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Thread: Roho Quadtro High versus Low?

  1. #1

    Roho Quadtro High versus Low?

    Hello

    Just found out I have a Stage I (probably close to a Stage II) pressure sore two weeks out of rehab, (yes I've been doing my depressions etc, don't know how I got this) so I need to get off this foam cushion that came with my loaner chair and get onto a Roho ASAP.

    My question is, do I want a High or a Low Profile Quadtro? I'm not getting a lot of help from the OT's etc right now so any help you can give is welcome. I have a nurse friend helping with the actual wound care but need advice on the cushion.

    T12 Para with no other issues except being a friggin para...

    Thanks

    - Eric

  2. #2
    If the skin is broken, it is a stage II. You need to stay completely off a stage I or II now until it completely heals, or risk it becoming a stage III or IV. Just changing cushions is not sufficient.

    A Roho may not give you the best pressures. Were you not pressure mapped with your current cushion in rehab? If not, then you need to be seen in a good quality seating clinic and get pressure mapped on a variety of cushions to find out which one really gives you the best pressure reduction. It also may be that your wheelchair was not properly fit. Are you using a cushioned shower and commode seat as well? Are you smoking? There are many factors other than just your cushion or weight shifts that could be contributing to your current breakdown.

    (KLD)

  3. #3
    What the nurses said. Getting a seating evaluation and pressure mapping would be the first place I would start to find out where the sore is coming from. If the skin is broken or the markings are definitely a sore, you have to stay off of it. I've recently gotten pressure mapping done along with a seatingeval to make sure everything works just right in my chair. I've had pretty extensive surgery done on both of my ischiums from my Roho cushions being set to low or going flat from leaks. I don't really have any muscle or fat left in my legs on my butt from all of the work I had done so the bone basically book straight through my skin. We tried me on a whole bunch of cushions but the only one that worked for me, and I'm not saying it's the perfect cushion for everybody, was the Roho cushion, high-profile Quattro. Get yourself mapped. That's really important and really easy. It's made a really big difference on how my chair is set up now and now we inflate the cushion. For mean it has to be a little bit overinflated or I bottom out because the bone sticks through so much. There is a whole bunch of different brands out there and considering you still have some meat on your bottom, you may not need something as aggressive as our Roho high-profile
    C-5/6, 7-9-2000
    Scottsdale, AZ

    Make the best out of today because yesterday is gone and tomorrow may never come. Nobody knows that better than those of us that have almost died from spinal cord injury.

  4. #4
    I just got a quadtro low profile, and I'm quite pleased. If I were T12 I might go with the high profile, just for safety's sake. Since you have abs etc, the high profile shouldn't be unstable for you. Try placing 4" depth pillows in your chair and push a while, to make sure you CAN, from that height. The other question is transfers-try a few from that same 4" height.

    The Low-pro works for me b/c I have sensation in the area that gives me trouble. It got away from me b/c I was traveling, cushion went flat, etc. I got careless.

    A little tip-You can buy them on ebay for $159, yet I've found them retail for $577!

    Best advice of all is to get mapped, stay off it until then. A roho won't fix damaged skin. If that is somehow impossible, I'd order your quadtro of choice now, so you are ready to go when you're able. Remember to get up slowly, just a little bit at a time, when you are done healing.

    Also remember-once that skin breaks down, it is forever fragile. Pound the protein and water, and stay off that sore!

    Have you seen a wound dr? I'd highly recommend that, as well.

    Coming out of rehab w/ a sore is pretty inexcusable, imo. And those loaners w/ foam cushions are bs. I recently visited my mom in a nursing home, found her sitting on a DONUT! So I gave her my recliner/driving cushion (roho airhawk) And suddenly I had no cushions at all any more. Ebay came through, thank goodness.

    DEFINITELY stay in bed, off that sore, until your custom chair and cushion arrive! That loaner chair is clearly Satan!

    What cushion has been ordered for you already?
    Last edited by betheny; 10-08-2009 at 01:11 PM.

  5. #5
    FYI -- ROHO now makes a mid-profile Quadtro ROHO, it is 3 inches.
    C5-6 Complete - 8/13/1982

  6. #6
    Thanks for the replies. Don't smoke, not overweight, eat a high-protein diet, only drink water. Not diabetic, blood pressure normal, except for the SCI anbd the new wound I'm really healthy.

    Been doing depressions for pressure relief, try to remember to do them every 30 minutes, 30 seconds at a time, a few times I lost track of time at the computer but no more than an hour.

    Use a padded shower chair/commode combination.

    Due to the extent of my injuries I've burned through most of my insurance hours, including all the skilled nursing stuff. I'm working with insurance to try and get an RN to stop by once a day to at least check the wound and change dressings, but even if I get that I'm still on the hook for feeding myself and getting into the bathroom for my bowel program. I live alone, and while I have a few good friends who'd like to help they have jobs & kids etc. so I'm basically on my own for food prep and I definitely need to poop.

    So staying off it 24 hours a day is not really an option. I'll at least need to get on it 2x a day for BP and food prep/eating. Hence the Roho idea.

    I wasn't pressure mapped, didn't even know what that was until yesterday when I jumped on this site. I'll ask abot getting it done. There's a lot I didn't learn/do in rehab I've discovered from reading on this site. I was only there for 3 weeks, didn't get a chance to do much. I was injured April 26th but due to all the injuries I spent over 4 months in a sub-acute facility in bed 24 hours a day to heal up everything. They then rushed me though rehab. I made some noise about that but the insurance said that's all.

    I'm in a loaner chair until my custom chair comes, it's a bit too narrow and when the DME guy showed it to me I asked about the cushion. I'd been on a Roho first then a Jay2 cushion in the rehab chair, I asked about this Invacare Pin Dot foam cushion and if it was a bit too hard since my skin wasn't too used to this yet. He said no problem, just remember to do my depressions. This is a major issue for SCI folks I think, I knew just enough to ask the question but not enough to push back, I needed to trust the OT and the DME guy. They ordered me a Roho Nexus, so I asked, "if you're getting me an air cushion for my real chair, wouldn't it make sense to get something like that for my loaner that I will have for up to possibly 2 months?" Answer was 'no'

    So anyway, like I said staying off it 24/7 isn't really an option, I can try to shoot for 22 hours a day but I do need to get up for food and BP.

    Would the Roho be the best choice in this sub-optimal situation?

    Thanks

    - Eric

  7. #7
    Where is your sore? 22 hrs. a day isn't optimal, but it is what it is. Make sure you are off that sore, whether you are up or down. Lean to the side or something. Ideally, off = off, but I'm like you. If I stayed off it 24 hrs a day, I'd die of starvation or ruptured bowels.

    If you could see a wound dr., they might prescribe dressings that last 3 days. It is great for protecting against shear. Are you sure your sore is from pressure and not shear? Sounds like you've been pretty conscientious, that's why I ask.

    That roho med profile might be just the ticket. Make sure it fits the chair you've got coming!

  8. #8
    So wound care nurse came by today, cleaned it up, said it was in fact Stage II, put a dressing on it that should stay for a few days and told me stay off it. Got a hold of the DME, and he has a Roho I can use for those times I do need to be in the chair to eat/poop, a friend is picking that up tomorrow and dropping it by. It may not be the ideal cushion according to a pressure mapping system but it's a damn sight better than what I have now I would think regarding skin care, nurse agrees.

    The nurse contacted my doc and she should be faxing in Home Health care orders so I can at least get the wound attended to a few times a week. I'm on my own for BTP and food.

    So other than eating and BTP I stay in bed or on the couch on my side for the next ??? (days/weeks)

    I really hate this SCI thing...

    Thanks for the advice.

    - Eric
    T12

  9. #9
    Sorry to hear of your hassles Eric. It sounds like your cushion was not the best and I can't help but think the ROHO will be far better.
    C5-6 Complete - 8/13/1982

  10. #10
    There are old timers on here who have healed sores staying up on rohos while working .
    Bike-on.com rep
    John@bike-on.com
    c4/5 inc funtioning c6. 28 yrs post.
    sponsored handcycle racer

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