Brad Johnston
When Brad Johnston, who lost mobility below the shoulder following a diving accident, challenged his care team to create a hands-free drinking system that would enable independence, they combined their collective disciplines to develop a solution. (Photo: UHN)

A low-tech solution to a high-priority need has helped one spinal cord injury patient regain some independence.

When UHN's Toronto Rehab, Lyndhurst Centre closed its doors to visitors in March in a difficult but necessary step to help protect patients and staff from the risk of COVID-19, the move underscored the essential role families play within a care team.

"At first, it was devastating," says Brad Johnston, 31, who became quadriplegic and lost mobility below his shoulder following a diving accident.

"My parents had been with me every day since the accident, and I relied on them to help me eat, drink, and move around the hospital."

When one of the most pressing questions became how he'd stay hydrated on his own, Brad, a tech-savvy business analyst, challenged the team to find an innovative solution.

"I knew I couldn't call my nurse every time I wanted a sip of water," Brad says. "I needed to be able to drink, and to do it on my own."

Bring together one piece of flexible tubing, a handful of Velcro cable ties and a 3D printer, and a hands-free drinking system was born.

Combining disciplines to problem-solve a solution

Patients with spinal cord injuries are prone to extremely dry mouths, as a side effect of their medications.

"I always recommend steady or more hydration, to help balance the onset of xerostomia, which is dry mouth," says Nelly Ventre, a speech-language pathologist at Lyndhurst Centre.

"Sipping water also helps protect the vocal cords of patients like Brad, who use voice-activated technology to operate various devices."

But when the team told Brad how much a hands-free, wheelchair-mounted cup holder would cost, he laughed at the US$200 price tag, and challenged them to find a less-expensive option.

Conscious of the fact that he had more pressing expenses ahead, such as the cost of a wheelchair, the team combined their collective disciplines to develop a solution that would remove financial and physical barriers to Brad's safe, independent fluid intake.

It was an easy challenge to get behind, they say.

"When you work with Brad, you're never stagnant," Nelly explains. "He's always turning the water, moving forward, and contributing to a dynamic circle of care."

Occupational therapist (OT) Anita Salehoun found a blueprint for a cup holder online, and brought it to life with a 3D printer that had been donated to Lyndhurst to print and design assistive devices. Rehab engineer Carol Scovil mounted it onto the wheelchair.

For a straw, Nelly re-imagined how a "Foley tube," which is flexible tubing typically inserted into the bladder of a patient to drain urine, could be used. OTs Chandy Green and Kaare Naelapea helped collect the remaining parts, including two long-handled bottle brushes, and soft, Velcro cable ties, to hold it all together.

'Any little bit of independence I have is huge'

According to Brad, the drinking system is simple, but impressive. Once someone fills the water bottle, he can sip on his own, as he goes about his day.

"I wouldn't have thought to use a Foley tube. And, we've even turned it into a joke: in one Foley, out the next, like a Foley circle," Brad says with a laugh.

The restrictions posed by COVID-19 have highlighted the key role visitors play within the care team.

"Family and friends typically assist with personal care needs, and participation in activities of daily living," says Anita.

"They should be recognized for being everyday healthcare heroes."

Still, Brad says he's benefitted from working around the challenges the policy has posed.

"I know that with my level of injury, I'm going to be reliant on other people," he says.

"So any little bit of independence I have is huge. I can't overstate that."

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