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Thread: New directive for wheelchair parts (and a whine)

  1. #1
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    Angry New directive for wheelchair parts (and a whine)

    My SCI doc at the West Roxbury, MA SCI center wrote me a Rx for Frog Legs forks and Softroll casters after a couple of endos in the last 2 years due to sidewalk gaps. I talked to the wheelchair guy that I've been dealing with for the last 10 years ago, and he can no longer order the parts and let me put them on. This more than doubles his workload, as he has a number of vets that change their own tires, upholstery, bearings, casters, etc. I live 100 miles from Boston, so that's a pain, but what the heck it's better than buying my own for $400 or so.

    Now he calls me and says that he can't order them because the frog legs are taller and will change the dump, and I have to see OT for a chair evaluation. The frog legs are about an inch taller than the normal ZRA forks, and I have my casters in the bottom hole. If I simply use the top hole in the froglegs, I have a net gain of zero, but do you think that I can convince them of that?
    FTA!

    Don
    Don - Grad Student Emeritus
    T3 ASIA A 26 years post injury

  2. #2
    Sounds like a local decision, but I would have to support it since the vendors job is to provide the service, not simply order the parts. I would have concerns as well, but I don't have time to fully respond at this time.


    I'll post later.


  3. #3
    Let's preface what follows with the fact that if you were to call Sportaid or Spinlife and pay out of pocket, you would be paying $616 for FrogLegs forks for your ZRa.

    If you were followed by our SCI Service, I would want to see you for a wheelchair re-eval as well. As an SCI Center, one or more of the therapy staff should be knowledgeable about wheelchairs, and this is an issue with your ability to function in your wheelchair. That is different from repairing or replacing something. As a clinician, I would have concerns about having a vendor order and send you suspension forks.

    While I don't know the specifics of your situation, a new ZRA ordered with FL forks would be built with a 1" longer frame and the CAD for the chair would be drawn to accommodate the wider swivel radius. This raises some concerns I would want to rule out a a clinician before I felt that changing your forks would be appropriate.

    Would you have sufficient footrest clearance?

    How will they affect the static and dynamic stability of the chair? Many a cantilevered frame with FL forks has been endo prone during transfers.

    I realize from your posts here that you are knowledgeable end user, but had I not known that, I would want to see you to determine if there might be some other modification, wheelchair skills training, or some other adjustment to prevent the endos over sidewalk cracks. (BTW, you'll rarely see FL forks on the ZR's or ZRA's I post. When I do spec them, it is usually to prevent spasms going over bumps, not endos).

    For routine maintenance items, once it has been established that the veteran is able to change tires, casters, and other parts, our Prosthetics service would order the parts and have them sent directly to the veteran. No DME would be required. If the person was unable to perform routine tasks themselves or a repair was needed, then the DME would be authorized to handle it.

    Prosthetics can purchase items at a lower cost than any supplier, so there are some cost savings as well. There is documentation that the item is medically justified and there is some oversight of the DME. Your DME sounds good, but I have seen some run a muck when Prosthetics gives them cart blanch to handle wheelchair issues. I believe West Roxbury also has a very good tech.

    I know it can be a hassle to get to an SCI Center. If FL suspension forks would solve your problem, they will provide them. Since I am not a veteran, I would have to pay over $600 to get them for my wheelchair. If you keep that in mind, that long trip to West Roxbury may seem a little shorter.
    Last edited by SCI_OTR; 12-16-2010 at 08:08 AM.


  4. #4
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    Thanks for the considered reply. Now that I have calmed down, (and with your input in mind) I can see why it's a good idea to get the eval. Fortunately, I am not dealing with a DME, but with Prosthetics; and even if they approve the FL forks, I will have to bring the chair back to get them installed. I have done all of the maintenance on my chairs for the last 15 years, and they were always able to just send me the parts. This has worked out well for the wheelchair tech and me, as I have gotten the independence of keeping my chair in top shape, and he does not have to schedule time to do repairs while I wait.

    Ah well, nothing ever stays the same.

    Don
    Don - Grad Student Emeritus
    T3 ASIA A 26 years post injury

  5. #5
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    If you don't normally spec FL forks for endos, do you have another suggestion? I have 4" Tilite 2 piece aluminum wheels presently, and I have had 2 major endos from hitting sidewalk/pavement gaps that have stopped me dead. Also had a number of times when I was going slow enough that I was able to get my hands down to the ground in time to keep me in the seat. As long as i see the crack, I can wheelie over it, but at times it will be at the bottom of a curb cut and not look wide enough to bother. I know the Softrolls will help, but figured that the suspension forks would add another layer of safety. I rarely have any spasticity,

    Thanks,

    Don
    Last edited by Donno; 12-16-2010 at 11:34 PM. Reason: clarity
    Don - Grad Student Emeritus
    T3 ASIA A 26 years post injury

  6. #6
    Would that be Warren?

    If they approve the FL forks, I would think you should have the option of having a DME come to you for installation.


  7. #7
    Quote Originally Posted by Donno View Post
    Thanks for the considered reply. Now that I have calmed down, (and with your input in mind) I can see why it's a good idea to get the eval. Fortunately, I am not dealing with a DME, but with Prosthetics; and even if they approve the FL forks, I will have to bring the chair back to get them installed. I have done all of the maintenance on my chairs for the last 15 years, and they were always able to just send me the parts. This has worked out well for the wheelchair tech and me, as I have gotten the independence of keeping my chair in top shape, and he does not have to schedule time to do repairs while I wait.

    Ah well, nothing ever stays the same.

    Don
    I've done endos as well, though thankfully very infrequently, as a result of my casters catching in broken cracks in the sidewalk. I've never tried FL suspension forks, but I'm not sure they would have helped in those instances. For me the solution is being obsessively vigilant about scoping the ground I'm approaching and wheelie-ing over the bad patches, which in NYC are everywhere. I really can't lower my guard.

  8. #8
    You are being taken care of by the VA so you can take a more incremental approach to the problem. Assuming you have the older narrow fork, I would talk with them about switching over to the wider bearing fork and getting 4x1.5 FL aluminum hub soft rolls and the "wide axle kit" from Sportaid who would be "on contract".

    FL-CAS4
    Frog Legs Soft Roll Casters (1 pair)
    Size: 4" x 1.5"
    Hub: Aluminum/Silver
    Tire Type: Black Soft-Roll
    FLT00602
    Frog Legs Wide "Axle Kit" (1 pair)
    Includes All Axle Sleeves/ Spacers/Screws
    If that didn't fix the problem, then I would move on to FrogLegs forks.

    I know switching from 4" light ups to the 4x1.5 FLAHSR's transformed my chair.


  9. #9
    Or try the 5x1.5 Soft Rolls. I found an amazing difference in the endo problem by putting on a 5". I have a gravel driveway so the gravel ends up on my cement sidewalk to my workshop. With the 4"s I had to be extremely careful wheeling in the night duw to endos hitting the gravel. With the 5's, no problem.

  10. #10
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    Thanks for all the input! The incremental approach sounds like a much better idea, I'll give Warren a call.
    Don - Grad Student Emeritus
    T3 ASIA A 26 years post injury

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