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Medical Forum / Diseases and Disorders / Arthritis / September 2005

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Motorised wheelchairs: any advice? Vehicle choice for transporting?

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spodosaurus - 07 Sep 2005 20:31 GMT
Hi all,

Well, it looks like I'm going to be in an electric wheelchair for the
foreseeable future. Both my feet have multiple fractures as well as my
spine (including a collapsed vertebra). This is beyond the
osteonecrosis. We've stopped looking for new fractures because getting
up off the MRI table after the scan of one of my feet resulted in a
further spinal fracture (we will probably have to scan one of my hands,
though). The treatment of choice isn't available due to it's
nephrotoxicity (and my kidneys are already suffering long term stress
from treatment for tha aplastic anaemia) as well as concerns about
furthering the osteonecrosis (though this can be minimised by a slower
infusion, further kidney damage could drastically reduce my transplant
survivability).

Now I have to decide which type of electric wheelchair I'll be going in.
I'll definitely need it outside the house (I can't even operate a
regular wheelchair anymore) but in the weeks since we found all these
fractures it seems I've gotten about 4 more due to shuffling around the
house on crutches, so it looks like I'll need to use it at home as well.
I can't even get into the different university buildings on my crutches
anymore (not that these buildings are disabled friendly in the first
place).

I'm looking at the different shoprider models. The first few are small
and have limited charge (~1 of constant use) and I'm not too keen on
these and having to try and charge them everywhere I go. They also have
low seat backs, and this irritates my spainal damge. However, they are
small and get into tighter spaces and turns better.

The next model I'm looking at is a mid-wheel drive one that weighs about
190 pounds. It's a big chair, but not a full size electric wheelchair.
It has a great turn radius: it turns around its axis! The charge also
lasts for several hours. However, if I ever need to go across grass,
such as when they're doing work on campus and they've dug up the
footpath for an area and students have to walk around it, I'd be worried
that the chair might get stuck. We're enquiring further about this.

The final model is wider than this one and about the same weight. It's
got inflatable wheels so it does have limited off-path capability.
However, it's not truly a mid-wheel drive model, and that combined with
it being wider has me a bit concerned as our home isn't very large, and
neither are a lot of campus areas.

If we don't get the grant money we're applying for I'll have to default
to a small portable scooter. These are not ideal: they're harder to
control as precisely as I want, harder to fit into tight spaces and turn
around, the backs are small and irritate my spinal damage, and with
probably fractures in my hands, including one thumb, I'm worried about
continuously having to press the accelerator with that cracked thumb.
However, these small little scooters have good range and are THOUSANDS
of dollars less expensive than the chairs. I simply feel like more of a
person in the chair (I can turn easilly to face people I'm talking to or
to see things), it's much easier to use, and most of them support my
spine much better.

Does anyone have any words of advice regarding small to mid size
electric wheelchairs?

What about self-deployment of these? We cannot afford a van or a full
size four wheel drive. We're looking now at a used Honda CRV as this has
a 90cm height for the rear door entry. Other SUVs aren't any better in
trunk (or boot as we say here in Australia) height than a station wagon.
90cm is the minimum height we'd need for the wheelchair and deployment
arm. A ramp is not something that I can safely use nor is it practical
for parallel parking when I attend important doctors appointments. I
need to be able to deploy the chair (or scooter) on my own. Station
wagons might suit for a scooter, but only if I use the deployment arm to
remove the seat and store that in the vehicle first followed by using
the deployment arm to lift up the scooter and put that into the vehicle.
This is quite time consuming, but there's a $10,000AUD difference in
price between the various wagons and the Honda CRV!

Thanks for any advice you can give.

Cheers,

Ari

Signature

spammage trappage: remove the underscores to reply

I'm going to die rather sooner than I'd like. I tried to protect my
neighbours from crime, and became the victim of it. Complications in
hospital following this resulted in a serious illness. I now need a bone
marrow transplant. Many people around the world are waiting for a marrow
transplant, too. Please volunteer to be a marrow donor:
http://www.abmdr.org.au/
http://www.marrow.org/

Gwen Love - 07 Sep 2005 23:58 GMT
Ari, you really do have it hard, don't you. Wish I could give you some
information or help of some kind, but the only thing I can offer is prayer.
Gwen

> Hi all,
>
[quoted text clipped - 74 lines]
>
> Ari
MikesBrain - 08 Sep 2005 00:40 GMT
2005-09-07, Responding to spodosaurus...
> Hi all,
>
[quoted text clipped - 19 lines]
> anymore (not that these buildings are disabled friendly in the first
> place).

You've almost written your own prescription already here.

You'll need a powerchair.

You'll need one with a full back and headrest.

You'll need one with a tilting seat base, not just a
reclining back as many "therapists" seem to think will "do
the job", as you will need to alter your pressure points on
a regular basis. Lifting footrests with calf support may be
an idea to consider too. (Oh the luxury! ;)

You're also going to need suspension as the jolts from
unsprung wheels will doubtless bring further
"complications".

Effective cushioning is a must by the look of things. This
will not be cheap, but with a little ingenuity you may be
able to put your own together if you can find a supplier of
the gel inserts that help "spread the load" and provide
support where it is required. Either that or get persistant
with your grants services and make sure they realise that
your documentation on how they are refusing your medical
needs is turning into a news item. >8)

> I'm looking at the different shoprider models. The first few are small
> and have limited charge (~1 of constant use) and I'm not too keen on
> these and having to try and charge them everywhere I go. They also have
> low seat backs, and this irritates my spainal damge. However, they are
> small and get into tighter spaces and turns better.

What you say here indicates to me that you should not even
consider this option. Many do in an attempt to reduce cost,
but this is skimping on your health. Don't do it.

No. Seriously. Don't do it.

> The next model I'm looking at is a mid-wheel drive one that weighs about
> 190 pounds. It's a big chair, but not a full size electric wheelchair.
[quoted text clipped - 3 lines]
> footpath for an area and students have to walk around it, I'd be worried
> that the chair might get stuck. We're enquiring further about this.

Mid-wheel chairs are a nightmare unless your environment is
flat and provided with plenty of ramps. Forget the spin,
they don't do what they claim, and the weight distribution
is impractical for anything but the most forgiving of
terrain.

[...]
> If we don't get the grant money we're applying for I'll have to default
> to a small portable scooter. These are not ideal: they're harder to
[quoted text clipped - 7 lines]
> to see things), it's much easier to use, and most of them support my
> spine much better.

If you can't afford a decent powerchair, look out for a
second-hand foldup type to start with. You can do a lot with
offcuts of different foams too, and if it comes to it, some
old broom handle, and old small cushion, and gaffertape
should get you a temp extention to your backrest. Crappy
looking, but the top priority here is your health.
Everything else takes second place.

[...]
> What about self-deployment of these? We cannot afford a van or a full
> size four wheel drive. We're looking now at a used Honda CRV as this has
[quoted text clipped - 9 lines]
> This is quite time consuming, but there's a $10,000AUD difference in
> price between the various wagons and the Honda CRV!

To self-deploy, you WILL need a two-motor winch fitting to
the vehicle. This should not only lift, but have a motor
that pulls/swings it back into the vehicle so you don't get
injured trying to push and pull at it. Consider this a
minimum spec!

Even if you end up with a lightweight foldup powerchair,
don't try being clever and stripping it to load/unload. I
did this for some time with Elaine's go-cart and I think
those days have contributed to my lower back problem. Power
is the answer!

Regarding chair sizes, the "standard parking space" of a
powerchair is about 2 foot by 3 foot. This may seem a chunk
to load into the back of a car, even with a winch, but when
you strip off a few of the lighter bits like the footrests,
things can get easier.

I'd strongly recommend you look toward a properly fitted
powerchair rather than a scooter. Scooters are a cheap
alternative, but do not have the flexibility of a
powerchair, and as you've already figured out, could injure
you further.

Stick to your guns, write up your list of requirements and
do a full risk assessment for each option you'll be
considering. Once you know well enough why you need what
you've decided you need, don't settle for refusal by
whatever services you deal with. Expect to be messed about
and treated as if its your brain thats faulty. Expect to go
home angry often before you get what you need. Play the long
game to win. As the documentation builds, so does the case
for injury by neglect. Yes, you now have to think this way,
or you will be simply passed off with a disfunctional
"solution" that only serves somebody else's paperwork.

There are a few bits here that may be of interest or use.

www.webtribe.net/~mikeswebstuff/articles.html

All the best.

Signature

----
* Another squeaking wheel @ http://tinyurl.com/6bf56
* Mike's (curious) Brain  @ http://tinyurl.com/4872c
- Have a nice day, it really does do you good! :)

Skip - 09 Sep 2005 04:19 GMT
Hey, I'll sign you up for MTV's "Pimp My Ride" show and you could end up
with the most smashing, colourful, sound system blaring bad-boy chair
around. ;-)

Skip

> Hi all,
>
[quoted text clipped - 71 lines]
>
> Ari
spodosaurus - 09 Sep 2005 05:17 GMT
> Hey, I'll sign you up for MTV's "Pimp My Ride" show and you could end up
> with the most smashing, colourful, sound system blaring bad-boy chair
> around. ;-)
>
> Skip

heh, I can see that going over real well in the university library! :-)

>>Hi all,
>>
[quoted text clipped - 71 lines]
>>
>>Ari

Signature

spammage trappage: remove the underscores to reply

I'm going to die rather sooner than I'd like. I tried to protect my
neighbours from crime, and became the victim of it. Complications in
hospital following this resulted in a serious illness. I now need a bone
marrow transplant. Many people around the world are waiting for a marrow
transplant, too. Please volunteer to be a marrow donor:
http://www.abmdr.org.au/
http://www.marrow.org/

RoseB - 09 Sep 2005 05:29 GMT
What do you do at the uni Ari? We don't know all that much about your
personal life. (If you want to share of course.)

    Rose   @}>->--
    Being educated means that rather than fearing the unknown, one seeks to understand it. RB

    Please remove "Ima" to reply.
spodosaurus - 11 Sep 2005 10:43 GMT
> What do you do at the uni Ari?
> We don't know all that much about your
[quoted text clipped - 4 lines]
>
>      Please remove "Ima" to reply.

I had started a computer support/tutoring/web design business (still
have clients who I've known for about 7 years now! good service and
support means happy long term customers) but I really can't do very much
anymore, especially now that I have all these fractured bones and the
risk of infection. Once I'm well again I intend to fire the business up
(I'm having to turn away so many referrals because I simply can't work
right now) and PAY TAXES AGAIN (yeah!!! - hey, it's something I look
forward to) and use it while I complete my PhD.

Since I was attacked in 1998 I've been slowly struggling through my BSC
in Psychology (had to start over) and next month I'll finish my honours
thesis in neuropsychology. We do a three year intensive degree here in
Australia rather than a four year broad based degree. There are
differences in law and medicine as well: no undergraduate degrees you go
straight into law or medicine and that's what you do until you become a
doctor or a lawyer. It's all very intensive and focused. I like this way
better, but I understand the arguements in favour of the broader
exposure degrees used in the USA university system.

After the three year undergraduate degree, if you've achieved high
grades (and in Australia grading is very harsh and we use a different
grading system than what I was used to when I started my science degree
in the States), you can apply for entry into an honours program. This is
like a one year Masters by coursework AND research all squished into one
year. It's rough. I've been scraping my way along for the last three
years to finish this one year in between surgeries and hospitalisations
and opportunistic infections etc etc etc. I've done more than half of my
papers from hospital beds, the majority in the isolation rooms.

Now I have a very difficult decision to make. I must choose, fairly
soon, whether to continue my work in neuropsychology or return and do
another BSc in human biology and genetics following on with a PhD in
that field and going into medical research (I had to make a choice
shortly after I was attacked about whether to do Psychology or Human
Biology, and at the time psych was more salient to me...I'm good at
both). I'm particularly interested in refining and creatign a more
sensitive and universal method of quick post-brain injury assessment
(post stroke, traumatic injury, infection, etc). I also desperately want
to go into medical research as those doing good research need all the
help they can get in that area (I've read a lot of medical research
papers and I wonder if some of these folks had ever been educated in
research design!).

All this depends on whether or not I survove the transplant, which is
coming very soon now, and the odds are not in my favour. But I'm
stubborn and have thus far refused to die, so we're hoping that'll help
me make it to the finish line.

Cheers,

Ari

Signature

spammage trappage: remove the underscores to reply

I'm going to die rather sooner than I'd like. I tried to protect my
neighbours from crime, and became the victim of it. Complications in
hospital following this resulted in a serious illness. I now need a bone
marrow transplant. Many people around the world are waiting for a marrow
transplant, too. Please volunteer to be a marrow donor:
http://www.abmdr.org.au/
http://www.marrow.org/

Harvey R. Stone - 11 Sep 2005 15:49 GMT
> I had started a computer support/tutoring/web design business (still have
> clients who I've known for about 7 years now! good service and support
[quoted text clipped - 46 lines]
>
> Ari

Hi Ari,    Be proud of what you have done in the past.  Look at the future
and all it holds with great interest and the joy of doing what you want to
do,,,, well.   I know that some of what you face scares the hell out of you.
A person just has to have faith that their doctors and the procedures will
do what is expected for us.
   When the good Lord says it is our time,,, it is our time.   Just know
that you have done well,,, planned well even though some of those plans may
not get finished.   Prayers have been said for the person we know in this
newsgroup as Ari and will be said again.  Please do not let your fears stand
in the way of planning for tomorrow.  I want you to know that there are many
people over all of this world that are pulling for you,,,, wanting you to do
well.   Please continue to let us know as things happen.
Harv
MikesBrain - 11 Sep 2005 16:49 GMT
2005-09-11, Responding to Harvey R. Stone...

[...]
>> Now I have a very difficult decision to make. I must choose, fairly soon,
>> whether to continue my work in neuropsychology or return and do another
[quoted text clipped - 31 lines]
> well.   Please continue to let us know as things happen.
> Harv

Er' sorta whut Harv said... ;)

Signature

----
* Another squeaking wheel @ http://tinyurl.com/6bf56
* Mike's (curious) Brain  @ http://tinyurl.com/4872c
- Have a nice day, it really does do you good! :)

Navy1 - 12 Sep 2005 22:08 GMT
Hooray for you, Ari, you are an inspiration to us all.

Loujean

>2005-09-11, Responding to Harvey R. Stone...
>
[quoted text clipped - 36 lines]
>
>Er' sorta whut Harv said... ;)
Duckie - 12 Sep 2005 22:32 GMT
You take my breathe away Ari. I can't imagine doing all
you have done even with no disease or medical issue
facing me and you have both.
Do you have a date for the transplant yet?
Duckie

......

> All this depends on whether or not I survove the transplant, which is
> coming very soon now, and the odds are not in my favour. But I'm
[quoted text clipped - 4 lines]
>
> Ari

Signature

  _('>
 (_<_)

    _
  _('< -quack
 (_<_)

    _
 __('< *QUACK!*
<_{__)

  _('< "|,,|_"
 (_<_)

  _('< "AFLAC!"
 (_<_)

RoseB - 13 Sep 2005 02:01 GMT
You are amazing. As one who has been working on a post graduate degree
and having miniscule health problems in comparison to yours, I can
relate to the struggle you go through.
Good on you, mate! (Or something like that...lol, if I remember my
Australian). {only kidding}

    Rose   @}>->--
    Being educated means that rather than fearing the unknown, one seeks to understand it. RB

    Please remove "Ima" to reply.
Duckie - 10 Sep 2005 04:48 GMT
He is our go to guy for wheelchair info.
Duckie

> Hi all,
>
[quoted text clipped - 74 lines]
>
> Ari

Signature

  _('>
 (_<_)

    _
  _('< -quack
 (_<_)

    _
 __('< *QUACK!*
<_{__)

  _('< "|,,|_"
 (_<_)

  _('< "AFLAC!"
 (_<_)

spodosaurus - 10 Sep 2005 09:37 GMT
> He is our go to guy for wheelchair info.
> Duckie

Who is?

>> Hi all,
>>
[quoted text clipped - 76 lines]
>>
>> Ari

Signature

spammage trappage: remove the underscores to reply

I'm going to die rather sooner than I'd like. I tried to protect my
neighbours from crime, and became the victim of it. Complications in
hospital following this resulted in a serious illness. I now need a bone
marrow transplant. Many people around the world are waiting for a marrow
transplant, too. Please volunteer to be a marrow donor:
http://www.abmdr.org.au/
http://www.marrow.org/

spodosaurus - 10 Sep 2005 10:00 GMT
>> He is our go to guy for wheelchair info.
>> Duckie
>
> Who is?

Nevermind, just noticed the altered subject line :-)

>>> Hi all,
>>>
[quoted text clipped - 76 lines]
>>>
>>> Ari

Signature

spammage trappage: remove the underscores to reply

I'm going to die rather sooner than I'd like. I tried to protect my
neighbours from crime, and became the victim of it. Complications in
hospital following this resulted in a serious illness. I now need a bone
marrow transplant. Many people around the world are waiting for a marrow
transplant, too. Please volunteer to be a marrow donor:
http://www.abmdr.org.au/
http://www.marrow.org/

Duckie - 10 Sep 2005 23:42 GMT
Paul H.  He lives in the DC area and repairs donated
wheelchairs and scooters to pass along. He knows lots.
Surprised he hasn't checked in. Anyone know Paul's
email address?
Duckie

>> He is our go to guy for wheelchair info.
>> Duckie
>
> Who is?
Paul T. Holland - 11 Sep 2005 22:23 GMT
hey ari!!!

[and duckie...i've not been on for a while so just reading this thread lol!]

i'll be happy to talk over any and all issues about equipment - either here
on the board, or in email -

two things are relevant to start off with:

what insurance coverage is available to you down under
if you don't have - email me as to avail. funds  - it will make a diff. re
what we go over - no sense in wasting your time

have you had - or is it available to you - a seating and function analysis?
this can and does make a sig. diff. re which 'types' of  power device is
contemplated - particularly as it reflects not just your needs 'today', but
as important - into the future. your particular spinal involvement is the
type that great care should be devoted to 'positioning'...

you mention indoor/outdoor usage, and they are such vastly diff. forms, that
it can change which device would best serve you.

from there we'll go into things like leg position, arm support, hand
function, etc.

ok?

paul

> Hi all,
>
[quoted text clipped - 85 lines]
> http://www.abmdr.org.au/
> http://www.marrow.org/
 
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