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Thread: Shoulder arthritis, power assist wheels???

  1. #1

    Shoulder arthritis, power assist wheels???

    So I am a manual wheelchair user. Its been 3 years. I am mostly in bed and honestly don't use my chair 'that much' because I am in too much pain to really be any kind of active.

    Even so, I woke up one day and realized my shoulder hurt quite a bit. I continued physical therapy on it for 2 months to try and keep it strong and hope it helped. It didn't. I stopped using it altogether for 2 months and that didn't help either. So off to the shoulder Dr I went. I found out I have Acromioclavicular arthritis and Shoulder Impingment Syndrome. Degenerative.... i got cortisone injections in my shoulder the other day. It hurts worse. And I also read that you can really only have a few cortisone shots in these joints in a lifetime so it is not a long term solution.

    So it is impossible for me to get a power chair or a vehicle to carry it. So cross out that solution. Not available.

    Next thought is power assist wheels. I am on Medicare and appropriate supplements. What would be the process to try and get power assist wheels covered? Are there a certain brand of power assist that are better than others? Some lighter than others (Still have to get chair into car and with bad shoulder that is getting harder). Any tricks to talk to Drs and Medicare folks to get them covered? Is it even possible? Because I do NOT have 6 grand!!!!

    Thanks in advance!
    Chanda & Kestrel. Service Dog In Training

  2. #2
    Senior Member
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    I don't know much about power assist units for manual chairs, but I can speak to the hoops you need to go through for Medicare coverage.

    First, you will need your doctor to submit a letter and/or clinical notes to a physical or occupational therapist preferably with a RESNA, Rehabilitation Engineering and Assistive Technology Society of North America certification in Assistive Technology Certification (ATP) and/or Seating and Mobility Specialist (SMS) and get a seating and positioning evaluation and recommendation for a power assist unit based on your doctors diagnosis of your shoulder issues. This recommendation needs to be written in a form of a prescription that your doctor must sign. Then you need to find a durable medical equipment supplier who can submit the doctor's prescription to Medicare for approval of a particular power assist unit. Once Medicare approves the unit, then supplier can proceed with ordering the unit you need. Then it is matter of waiting for delivery of the unit. This can take anywhere from about 2 to 6 months.

    Re cortisone injections: It has been my experience that I have felt worse for a couple weeks after I have gotten an injection. It usually takes 2-3 weeks to feel a difference.

    Hate to see someone your age have to be stuck in bed. Have you talked to your orthopedist about shoulder surgery? It is a long process of healing and physical therapy. but you have a lot of life ahead of you. It might be a good idea to plan for the future. That said, what ever you do, you are going to have to modify what you do with your shoulders. Car transfers, bed to chair and back transfers, and push up weight shifts are shoulder killers, especially when you already have limitations and injury to them. The physical or occupational therapist may be able to help you change how you do certain things that are only causing more damage.

    Good Luck! Hope someone has some good suggestions for power assist units.

  3. #3
    I am in the same situation. Waiting for a resolution. First you determine if you qualify for a power wheelchair (you should qualify). Then you submit a request for a SmartDrive power assist with the justification that it serves the same purpose to you as the power wheelchair at a lower cost to them. If not, then take the power wheelchair.

  4. #4
    OK, Wow, I don't even know what a "physical or occupational therapist preferably with a RESNA, Rehabilitation Engineering and Assistive Technology Society of North America certification in Assistive Technology Certification (ATP) and/or Seating and Mobility Specialist (SMS)" IS!!!!! I feel like an idiot!

    Should I literally google for one of those in my area?

    The Dr who diagnosed me and gave me the injections is simply a shoulder
    specialist. Nothing more. He didn't recommend surgery at this time.

    I have an internist who is my Primary but she isn't much use as 'internally' I am ok and she doesn't really deal with my car accident stuff.

    The DME who measured me for the chair was great. I didn't go through insurance because I thought the lawsuit was going to cover the cost of the chair so we paid cash. Duh, lawsuit didn't cover it.

    I also didn't have Medicare way back then so dealing with Medicare is very new to me. I spent the last couple years with no medical care because I couldn't use my insurance so I wasn't even able to start seeing Drs until this December. So I don't have a good medical team taking care of me. I am kind of trying to 'piece meal' a few Drs together to start trying to help me with my pain again but since I live in a small town the Drs aren't that great (which is putting it mildly).

    I definitely can't do a power chair no matter what. Especially because of the cost of trying to be able to transport one. I can't buy a whole new vehicle. I only bring in about $500 a month from disability.... I HAVE to be able to get this thing in my SUV by myself no matter what.

    Ug, getting scared now. And yes I feel far too young to no longer have ANY kind of life at all. at 42 my life officially stopped. No job. Lost my home. No friends. No family. My husband has stuck with me but is now working for two so he travels nonstop and works pretty much 7 days a week just trying to feed me and pay our bills. I feel really guilty.

    I now suddenly feel more confused!!!!

    I will start googling???
    Chanda



  5. #5
    Senior Member
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    You may want to try this search to find someone near you: http://www.resna.org/member-directory/individual

  6. #6
    Where in California are you? Where did you do your rehab? Medicare requires that you have an evaluation for power wheelchairs or power assist done by a RESNA certified provider, and most large rehab centers have such staff available for doing these evaluations.

    What is your level of injury (it is great when people add this to their profile)?

    Are you planning to go back to work or school? Have you opened a case with the Dept. of (Vocational) Rehabilitation? If you need a van to get to work or school, and no other wheelchair transportation is available, they may get you a van. Trying to transfer in and out of a SUV is a sure way to damage your shoulders further.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  7. #7
    I am in Santa Maria California. It is just north of Santa Barbara and it is on the Central Coast. Basically not much around me.

    I didn't do any rehab. So far I am a medical mystery and no one knows what is wrong with my back at this point. From the belly button down I have SEVERE pain and numbness that goes all the way down both legs equally. Making standing or walking, and most of the time even sitting, near impossible. But as to 'why' the Drs don't know and don't seem to care.

    From the car accident I injured my lower back->legs, neck and head. I spent two years seeing every Dr I could find from San Francisco to Los Angeles and was brushed off every time. Local Drs are also at a loss. Some Drs tell me I have all these little things wrong here and there. Other Drs tell me my spine looks perfect. So it is a little hard to know which is the truth. But the fact is I was incredibly active before the car accident and completely disabled after it.

    Now in addition the shoulder arthritis (hooray), and massive hand issues most likely stemming from my neck injury. I haven't seen the hand specialist yet so that hasn't officially been determined. Because I have been without medical care for over a year. Gotta handle one thing at a time.

    At this point there is NOOOOO way I can work again or even do school. I don't have any vocab stuff because it has been determined that I am disabled in so many ways it that I am not capable of ever working again.

    Does that help explain my situation???

  8. #8
    Senior Member elarson's Avatar
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    You might also want to look into a Spinergy ZX-1 Power Add-on. It gives power functionality to a manual chair. It's quite pricey, but I don't think any more than power assist wheels.
    Partner of an incredible stroke survivor. Limitations: hemiparesis and neglect (functional paralysis and complete lack of awareness on one side). Equipment: TiLite ZRA 2 and 2GX, Spinergy ZX-1, RioMobility Firefly. Knowledge: relative newbie for high-level equipment (2012), but willing to try to help others who are new with similar limitations (definitely not a guru, but inquisitive).

  9. #9
    It seems you might want to consider starting from square one, that is, get a doctor to refer you to an accredited rehabilitation center/hospital for out patient services. It seems you might benefit from a complete rehab evaluation rather than specialists who look at individual body parts.
    I think you said you never had rehab after your accident, so you may want to discuss this with one of your doctors who might be inclined to refer you to the rehab center/hospital for evaluation.
    I'm referring to a large rehab institution, not your corner PT service. Not sure it really matters at present about a "diagnosis" of why you are in pain, but important to get involved with a comprehensive rehab. program.

    I would also suggest you identify one or two friends/family members who would be willing to team up with you to put a plan in action, and maybe even drive you where you need to go. In addition would not suggest you purchase any mobility equipment until you thoroughly research this as you said you need to be able to get any device into your vehicle. That said, it would also be important to also consider equipment that will help you get around if your condition requires more help. Some equipment would require additional expenses to add a ramp or lift into your car.

    Hope you let us know if things progress and what you decide to do.

  10. #10
    Thanks, a person I met recently had the Spinergy ZX-1. But I would not be able to get that in my car...

    Sad story, I was referred by a physiatrist up to Standard to be evaluated for a 3 week inpatient physical rehab program. My husband took 3 days off of work (which we couldn't afford). We drive the 8 hours up there. Stayed in a hotel (expensive) saw the Drs. They were INCREDIBLY rude. And they asked if I had any questions at the end. I asked if I got into the program and they said they didn't have that program. All they had was a 3 day 'get off opiates' program. Thats it. Didn't need that program at all.

    So they accepted my referral for a program they didn't even have!!

    So I spent hundreds of dollars. Had to pay Stanford for the appointments (big $) and got nothing out of it. Then when I came back I tried to make an appointment with the physiatrist again to find the next plan and he refused to see me.

    There are no rehab programs in my area. I would have to travel hundreds of miles and stay in hotels. I can't drive that far. My husband travels nonstop. I can't afford even one night in a hotel. I have no family and no friends (hard to make any friends when you spend 3 years in bed) So it is basically impossible for me to go to a rehab program.

    The only thing I can do is find an individual Drs to treat each of my individual problems. One for head, one for neck, one for lower back/legs, one for shoulder and so on...

    There is nothing near me that can help me and I have no one to help drive me anywhere or help me at all. I often go days without eating because my husband is traveling.

    So my solution was to try and get power assist wheels on my current chair. That way I can still get it into the car. And it will help me push around a little. Since I am in bed SO much I really only use my chair when I have to drive to a Drs appointment and get into their office. So it isn't 'that' much.

    Until SOMEONE can help me with the pain I can't really do much more than lie in bed and go to Drs appointments. That is the extent of my life for the last 3 years.

    I can NOT seem to get any Drs to actually help me or care. They basically seem to think I am a Dr seeking, attention seeking, crazy person, that there is nothing wrong with. That is my assumption anyway. That is how they treat me.

    In all honestly I don't want to have to see Drs ever. I don't want to be in pain. I don't want to live in my bed alone. I don't want to be like this. It is a miserable existence with zero help.

    So my only solution is to keep on the path I am on and try and get power assist wheels???? I just don't have any other options.

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