You and your wife will be in my prayers. As far as start off, or take off from a start, gas and cluch coordinating can be used with any gearing to produce smooth starts.

 

I have also used the 49T sprocket from EVO, it works very well, it improves the way the bike responds in every gear and your 255's will love it.
I have to advise against the 30T, I also had one one those and it is noisy and jerky at lower speeds which isn't going to help your wife one bit.