Q&A with Blogger Priscilla Hedlin

Blog site: WheelchairMommy.com

 

How long have you been blogging? I started blogging before it was blogging. I had my first website in 1999 on a geocities site.

Priscilla Hedlin - Interview

Describe yourself in 3 words. Devoted, resourceful and passionate

 

First thing you do when you wake up? Drink coffee and check my email.

 

Last thing you do before you go to bed? I kiss my husband, you should ALWAYS kiss goodnight!

 

Last book you read? Somewhere with You by Britney King.

 

Finish these sentences:

In the next 10 years I really hope… to see my boys growing into amazing young men and to be successful in my speaking goals.

If no one read my blog I would…be sad. I am thrilled when someone says it has inspired them but it’s for me too, so I wouldn’t stop!

Visit my blog if you….want to see how I can take care of 3 boys sitting on my butt all day.

I would be very rich if I had a dime for every time someone asked me…to stop speeding in that thing.

I get happy when I….see my boys succeed and reach their goals.

Q&A with Jamie Goodwin

Blogging via Facebook.com/Wheelin’ Weightloss

Why did you start blogging?

I started writing and sharing my story to inspire others to lose weight and to have accountability partners in return.

 Jamie Goodwin - Interviwe

   If you could give your page a permanent hashtag what would it be?  
#noexcueshere
 

 

 

 

Gadget/”trick” you use that makes life in a wheelchair a little easier?

Ask for help. People are always willing to help.

What would your followers be surprised to learn about you?

I grew up on a farm and milked goats until I was 12 years old.

Finish these sentences:

I wouldn’t have believed you if you told me ten years ago that…. I would be the mom of 3 boys and a pastor’s wife!

In the next 10 years I really hope… To have reached my goal weight (45 more pounds to go) and to have written a book.

If no one read my blog/posts I would… keep posting! Seeing my progress and setbacks always help when you are on a weight loss journey like this.

Visit my blog/page if you….want to be inspired to lose weight and get healthy!

I get happy when I… go camping with my husband and 3 boys!

ROHO Elite Interview: John McRoberts

October 1, 2014 by  
Filed under Feature Story, Lifestyle, Sports

John McRoberts - Elite LiveRoho

Meet John McRoberts, a medal-winning Paralympic Sailor for Canada. John splits time between Victoria, British Columbia and St. Petersburg, FL. Always an active person, John participated in everything from wheelchair rugby to racing before finally settling on sailing. To John sailing has longevity, “Other sports have a shelf life because of your age. Sailing can be done until the day I die.”

Disability or Age Doesn’t Matter

Unlike other sports that require being able to move a wheelchair around aggressively or upper-body strength, John points out that with sailing disability or age doesn’t matter, it’s mentality. “The beauty of sailing is that you can compete with a high level disability. Anybody can do this. [On the water] it’s about being faster and smarter – it doesn’t matter about the chair. I get to leave my chair behind. It’s really good mentally to be free from it, you know?”

Training

As part of John’s training he spends time both on the water and in the gym. Four days a week he spends 3 hours on the water practicing. At the gym John is stretching and working with a trainer on machines.

Paralympic Sports

We asked John if he weren’t sailing, what Paralympic sport would he want to compete in? “Rugby. I played when I was younger but since then the chairs have evolved; the whole sport has evolved. Rugby is the ticket everyone wants at the games.”

Security is Peace of Mind

John is equipped with a ROHO cushion both in his chair and on his boat. “You can be as talented and adventurous as you want but if your health isn’t good you can’t do anything. Sitting on a ROHO is a huge peace of mind. I know I’m going to be fine. It allows me to check off one of those precautionary things that I have to worry about each day. It’s my security blanket. “

The Future

After meeting John his wife Jackie sailing, they got married in 2010.  Jackie also enjoys staying active and is John’s sailing partner.  Together they are committed to going to the 2016 Paralympic Games in Rio de Janeiro.  Best of luck!

Important Reimbursement Changes to Consider When Choosing Your Next Wheelchair Cushion

Every wheelchair cushion has a finite lifespan and eventually, every brand, make and model of cushion will wear beyond its usability. When this happens the cushion no longer supports and protects your skin the way it was designed — putting you at risk of a pressure sore.  This is why it is vital to replace your cushion before it fails. Two important questions I’m frequently asked and have written about in the past are, “How often should I replace my cushion?” and “How often will insurance pay for a new cushion?” The answers to these two questions are linked. It is a good idea to replace your cushion as often as your insurance will pay for it. This way you are best protected with a cushion that’s performing optimally, plus you can keep your old cushion for back-up use.

The answer to “How often will insurance pay for a new cushion?” is a moving target, and in my opinion has moved in the wrong direction in the two years since I last wrote about it. In my September 2011 blog post, “How Often Should You Replace Your Cushion?,” Dave McCausland, senior VP of planning & government affairs for The ROHO Group explained that CMS (Centers for Medicare and Medicaid Services — the federal agency that decides how often Medicare will pay for a new cushion) said that in the past it was generally accepted that Medicare would pay for a new cushion approximately every three years, and Medicaid and private insurance tend to follow Medicare’s lead. To reinforce this position, back in 2004 when Medicare established the current policy for coverage and reimbursement of medical seat cushions, they stated that they did not anticipate that cushions could last the five years necessary to be classified as “durable medical equipment” (DME).  This was the justification that they gave regarding why a beneficiary must have, and qualify for, a wheelchair in order to get a seat cushion. They stated that since a cushion was not expected to last five years it had to be considered as an accessory to a piece of DME in order to be eligible for coverage and reimbursement. In this case the piece of DME that cushions were associated with was a wheelchair. However, recently it appears that Medicare is changing its position. I learned from Mr. McCausland that in recent correspondence and communication Medicare has indicated that they will require five years to pass before they will pay for the replacement of a cushion! Why they are making this change is anyone’s guess…

Another important change, as of May 1st, is that CMS has enhanced the definition of an adjustable skin protection cushion vs. non-adjustable cushion under HCPCS codes (Healthcare Common Procedure Coding System numbers — the codes used by Medicare for medical goods and services). The old definition was very subjective and vague. Under the new CMS definition, only cushions that contain a fluid medium (air, gas, liquid or gel) and that can be altered by addition or removal of the fluid (as in adding or removing air from a ROHO cushion) will be considered adjustable. The adjustable cushion definition also covers cushions in which the adjustment is done by adding or removing packets of fluid medium (such as adding or removing a gel pack under a gel cushion). Cushions that are custom fit and/or custom molded are in a different HCPCS category than adjustable cushions.

Cushions that are custom fit and/or custom molded are in a different HCPCS category than adjustable cushions.

An important part of the enhanced CMS definition of adjustable cushions is that the adjustment must be able to be accomplished by the wheelchair user or their caregiver with the items supplied when the cushion is delivered, and the adjustable cushion must be able to address changes in skin protecting/seating issues such as weight gain, weight loss, or muscle tone changes. CMS wants to ensure that when they pay for an adjustable cushion, it will protect a wheelchair users skin not just today, but months and years down the road.

CMS’ coverage criteria for wheelchair users to qualify for an adjustable cushion are the same as it is for a non-adjustable cushion. With the time to get a cushion reimbursed getting longer and longer, it seems only logical to get an adjustable cushion rather than non-adjustable. Five years between cushions is a long time, and seating needs are dynamic, not static.

In my personal experience with spinal cord injury (SCI) – I’m a T10 complete para – as well as the experiences of friends with SCI, by not having the “guywire” support of trunk muscles it seems more often than not our seating requirements change and shift a bit here, a bit there. An adjustable cushion addresses these changes; changes such as sitting more on one ischium. This is something that is easily caught during a mirror skin check and can be quickly addressed with an adjustable cushion. For instance, if I notice a bit of pinkness on an ischium during my evening mirror skin check, I will hop into my chair and push the green knob on the ISOFLO Memory Control® of my ROHO QUADTRO SELECT® HIGH PROFILE® Cushion, then put weight on the ischium with the pinkness to let some air out of that chamber.  When I push the ISOFLO’s red knob to lock the cushion in place, the cushion is now adjusted to put less pressure on that ischium.

An important caveat: Anytime the cushion you are using shows signs it isn’t doing an effective job of protecting your skin, for example you notice your skin remaining red after a day of sitting (another reason it is vital to do skin checks with a mirror each evening and morning), please see your doctor right away and get a seating evaluation, (SeeIs It Time To Replace Your Cushion?”)!

Be aware that the process of getting in for a seating evaluation and seeing if you can get approval of funding for a cushion that meets your changed skin protection needs may take months – months where a serious pressure ulcer could develop. Whereas with an adjustable cushion you can quickly adjust the cushion to adapt to the change, and the skin issue should vanish.

As always, when it comes to ordering a new cushion, it is vital to make sure the exact make, model, and size cushion are on all therapists’ and physicians’ prescriptions.

Last but not least, knowing that CMS reimburses a new cushion only every five years, it is important to make sure you get a quality cushion that will go the distance.  For a good look at an example of the stringent quality control, testing and tracking that a quality cushion manufacturer employs, as well as warrantee, repair and replacement policies, read “Why there is such a big price difference in medical products that look so similar?”

The article addresses important questions to ask when you are looking at a new cushion. When getting a new cushion that will be protecting your butt for five years it is important to do your research!

Questions you should ask include:

  • Is the cushion manufactured entirely at the manufacturer’s plant?
  • What kind of quality control does each individual cushion go through before it is shipped?
  • What is the return policy?
  • How is the manufacturer’s customer service?
  • Does the manufacturer maintain quality control over every aspect of its cushions onsite?
  • How long is the warranty?
  • Is the manufacturer continually improving the product?
  • Does the manufacturer include research papers about its product on its website?

Bottom line, as reimbursement time between cushions gets longer it becomes even more important to educate yourself about the cushion you choose. By taking the time to do your homework, and choosing a quality adjustable cushion that will last and address your needs, you are taking control of your health.

___________________________________________

Bob VogelBob 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.

Is It Time To Replace Your Cushion?

February 12, 2013 by  
Filed under Guest Bloggers, ROHO Community News, ROHO Products

Guest blog post by Bob Vogel

“How do I know when it’s time to replace my cushion?” This is an important question that frequently comes up at consumer shows, a question that has a several answers.

The first and foremost reason to replace your cushion is if you have a change of medical condition that effects your skin such as weight gain, weight loss or if the cushion you are on is showing signs that it isn’t doing an effective job protecting your skin— if you start to notice your skin remaining red after a long day of sitting–insurance should pay for a new cushion with the proper seating evaluation.

This is why it is crucial to check the skin on your butt with a mirror every evening and morning—taking a few moments to do a mirror-skin check gives you the best odds of catching a potential skin problem early, before it progresses into a serious pressure ulcer.  If you start seeing a red area at the end of the day, it is important to tell your doctor and ask for a referral for an evaluation with a seating clinician—as soon as possible. Don’t wait!

This recently happened to me.  I’m 52 and in my 27th year as a T10 paraplegic and except for one tiny pressure ulcer right out of rehab I’ve had healthy skin.  But as we age our skin gets thinner. Lately I’ve noticed some redness on my left ischium during my evening mirror checks. I have a pelvic obliquity; my left ischium is slightly lower than my right. I tried readjusting the pressure in my cushion and doing extra weight shifts but the redness would return by evening. Although the redness blanched—turned white when I pushed on it with a finger and would disappear within 30 minutes– I knew I shouldn’t have any redness at all.

I took this very seriously. I know way too many wheelers that “never have skin issues” and felt they didn’t need to do mirror skin checks anymore.  Then somewhere 15 or more years after their injury they end up with a pressure ulcer, skin flap surgery and 3-month hospital stay.

The usual protocol in my case would be to phone my physician right away and get a referral to the first possible seating clinic. AND have the doctor emphasize, “there is compromised skin”.  This should get a timely seating clinic appointment because a new, properly fitted cushion is much cheaper than hospitalization and a skin flap.   If the seating clinic determined the cushion I was currently on was not adequate and I needed a new cushion, I would be sure to have them write that my skin is “compromised” on the Letter Of Medical Necessity.  As always it is important that the Letter Of Medical Necessity and cushion prescription say the exact seating needs; for example, ROHO® HIGH PROFILE® Single Compartment Cushion (4-inch).

I went through this once—26 years ago—with a tiny pressure ulcer due to the wrong cushion.  Because of the pressure ulcer I got a timely appointment at a seating clinic and Medicaid quickly approved payment for a ROHO cushion–an upgrade from the inadequate memory foam cushion on which I had been sent home from rehab.

In my current instance I was fortunate that I know a physical therapist that is an expert in seating and positioning. She took all of my seating information into account and suggested I switch to a ROHO® QUADTRO SELECT® HIGH PROFILE® Cushion, that has deeper cells than the ROHO QUADTRO SELECT that I was currently on. This would give me deeper immersion sinking into the cushion to provide more support in the areas surrounding my ischiums, and allow me additional depth to adjust the cushion so the left rear quadrant is significantly lower than the right without bottoming out—thus taking weight off of my ischium.  A disclaimer: Since I am in the ROHO elite program I didn’t have to get insurance approval.  Several weeks ago I received my ROHO HIGH PROFILE QUADTRO SELECT.  Evening mirror skin checks reveal success!  At the end of a long day my skin looks fine!

Another important reason to get a new cushion is time.  Every brand, make and model of cushion will break down over time. When this happens the cushion no longer supports and protects your skin the way it was designed—putting you at risk of a pressure ulcer.  Even if the cushion you are using is working fine, it is important to replace it before it starts to break down!

How often funding sources will reimburse a new cushion varies from one type of insurance to another.

In order to get a new cushion before your current cushion breaks down it is important that you are the squeaky wheel and ask about getting a replacement cushion. The way to do this is contact your local DME (durable medical equipment) supplier and tell them you need a new cushion. They will be happy to guide you through the step by step process of getting a new cushion, based on your seating needs, including gathering your insurance information to let you know how often your insurance will reimburse a new cushion.

If you don’t already have a working relationship with a DME supplier, locating one is your next step. ROHO makes this easy. To find a DME supplier go to www.therohogroup.com/where_to_buy.jsp and click on Buy from an Authorized Retailer Near You.

You can find Medicare DME provider(s) in your area by going to www.medicare.gov. On the main page pull down Resource Locator, scroll down to Medicare Supplier Directory, from there, type in your zip code and click submit. On the next page check Wheelchair Seating/Cushions and hit view results. The “default” setting on View Results is 10 miles — to find more DME supplier options it is helpful to expand the View All Suppliers Within (on the right side of the page) to a larger distance in order to find a Medicare DME provider that is also a ROHO authorized retailer.

It’s much better to be a proactive “squeaky wheel” and work on getting a replacement cushion while the cushion you are sitting on still provides proper support for your skin than waiting too long and risk developing a pressure ulcer because your cushion gets so old it is breaking down.  Plus, getting a new cushion while your old cushion still provides proper support means you now have a back up cushion—one you can use while cleaning your new cushion and/or to use on the seat of your car for extra skin protection while driving.  If your cushion is getting replaced, be sure that all of your paperwork specifies the exact manufacturer, model and size of the cushion you were fitted for.

Keep doing daily mirror skin checks and replace your cushion before it breaks down.  Stay healthy my friends!

 

___________________________________________

Bob VogelBob 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.

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