Medicine Change (It’s like an oil change)


I recently had surgery changing the pump – when they change the battery, they change the pump, too.  I have the standard (40 ml) Medtronic Sychromed II pump installed in me.  It’s a little like being the bionic man.

An oil change for the pump

Typically, the pump is refilled with new medicine every three or for months.  It’s more like an oil change.  The bad (old) medicine is taken out and good (new) medicine is put in the pump.

I have a service that comes to my home and will change the medicine while I am in bed.

Surgeon’s office says new medicine

The service called me on Saturday to tell me that they would come on Monday for the pump refill.  I said that I was told at the surgeon’s office that when the surgeon changed the battery and pump, they put in new medicine.  Accordingly, on Monday someone would come, but only to check out the pump.  This is called interrogating the pump.  Thereafter, I realized that Monday would not be good for me.  I spent all weekend trying to get in touch with them to change th day to Tuesday, to no avail.

The nurse and the medicine plan to arrive

Monday came and the nurse who would change the medicine called to tell me new medication would arrive at the house and so would he.  Still trying to change the day, I explained that the surgeon’s office had told me that new medicine was put into the pump when the surgery was performed and the medicine had not arrived at the house.  He assured me that the medicine would arrive shortly and so would he.

The nurse calls the surgeon’s office and is told of the new medicine

Apparently, the medicine and he arrived in the afternoon, negating my reason to change the day to Tuesday.  When he arrived, I again told him that I was told at the surgeon’s office when I had the staples removed, that new medicine was put in the pump at the time of the surgery.  He decided to call the surgeon’s office.  He was told that new medicine was put in the pump at the time of the surgery.  He came back to the pump, interrogated the pump, and he noticed that I had a fair amount of medicine in the pump.

The nurse calls the surgeon’s office a second time and is told they are uncertain about the medicine

He again called the surgeon’s office, but this time they were uncertain whether new medicine was put in the pump at the time of the surgery.  He said that they usually put in new medicine, but might not have because I was getting such a low dose that the medicine was diluted, and they may not have had diluted Medicine  available at the time of surgery.

The nurse decides to change the medicine

In view of this uncertainty, he decided to change the medicine in the pump.  Usually, this does not hurt.  The pump has no port.  A needle is inserted into the middle of the pump.  The area of insertion is found by feeling for the depression in the pump, and with the help of a template that shows the area of insertion.  This time the needle hurt.   This was so probably, because the whole area was sensitive as a result of the recent surgery.  Anyway, he took the possibly old medicine out and put in new medicine.  I was relived when the procedure was concluded.


Usually, no bandage was used, but this time a small bandage was used.  I removed the bandage two days later.

Trip to the Oral Surgeon

Trip to the Oral Surgeon
Trip to the Oral Surgeon

The appointment

I made an appointment with the oral surgeon.  I confirmed that they take my insurance, which they do.  I made sure that the driver would be available.  The night before the day of the appointment, the driver calls to say that he cannot make it.  He has no explanation.  This one of life’s problems when you are a paraplegic with multiple sclerosis.  You rely on other people and sometimes they come through for you, and sometimes they don’t.  Fortunately, I was able to get another driver.

The day of the appointment

The driver finally shows up but he is late.  There is traffic on the expressway, and we arrive late.  I give the receptionist, the x-rays which are on my smartphone, and I email the x-rays to the receptionist.  Apparently, I don’t fit in the oral surgeon’s x-ray machine in my power wheelchair.

Seeing the Oral Surgeon

I waited an hour and finally the oral surgeon sees me.  I explain that I am there for one extraction.  He explained that someday the other two would need to be extracted because they really cannot be saved.  I was considering anaethesia, but since this was not my regular driver, and he no idea how the van door and ramp work, and no idea how to get home, I decided to have an injection.   The oral surgeon gave me two injections.  He said that the tooth was being held together by a cap that was over the tooth.  The tooth came out in pieces.  He said this was a difficult extraction, because the bone underneath was strong but the tooth was cracked in pieces.  It was being held together by the cap and in place by the strong bone.  I left the office with instructions to bite down for at least 20 minutes.

Leaving the Oral Surgeon

Of course, I had to ask the driver for the key, so that the door would open and the ramp come out, which it did flawlessly.  This is particularly difficult to say when you must bite down for 20 minutes.  Then I directed him on the way home.  We stopped off at Autospa which finally had the dip stick in stock.  The big job was getting the old broken dip stick out of the van.  This was finally accomplished, at no cost to me since an Autospa employee broke the dip stick while doing an oil change.

Arriving Home

We left Autospa and went home.  Now I had to continue recovering from the pump (battery) replacement surgery, and the oral surgery.

Trip to the Dentist

Finding a dentist

I did not want to pay $5,000 to the dentist that saw me at home.  I have dental insurance and I knew I could get dental work done for a lot less.  I called my old dentists who I had seen 3 years ago, and to my surprise, they were willing to work on me while I was in the wheelchair.  I made an appointment and on the day of the appointment, I was off to see the dentist.

Getting into the van

I was dressed and I was patient lifted into the wheelchair.  I took the wheelchair to the van.  As sometimes happens the van door which is supposed to open electronically by remote control did not open.   I had my driver manually open and close the door and then the van door electronically opened.  The old used van has a finicky electronic door and ramp, but with a little work, it functions.

Dentist Office

I got to the dentist office and had the usual one hour wait. Then they took me.  I provided them with the x-rays that the dentist that came to my house provided.  Therefore, I did not need new x-rays.  I had a cleaning, and after the cleaning, I heard the dental hygienist complaining to one of the dentists how hard it was to work on a patient in a wheelchair.  The dentist told the hygienist this is part of dentistry.

Seeing the Dentist

The dentist looked at the x-rays and looked in my mouth, and told me that I had three broken teeth that needed to be extracted.  Then he left to see another patient.  An assistant came into the room to say that I’m all done for today.  I said I wanted to see the dentist again.  I waited for the dentist to return.  When he finally returned, he said the teeth would have to be extracted by an oral surgeon.  I asked why he could not do the extraction?  After all, he had performed extractions on me in the past.   He said that although they had done extractions in the past, my bone was strong but the teeth were cracked and these teeth would come out in pieces, so it was best to have an oral surgeon do the extraction.  I advised him that I was not in pain and I wanted to keep as many teeth as possible.  He then said that one really needed to come out and that the other two could be done later.

Check out

I went to the front desk and made another appointment.  Since I have insurance and these dentists are on my plan, there was no co-payment and no charge.  Of course, upkeep of the van and the driver cost, but the dentist is free.

The trip home

This time the van door and ramp worked, and I was on my way home.  We stopped off for some gas and we stopped off at AutoSpa to see whether they received the new dip stick.  They hadn’t and we continued home.

Dentist Comes to my House

Doctor Recommended

I have a general practice doctor that comes to the house.  I have not seen a dentist in three years.  It was really time to see a dentist.  The doctor recommended a dentist who could come to the house.   I called the dentist and he came to the house.

Dental X-rays

The dentist began by taking x-rays of my teeth while I was in bed.  He looked in my mouth and saw that I needed two new crowns.  He said that this would cost $5,000.  I told him that I have dental insurance.  He told me that he does not take that insurance and that he was very sorry for people who had that insurance company.  He apparently did not think highly of that insurance company.

He left my house while reminding me that I would need the new crowns. We talked a little about Star Trek.  We parted amicably.

Van Air Conditioning

Oil Change

I own a handicap van.  It is not a new van.  It is on old used handicap van.  It is a 2006 Chrysler Town & Country.  Of course, it cost much less than a new van.  However, an old used van is going to have many more problems than a new van.  It will cost a lot of money to fix an old used van, but then I knew this when I bought it.

I took it to an AutoSpa for an oil change and air conditioning service.  I finally realized that it needed help with the air conditioning when (a) the air conditioning did not work and (b) I hear this really bad grinding sound from time to time.  It was still summertime, but it was the end of summer.  I don’t use the van as much as I had expected originally.  At first, I drove the van, but now I let another driver handle the driving for me.

It was time for an oil change and Autospa is usually empty, or almost empty, and can do a 10 minute oil change.  There are probably less expensive places for an oil change but most places take much longer to do an oil change, not because the are slow at doing oil changes, but because they are so busy that there is a long line.   Of course, the driver costs money and that is a factor too.

While doing the oil change, an Autospa employee broke the dipstick, and Autospa agreed to provide me with a new dipstick at no cost, which they later did.  I put in regular oil since the van is not used much anyway.

Air Conditioning Service

Then came air conditioning service which did not go well.  I was told that they could not do air conditioning service, because the compressor was broken.  I was directed to take the van to two different places.  The first place was closed.  The second place was way too busy to do the job, but that place directed me to a third place that could do the job.

MS Patients Need Air Conditioning

At the third place, I was told that I needed a new compressor and an air filter, and that it would cost $900.  Frankly, I have MS, and I really did not have much of a choice.  Many people with MS can not tolerate the heat.  We lose function.  We can hardly move in the heat.  It is not a matter of leaving the car window open, because the hot air blowing does not help much.  For someone with MS, air conditioning is not a luxury, it is a medical necessity.

Waiting for Air Conditioning

It took about three hours to get the parts and install the new parts.  They also put in new freon.  I waited for the repair.  Finally, the air conditioning was working and I felt much better in the van.  We went home.

Remove staples

Who will remove the staples?

I am home with 12 staples in me holding the surgical site in place.  I can have a nurse come to my house to remove the staples or I can go to the surgeon’s office to remove the staples.  I decide to have the staples removed by the surgeon so he can see how the surgery went.  I make an appointment with the surgeon only to confirm the appointment, to find that the surgeon has decided to schedule a surgery at the same time as my follow up visit.

If not the doctor, then maybe his nurse

I suppose the surgeon makes more money from surgeries than he does from follow up visits.  I tried to reschedule the appointment for the next week, but the doctor was off that week.  However, his nurse could see me.

The surgeon’s nurse removes the staples

I had the nurse remove the staples.  It was 12 days after the operation.  Generally, the staples were removed 12 to 14 days after my operations.  She said the staples were about to come out themselves.  That is how ready I was to have the staples removed.  Although there were a dozen staples, it was essentially painless to have the staples removed. There were no further follow up visits with the surgeon.

The Operation

I have been recovering from the surgery and so I have not been able to update the blog.  In the interim, I have added a recommended product and services page.  I would very much appreciate it if you took a look at the new page.

The trip to the hospital

The day before the operation I received a call from th hospital and I was told that I would be the first person to be scheduled for surgery with my surgeon.  I would need to get to the hospital by 6 am.  I am generally an early riser, but not that early.  I would need to get up about 4:30 am in order to arrive at the hospital by 6 am.  I did this.  I had my aide dress me, put me in the patient lift, and put me into the wheelchair.  I own the wheelchair.  I do not have a wheelchair rental.  The van has a wheelchair ramp.  The wheelchair ramp comes out electronically when I double press a button on the key.  It is remote controlled.  Into the van I went and we went to the hospital.  I needed ID which I had.  The hospital already had the insurance information.  I waited in the emergency room and since I was the first surgery, I did not have to wait long.


I was transferred from the wheelchair to a hospital bed and dressed for surgery.  I saw my surgeon, anesthesiologist, and the rest of the surgical team.   Shortly thereafter I was brought to the operating room, I was slide over to where the surgery would be performed.  The mask was put on my face and I was out almost immediately.  The next thing I remember was the mask coming off me.  I was told that the operation was over and I felt as though I could go right home.  However, they took me to recovery, and I would have to wait to be picked up.  This took hours – probably longer than the operation.  I had a tuna fish sandwich for lunch.  I have to admit I had no pain from the operation.  I had 12 stapes in me, which I counted after I went home.

Lack of pain, and the trip home

Although I had no pain, they gave me a prescription for oxy contone.  The prescription was filled, but I never took the medicine.  In fact, I did not even take Tylenol.  I had no pain throughout the recovery.  The medicine was discarded.  The operation was performed as an outpatient.  I was put in my street clothes and transferred to the wheelchair.  The transfer was performed by only one person.  Usually, it takes three people to transfer me.  I left the hospital and went into the van for the ride home.


When I got home it was the usual routine of being transferred to the bed.  I was happy to be home and eating regular food.  The evening before the operation I was not allowed to eat at all.

Medical Clearance

Baclofen pump



I have a baclofen pump installed in my abdomen. In 2012, I had the pump installed. I get very bad reactions to oral baclofen. Baclofen is muscle relaxer. By taking baclofen through a pump system, I avoid all the bad side effects.

Operation number one



The first operation was a really significant operation, where the doctor has to create the pouch for the pump in the front side of the patient. Then a catheter is placed up the patient’s spine. This surgery results in both front and back incisions to the patient. The second procedure, which I had is much less invasive. It is essentially a battery replacement, but they do not just replace the battery, they replace the entire pump.




In order to have the operation, the surgeon requires medical clearance. I can have the tests and EKG performed at home. I can also have the x-rays performed at home. The problem was that the surgeon wanted the x-rays performed at a testing center so that the x-rays would be on a disc. The x-rays taken at home could not be transferred to a disc.

Bad blood pressure and EKG



So off to the testing center I went, which means I transferred from the hospital bed to the power wheelchair with a patient lift to the van. Apparently, my blood pressure was too low, and my general practice physician had to adjust my blood pressure medicine. What they didn’t tell me at the center was that my EKG was bad. I canceled an appointment for an EKG, because I didn’t know why they would have me take two EKGs in one week. My general practice physician saw me and told me that I had done badly on the initial EKG and a second EKG was ordered.


I rescheduled the EKG and I apparently passed. I got medical clearance and I was a go for the operation.

Standard walkers and Rolators

I have been using walkers for many years and I want to give you some insights into my experiences with walkers.

Standard walkers without wheels

These standard walkers do not have two front wheels. While these walkers are not necessarily heavier than walkers with two wheels, they are more difficult to move. I have found that walkers with two front wheels make the walker easier to move.


My walker without wheels was located in my den, and I would use it to help me maintain a fish tank that I once had. Ironically, the walker had one leg that was shorter than the others, which made the walker somewhat unbalanced. At first, I almost fell with the walker, but in time I learned to compensate for the short walker leg. It may have been possible to get a spare rubber walker foot for the walker leg. Typically, the walker feet have a metal ring that helps to maintain the walker’s rubber feet. Adding this may have helped balanced the walker, although I admit that I never did this.

Hand grips

All walkers, both with or without wheels, have rubber or plastic grips. I found that the rubber grips gave me a more secure grasp on the walker, however, rubber grips after a few months were notorious for moving to an inconvenient place on the walker’s handle bar. They could be moved back in place, but only with a substantial effort.




Household walkers with and without wheels cannot be used for a substantial amount of walking outside the home. The rubber feet get worn out very quickly on concrete and asphalt. You will find that you are almost constantly putting on new rubber feet. A task which is neither easy nor convenient because the rubber feet are typically tight around the legs of the walker. Invariably, you will find it necessary to purchase a rolator. They come in different colors, sizes and styles. They often have four wheels.



How do you get any stability from a device that has four wheels?  The answer is that they have front and back brakes. When you need stability, you grab the front and rear hand brakes for dear life, otherwise you are likely to fall. The hand brakes are very similar to the hand brakes on a ten speed bicycle. Unfortunately, as the wheels wear down, and they will on concrete and asphalt, the hand brakes, like the hand brakes on a bicycle, often need adjustments. This is why you grab both hand brakes for dear life. It is likely that one or the other will be misadjusted and you will need all the remaining brakes to stop.




Rolators are often useful for shopping. I have used a rolator many times to do shopping. However, when one or more of the brakes became misadjusted, it was not unusual to find some or all of my bags on the ground. This was a common occurrence for me at the local CVS. It was not easy for me, or any disabled person, to adjust the brake system, but I often adjusted the brakes.


Inflatable items


Since we are on the subject of similarities to a bicycle, it is timely to note that the wheels of a rolator do not have to be inflated. However, some power wheelchair tires do need to be inflated. My wife and I have a son, and believe me, it is difficult for a disabled person to inflate bicycle tires, footballs and basketballs (all of which I have struggled to do).




Another issue is getting up and down curbs with a rolator. This is where good brakes are essential. You need to grab the hand brakes and balance yourself with the rolator. If everything does not work just right, you are likely to fall. I recognize that you should find the curb cut to enter and exit the street. I realize this is often easier said than done. Just be very careful.


I hope this post has helped people understand the trials and tribulations of dealing with standard walkers and rolators.





Mobility devices – the good, the bad and the ugly



I have been diagnosed with multiple sclerosis since 2003. I have been struggling with this disease ever since Presidents Day 2003. My neurologist told me that I probably had the disease for 20 years prior to 2003 but it was undiagnosed. In 1985 I believe that I had optic neuritis, but most ophthalmologists told me I had a detached retina. The eye problem cleared up, and went on with my life until 2003, when I developed a limp. I continued my career until 2009 when I had to resign my position because walking became very difficult. I have learned a great deal about mobility issues and products and I would like to help others to choose appropriate mobility devices.

Wall walkingWall walking

I began my struggle to walk with wall walking. I would hold onto walls, doors or anything I could find to maintain my balance. I used walkers, rollators and other devices to get around. I would hold onto the sides of cars to get through a parking lot. I would hold onto shopping carts for dear life.


I would like to start with walkers. I tend to prefer walkers with two wheels in front. I have used both walkers with no wheels and walkers with two wheels. I have found that walkers with two wheels are easier to move and give me less fatigue. Walkers with no wheels are sturdy but are more difficult to move from place to place. If you find that you need the stability of the walkers without wheels, feel free to use them. The key is finding something that is comfortable for you.


I have used canes and they can be very useful. They provide the extra balance that I need to get around.


There are many types of wheelchairs, and depending on the circumstances, I have become familiar with all of them. Travel wheelchairs are light and convenient for the caregiver, but are a nightmare for the disabled person. It makes the disabled person totally dependent on the caregiver for mobility. However, it is lightweight and easier to get into a car. Manual wheelchairs give the disabled person more flexibility, and is an excellent source of upper arm exercise for the disabled person, but is a nightmare for the caregiver to get into a car. They often weigh too much and are too bulky for the caregiver to get into a car. Some power wheelchairs are designed for travel, but are often difficult for the caregiver to take apart and even more difficult to figure out how to put it back together. Power wheelchairs that are not designed for travel are often the only power wheelchairs that work in mobility vans, because they cannot come apart in the event of an accident. By the way, it is a good idea to keep the wheelchairs plugged in when not in use. I’ve had many technicians tell me that the power wheelchairs should be unplugged so as not to overcharge the battery. I have found that most power wheelchairs do not overcharge the battery and the battery lasts longer if it is plugged into the charger.

Lift chairsLift chair

The next subject I want to discuss is lift chairs. I have spent considerable time in a lift chair. It is important to get a comfortable lift chair. These chairs are motorized and electronically help lift the disabled person out of the chair. It is important to get a chair that is not too big. It should not be so wide that the disabled person cannot help push him or herself up and out of the chair. It also should not be so narrow that it is uncomfortable. The disabled person needs some room to move. Sitting in the same spot for an extended period can lead to ugly and painful sores. Also, the chair should not be so high off the ground that the disabled person’s feet are off the floor. None of these chairs move very fast and that is probably a good thing because you do not want the disabled person flying off the chair.

Hospital bedsHospital beds

As the disease progresses, I find myself spending more time in bed. There are a variety of hospital beds. You will need to find one that has comfortable and convenient side bars. The side bars are the only practical way for the disabled person to move up or down or side to side in the bed. The mattress and gel overlay also need to be comfortable. The gel tends to accumulate in one or two spots on top of the mattress making positioning and movement uncomfortable.

Patient lift

As time goes on, I rely increasingly on a patient type lift to transfer from place to place Whether it is a bed or chair, a patient lift is becoming more important. There are manual and motorized electronic lifts. The manual ones generally do not require any electric power, but the hydrolic part needs to be replaced periodically.


In conclusion, it is important to get a useful comfortable functional device that works well for the disabled person and caregiver.