Saturday, 27 May 2017

Accessibility - Really?

Be skeptical!  When you hear the word 'Wheelchair Accessible" be skeptical.  Some may try (perhaps half-heartedly) to comply with regulations and make their facility wheelchair accessible, however, they may fall short.  For your own convenience, if at all possible, check or have someone check for you beforehand.

Invited to a wedding, I was assured that the reception hall washrooms were wheelchair accessible -including stalls wide enough to accommodate a wheelchair.  I soon discovered, while the door to the washroom was wide enough, there was an immediate 90-degree right hand turn to further enter.  The turning radius of my manual wheelchair would not allow me to make the turn.  In effect, became wedged half way in.  Crowds gathered;  elegantly dressed women holding their champagne flutes offered solutions.  Hefty men in suits offered to carry me and seat me on a toilet.  You turn beet-red and want to shrink to nothing.  I held it all evening thinking I'd explode before the evening was over.

My first doctor's office, located within a retail pharmacy, was no different.  Once you got past the automatic doors that were broken and refused to slide, you immediately found yourself confronted by a 90-degree turn (a wind corridor thought to block cold breezes from the cashiers).  Immediately inside the corridor I found that I could not back up enough to get the open the second manual 'swing' door.  Can't go backwards - can't go forwards.  Several gum-ball machines within that breezeway may have been placed there so that persons stuck between doors would never go hungry.

My doctor's second office is not much better.  There is an automatic sliding door that opens to the building unit.  To the right another set of sliding doors allows access to the commercial pharmacy. To the left, a manual door has to be pulled open by myself while corralled in the corridor - or  opened by an obliging passerby.  The examination room is no better as my chair's canted wheels scrape the door jambs when entering and I cannot enter fully as I run into the examination bench.  The examination rooms are nothing more than a slightly larger closet.  Imagine getting a digital prostrate examination with the door open as other patients are lead down the hallway to their rooms!

Accessibility door activators placed by able bodied persons without a clue (a mental handicap perhaps?)  The activator at my gym was placed on a pillar so far away that it was a difficult scramble to get to the door before it once again closed.  Even in my rehab hospital the door actuator was placed on the far side of the door against the wall.  When the button was pushed, the door would open it would be impossible to clear the wheelchair from in front of the door before the door hit the chair -sensed an obstacle - and immediately reversed - closing to prevent damage.  The wall immediately on the other side of the door prevented approaching from the opposite side.  I was trapped.  The room was used as a 'chapel'.  Looking around I retrieved the only item available, the New Testament bible and I took aim, throwing it at the switch to activate the door.  Religion set me free!

Funeral homes - where my only access was through the casket elevator.  Handicap parking adjacent to a wall where the car door cannot be opened.  Ramps that are far too short -never reaching the top of the obstacle.  And on and on...

Just check.  Ask lots of questions -specifics -to avoid frustration and stay safe.

With the death of my dad last Boxing Day, the New Year was spent cancelling credit cards, pensions and making appropriate notifications.  One immediate chore was to retrieve his original, notarized will from his lawyer's office.  Located downtown in a major Ontario city, you would think there would be little problem.

The most frustrating situation occurred in the parking garage.  Leaving the car, my wife and I entered the elevator/stairwell/exit.  As we were lucky enough to be on the ground floor we anticipated no problem -just exit through the doors.  As it turned out, we were about a half a floor up from the main concourse.

Okay, there is an elevator (a ramp would be too steep) -but it is locked up tight and requires an assistant to operate. Instructions are to push the intercom button and wait for a reply.  No reply!  Try again several times.  Finally, after several minutes we get a reply. (Cleaning personnel passing through offer to operate the elevator for us as they use it even though they can get into trouble for doing so.  We decline their offer as we have someone coming.)  A nice young security guard comes down and opens the elevator door to allow me to get in -to go down the equivalent of 5 steps!  Very apologetic for the delay, he suggests that on the way back we ask the front lobby receptionist to call ahead and security will be waiting for me at the elevator to take me back up those 5 steps.

The lawyer's office is located behind a wall of glass and chrome with a bank of revolving doors for entrance.  Each revolving 'hamster cage' wheel/door is too small for my chair, or any chair to enter.  There is an old-fashioned 'swing-hung' door but it is locked tight - again, I suppose to keep the winter weather from blowing through the lobby.  We were lucky to gain access through an adjoining facility -a bank which had the swing mounted doors - but not automatic.  It is up to you to get yourself through the first door and open the second inner door while holding the first outer door behind your head so as it doesn't hit you in you (chair's) butt.  Lucky I had my wife along!

On our way back out we stop at the lobby desk and ask that security meet us at the elevator.  We were met by that wide-eyed 'deer in the headlight' look.  "Elevators are right over here - you can operate them yourself."  "No, not those ones - the handicap parking garage elevator."   That puzzled look again...

We go back through the maze of tunnels to find the parking garage 5-step elevator.  Pushing the intercom button to summon our security elevator operator fails to connect.  They pick up but nobody shows.  After 10 or more minutes a different security guard shows up.  He looks impressive with a large jingling ring of what looks to be fifty or more keys.  He must be important!  So he tries this one -nope, tries that one -nope -as he slides his way around the key hoop.  Calls for backup on his two-way radio.  Another two security guards show up.  (who's minding the shop?) "You don't need a key to operate it - just punch in the code on the key pad!"  "What's the code?"  Nobody knows the code. (They always change the code so the cleaning personnel don't use it!) Nobody has received training on this elevator though it was installed when the building was built -not long after the date of their birth by the looks of it.  They can't find the original security fellow who had no trouble.

Finally... they find a key and send me on my way.

Though I didn't time it, we must have wasted up to 40 minutes waiting for service -extra time happily added to our parking charge.

So I have to wonder - at what cost?  Perhaps a $50,000 elevator installed for 5 steps.  $10,000 per 7-inch step.  A lobby receptionist with no clue as to what exists within the facility.  Several security guards who lack specific training on the operation of specific equipment within their facility.  What happens in the event of a fire or evacuation?  (But they can boast -"yes, we're accessible!")

All for 5-steps in a public facility!

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A Few Thought on our Medical System and my Late Dad

This blog of mine has such a negative tone running through it.  Perhaps at my age I've become a curmudgeon and find myself irritated by most and critical of everything.  I really don't believe I'm have such a negative outlook on life but I am finding it harder and harder to find "professionals" who care and live up to their title or companies that take pride in producing well manufactured products and stand behind them with a realistic warranty.

This fast paced life often has us trapped.  Job stress, climbing the payroll ladder, road rage, mounting bills, stay-cations, increasing taxation and over-regulation.  Fast food, tethered to a cell phone or pager, internet tracking your interests & "Likes" - spam, GPS, telemarketers.  House prices that skyrocket 15 - 20% in a year.  Student loans that will take a lifetime to pay back.  CEOs make more money in one week than you earn in a year.  A hockey goalie makes more money protecting a goal than a soldier protecting your country.  Go figure.

Do we care about anything anymore -except how to make more money?  The hell with the customer; the hell with the product we foist upon them.  Make it cheaper but not less expensive.  Planned obsolescence!!  If it breaks -Great!  They'll have to buy another.  Chase that unreachable stock market carrot dangling in front of your nose -more, more, more - always more!

In pursuit of, and the worship of the Mighty Dollar!!

I've been away from this blog for a while due to the death of my father.  His life spanned good 92 years on this earth having grown up with silent movies, bi-planes the wonder of black & white television to having traveled in jet aircraft, watched man walk on the moon, even utilized the internet. He even survived WWII, having slept in the snow and survived on supper stolen from a dog's bowl.

Still his last days should have run out more smoothly than they did.

About two years ago he went to an optometrist to get new glasses as he was a voracious reader -books were his primary joy in life.  The optometrist detected the presence of glaucoma and a forming cataract which, by my dad's account, did not interfere with his enjoyment of books.  He began receiving treatment for the glaucoma and was booked to have cataract surgery.  As he loved to read, I urged him to get the cataract surgery.

By all accounts, the surgery was botched.  He followed post-op instructions yet his vision was less clear after the cataract surgery.  The eye looked different - something looked 'off center' for lack of a better term.  Follow-up had the doctor 'hem and haw' -never acknowledging a problem -yet he would get comments "what's wrong with your eye".

He could see less well and therefore decided to postpone surgery for the other eye.

Now two years later, he is still living alone in the country home -self reliant, only with lunch brought in by a 'meals on wheels' type of organization.

He calls me up on my birthday and we have a nice long chat.  Two weeks later my wife answers the phone to hear him gasping for air.  No longer driving, he asks her to take him to his doctor.  On arrival, my wife finds him in severe distress, still gasping for air so she calls for an ambulance. (In my wheelchair, I'd only slow my wife down during this emergency!)

He's admitted in a local hospital (only the second time in his life)  and they determine by his symptoms that he has pneumonia.  He's placed on antibiotics and sent for X-rays, CAT-scan etc.  He is left on a hallway stretcher for an extended period of time -waiting.  He cannot get anyone's attention to take him to the washroom to relieve himself - so he has no choice but to urinate on the stretcher.  Nurse sees that a 92 year old man has peed himself; must be incontinent at his age -so he is catheterized so as to avoid any further accidents the staff may have to clean up.

Scans show that he probably has some congestive heart failure - fluid built up around the lungs and heart making his breathing difficult.  They drain the fluid, put him on diuretics and oxygen.  But Pneumonia??

He hates that catheter irritating his insides and sure enough he comes down with a urinary tract infection (UTI).  But not just any UTI - he has an ESBL (Extended Spectrum Beta Lactamase -producer) which is a "superbug".  He now finds himself in an isolation ward with others -apparently the hospital has a 'super-bug' outbreak.  More antibiotics!!

I cannot obtain much information on his condition, treatment or prognosis.  Nurses can't say much, doctors don't return calls.  At a so called family meeting, I can't get any useful information.  While I worked some 34 years as a Microbiology Medical Technologist, I just can't get any useful, information.  Doctor tells me that they don't culture respiratory samples as "they are of no use -always mixed cultures".  Analyzing those sorts of specimens was part of my job for those 34 years, and if they are mixed, it is more a function of poor collection by the doctors and nurses and not the Lab Technologists analysis.  How are they certain the infection is bacterial and not fungal or viral?

To make a long, sad tale shorter, he was discharged after almost two months in the hospital.  He was a different person who came out than who went in -and he knew it.  "What the hell did they do to me in there?"  he would ask.  He felt totally drugged and in those two months his eyesight deteriorated until he was virtually blind.  Still he was being treated for glaucoma.  My understanding was that treatment was to prevent/slow down the progression of glaucoma to prevent blindness.  The why continue to treat a blind man?? (Is there a legitimate reason??)

On discharge we were instructed by his doctor to obtain a weight scale and weigh him daily (presumably to measure water retention?) -never made clear.  And we were to measure his urinary output each day which we did so diligently -keeping a record.  But in the end, nobody wanted the information we were instructed to collect!

Still catheterized he continued to be tormented by "that stick" stuck up his penis.  We tried to have the catheter removed but they gave him four hours off the catheter in which time he had to urinate.  Without drinking sufficient fluids, he was unable to urinate.  Back in went the catheter for now his problem was no longer deemed to be incontinence but rather retention.

He went into the hospital as my dad and came out someone else.  Gaunt and pale, a few days of home cooking had him looking better.  Still he drifted;  he could talk about world history and provide accurate events with dates or speak with friends and relatives clearly and concisely but then babble nonsense - all the while asking "what did the hospital do to me?"

Each morning I wake and listen to for his voice, a cough -something to let me know he is still with us on this earth.  I hear his gravely voice and for the time being, am relieved....

He lasted another month with us.  Now, unable to see at all his circadian rhythm was messed up -waking up and asking for breakfast at 2:00 am.  He was fidgety -continually fussing with blankets and other items before him.
With bilateral pain developing it appeared he had re-acquired a urinary tract infection (UTI).  Was it something new or was he sent home with the ESBL superbug still in his system?  Another ambulance was called and he left home for the final time.  Readmitted he continued to decline until he was moved into palliative care.  My wife and I went to see him in the hospital on Christmas day.  Unresponsive in an isolation room, we said our goodbyes.  A doctor called on Boxing Day around 2:00 in the afternoon to let me know that the 'old soldier' had passed.  And so it goes....

Was his decline typical?  The hospital would have us believe so.  However, having worked in one for some 34 years, I believe a hospital is no place for a sick person.

From his misdiagnosis of incontinence-  to the empiric treatment of a possible pneumonia without knowing what the pathogen was or it's sensitivity to the antibiotics used -I feel the system failed him.  The acquisition of a hospital 'Superbug' (a noscomial infection) to continued treatment of a blind man for glaucoma.  Keeping family members 'out of the loop' -inquiring family seemed to be a nuisance.

Was a 92 year old man of lesser worth than a young person?  That 92 year old man was my father and he meant the world to me!  And now he is gone....

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