Californians Barbara Ball and her husband have travelled extensively: Greece, France, Italy, the Bahamas and all over the United States, to name a few.
She feels fortunate to have visited so many places before a blood clot in her right leg led to its amputation five years ago.
Ball now has a prosthetic but spent a few months in a wheelchair during rehab. So it struck a chord when she heard about her friend's brother, a double amputee in a wheelchair living in South Carolina, who can't take a domestic flight top visit because he can't access the onboard bathrooms.
She wondered if disabled-accessibility rules weren't the same in the air as they are on the ground.
It's a good question.
Disabled accessibility on airplanes in the United States is not covered by the Disabilities Act, and there the Air Carrier Access Act, written 30 years ago, has limitations.
Washington resident Malcolm Cumming cares for his wife, Deborah Livesey, who has multiple sclerosis and has been in a wheelchair for two decades.
It was just two years ago that he accidentally broke his wife's arm trying to get her into a lavatory that was not disabled accessible during a flight to San Antonio.
Accessible lavatories are required only on aircraft with more than one aisle, but not on smaller aircraft used for domestic flights.
America's Department of Transportation reasoned that the larger aircraft are used for longer flights and transport the greatest number of people, so it is more likely a disabled passenger will need an accessible lavatory, said department spokeswoman Caitlin Harvey.
But Cumming said most domestic flights, even across the country, are in single-aisle aircraft and can last the better part of a day, depending on the number of stops. Furthermore, wheelchair users are the first ones on and the last ones off, adding about another hour to the onboard time.
It's unrealistic and unfair to expect a disabled passenger to refrain from using the rest room for that long, Cumming said.
Wheelchair user Barry Smith has been on flights lasting more than eight hours to Washington, DC, and 13 hours to Alaska; nearly all of them were on single-aisle aircraft.
Smith suffered a spinal cord injury from a diving accident as a teenager. He uses a catheter but said he could not access the lavatories if he needed to.
Smith is the executive director of the Disability Resource Agency for Independent Living in Modesto. He's helped clients prepare for air travel by sharing some of his experiences.
An onboard or aisle wheelchair is needed to board the plane because standard wheelchairs are too big to fit through the doors, down the aisle or in the bathrooms.
Smith describes such a chair as essentially a refrigerator dolly with a seat. The wheels are on the bottom so it cannot be operated by the person with the disability. Instead, the chair is pushed or pulled backward down the aisle by an airline employee after the passenger is strapped in like "a NASCAR driver," Smith said.
He said employees need to be better trained to operate the chair and help the person with the disability get into a seat. Smith's feet have dragged on the ground, he's bumped into things and he's been dropped on the chair's armrest.
He said he's never tried getting into a lavatory with the onboard wheelchair but can't imagine being able to fit in most circumstances.
Cumming said Livesey is not medically required to use a catheter and shouldn't be required to do so just to get on an airplane.
"Someone should not be forced to get a catheter to go on holiday," Cumming said. "The Air Carrier Access Act was not based on the idea that people would use catheters or dehydrate themselves or wear diapers (to get through the flight)," Cumming said. "That is not treating people equally."
Unlike disabled-accessible bathrooms in buildings, which must have a diameter of at least 60 inches, airplane lavatories do not have to meet specific dimension requirements.
Rather, the "lavatory shall permit a qualified individual with a disability to enter, manoeuvre within as necessary to use all lavatory facilities and leave, by means of the aircraft's on-board wheelchair," according to the act. They must also be equipped with grab bars and a call button.
"The language at the very beginning falls apart because the wheelchair cannot be operated by the person with the disability, only pushed by someone else," Cumming said.
Airline staff members are responsible for transporting a disabled passenger to and from the lavatory, but the passenger is on his or her own once inside.
Department of Transportation regulations do not require the accessible lavatory to be large enough to accommodate an attendant to help the person with the disability, Harvey said.
"If we could get into it, (Livesey) would be just facing a toilet she could not get to," Cumming said. "I would have to reach over the chair holding her out with my arms like a forklift. The bathrooms needs the space for an attendant."
More frustrating, Cumming said, airlines slap wheelchair-accessible signs on lavatories because they have grab bars in them, which actually serve only to narrow the space for the people who need help into a bathroom.
The lavatory on the flight to San Antonio had the symbol on the door, so he thought it would be safe to help Livesey in by holding her under her arms and pulling her in backward.
"With my arms wrapped under hers as I eased her in, the narrow entrance crimped her elbows inward until her arm bone cracked just below her shoulder," Cumming wrote in an article for the online news site Airlines Reporter.
The experience hasn't deterred the couple from travelling, but the lavatory layout is always a concern.
"If you are flying domestically, you are going to be in the world of single-aisle airplanes, and there is nothing to accommodate the fully disabled or nonambulatory person," Cumming said.
The Department of Transportation has recently announced its intention to establish a committee to negotiate proposed amendments to disability regulations, Harvey said. The committee will consider three issues, including whether to require an accessible lavatory on single-aisle aircraft over a certain size.
"The department has done so in recognition of the fact that a higher percentage of long-distance flights are now being conducted by single-aisle aircraft," Harvey said.
But what about New Zealand?
On its website Air New Zealand has a section dedicated to passengers who need "special assistance".
"We understand that the carriage of people with disabilities can present unique challenges for both passengers and staff.
"As a result we will make every effort to provide a consistently safe and dignified travel experience."
It goes on to state that staff are trained to assist those with disabilities, and airport and aircraft have "environments that facilitate appropriate levels of access", though it does not mention whether aircraft have disabled toilets.
The airline's Boeing 777, 767 and International Airbus A320 aircraft have onboard wheelchairs, so passenger can be taken to their seats or the toilet. But the chairs are available only for international flights, not domestic flights due to "limitations of space".
LIkewise, Jetstar says it provides assistance to passengers needing wheelchairs. However, on its website it states that those passengers must be able about to travel independently.
Advice for flying as a disabled person, from people with experience:
Call ahead to ask whether the airplane will have accessible lavatories. Cumming said airline employees can tell you "yes" or "no," but can't describe the type of barthroom or tell you how much room it will have.
Book flights on double-aisle planes, if possible, or prepare for longer flights by getting one with several stop-overs. It will make your travel longer but provide more opportunity to get off the plane and use bathrooms at the airport.
Remember that airline staff members will transport you via the aisle chair to the lavatory but will not assist within the lavatory. "Since you must be able to stand and walk, (but if taking) a few steps is difficult, you're better off choosing a seat near a lavatory rather than going through the humiliating hassle of being strapped into an aisle chair," Cumming said.
Always get the travel insurance. Cumming recommends this not just for disabled passengers but for everyone. He and his wife had travel insurance when she broke her arm on the way to San Antonio. It paid for a nurse to accompany them back Washington on the plane to assist with her medical needs.
Take all valuables off your wheelchair. Wheelchairs are stowed in the cargo area and can slide around and break. It's happened twice to Smith, who said he always takes off the electric hand controls (the most expensive part) and removes his seat pad to use on the plane to avoid getting pressure sores.
