gary struggles to open the cat’s mouth and get the pill down it. The poor thing then shoots off of the wheelchair (the cat, I mean, not Gary ;-)). I then give him a reward of some Fancy Feast Cat Food (again, I mean Blackjack ;-)) Blackjack then doesn’t whine for food as much as he usually does, because he’s afraid it might mean I try to shove another pill down him. Gary and I joked that maybe every time Blackjack whines for food, we should shove a placebo pill down him. That would probably cure him of this habit – a little negative reinforcement!
Gary then later yelled that Tigger had brought into the house a big long worm. Turned out to be a little snake – probably the tiniest one Tigger had ever brought in (and unfortunately, he does seem to like to bring in snakes). The only way I can get them out is by sweeping them with a broom into a box, but Gary said this one was so small I could pick it up. No way. Gary decided he himself could get it, and he leaned over and picked it off the floor and took it out of the house. Now, if he could only get the “foot-long plus” ones that Tigger brings in.
Gary had a couple appointments today. On the way to the foot doc, we somehow got talking about car-make recognition. Gary recalled how when he was a kid he wanted very badly to be able to be able to tell the make of a car just by the car’s appearance – all the other boys seemed to be able to do it. So he used to consciously look at cars and try to memorize their distinguishing characteristics – but it never “stuck.” He then finished up this reminiscence by saying that at least he was better than me at it – I sometimes forget what kind of car it is that I am driving or what color it is :-).
The foot doc says Gary’s toe is healing nicely and he doesn’t think Gary needs another appointment to see him unless there is some problem. We were both glad to hear Gary doesn’t have to soak it twice a day :-)
After that, Gary had an appointment for his driver evaluation. Unfortunately, it turned out we went to the wrong place for it, so we ended up being about twenty minutes late. The evaluator asked Gary questions like, “How is your endurance now – pretty good, or are you totally wiped out by the end of the day?” Gary told him it was pretty good. Gary got to skip being asked a whole lot of questions pertaining to his cognitive abilities because he wasn’t documented as having had a head injury. The evaluator had Gary go through some balance tests: Gary had to raise both arms straight up (his arthritis definitely limited him on that – not sure how much his balance problems affected that), then straight out to the side, etc. The evaluator said he did fine. He next wanted to see how far Gary could bend forward and bring himself back upright, and then to each side and then back upright, all without the aid of his hands. Not having trunk muscles Gary couldn’t bend very far, but he could do it some as the result of learning at Shepherd how to use his head as a counterbalance.
Next Gary had his grip tested. It turned out his grip is about thirty-five to forty pounds below normal. We are not sure why this is so – maybe just from the disuse of his muscles during the hospital stay. I guess this is why Gary can’t open the bottles of spring water we get – I have to do it for him. We had been laughing about that, thinking it was somehow psychological or some technique he didn’t have down, but I guess it really is physiological.
Next Gary had his vision tested, and it turns out he is color-blind to green! We never knew that before. The tester said that was no problem, however, since he would be able to figure out if a light was red, yellow, or that third color.
Next Gary had his reaction time tested, each hand separately, right then left. He put his hand on something that looked like an accelerator pedal, and then when a little light on a machine changed from green to red he was supposed quickly move his hand to what looked like a brake pedal next to the accelerator pedal. The tester said this machine used to be used in high school driver training classes but it isn’t made any more. He also said it wasn’t what Gary’s hand controls would look like or how it would function. Anyway, Gary scored average on that (both hands), which was fine, and the tester thought that with practice on the hand controls his reaction time would improve.
The tester finished up with a simple strength test where Gary pushed then pulled against the tester’s arm.
The tester said all in all Gary did fine and he foresaw no problem in training Gary to drive.
Next he talked to us about the different kinds of mini-vans, mentioning the Dodge Caravan, Chrysler Town and Country, Honda Odyssey, Toyota Sienna, Chevy Uplander, and Buick Terraza. (The Sienna is the one we looked at while at Shepherd.) He told us basically all mini-vans are the same, as far as conversion goes, except the Kia, Hyundai, and Nissan, although there’ve been some problems doing it with Fords. In the conversion, the floor will be lowered and the middle seats will all be taken out. The driver and front passenger seats start out as “quick-removable,” for access by a wheelchair in their stead, but since Gary won’t be driving in his wheelchair, the driver seat will be replaced by a “transfer base,” which will no longer be quick-removable. The transfer base will, at touches of a button, go back toward the middle of the van (where Gary will have entered in his wheelchair), face Gary, and then after Gary has transferred into it, face around to the front and go back to the driving position.
For floor ramps Gary has the choice of an in-floor ramp or a fold-up ramp. The evaluator said they take up about the same amount of space and he recommended the fold-up ramp because if there was ever any problem with the electronics, it would be much easier for Gary to work the fold-up ramp manually than the in-floor one. Also, the fold-up ramp is slightly less steep, an 8% grade instead of a 9% grade – every little bit helps when it comes to arthritic shoulders.
After Gary transfers out of his wheelchair to the driver’s seat, he would need to lock down his wheelchair in the van so it doesn’t become a projectile in case of sudden stops, etc. The evaluator said the usual place he gets a lockdown system from doesn’t make one for Gary’s type of chair. He called around to some places all during Gary’s evaluation, but I don’t think he came up with a source as yet.
Other modifications that would be made: a spinner knob on the wheel for one-handed driving, and a manual gas-brake hand control. Gary would drive with his right hand and keep his left on the hand control to accelerate and brake. We saw a little video of the “sure-grip hand control” – it kind of looks like a long stick with a grip and is situated to the immediate left of the wheel. You push it in to brake and tilt it back to accelerate. (See http://www.suregrip-hvl.com/ ) I wouldn’t need to learn this, fortunately – I would just drive the van as I normally would.
I think the last thing he mentioned was a column shifter that would be between the front seats, but I’m not sure if that is any different than the kind of shifter we are used to.
We would have to buy the chassis on our own (i.e., the unmodified van), the typical price around $25,000. The modifications would be in the range of about another $25,000. As I mentioned before, based on our income, we will most likely have to pay for the modifications to the vehicle ourselves, but it is possible it could be presented as a “RAVE” case (“Retaining A Valued Employee”) through the university, and if so the Dept. of Vocational Rehab (VR) would pay for the modifications. It wasn’t clear at our previous meeting with the VR person what the likelihood of that is.
We are to go around and decide what van we want, but we are not to buy one until all the quotes are in. That is, we decide which van we want, and then we tell the evaluator which one that is. He will then collect quotes for the various modifications to be made (he thought that would take about ten days), and he will give these quotes to the VR person. The VR person will then meet with us and tell us what her department will pay for, if anything. Based on that we tell the evaluator whether or not to go ahead. Then the evaluator will work with us and a “mobility dealer,” not a regular dealer, to get the van.
Since everything in the middle of the unconverted van will be taken out and the third row seats will not have the option of being stowable because the gas tank will be moved back to make room for the floor to be lowered, the only things we are supposed to be concerned about with the vehicle are the cockpit setup, the warranty, the outside appearance, the accessbility of the van, and things of that nature.
Once we have the converted van, the evaluator will train Gary to drive it. He didn’t think it would take long. He said he’d start Gary off in an empty parking lot, then on residential streets, then moderate city roads, etc. He’ll be training Gary a couple of hours a day, but I don’t recall if he said exactly for how long he expected the training to go on. Since Gary has been driving for 40+ years, what the training is really about is getting used to automatically using the hand controls in an emergency situation. The trainer said that it is automatic that one goes to use the feet to brake in an emergency (dog runs in front of you, etc.) – but of course Gary’s feet aren’t going to get that message. So the idea is to practice, practice, practice, so that the emergency response is to go to the hand for the brake, not the feet.
We thought it was great that this one person, whom I have referred to the evaluator, not only did Gary’s driver evaluation but will get all the quotes, help us get the vehicle, and then teach Gary to drive! Needless to say, Gary gave him the highest marks on the satisfaction survey that finished our meeting.
I was a little sore the next day, Tuesday, as I had to break down and put together Gary’s chair ten times on Monday to get him to and from his various appointments – now that Gary takes the bus, I’m not doing that as often as I used to. This will be another advantage of the van, since when he drives it I won’t have to be breaking down his chair in order to transport him ;-)