Ventilator-Assisted Living©

Spring 1999, Vol. 13, No. 1


Computers – A Curse, A Blessing, A Necessity

Steve McPherson and Lew Boles

Steve McPherson: "I first chose a unique type of technology when I was faced with longterm ventilation. Sixteen years ago, as an individual with a high-level spinal cord injury (SCI), I faced the prospect of being tied to a typically cumbersome ventilator. It was not nearly as appealing as phrenic pacers, small electronic devices which are about the size of a Walkman. I chose the Avery Phrenic Pacer from Dobelle Laboratories, the only type of phrenic pacing system available at that time. My two pacers have kept me relatively free from infection; I have had only one small cold in the past four years. The phrenic pacers have even given me the freedom to close my tracheostomy. I use assisted coughing plus frog breathing, and the pacers give me as strong a cough as any adult male, at 8 L per second."

Lew Boles: "I became disabled in 1967 after a football accident caused a spinal cord injury (C4-5). After rehabilitation at Toronto's Lyndhurst Hospital, I moved to Queen Elizabeth Hospital. I transferred to Kingston General Hospital when they developed the technology I needed to learn to access computers. I obtained a B.S. degree in computer science at the University of Toronto and became employed as a junior programmer. Now I work in research and development of Internet computer systems. I have become involved in promoting shared accommodation facilities as an independent living alternative to institutionalization."

State-of-the-art adaptive technologies with computer chips have greatly enhanced the lives of people with disabilities. If you have a disability and want to live in the community, attend school, work, travel, or volunteer, computer-based technology provides access to and control over much of our functional environment, from augmentative and alternative communication devices to power wheelchairs. Computers give people with disabilities the freedom and flexibility to work in an office or from home. They allow us to compete on a level playing field with our nondisabled peers, as computer programmers, journalists, architects, graphic designers, engineers, lawyers, and social workers, etc. We are only limited by our dreams.

Both of us have been using home computers for over 10 years. There are two types of platforms available – Macintosh and Windows. Today, both operating systems are very similar. They are easily used with a mouse to point and click on icons on the screen and by typing on a keyboard. Certain adaptive devices, like speech or voice recognition, make using the computer even easier.

A voice recognition program for the Macintosh is called Power-Secretary. PowerSecretary (recently discontinued by Dragon Systems) does not have continuous speech, so it takes more time to train your voice to pause between words. Dictating this way may also strain your voice. Users are advised to take regular breaks and sips of water.

A new voice recognition program, MacSpeech, for Mac O/S 8.5 is being developed by the company that started PowerSecretary. It is unclear at this time whether Apple will develop a new voice recognition program as well. I (Lew Boles) usually have two speech recognition applications loaded into memory at the same time: Dragon Dictate for discreet utterance navigation and Dragon Naturally Speaking for continuous speech dictation. Keep in mind that the Celeron chip for PCs does not support voice recognition very well.

For people who are more severely disabled, there are head-pointing and eyebrow switch devices that take the place of a mouse. These devices allow users to move the mouse by merely moving the head or lifting an eyebrow. All can be made wireless, usually drawing power from a power wheelchair to provide the user with the freedom of a wireless connection. There are also on-screen keyboards (Screendoors for the Mac and WIVIK for Windows). Some people who are able to move only one arm or foot can use a track ball.

If you are considering a new computer, the minimum configuration should be a Pentium II or Power Macintosh G3, running at 333 MHz. It should also include an 8 GIGB hard drive, 64 MB SDRAM memory, 56K fax/modem, and a 32X CD-ROM drive with a 17" color monitor.

For die-hard Macintosh users interested in learning Windows applications, a G3 233 MHz system, with a 4 GIGB hard drive and 64 MB RAM memory will run Virtual PC with Windows '95 or '98 at Pentium MMX speeds.

You should consider backing up your data using an internal or external Zip or Ditto Drive. For PCs, you will need a 16-bit Sound Blaster sound card or 16-bit multi-purpose sound card. Then you will need a high quality inkjet printer. A good rule to follow is, "Buy as much you can afford."

The faster fax/modems use Integrated Services Digital Network (ISDN) – the name for digital telephone service that works over the existing phone line or you can use the same cable your television uses and satellite, but this is considerably more expensive. You will need to check with the service providers in your area.

There are two main reasons to acquire a great deal of power as well as a large amount of memory and storage space: 1) the applications today are fairly large, and more memory and storage allows you to have several windows open at the same time; and 2) speech recognition programs run with a higher percentage of accuracy.

In our personal lives, the computer can serve as a special tool to help keep us organized and to maintain personal communication links. The Internet, and in particular, the World Wide Web have become invaluable resources for gathering information and making decisions. One can plan activities by checking the online Eye magazine movie and theatre guide or browsing the CitySearch events Web site. The Web can be used for making travel plans and bookings on trains and planes. One can manage one's finances via online banking or read an electronic newspaper, magazine, or even a book while waiting for file transfers. With push technology like Pointcast News, activities such as reading headline news, checking the weather forecast, following your favorite sports teams, or trying to complete crossword puzzles are just a click away. There are also specialized applications that provide digital stereo quality sound for music CDs.

Beyond the Internet software, the personal organizers and information managers can help you stay on top of appointments and remind you about special occasions with interesting pop-ups. They keep you in contact with friends and family using an electronic rolodex of telephone numbers and addresses.

Computers have become vital and indispensable resources and tools. Over the many years we have used computers in their many guises and diversified roles, they remain necessary evils and invaluable friends.

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