Why there is such a big price difference in medical products that look so similar?

Guest Blog Post by Bob Vogel

Evaluating a product by price alone can be confusing and misleading. Why do two cushions that “look” similar have significantly different prices? This is an important question, especially when it comes time to order your next cushion. In order for a DME (durable medical equipment) cushion to be sold as a medical device in the US it must comply with a specific set of rules and tests set forth by the FDA. These rules and tests are a good thing — I want to be sure that the cushion under my butt has been tested and proven to protect my skin.

However, there is a big difference between doing the minimum required to meet regulations and doing the maximum to ensure that wheelchair users have the best skin protection possible.

The first expense is research and design costs associated with making a cushion before it can be submitted to the FDA for approval to be sold. Companies like ROHO (and other market leaders) spend a tremendous amount of money in this area, while other companies that might make similar looking products spend very little in this area. ROHO continually invests money in research and design in an ongoing effort to make the best product for consumers. Research costs include a prototype tool for every research cushion — something that is very expensive with no guarantee that it will ever reach the consumer — laboratory studies, clinical studies, and support papers for the research. Examples of published ROHO papers and research can be viewed here: http://www.therohogroup.com/roho institute

The FDA has a specific set of rules and tests it requires for DME complex rehab cushion to be sold as a DME product in the US. The manufacturer has to be registered with the FDA and pay associated fees on an annual basis and must meet FDA quality system regulation (QS) manufacturing requirements for designing, purchasing, manufacturing, labeling, storing and servicing medical devices (in this case, cushions). The manufacturer has to have traceability of the product (cushion) and report if there is any kind of recall or adverse event with the product.

The FDA inspects manufacturing facilities and if an inspection or an FDA audit finds there isn’t compliance with its rules, the FDA can shut down the plant.

ROHO takes quality control much further than the FDA model with its quality management systems’ being certified to two ISO standards — ISO 9001:2008 and ISO 13485:2003, which is a medical device quality standard. Manufacturing all ROHO cushions, except the PostureLITE™ by ROHO Cushion at its plant in Belleville, Illinois, ROHO is able to maintain the highest levels of quality control in every aspect of every cushion.

An example of ROHO quality control is the neoprene used to make its cushions. Instead of relying on an outsourced compound, ROHO compounds and mixes its own neoprene and every batch is tested to ensure each cushion maintains the highest standard. To further enhance quality control, each ROHO cushion has a unique serial number that ties it back to the specific date that it was made and processes under which it was manufactured in order to pinpoint any issue regarding quality if needed.

Each and every ROHO cushion goes though multiple layers of quality inspection to ensure each cushion performs to specification before it is shipped.

Another important thing to consider when ordering a new cushion is warranty return policy and customer service — a manufacturer expense that ROHO feels is of vital importance. If you have a problem with a ROHO cushion you call customer service and give them the serial number of the cushion and tell them the problem. Customer service will be able to immediately tell the manufacture date, exact model and size of cushion and warranty information. If it is under warranty, they will send you a new cushion right away, and have you send your old cushion back in a pre-paid shipping box. This enables ROHO to examine the cushion, document the problem and further enhance quality control by gaining knowledge to take steps to work on eliminating problems and improve cushions.

An example of this is, years ago ROHO identified an area of wear on the cushion where the cell met the base of the cushion. To address this, ROHO Engineering spent a great deal of money to redesign the cushion so the cushion cells had a more gradual taper. The redesign meant great expense for re-tooling for all cushions, but the end result was a longer wearing cushion for the customer.

When it comes to qualifying for reimbursement for a DME cushion, most insurance companies follow Medicare guidelines — the product has to meet a Cal-117 Fire safety test, the cushion must have minimum of an 18-month warranty and show that the cushion will pass a Simulated Immersion Laboratory test — a test that measures a cushion’s ability to allow cylindrical devices (meant to simulate a human pelvis) to sink 40 mm into a cushion with a 31-pound load without bottoming out — about 18 months of use. 40 mm is the goal because it simulates immersion of the entire pelvis.

Unfortunately, the Simulated Immersion Laboratory test does not measure pressure, meaning you could end up with a cushion that passes all of the tests, yet puts tremendous pressure on bony areas of the pelvis and puts the user at risk of a pressure ulcer.

Which brings us to another example how ROHO goes the extra mile for consumer safety. ROHO, in conjunction with Sunrise Medical, has spent considerable time and a huge sum of money to develop a superior Simulated Immersion Laboratory test device — one that is in the shape of a pelvis, designed to address the most difficult seating/pressure challenge. The device has eighteen sophisticated pressure sensors imbedded in the indenter at typical pelvic pressure points so you can see the actual pressure readouts on the pelvis. The device is designed to measure all 18 points when immersed at 40 mm in the cushion — the goal is equal pressure distribution on all areas without any high pressure points. An analogy is a scuba diver under water — they have a ton of force applied to them but it is equally distributed so they don’t develop problems.

To make seating safer for all consumers, ROHO and Sunrise have done all of the testing and research on their Simulated Immersion Laboratory test device, and are offering the research and plans for the device to testing agencies for free to try and raise the bar and make seating better and safer for all consumers.

When looking at your next cushion, do your research:
• Where is the cushion manufactured?
• How long is the warranty? (ROHO cushions’ warranties are 24-months and 36-months depending on model).
• What is the warranty policy?
• Is the manufacturer continually improving the product?
• Does the manufacturer include research papers about its product on its website?

The bottom line of all this is, there are a lot of cushions that “look” like a ROHO but cost less — performance, seating and positioning and how a cushion protects your skin, how a cushion protects your bottom, should be the bottom line on cushion choice. And as always, it is vital to ask and make sure the exact make, model and size of cushion are included on all therapists’ and physicians’ prescriptions as in “ROHO^® Quadtro Select^® High Profile^® Cushion, 16″ X 16″.

 

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Bob Vogel, 51, is a freelance writer for the ROHO Community blog. He is a dedicated dad, adventure athlete and journalist. Bob is in his 26th year as a T10 complete para. For the past two decades he has written for New Mobility magazine and is now their Senior Correspondent. He often seeks insight and perspective from his 10-year-old daughter, Sarah, and Schatzie, his 9-year-old German Shepherd service dog. The views and opinions expressed in this blog post are those of Bob Vogel and do not necessarily reflect the views of The ROHO Group. You can contact Bob Vogel by email at online.relations@therohogroup.com.

7 Adaptive Parenting Ideas and Tips

Guest blog post by Bob Vogel

A good friend excitedly shared the news that she is expecting her first child. She is a T4 complete paraplegic and asked if I had any adaptive ideas that will make parenting easier.

Although my daughter Sarah is going on 11-years old, it seems like just yesterday that I was asking the same question, and coming up with solutions of my own — here are some of my favorites.

1. Develop a shift schedule for sleeping

The first adaptive parenting hurdle Joanna and I ran into had nothing to do with disability — it was figuring how to adapt and function on little to no sleep. As any parent can tell you, the feeding and changing needs of a new baby quickly lead to sleep deprivation that rivals commercial crab fisherman. Our method to battle this was to parent around a “shift schedule” — “on watch” spending nights on the futon next to the bassinet for 72-hours, while the other parent got to sleep in the bedroom with the door closed.

 

2. Find a table for changing diapers that’s wheelchair accessible

To make it easier for me to change Sarah we put a changing pad on the dining room table — dinner parties would be a distant dream for a while — because the table was the perfect height and enabled me to wheel right up to the table to change her. A word of caution on changing — there is a Velcro strap in the center of a changing pad, it is there to secure your infant’s mid section so they don’t scoot off the table. Get in the habit of using this early — many parents can attest there is no warning between, “The baby never scoots” and, “I turned my head and the baby scooted off the table and onto the floor!”

 

3.  A high chair with wheels

Kristi Hruzewicz has a 6-month-old boy named Alex. Hruzewicz — a T4 para — adds some adaptive tips. She recommends the Chicco high chair (see resources) because it has wheels and you can roll the baby around the house with you when they are awake or sleeping. It also has a reclined position so you can use it on infants that don’t have the ability to hold their head up yet.

 

4. Bassinet/crib that has sides that lower or open

For sleeping, Hruzewicz uses a Side Crib (see resources) bassinet that has a side that lowers so she doesn’t have to lift Alex up and over the side of the bassinet. She says when Alex outgrows the bassinet she has a standard size crib that has sides that open like a barn-door so she can easily wheel him in and out of the crib. This is great idea, as I recall it was really difficult trying to get Sarah up and over the rails of her crib from my wheelchair and even more difficult to get her out of the crib.

 

5.  Lifting an Infant or Toddler

To make it easier to pick up your child Hruzewicz suggests a Baby B’Air Flight Vest, a small cotton vest designed to secure an infant to the seatbelt on an airplane (see resources). Hruzewicz says being able to grab the vest makes it much easier to pick her child up from a chair and makes her feel like a momma cat.

 

6. Use a baby sling or carrier for transporting an infant

When it comes to carrying an infant or toddler all day — we wheelchair users have a huge advantage — a permanent lap. When Sarah was an infant I carried her in a baby sling (see resources). A word of caution, the U.S. Consumer Product Safety Commission issued an advisory safety warning on the proper way to use an infant sling (see resources).

When Sarah was strong enough to hold her head up, I switched from the baby sling to a BabyBjorn baby carrier (see resources). At the time it was the only chest pack baby carrier that enabled carrying a toddler with their legs facing forward, so they can sit on your lap in your wheelchair. Although it’s kind of pricy, you can find them used on craigslist or eBay and when your child outgrows it they sell quickly online.

As Sarah outgrew the need for the chest pack I made a custom seat strap to keep her on my lap, it consisted of a soft stretchy material about 6″ wide and long enough to wrap around my back and Sarah’s waist. It also had Velcro on one side that made it easy to instantly put it on or take it off.

To this day I treasure memories and the time I was able to spend with Sarah on my lap, doing anything from working at the computer and puttering around the house, to going on walks.

I do have a couple important words of caution about wheeling with an infant or toddler in your lap. First, be aware that the extra weight of your child in your lap puts extra load on your wheelchair’s front casters that will make them more susceptible to catch on rocks or cracks. The added weight on your lap also puts added pressure on your butt — it is important to be extra vigilant with mirror skin checks.

 

7. Develop a method for putting the infant into a car seat

Last, but not least is figuring out how to get an infant into a car seat. I found the best way to do this was to strap Sarah in the car seat when it is free from the base — then with her securely fastened in, move it across the back seat of the car to the car seat base and latch it into the base. It is a maneuver that works, but takes quite a bit of time — and I learned to plan extra time into my trips accordingly.

When Sarah was finally big enough that she no longer needed a car seat — at age 7 — simply getting my chair in and out of the car seems like a breeze.

Resources:

• Baby B’Air Flight Vest:http://www.babybair.com/product.html
• Baby Bjorn Baby Carrier:http://www.babybjorn.com/products/baby-carriers/baby-carrier-synergy/synergy/
• Baby Sling Advisory:http://www.cpsc.gov/cpscpub/prerel/prhtml10/10165.html
• Example of Baby Sling:http://www.amazon.com/Karma-Organic-Cotton-Twill-Sling/dp/B001TEIS0A
• Chicco High Chair:www.chiccousa.com/gear/highchairs-hookons/polly-highchairs/polly-highchair-adventure.aspx
• Side Crib:http://www.diapers.com/p/arms-reach-concepts-inc-mini-co-sleeper-natural-74235?site=CI&utm_source=cse&utm_medium=cpc_D&utm_campaign=Google&utm_content=pla&ci_sku=AR-036&ci_gpa=pla&ci_kw=%7Bkeyword%7D

*The ROHO Group is not endorsing these products and we have not tested them.

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Bob Vogel, 51, is a freelance writer for the ROHO Community blog. He is a dedicated dad, adventure athlete and journalist. Bob is in his 26th year as a T10 complete para. For the past two decades he has written for New Mobility magazine and is now their Senior Correspondent. He often seeks insight and perspective from his 10-year-old daughter, Sarah, and Schatzie, his 9-year-old German Shepherd service dog. The views and opinions expressed in this blog post are those of Bob Vogel and do not necessarily reflect the views of The ROHO Group. You can contact Bob Vogel by email at online.relations@therohogroup.com.

Irony of the best-known wheelchair user

Guest blog post by Bob Vogel

Ironically, the best-known wheelchair user these days doesn’t even use a wheelchair. Non-disabled actor Kevin McHale plays Artie Abrams, a 16-year-old high school student in a glee club who became a paraplegic in a car crash at age eight. Each week over eight-million TV viewers tune in and watch Artie on the hit TV show Glee on FOX Broadcasting Network. Hiring a non-disabled actor to play Artie has stirred up a lot of controversy in the disability community. The huge TV audience, along with the controversy prompted New Mobility Magazine to name Artie as their Person of the Year.

What bothers me about Artie’s character is, it appears that (at least for the first two seasons) the TV show didn’t bother hire a consultant (a physical therapist, occupational therapist or paraplegic) to create an accurate portrayal of a paraplegic. This is glaringly apparent by Artie’s ridiculous seating and positioning. The promotional photos of Artie — including the ones in New Mobility — are typical of Artie’s seating for the first two seasons, lower body contorted to the right, and his right leg is jammed against frame of the chair. Most of his weight is shifted onto his right side — right ischium — and he is sitting on a foam cushion. Apparently the folks involved with Glee thought this made Artie “look” paralyzed.

I took a small unofficial poll of wheelchair users and therapists and asked them what they thought of Artie’s seating and positioning, most quickly noticed that his seating was poor, and was an inaccurate portrayal of the way an average paraplegic sits.

“If an actual para sat like that he would quickly end up with multiple pressure ulcers that would likely land him in the hospital for months and cost $100,000,” Delia Freeny an occupational therapist registered/licensed (OTR/L) and an assistive technology professional (ATP) says. “Proper seating and positioning are preventative — it helps prevent pressure ulcers and orthopedic problems. Spending the time and money to get the proper equipment for each wheelchair user is inexpensive compared to the serious medical problems and huge hospital bills the wrong equipment will cause.”

Like it or not, television and media define much of our reality. The way Artie has been portrayed teaches the general public — including policy makers that decide on equipment funding — that a contorted seating position and sitting with all of your weight on one ischium on a foam cushion is the norm. We never see what would really happen with this kind of seating, a lengthy and expensive hospital stay with life threatening pressure ulcers.

Unfortunately, failure to see the importance of proper seating and positioning is not limited to TV shows. Although some progress has been made, it seems the people who create Medicare policy have also failed to see how crucial proper seating and positioning is. They’ve failed to see the difference between standard durable medical equipment (DME) like a wheelchair or foam cushion you can purchase at a drug store, and complex rehab equipment — a cushion, wheelchair etc., specifically fitted by a rehab team and prescribed by a physician to address the seating requirements of a specific individual. New Mobility provides an in depth explanation of complex rehab vs. standard durable medical equipment here.

This why it is important for each of us to continue calling, emailing and writing our senators and legislators, elected officials that work for us, and tell them we do not want complex rehab equipment included in competitive bidding. The continuous efforts of everyone so far have mattered because on December 27, 2011, CMS officially announced that cushion codes E2622–E2625 have been removed from the competitive bidding program! To find out how to contact your senators and legislators are see, “A Step-by-Step Guide to Contacting U.S. Representatives and Senators.”

Back in the TV world of Glee, after enduring two seasons of poor seating and positioning, Artie’s seating improved in season three. He is sitting straighter, his legs are no longer contorted to the right and his right leg is no longer pressed against the frame. It also appears he is sitting on some type of complex rehab cushion that addresses his seating needs, rather than the foam cushion. I imagine this change came about because folks at Glee either hired a consultant, or took heed of criticisms — including mine — about Artie’s seating. Either way — good for them!

In my imagination, one of two story lines transpired in Artie’s TV world to change his seating.

In my first storyline, Artie ends up in the hospital with massive pressure ulcers on his right calf and his right ischium. He develops osteomyelitis in his right ischium and almost dies. The kids at McKinley High School hold a constant vigil for Artie during the weeks he is in intensive care on strong antibiotics to kill the infection. He manages to beat the infection and undergoes surgical skin flaps to repair the wounds and spends another three months in the hospital to recover.

Once healed, Artie’s physician refers him to a much-needed evaluation at a seating and positioning clinic. At the clinic, Artie’s wheelchair and cushion requirements are evaluated by a team including a physical or occupational therapist, as well as an ATP and a physical medicine and rehab (PM&R) physician. After the evaluation, his PM&R physician carefully writes a prescription for his new equipment needs making sure to write the exact manufacturer, brand and size, of each piece of equipment to ensure he gets exactly what is prescribed. Because of Artie’s hospitalization, the physician is sure to write “to prevent re-hospitalization” on the prescription — key words that quickly get his equipment requests authorized and delivered. Artie is now sitting straighter and enjoys a successful season three.

In my less dramatic, but much more hopeful storyline, Artie notices a red area on his right ischium and right calf during his daily skin check. His parents make an immediate appointment with his primary care physician — she looks at the red areas and writes a referral to the seating and positioning clinic (described in the previous paragraph). Artie gets a full seating evaluation and a prescription for the proper equipment. Over the summer he does extra weight shifts, and extra skin checks until his new equipment arrives. When his new equipment arrives, his seating is improved, he has no more red “hot spots” and enjoys a successful season three.

 

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Bob Vogel, 51, is a freelance writer for the ROHO Community blog. He is a dedicated dad, adventure athlete and journalist. Bob is in his 26th year as a T10 complete para. For the past two decades he has written for New Mobility magazine and is now their Senior Correspondent. He often seeks insight and perspective from his 10-year-old daughter, Sarah, and Schatzie, his 9-year-old German Shepherd service dog. The views and opinions expressed in this blog post are those of Bob Vogel and do not necessarily reflect the views of The ROHO Group.

Christmas with the Mermaids (Manatees)

Guest blog post by Bob Vogel

Rays of sunlight broke through early morning mist as I piloted the pontoon boat toward an area where the gentle giant manatees are known to congregate. Our eyes combed the calm waters looking for swirls created by the mammal’s huge, flat, mermaid-like tail. “I see a swirl! Look there’s another!” shouted my daughter Sarah and her best friend, Alyssa, as they excitedly watched a mother and her calf swim by the boat. Dropping anchor, we donned our gear, I transferred to my ROHO^® ADAPTOR^® Pad protector on the deck of the boat and got ready to join the others in the water to begin our quest — snorkeling with manatees.

In early December, my ten-year-old daughter Sarah and I flew to Florida for an early Christmas vacation — snorkeling with manatees was our main goal. Sharing our adventures were Sarah’s best friend Alyssa and her mother Debbie Pettit.

Our base for the manatee adventure was the town of Crystal River, Florida, home of the Crystal River National Wildlife Refuge — an area that supports the Florida’s largest concentration of manatees during winter months.

Manatees have a walrus-like face, two front flippers, and a large, flat, rounded tail. Adult manatees average 10–12 feet in length and they weigh between 1,000–1,500 pounds. When ancient sailors saw their long flat tails they mistook them for mermaids or sirens and were disappointed that they weren’t as attractive as the legends say. During the summer months they roam in warm, shallow coastal waters from Virginia to Louisiana. As ocean waters grow colder during winter months they swim inland to Florida’s warmer spring fed rivers — peak months to view them in these areas are November through March.

Protected by strict state and federal laws, it is illegal to harass manatees — this includes swimming toward them. But manatees are curious and playful and when you remain still, they will often swim up and gently rub against you in a motion that any dog owner will recognize, “rub my back.” According to the rangers I spoke with, when a manatee swims up to you, it is OK to gently rub or scratch them.

As we hovered in the water, the first manatee gently swam by — for Sarah and Alyssa, having a 10-foot creature swim this close was a bit scary at first and they decided to get back in the boat and watch. The manatee came up to me and I gently scratched its back and it rolled over like a 1,000-pound puppy wanting a belly rub. After playfully scratching its back and belly for a while I slowly swam back to the boat — and the manatee followed, wanting more scratches. At this point Sarah, Alyssa and Debbie joined me and we all took turns letting the gentle giant swim up to us for back scratches and belly rubs.

When we finally climbed back in the boat I checked my watch — thinking we had been in the water for about ten minutes — we had been in the water for 1½ hours, the experience was so powerful that we lost track of time.

The dock and pontoon boat at the Crystal River Lodge Dive Center were fairly easy to wheel onto and there was plenty of width to spare on each side of my (14” seat width) chair. There is no lift on the boat, so getting into and out of the water requires good upper body strength and/or strong companions.

Our next stop was an amazing visit to Homosassa Springs Wildlife State Park. The fully accessible park that offers manatee encounter programs, boat tours and showcases native Florida wildlife including alligators, panthers, black bears, bobcats and key deer.

The following day we drove to Clearwater Marine Aquarium to see Winter the dolphin, star of the film “A Dolphin’s Tale,” the true story about a bottlenose dolphin that was fitted with a prosthetic after he lost his tail from becoming entangled in a crab trap. It was very cool that the aquarium and animal rescue center are exactly as they appear in the movie — and fully accessible.

After watching Winter, Debbie said, “You swim like him.” When Winter isn’t wearing his prosthetic tail he propels himself with his pectoral fins. When I snorkel I propel myself by waiving webbed finger gloves at my side. Debbie said “I was following you when we were with the manatees, and the way you swim with your webbed gloves looks just like Winter when he swims.” I thought. “Wow, me and Winter. That is cool!”

Last but not least on our adventure was a day at Universal Studios, — Sarah and Alyssa’s focus was The Wizarding World of Harry Potter. I haven’t read the Harry Potter books and have only seen a few of the movies, however the park is so cool that I got caught up in the excitement along with the other muggles and I’m now looking forward to reading the books.

The feature ride of the park is Harry Potter and the Forbidden Journey, which takes you through fully accessible passageways and corridors of Hogwarts Castle and School of Witchcraft and Wizardry. The tour culminates with a state of the art, four-person flight simulator that takes you on a wild flight behind Harry on his broomstick through the castle, past the Whomping Willow and a horde of Dementors, into a Quidditch match. There is a secret (much faster) wheelchair entrance and a car reserved for wheelchair users and their families.

The side-to-side, up and down movement of the ride is intense and wheelers must be able to transfer to the (hard plastic) seat under their own power to be able to go on the ride. Once again, my ROHO ADAPTOR^® Pad enabled me to safely enjoy the ride. Because the ride was a bit much for Sarah, the staff let Debbie and Alyssa go first. When they returned from the 5-minute ride it was my turn — Debbie stayed with Sarah and Alyssa got to stay on the ride with me. Alyssa got to ride twice and the ride was amazing! As a hang-glider pilot it takes quite a bit to impress me — this really felt like flying — flying through the world and stories of Harry Potter from the Forbidden Forrest to playing Quidditch! Even better — when the ride was over, the staff said, “You are welcome to stay on and ride again if you want!”

On the flight home I reflected on sharing the adventures of our Florida Christmas trip — more adventures to add the treasure chest of memories.

Resources:

• Clearwater Marine Aquarium: www.seewinter.com
• Crystal Lodge Dive Center: www.manatee-central.com
• Homosassa Springs Wildlife State Park: www.floridastateparks.org/homosassasprings/

 

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Bob Vogel, 51, is a freelance writer for the ROHO Community blog. He is a dedicated dad, adventure athlete and journalist. Bob is in his 26th year as a T10 complete para. For the past two decades he has written for New Mobility magazine and is now their Senior Correspondent. He often seeks insight and perspective from his 10-year-old daughter, Sarah, and Schatzie, his 9-year-old German Shepherd service dog.

Try Out a New Adaptive Sport this Winter Season

Guest blog post by Bob Vogel

Winter is here, temperatures are falling and so is the snow. This is Mother Nature’s way of telling wheelchair users “I’ve covered the outdoors with an amazing accessible blanket of snow and ice. Switch from wheels to skis or skates, and come out and play!”

Adaptive gear for winter sports has evolved to the point where people with almost any disability level can actively participate. It’s time to grab your warm clothing, choose your preferred method of gliding, skating or sliding and play in the winter wonderland. Here are some ideas.

Adaptive Downhill Skiing

For enjoying a dance with gravity in stunning mountain surroundings, adaptive downhill skiing is the ticket. There are several types of adaptive skis for wheelchair users. One option is a bi-ski — a molded bucket-style seat mounted to a frame attached to two, wide, specially designed skis — enables anybody to ski. For skiers that have hand movement, bi-skis can be turned using outriggers — forearm crutches with small skis attached at the tip used for balance and for turning. Bi-skiers are usually “tethered” — a stand-up skier holds a tether made of climbing webbing to assist speed control and turning — and also assisted on and off the lift. If you have the ability to move your head you have the ability to turn a bi-ski and enjoy the slopes.

 

 

Mono-Ski

A mono-ski — a molded bucket-style seat mounted on a suspension system and shock absorber mounted to a standard snow ski — is arguably the ultimate sports prosthetic. Expert mono-skiers shred the entire mountain and back country — from powder, to terrain parks, to extreme steeps and huge jumps the same as stand-up skiers. The learning progression, and length of time it takes to become proficient at mono-skiing is similar to stand-up skiing. Although trunk muscle control makes the sport much easier to learn, I know several low level quadriplegics — including a C6/7 complete quad — that are accomplished mono-skiers.

Nordic Sit Ski

If you are looking to get away from the crowds and glide through the beauty and quiet of nature — nordic sit skiing is for you. A nordic sit ski (also called XC sit ski) is a lightweight molded bucket-style seat mounted on two cross-country skis — the rig is propelled with ski poles. XC sit skis are surprisingly easy to propel, and the polling action helps keep shoulders healthy and balanced by working the muscles in the back of the shoulder. The sport can be as simple as a XC glide over a meadow or through the woods, to multi-day hut trips — skiing from one cabin to the next, to races of anywhere from half-kilometer to 20 kilometers.

Skijouring

A fun addition to XC sit skiing that I enjoy is skijouring, getting towed by one or more dogs. When I’m out XC skiing with my daughter Sarah and Schatzie, my German Shepherd service dog, I attach a tether to Schatzie’s harness and yell “squirrels!” to enjoy a high-speed winter dog tow.

Sledge Hockey

Perhaps hockey is your game. Sled hockey, also known as “sledge” hockey is an international and Paralympic sport with the same the same high-speed excitement as stand-up hockey, but adapted to a sitting position. A hockey sled is a molded bucket seat mounted on a lightweight aluminum frame, mounted on standard hockey skate blades. Players hold a hockey stick in each hand, the bottom of the each stick is fitted with a serrated spikes used to propel the sled. Simple adaptations like duct tape enable people without hand-grip to play. Hockey sleds are easy to propel, and a good player can reach high speeds and carve sharp turns and high speed check stops.

Adaptive Skating

A very cool spin off of sled hockey is adaptive skating. The potential for possible high-speed impact in sled hockey is a bit much for my aging brittle bones — but thanks to sled hockey’s popularity, many ice rinks offer hockey sleds, usually at no cost, or the cost of rental skates. I have a blast going to my local rink, strapping into a hockey sled and skating with Sarah. It is a fun workout and also helps keep shoulders healthy by working the same muscles as cross-country skiing. Ask your local rink if they offer sleds, if they don’t suggest they get one, most will be happy to purchase one since it means more business for them.

Dog Sledding

Dog sledding is another unique activity, ready made for wheelers. I’ve had the opportunity to go dog sledding and it’s an amazing way to travel into the winter wilderness. Riding in a dog sled, the only sounds are the hiss from the runners of the sled and the pitter-patter of dog paws. The tether to the dog team seems to make a direct connection to your senses, and watching ten wagging tails in front of you — running with its pack towing a sled through the snow on a crisp clear winter day, must be a blast for a dog. The experience is sure to put an ear-to-ear grin on your face. Dog sled operations are surprisingly common in snow country and trips range from 45-minute outings, to half day and even full day trips.

So pick a winter pastime, and enjoy mother nature’s winter adaptive blanket. See you on the snow!

Resources:

Adaptive Ski Programs

• Adaptive Adventures: www.adaptiveadventures.org
• Disabled Sports USA Far West: www.dsusafw.org
• Disabled Sports USA: www.dsusa.org
• Adaptive Ski & Sport Programs — Once on the page, scroll down to the map of the U.S. and click on the state where you want to ski: www.sitski.com/pg3.htm
• National Ability Center: www.discovernac.org

Dog Sledding:

• Wilderness Inquiry: www.wildernessinquiry.org
• Wintergreen Dogsled Lodge: www.dogsledding.com

Nordic Sit Skiing:

• Environmental Traveling Companions: www.etctrips.org
• Crested Butte Adaptive Sports Center: www.adaptivesports.org
• National Ability Center: www.discovernac.org
• Northeast Passage: www.nepassage.org
• Ski For Light: www.sfl.org
• Turning Point Tahoe: www.turningpointtahoe.com
• Wilderness Inquiry: www.wildernessinquiry.org

Sled Hockey:

• National Ability Center: www.discovernac.org
• Ski For Light: www.sfl.org
• United States Sled Hockey Association: www.usahockey.com/disable_hockey/default.aspx?NAV=AF_14&ID=62272

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Bob Vogel, 51, is a freelance writer for the ROHO Community blog. He is a dedicated dad, adventure athlete and journalist. Bob is in his 26th year as a T10 complete para. For the past two decades he has written for New Mobility magazine and is now their Senior Correspondent. He often seeks insight and perspective from his 10-year-old daughter, Sarah, and Schatzie, his 9-year-old German Shepherd service dog.

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