Impending Wheelchair Assessment

[davidgillon]

I have my assessment with Wheelchair Services coming up a week today, so I'd appreciate any thoughts on stuff I should make sure to mention. The aim is to get them to supply a rigid framed manual with ideally a Jay back. I think I can demonstrate the current chair is inadequate, but the risk is they might just throw me a voucher for part of the cost.

Current thoughts:

Shoulder stuff
1a) Hypermobility shoulder issues causing problems with pushing the current chair with back erect, never mind with armrests fitted. The instructions are to take all of your chair with you, I plan to take the armrests in a bag on my lap because there's no way I'm pushing with them fitted. They came off the chair within the first 10 minutes. And I'm also going to have the back folded down (see icon!) to demonstrate its width is an issue in changing the way I push - medical appointment as performance art.

1b) Hypermobility shoulder issues/neuro issues and the extreme weight of the current chair for lifting into and out of the car, which I'm generally doing single handed because my left arm is so screwed it's easier to do it with right alone. I switched to the chair because my shoulders were getting iffy for crutch use, straining them lifting the chair instead isn't a positive move.

1c) Hypermobility shoulder issues/neuro issues and general pushing issues. My left arm is measurably weaker than my left, and that's a problem that gets worse the more I push. It's particularly a problem with the current chair on Rochester's cambered pavements as it won't hold a line and often I'm reduced to braking with the strong arm and pushing with the weak to try and get it to go straight. I know that's not a factor on a rigid framed chair with cambered wheels because I've used one and specifically checked that.

2) Hypermobility pelvic and hip issues and seating difficulties. Not so easy to draw attention to, but I'm definitely going to be talking about having had my hips sublux when the chair flexes under me on something as simple as a kerb-cut, and about two days on Athenian cobbles irritating my SI joint to the point I couldn't stand for more than a moment or two for six weeks. And that I've had the opportunity to try a rigid chair over the same terrain and that a rigid frame makes it a non issue. Any suggestions for also pressuring them for a better cushion than the £20 lump of memory foam they supplied gratefully accepted!

3) Hypermobility and back issues and seating issues. Need to emphasise that I'm not getting enough support from a low-backed chair, that I'm only using the chair that way because it's worse with the back up and with the back down it's only viable for an hour or two, and that if I need to sit without pushing then I have to have the back raised, but  that even then I'm supplementing it by using a thin seat cushion to make it more rigid (and I could really have done with a headrest too on that train journey last week). I may need to bring up the problems I had with seating at work, but I think the trick here will be avoiding them saying 'That's a work issue, therefore it's Access to Work's problem, not ours".

4) Leg length discrepancy - when I sit in the chair my right knee is visibly further forward than my left, it's difficult to measure, but it looks to be around an inch. I'm not sure if that's an actual leg length discrepancy, or if I'm consistently sitting with the right side of my pelvis twisted forward. If the latter then clearly it's an issue for Wheelchair Services, if it's the former it would be nice to get it confirmed so I can point it out to my GP as possibly a factor in my ongoing pelvis/hip issues.

5) General usability. The current chair seems to be explicitly configured to make it as difficult to wheelie as possible. That's all very well for a pensioner who only goes out with someone to push them, but I'm independent, active, and invariably on my own. I need a chair I can wheelie up kerbs without having to push so hard to do it I throw myself over backwards. And while they're at it actually giving me some training in using it safely would be nice!

Possibly also worth mentioning, intermittent problems with bendy left thumb interfering with pushing.

Any and all additional thoughts gratefully received.

(I've also had an email from them, I suspect all of their clients have, asking if I'm interested in being a patient rep on their board. I'm tempted, but I suspect I'm their nightmare candidate).
 

Comments

[kaberett]

Is the seat width appropriate for you?

Tell them you've sat in a Jay J3 deep-contour backrest with deep-contour headrest and on a Jay Easy cushion and they

"Independent active wheelchair user, requiring lightweight frame" is good. Emphasise chronic fatigue and needing lateral support -- if you can manage visibly drooping at them that's good.

Emphasise all the things you can't do because this chair's unsuitable, but that you want to.

Emphasise the limit on how long you can sit in it/push it, and how much that would be improved by a lightweight chair with appropriate support.

uhhhhhh kinda coming up blank, sorry; hope that is some help at least.

[kaberett]

USING IT AROUND THE HOUSE. you need something more maneouverable and MUCH SMALLER to make it possible (& safe!) to use indoors!!

[davidgillon]

Good point! I did mean to mention that I have to take the footplates off to use it around the house.

[kaberett]

... which throws your hips out, because it's not set up for you to be using it for foot-propulsion...

[davidgillon]

I'm not foot-propelling, it's literally so large I have to take the footplate off to use it indoors. Part of the reason I'm using it in the house is to make sure I use my arms for pushing every day.

[kaberett]

Right, but this means that your legs are dangling rather than supported, which is Ergonomically Bad. (If the chair were set up for you to foot-propel, there'd be an appropriate height from the floor to the seat; as it is, the height is set up on the basis that your feet should be supported, which in the absence of footplates they are Very Not, and given your hip issues this is BAD AND THEY SHOULD FEEL BAD.)

[davidgillon]

Now that's a very good point that hadn't occurred to me!

[davidgillon]

Seat width probably isn't appropriate. It's 17.5" (and barely squeezes through some of the doors at home). I suspect I need a 16", possiby even 15", 14" is too small, but almost viable.

Jay stuff, yes, definitely. I'll repeat the line from my original letter to them where I point out they let me get through a 7 hour day of continuous sitting, which wouldn't normally be possible. Should probably mention c-spine issues as well.

Chronic fatigue and limits is good. I'll mention I end up canted to one side if I sit without the back up.

"Independent active wheelchair user, requiring lightweight frame" Good wording!

Lateral support is good - very apparent on public transport - that damn Pendolino the other week!

[kaberett]

Yes, that definitely isn't appropriate, especially given your shoulder issues -- if your shoulders are *substantially* wider than your hips that will need taking into account, but otherwise that's very no.

Emphasise risks of damaging yourself in the absence of lateral support esp on public transport -- even if it's just "I get much more tired", but "I get thrown around a lot and it hurts/risks wrenching things" is very much worth mentioning.

[green_knight]

I can't help with the assessment stuff other than to wish you all the best, but for training, you might try and contact various wheelchair sports to see whether they offer basic handling courses. Somehow I don't think that the NHS makes provisions for that.

[jesse_the_k]

Re Cushion: since you'll be sitting more, consider sweat management & pressure sore issues.

Re specific models: prefer ones which could accept aftermarket powered wheels or rowing attachments.

Re interview itself, I find it easier when I'm working off a checklist, and I hand a copy to the consultant so we are literally on the same page.

Best best wishes.

[davidgillon]

That's a good idea with two checklists. I do checklists, but it's always an issue when one of you doesn't have a copy.

[davidgillon]

Another good point. I hadn't thought about the impact of seat width on pushing posture/shoulder positioning.

Yep on the public transport, that Pendolino ride up to Lancaster was horrible.