5 lessons learned from 27 years of having an SCI
February 29, 2012 by The ROHO Group
Filed under Feature Story, Guest Bloggers, Lifestyle, ROHO Community News
Guest blog post by Bob Vogel
This Friday, March 2, marks the 27th anniversary of my SCI (spinal cord injury)—T10 complete para—the result of a crash while performing aerial acrobatics on skis at age 25.
Each year when the anniversary rolls along, I honor it by taking a few moments to reflect on the amazing life and adventures I’ve had since my injury, as well as, odds and ends I’ve learned along the way. Here are a few random thoughts on life with SCI—things that have worked for me and things I wish I had known and/or would have done differently.
Random Thoughts—Things That Have Worked
1. The most important tool for healthy skin is a mirror-check twice a day.
An example of how a mirror check helped me avoid skin problems happened back in the mid 90s—a new cushion manufacturer offered me a demo of one of their cushions—a unique design that looked and sounded really cool and worked well for some people.
Before using the new cushion I had a pressure map reading (a system that displays areas of high and low pressure points—typical high pressure points are usually bony areas) done on it. From the pressure map reading, it looked good, so I gave it a try.
I did a mirror skin-check that evening and the skin on my butt was bright red—a serious warning sign. By the next morning the skin color had returned to normal so I figured I’d give it another try. While sitting on the cushion, I double-checked to make sure that I wasn’t bottoming out—and I wasn’t. After a few hours, I did a mirror check, and sure enough my skin was bright red and looked even worse than the previous night. I returned the cushion. If I hadn’t been in the habit of doing daily mirror checks, I wouldn’t have known the cushion wasn’t working for me. The first sign of trouble would have been a major pressure sore.
Another important reason to do a mirror check is because pressure sores usually occur with within the first years of the SCI, or 15 or more years after the SCI. The reason pressure sores often occur 15 years or more after SCI is that skin gets thinner and weakens as we age.
Too often I’ve heard of a friend that has gone years with healthy skin and no redness, and becomes complacent about checking. Without daily mirror-checks they don’t notice any areas of redness—a warning sign that skin, or posture has changed—and the red area continues to worsen. The first sign of trouble ends up being a major pressure sore and a hospital stay. Something that could easily be avoided by a simple mirror check.
2. Document medical issues for reimbursement purposes.
Often we wheelers become so adept at managing small SCI problems like minor pressure ulcers, or back or shoulder pain that we neglect to mention it our physicians. But we should. By making sure your physician documents—writes it down in your charts—any and all pressure ulcers, however minor, or back or shoulder pain, you have a written record in your medical charts, something that can make all the difference when it comes to time to request reimbursement for a specific cushion or wheelchair.
In my case, when I first got out of rehab I was sent home on a memory-foam cushion despite asking for a ROHO® HIGH PROFILE® Single Valve Cushion. Even though I was diligent about doing weight shifts, I got a small pressure sore within three months. Fortunately, I caught it during a mirror check and went to the doctor right away. After the pressure ulcer was documented, I was immediately approved for a ROHO and managed to heal it at home.
3. Connect with others with SCI.
Connecting and networking with other people with SCIs has been vital for me on many levels. It has helped me learn tricks and tips to living and thriving with an SCI. Being able to share thoughts and feelings, and get feedback from other people with SCIs helps put things into perspective.
Since I first attended SCI support groups in rehab, mentors with SCIs have had an important impact on my life. At the support groups, I was still trying to grapple with the idea that there is life after SCI, mentors would wheel into the support group and share their lives and what they were doing and show that life goes on after SCI. It is every bit as rich and exciting as ever.
When I first got of rehab, a hang glider pilot acquaintance, Dan Buchanan, who is also a T6 para, became a mentor to me and helped me with things from how to set up hand controls in my car and how to modify my hang glider with wheels, to suggesting foods and strategies to help avoid bowel accidents, and what to do when the inevitable accident did happen. Dan and I became lifelong friends and we still bounce thoughts and ideas off of each other.
Over the years, I’ve been very fortunate to form close friendships with others that have SCIs, to this day we often touch base to ask about or trade information on some type of SCI subject, or just check in to exchange thoughts and feelings. A perspective from a friend that has experienced similar feelings and or circumstances often makes all the difference.
Good places to meet friends and mentors with SCIs are at various adaptive sports and recreation programs in your area. Local Centers for Independant Living (CIL) often have this information, or simply do an online search for an adaptive activity you are interested and your location.
There are also plenty of online options and chat rooms share SCI thoughts, stories, ask questions and get mentoring advice and feedback from other folks with SCI. (See Resources)
A word of caution—just like anything else online, do not provide personal information for safety reasons.
Important Lessons Learned—Things That Didn’t Work
1. Get a second opinion for important medical issues
When it comes to important medical issues, it is very important to get a second and even third opinion. This is another area where networks of friends with SCIs can offer advice.
In 1989, I hurt my lower back while mono-skiing. A few days later it still hurt and I went to the ER. An X-ray confirmed that I had severely fractured my sacrum. I was advised to take it easy and the sacrum would heal on its own. Over the next few weeks my back got worse, I went back to the hospital to ask if I should be put in traction, I was advised it wouldn’t be necessary. I asked about getting a second opinion and was advised that wouldn’t be necessary that the doctor on my case was “the best in the business.”
Having a wide circle of friends with SCIs—like I do now—or the ability to bounce the question off an online group like CareCure Community or another chat room would have led me to seek a second opinion. Instead, I listened to the first doctor and didn’t pursue any further treatment.
It turns out I should have gotten a second opinion and should have been in traction—by not getting a second opinion, my spine fused in a crooked position. It’s something that could have been avoided by a second, or third medical opinion.
2. It’s important to ask a physical medicine and rehab (PM&R) physician to weigh on medical advice
In 2000, I fractured my right hip—the result of rolling over in bed with my feet caught in the corner of the covers, combined with osteoporosis—from 15 years using a wheelchair (see resources below)
I went to the ER and had surgery—four screws to secure my femur to the ball (trochanter into the ball). The surgery went perfect and I was released the next day. I asked the surgeon if I had any restrictions while healing. He said “Nope, it should be solid.” Unfortunately, he didn’t have any PM&R experience; he wasn’t thinking that with SCI the muscles surrounding my hip wouldn’t pull the hip together like they would in a non-disabled person.
Within a month, the screws pulled out and the hip came apart. My lesson—I should have asked a PM&R doctor to weigh in on the healing process. If I had, I wouldn’t have done transfers that pulled on the hip during the healing process and it would likely have healed just fine.
When the hip pulled apart, the surgeon said I could get an artificial hip. Not knowing anything about artificial hips I figured it would be a good option and scheduled surgery to remove the screws and put in an artificial hip the next week.
Luckily, I was learning my lesson about getting a second opinion. Two days before surgery I consulted with a PM&R doctor. He immediately referred me to surgeon versed in PM&R. The surgeon said that in my case an artificial hip would severely limit the mobility of my leg and cause a high probability of severe complications including hip dislocations and high potential for fracture in the middle of the femur. The artificial hip could have cost me the leg.
Instead I had a girdlestone procedure—the ball of the hip was removed. The procedure went well, and 12-years-later my leg is fine. Learning to get a 2nd opinion from a physician versed in PM&R saved my leg!
Resources:
Chatrooms/Forums/Message Boards
- CareCure Community: http://sci.rutgers.edu/forum/index.php
- New Mobility Message Board: www.newmobility.com/bb/ubbthreads.php
- Osteoporosis Update: Avoiding the Breaks: www.newmobility.com/articleView.cfm?id=11538&srch=Osteoporosis
- QUAD-LIST Discussion Group: www.makoa.org/quadlist.htm
___________________________________________
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.
Why there is such a big price difference in medical products that look so similar
February 16, 2012 by The ROHO Group
Filed under Feature Story, Guest Bloggers, Lifestyle, Medical Resources, ROHO Products
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″.
___________________________________________
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
February 1, 2012 by The ROHO Group
Filed under Feature Story, Guest Bloggers, Lifestyle, ROHO Community News
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.
___________________________________________
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
January 4, 2012 by The ROHO Group
Filed under Feature Story, Guest Bloggers, Lifestyle
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.

Above is a photo of Artie Abrams seating and positioning during the first season of Glee. ©2011 Fox Broadcasting Co. Cr: FOX Photos
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.”

Above is a photo of Artie's seating and positioning from the second season of Glee. ©2011 Fox Broadcasting Co. Cr: FOX Photos
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.”

Above is a photo of Artie Abrams' seating and positioning during the third season of Glee. ©2011 Fox Broadcasting Co. Cr: Danielle Levitt/FOX
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.
___________________________________________
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)
December 21, 2011 by The ROHO Group
Filed under Feature Story, Guest Bloggers, Lifestyle
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.

A trainer feeds Winter, the dolphin from A Dolphin's Tale at Clearwater Marine Aquarium in Clearwater, FL.
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/
___________________________________________
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.






