Patch

I can't see it I say as Mr H repeats: it's on the left near the bottom

No I still can't see anything I moan - all I can see is black.

Let me look again it's probably moved... no it's still there he says with furrowed brows as he adjusts our birdwatching scope at a Dorset bird reserve in the summer of 2016...you can even see the snipe's stripes . try using your other eye...

Back home I booked an opticians appointment and after testing then retesting my eyes and the promise of a warning letter to my GP, I left the shop with a pounding heart. 

The following couple of weeks I squinted in and out of hospital doors to attend appointment after appointment and was soon lying flat in the noisy hoop of an MRI. With my brain tumour history; blurred vision could not be assumed to be just that; blurred and cloudy vision.

But at the eye hospital, my pupils were dilated with dripping drops and peering inside them the eye hospital consultant said; you've got rapidly progressing posterior capsular cataracts. This type of cataract is usually caused by steroids...I had steroids during my brain tumour and breast cancer treatments I say with a shoulder shrug and wry smile - no one warned me I mutter...

I stumble through the weeks and months with my unfocused camera lens vision. People give me puzzled looks as I develop a habit of flirty winking! It's hard to resist a constant check to see which eye is worse, which one is more out of focus... it's like looking through a peasouper fog! 

I grumble to Mr H that I can't see the pavement cracks and potholes swim in and out of focus, adding layers of risk to my wobbly walking. I grumble that I can't read books anymore as the words hide behind cloud covered pages. I grumble when, in the dark,  I crash into our gates as I walk down the drive and at the dazzling super moon of light around every headlight...

This year large print letters plopped onto my mat and after two further trips through hospital doors, my name is, at last, added to the cataract surgery waiting list. Two weeks and a phone call later, I have a date for the following Wednesday, and it's not with Mr H, wink wink! 

I have to tape an eye patch over my eye at night for two weeks after the surgery I read out loud to Mr H. Will you still love me as I get more and more like long John silver? He laughs; of course it's the person not the patch that I love!

Back home last night in time for fish and chips

You don't realise how important your vision is until it starts to fail

So relish the colours of summer flowers

delight in the blueness of the sky

take pleasure in swishing grass swaying

and be thankful for the gift of sight

Empty Wheelchairs...

I sit back down in the grey airport wheelchair and stuff my feet back into my converse. 

Sorry about that says the young man who is pushing me through into departures but no one escapes the shoe scan.

He helps me out onto a blue seat with a wheelchair picture printed onto the fabric. 

Thank you 

Mr H slips him a tip then wanders away to find the toilets. I pull my belt back through the loops of my jeans, push up my sleeves and wipe my forehead, it feels like its 29 degrees inside as well as out there in the Caribbean sunshine...

A few seconds later...

Bing Bong final call for passengers flying on TOM815 to Birmingham please make your way to Gate 4. 

That's us I call out as I frantically fasten my belt and grab my bag. Mr H returns and we ask where the wheelchairs are to take people with disabilities to the ambulift.

The lady responsible for getting the disabled onto the aeroplane tells us they haven't got any available...

But if you walk over there and out of the door the Ambulift is waiting she points. So a snake of crutches, sticks and mobility scooters weaves its way towards the pointed door. As we go out into the sunshine we spot thirty or more empty wheelchairs silently sitting. Waiting to be used...

One by one, like suntanned canaries in a cage, we are lifted on a yellow metal platform into the tin box ambulift. Mr H says to the Barbadian gents assisting us These people should be on the plane before the other passengers, little chance of that now. Again! 

I am fed up that the disabled are always last on the plane here in Barbados. There is a fifty dollar tip if you can get us all onto the aeroplane before the other passengers. A look of shock passes over the young mens faces, then they giggle as they whisper to each other. The process of loading us speeds up...

We trundle along the road by the side of the aircraft lined up, ready to fly. We watch anxiously as lines of buses fill with passengers about to head to our aircraft which is waiting on the tarmac. 

Get your foot down Mr H shouts as he waves the fifty dollar bill at the driver. 

We are all laughing and giggling as we clutch our sweaty fists. We must be doing the speed of light now Mr H laughs as the ambulift snails it's way towards the first aeroplane. 

We pass it. 

Not ours. 

We stop at the third. Reverse up to the side door. The ambulift mechanisms creak as like birds we are lifted into the air. The giggles of anticipation get louder. The gents knock on the cabin door. 

It is opened immediately. It's a miracle I shout!

Mr H calls to the air hostess is the plane empty, are we the first passengers.

Yes she grins.

We all cheer...

Mr H stands back to let the crutch and stick brigade clamber across the metal bridge to enter the aircraft. Then with a huge grin he hands over the fifty dollars...

That's a first I say to the blue hatted air hostess as she directs me to my seat. We have never made it onto the plane before the able bodied at this airport. Just proves that money talks...

Time to Relax...

My two pink bundles

Chatter, chatter, chatter...

Like a typewriter clacking on sheet after sheet of paper

my mind writes its own script for a play I want no part in

I pick up a pen, press it between my thumb and middle fingers, watch as it slots into place in my hand and black ink flows like blood from my blue and silver pen...

I looked at you when I opened my eyes and gave my first cry. I don't remember seeing you,  but you were there, two pink bundles of skin, bones and the teeniest nails. You helped me to eat, clutch my mommy's fingers, gave me something to chew on when my first teeth broke through. 

Now as I glance down I see years of hard work etched into the creases from hand washing and caring. You helped me through exam after exam scribbling on paper for hour after hour. You are always there for me...

So in 2008 when I wake up after my second brain operation to see my left fingers curled up like a claw. My arm coiled like a spring up to my chest. I lift you with my right hand and gently place you on a pillow on my bed. I ease each finger out and lie them flat. I whisper I will take care of you now. 

Like a baby I teach each finger how to hold a spoon so that I can feed myself cereal while steadying the bowl with my working right hand.  We progress to holding a flannel and reach up with the help of a nurse, to wipe my swollen face. I grin as we lift the items off my bedside table one by one, laugh when the nurse asks why so my left hand can put them all back again I tell her. I work you hard, we work together to get you moving again. Gripping a zimmer frame was our biggest challenge when I was re-learning to walk. But together we did it. Together my hands and I can overcome anything.

So today as words do a merry go round in my mind I once again turn to you, my precious hands. With all your wrinkles, dry skin and nails I am trying not to nibble; you help me to write out my thoughts. And my mind slows as unhelpful words float by on a cloud...

In a hole

Sue and I grin as we arrive at Mesmerize Me in Birmingham

This is it she says, Excited?

I  have been treated to a make over day with my friend, Sue's sister Jacquie bought it for her for Christmas  and told her: go with Dawn you will have a great time

Our pale, make up free faces stand out against the black sofa we are asked to sit on as we sip a cup of coffee.  Phase one Selfie Sue says as we grin into her camera...

We glance at the forms we need to fill in.

Mmmm which feature do you want enhanced in the photos I mutter as I glance at Sue, dimples for me, eyes maybe, for you she suggests

Which feature do you most want to disguise...wrinkles we giggle 

But I bow my head and instead scribble I don't want to look disabled. 

Upstairs our faces are transformed from pasty pale to palettes of colour. Our eyes and cheeks are defined as the beauticians apply more make up than I have ever worn!  We use theatrical make up they tell us, you will need it in the bright studio. They tease our hair into bouffant styles. Very Mary Quant I say to Sue when her rollers come out!

Back on the sofa we take phase two photos...

When it is our turn we wheel our suitcases into the studio. Lets look at your outfits first Laura the bubbly photographer suggests with her camera hanging around her neck...

She asks me what my limitations are...

Try me with everything, I don't want my stick to get a peep at your camera lens I mutter as I abandon it in the corner of the room.

She suggests we sit on the floor and clicks away as we pose, first on our front, after waiting for my left leg and foot to register what I want it to do. We laugh as I try to hang onto the position long enough for a good shot...

You look fantastic she smiles as we kneel...

Do you think you can get into this hole next Laura asks me with a grin.

I'll give anything a go...

I hoist my bum into position. 

Now slide down, let the curve do the work she tells me as Sue watches, her grin getting wider with each shuffle..

Oh my goodness thats amazing they both say as the camera clicks...

Not a disability in sight...

Toy soldiers...

i am frightened of kerbs I tell my friend Helen when we meet for lunch...

Yesterday I walked back from the bus stop in a step, leg-lift, head down kind of way to avoid a trip on the rippled pavements...

I come to a corner without a dropped kerb, (a lowered section to allow mobility scooters, pushchairs and people like me to cross). I stand and stare at it. Whisper to myself you can do this...

I hesitate and gaze at the kerb edge intently. Just step off I say to myself...

I shuffle my feet to the edge. The road seems so far away; like I am about to jump off a cliff and crash into the dark wild sea.

I stand for a few minutes then turn around and walk back the way I came. Take a running jump at it my inner voice tells me...

I walk towards the kerb 'at speed' as I try not to think about the challenge that looms ahead.. 

But at the kerb my heart drops down to my stomach and I come to a lurching stop. I look up and down the road to check that no one is watching this foot shuffling, hesitant kerb stepper.

Then I walk back again...

As I head towards the kerb for the third time I try not to think about it, la la la. Just step down it's easy I tell myself as the kerb silently taunts me...

But once again my feet come to a halt . 

I look right and left. No one watching. 

Then I lower my stick into the road. Lean on it with my frightened right hand and arm. Take a deep breath then launch my left leg into the air. It lands in the road. I pull my right one after it. I am down. Shaking but down. 

One last furtive glance around and with tears in my eyes I walk the short distance home.

On Friday, at my first one to one Pilates session for 18 months, I tell Sue that I am frightened of kerbs. I need help with my balance again I say as fresh tears drip off my nose...

Ok let's start at the beginning she says. Do you remember the toy soldier?...

Obstacles don't have to stop you.

If you run into a wall (or kerb) don't turn around and give up,

Figure out how to climb it, go through it, or work around it.

Michael Jordan

Call the fire brigade

I can’t do it I squeal as I look up into Mr H’s frowning face, my hiccupped laugh threatening to turn into a wail of despair.

I'm stuck. Not going anywhere. Get me a pillow…

There must be a way he says as I sit there shivering…

We’ve tried everything I mutter. I am getting tired. Give me a minute and I’ll try again.

Try turning round Mr H suggests…

I would then I could pull myself up onto my knees but I don’t have the room to turn in here.  I tap the metal white sides which hold me prisoner.

Why did I suggest this I weakly grumble as I grab hold of the taps and try once again to heave my, now almost dry body up…

But I only manage a few inches before my feet once again slide away from me despite Mr H attempting to hold them still with his glue like grip…

I don’t know what else to suggest he says as he paces back and forwards wringing his hands…

Call the fire brigade I say trying hard not to laugh knowing a spurt of mirth will quickly turn into tears. Can you imagine it we giggle; 

dring dring, fire brigade please

I am a naked lady stuck in the bath. I can’t stand to get out. My legs and arms are floppily fatigued...

What about putting your trainers on?

It’s worth a go I say as, like a fire hose, I spray clean water around my naked body. Trying to remove any soapy residue to stop my feet from slithering and slipping like I am trying to stand on an ice skating rink despite the bath mat…

I huff and puff as I dry my feet and ram my blue and white trainers on.

Deep breath, another snigger, then heave ho. My arms shake.My right leg quivers as my left leg goes uselessly rigid. Mr H puts all his weight onto my feet to stop them running anywhere.

I am back on my bath seat. Forty minutes after I emptied the bath water, I am out. Exhausted.

Bad idea I mutter to myself.

Never again.

Walking in the road...

I close the front door, crunch across our stone path then clutch my green handrail as I step down into the grey tarmacked road. Today my mindful walk is to the chemist to collect a prescription. At this time of year my attention is normally drawn to the orange, red and gold leaves still hanging onto almost bare branches. I usually stop in awe as I pass another crop of summer bright orange or Christmas red berries.


But today my head is dipped. I stare at the ground in front of my shuffling feet. Every crack, every hole, every ridge is waiting to trip me up. Make me fall. Or tumble. Each time it happens I leave a bit more of my walking confidence on the ground. Something else to trip over next time I am out!





As I gaze at the ground I see the cake crumbled grey stones which once resembled Tarmac. 








The rail road ridges caused by workmen digging channel tunnels into paths, then roughly filling them in without a thought for the pavement shufflers such as me.








My heart leaps over the hedge when my walking stick shoots away from my feet on the autumn leaf skating rink...






So I step out into the road.

My shuffling strides become lighter. My pounding heart plays a slower tune and at last I can lift my eyes from my feet.

I walk in the smooth gutter to stay near to the kerb in case a car dares to drive too close to this road walker. I would like to say "then I can hop onto the pavement". But getting from road to pavement is a precise four step procedure:

Step 1 hesitate then turn to face the kerb so my back is to the cars queuing to run me over...
Step 2 choose a foot to lift onto the kerb then lift as I lean heavily on my walking stick 
Step 3 (assuming I reached the target with step 2) lift the other foot onto the same patch of pavement
Step 4 step sideways to face the way I want to walk...

My knees are bruised and scabby, like a sock wearing school girl after a few tumbles in the playground I giggle to Julie when I tell her about my recent falls. I shall buy you some Barbie knee pads for Christmas she titters...

Dear Santa 

Last year the council resurfaced many of the roads which I walk on. I expect this is because they don't want cars and their drivers car-tripping into potholes.

This year please can you make the pavements as smooth as the roads. 

Thank you

Love Dawn

Where there's a will there is a way

On the TV programme Gardeners World this week, a lady, with numerous disabilities including blindness shared the joy of touching and smelling a tomato plant in her garden. As she inched her away among the plants stooped low over her stroller she told the viewers...You can tell if a tomato is ripe by touch, if it is hard it's not ripe, slightly soft and it is ready to pick...I am always tasting!



Her delight in the plants shone like the morning sun rising in the sky as she shared her garden with the viewers. It is my only private space she declared, people can only come in if I invite them. I have found that with all my difficulties I need to think tangentially she said 

Tangentially! A new word for me so I looked it up...well to be truthful I leaned across and asked Mr H, my ever present dictionary...be creative, think laterally he says. 

And my mind wanders back to my nurse training... I am working on an elderly care rehabilitation ward where laughter rings out all day as we help the patients get back onto their feet or find new ways to cope after fractured hips. The words of one such lady have stayed with me throughout my life...

Where there's a will there's a way she would say as she struggled to get up from her chair.

So I reflect on my life and my tangential approaches as I meet each day with a smile - well almost every day...! .

I now have rules: 

• Every day is a best dress day - nothing lies unworn
• When I feel well I say it out loud. Today I feel great. Today I am well.
• I am kind to myself when I am energyless. I watch a DVD or read a book instead of beating myself over the head with a stick for being tired!
• I only organise one thing a day. A visit from a friend blocks a day in my diary
• I always use my Energometer to calculate whether I can do something extra or not

         Action + Time + Energy Needed
                  __________________                                      = Do, Delay or Don't Do

      Current Energy Reserves (Zero, Red, Amber, Green)

• I have accepted that writing is my new career, it occupies my grey cells, keeps my fingers tapping and constantly brings new challenges. I no longer wish I was back nursing

• I mediate or do a mindfulness activity most days, even if it is only watching a butterfly or my breath for a few minutes. It matters. It helps keep me calm.

• And when my Gorgeous Sue comes down for the day, we snort and giggle as she tries to get me over a wall when faced with a locked, barbwired gate on a sunny short stroll...

 I may not be able to jump the hurdles in front of me 

but with the help of others I find the path (or wall)  around them...

Over and still in one piece! Just!

Are you with the wheelchair?...

Mr H is my legs as we reach airport security on our way to a wedding...

...with a wave of her arm, a suited lady directs fellow travellers to a queue to be scanned. She glances down at me, stripped of my coat, scarf, bags, belt, all metal objects except the plate in my head, then steals my smile as she asks Mr H

Are you with the wheelchair?

Aha. I had forgotten once I sit in a wheelchair I am a wheelchair!

 ...my journey with airport special assistance has begun... 

The smiling ground crew collect me from the gate and with fellow wheelchair users they escort us to lifts, then across the Tarmac to the aircraft ambulift which awaits us...




Yippee we all shout as the fridge like lift whirs us into the air to rest level with the closed aircraft's side door. Our entry into the warmth. Our man knocks. We wait. Tap tap. We wait, shivering in our coats. Knock knock knock...

Then out of our window we spot the able passengers beginning to snake their way out to the aircraft. We all know that they will now be allowed into the warmth before us even though we were there first.

Fifteen more shivering minutes pass with us suspended mid air in our ice cold, wind chilled, fridge. We watch with opened mouths as the aircraft is hooked onto the tug. I bang on the window and shout

wait for us. 

No one looks up!

Our man hammers loudly on the closed aircraft door. We wait. Knocks louder... then to squeals of teeth chartering relief the door is opened.

Do we get an apology? Not on your life!

When we land we are told to stay seated so the able bodied passengers can get off first. They climb aboard a waiting warm cosy bus to be transported from the aircraft to the airport terminal. 

At last we are ambulifted onto the Tarmac only to become a three carriage train: Mr H is my driver, a mother pushes her young child as he clutches his Spider-Man toy and an elderly man struggles with his wife in her chair. It is a long dark walk as we are escorted along the normally unseen outside trails of Bristol airport on a wind chilled winter evening...

Shivering we pop out by the luggage carousels to collect our lonely suitcases. Everyone else has already left!





But when the Groom jumps in early with his eager I do and love glistens in his brides eyes, the journey I have travelled this year to witness such joy becomes a distant memory...

Memories and Martin Luther King

I came across the transcript of Martin Luther King's speech 'I have a dream ...' when I was sorting through some papers at home... 

 I recall the events which led up to Mr H printing it out for me...

Dawn do you know what day it is
um.. it's..  I think it's still Wednesday

Do you know where you are
Ward one high dependency unit

Can you tell me who the President of the United States is
Aha (my swollen head smiles) trick question, President Bush; Barack Obama is the President Elect 

I hear the nurse smile...

I will answer the same questions and many more thousands of times before my release...

Barack Obama had been elected a couple of weeks before and when I was well enough to go back onto the ward it was the main topic of conversation with my bedside neighbours. The first black American President. Amazing. Momentous  We talked about Martin Luther King's speech and racked our brains to recall anything other than I had a dream... So Mr H was tasked to go home and print us a copy...

The speech lifted my spirits for in a different way I was trapped; by my body, unable to move freely. Unable to go where I desired. Unable to make free choices...

"But let us not wallow in the valley of despair...I have a dream...let freedom ring...free at last!"

As I recall this  I reflect on my own dreams:
I dream...that one day I will climb to the top of Old Man Coniston and feel the freedom of wind in my hair as I look down on the world.  

I have a dream that my legs will cast aside their chains to dance a waltz.

I have a dream that my epilepsy shall sleep, tucked in by effective drugs, so that I can legally travel with 'my Dorothy'.

But these dreams make me feel small and selfish; they are insignificant in comparison to the 1963 demonstration for freedom from segregation, poverty and racial injustice. A speech made when I was one day old!

But I too have big dreams... 

I have a dream... that one day the lives of people living with disabilities (visible and invisible) shall be free from discrimination

I have a dream... that I shall live to witness the cure for brain tumours...



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Monumental Dive

I bend into my start position. Breathe in. Breath out. Dip my head... 

10 But...

9 Instead...

8 I throw...

7 The wet washing...

6 Across the kitchen floor...

5 As I...

4 Launch myself...

3 While doing a backwards body flip...

2 Head first ...

1 Into a cupboard

I may be a clumsy clump with crazy balance; but a bruised knee, broken toe (I am sure), sore head and a shoulder that refuses to work like it ought, do not stop me chuckling.

After all Charlie Chaplin said:

Laughter is the tonic, the relief, the surcease for pain

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Moving out of my comfort zone

I fix my eyes on the ceiling and watch as the pale blue panels sail by. My mind is far below.  

Thats it move both your legs, good; keep moving your left one 

Slowly. Slower. Don't forget to breathe

A wave like grin crosses my face as my left leg, like a flipper takes it lead from my right

Keep smiling

OK. when you are ready, deep breath in...

I inhale as I repeat Bill's mantra in my head; 
Tip your head forward, sweep your arms through the water, knees up, bring your left knee up, concentrate,  push your bum back..keep your arms forward. Slowly I switch from lying on my back to upright. 

The bottom of the pool is now as deep as the sea, I have passed the safety of the green bollard.

 I lean forward, stretch my arms out and like a slow motion movie, switch to breast stroke. I float like a buoy it must be the extra air in my head...

Well done!

I would punch the air with delight but my arms are busy propelling me back towards the shallow end.

OK lets go again, Bill says...

...I walk on air as I hug my sense of control close to my chest and leave my comfort zone flapping in the pool...

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Like a seed acceptance spreads it's roots

Then

Swing my legs into the bath 

Roll over in bed

Pop out

Spring up and down steps

Run

Talk and walk

Drive

Carry a full mug of coffee without spilling a drop

Keep upright when I paddle in the sea

Burn endless energy without a thought



Now

A bath seat over the bath

A three point turn in bed as I pull on my bed lever

I slug out 

I grab rails, look for slopes or don't go up

A ten minute walk is my marathon

Sit to talk

Take a bus, taxi, ask for a lift or delay

Half fill a mug

Flop into the sea and giggle as I get wet

Savour the good days, rest on the others

Like a seed as it grows, acceptance spreads its roots and as the stem thickens and new leaves sprout, Dawn breaks through the canopy of change.

Kindness is Magic

The NHS is broken the media and politicians imply; filled with horrendous care; lacking compassion and basic kindness. More reforms, regulation and inspection will fix it. But is it? And will they?

A bitter sweet comedy drama called 'Derek' (written, directed and starring Ricky Gervais) sent me on a surfboard of emotion. Ricky demonstrates his innate ability to capture reality and illuminate every day occurrences.  

For those of you yet to watch, the series, which was inspired by members of his family’s work in care homes, is set in ‘Broadhill’ retirement home where Derek works as a care assistant. I was reminded that kindness lies at the core of high quality care. Derek is Kindness personified.  

.

My memory rewinds and I see the kindness that cradled me during my three months in hospital…

A hand on my arm when my inability to stand overwhelms me.

A nurse rubs cream into my lifeless legs and feet at night when I forget they are there.

Carers sit beside me to talk rather than standing miles away at the end of my bed.

We share a belly laugh when a nurse and I paddle in a puddle of urine as my urinary catheter comes adrift. 

I am met with open arms when I waddle across the physio gym for the first time.

None of these acts of Kindness were essential but to me they were 

My Everything Moments.

How do we train this Kindness into people? 

Can Kindness be taught? 

How can Kindness be measured in doctors, nurses, physiotherapists, healthcare assistants… as they embark on a career in healthcare?

At the start of my vocation in nursing I was interviewed. The ‘Matron’ running the hospital asked pertinent questions ‘to get the essence of me’, she watched my reactions, skilfully evaluated my responses. She knew I cared and wanted to care.  But even the interview process has flaws which allow some carers whose pool of Kindness is shallow, to slip through the net.

Now in recruitment the seed of psychometric testing is beginning to grow. But how will that test Kindness? We should ask Ricky or Derek….

Derek Channel 4 on demand Derek (please note this includes some Adult Humour).

As Ricky reminded me Kindness is Magic

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Kate and William celebrate their first baby as I celebrate a first too...

I woke today with quivers in my tummy. I pack my rucksack and trundle to the bus stop.

I press the button and the ding tells the driver I want him to stop. I clamber slowly off and stick, hitch foot, stick, hitch foot my way to the crossing.

I grab the hand rail to enter my destination. The swimming pool. 

The flutters are now crashing waves.

I pay my fee and go into the changing rooms. Costume on I walk alone for the first time to the pool.

Hand my ticket to the lifeguard and ask him where Bill is. He points to the third lane. 

I drag my feet towards the lane.

He stops and looks up from the water in the big pool.

Are you Bill?  I'm Dawn... here for my first swimming lesson.

He smiles.

Keeping my foot on the pedal

Yesterday I used a toilet for the disabled and as I washed then dried my hands using the hand dryer I remembered the distress involved in doing the same in hospital....

...I balance the weight of my body on the sink edge while I stretch across to grab paper towels. With dry hands I look around me and spy the bin. It has a pedal. To lift the lid I need to raise my foot off the ground. 

1. I can't lift either foot high enough to squash a fly as I walk.
2. Neither of my feet have the power to squash the fly let alone press a foot pedal.
3. I consider lifting the lid with my hands but years of working in infection control set my hand contamination alarm bells ringing.
4. The lids here are hands free so lifting the lid is impossible.

I look around while still hanging on to the sink edge like an abseiler about to launch off the edge of a cliff. Horror claws as I realise I will have to leave the paper towels on the side of the sink. 

I would like to say I scurry off; but crutch, foot, crutch, foot, crutch, foot is all I can manage.

Back by the side of my bed it dawns on me that the policy to implement foot operated bins is all encompassing. The possibility that people cannot press the pedal is not in the plans on the assumption that the bins will only be used by mobile staff. 

Nowadays when I visit the hospital I know why the disabled toilet with a foot operated bin has paper towels all over the floor. I chat about this with a friend who uses a wheelchair full time. He too has encountered the same problem in hospitals and resorts to trying to press the pedal with his grabber, often to no avail...

Patient involvement in healthcare services development is vital but I now know that involvement of wheelchair/mobility aid users needs to reach the core of every decision.