Wheelchair Gloves and Carpal Tunnel Syndrome

The hands of a manual wheelchair owner hold tremendous power. They are ?the engine?, ?the steering?, and ?the brakes?. They are the heart of a chair owner?s mobility.

They also take a great deal of abuse.

A wheelchair owner?s hands are exposed to constant friction and heat generated by pushing, stopping and turning. They are numbed and desensitized in cold and wet weather. Active and athletic owners are particularly vulnerable to the damage and irritation caused by constant use and exposure. In fact, At least 18% of all wheelchair users experience blisters, abrasions, and lacerations. Many more develop thick, rough calluses.

Carpal Tunnel Syndrome: A Wheelchair User's Enemy

Even more importantly, according to studies performed by Dr H.Gellman and his team from Rancho Los Amigos Medical Center in California, 49% of parapalegic patients showed signs and symptoms of carpal tunnel syndrome, a potentially debilitating condition. Dr. Coopers and Dr. Robertson of California State University report, ?Research in this area suggests that carpal tunnel syndrome may be the result of nerve compression which occurs during forceful exertions with the hand and wrist in hyperflexion or hyperextension. Repetitive strikes of the heel of the hand against the push rim may cause pain and numbness of the thumb and fingers.?

Hands were simply not designed to withstand the repetitive impact and constant contact with wheelchair pushrims. Fortunately, there are ways to minimize the effects of constant stress and exposure to the hands. Many researchers strongly recommend the use of properly designed wheelchair gloves to minimize hand injury.

Wheelchair Gloves Can Provide Relief

Properly designed wheelchair gloves can provide:

? Protection against skin damage caused by starting, stopping and turning the wheelchair.
? Protection against injury caused by vibrations and repeated impact.
? Improved stopping and maneuverability
? Comfort in cold or wet weather

Unfortunately, many gloves marketed as ?wheelchair gloves? fail. They fall apart under intense usage, or worse, are inappropriate for the lifestyles of their owners. The requirements of an athlete can be different from a moderately active person who is using a wheelchair in cold weather, while the needs of a person with limited hand function are different from those of a person who is experiencing a great deal of vibration or impact to the hand. Therefore it is important that a wheelchair user buys high quality, gloves that were designed for their specific needs.

To meet the unique needs of active wheelchair users, Med Services Europe has launched RehaDesign Gloves. For more information click here: RehaDesign Gloves or contact us at www.NewDisability.com

Dr. Gene Emmer is President of Med Services Europe GmbH a Zurich, Switzerland registered company. In addition to RehaDesign Wheelchair Gloves(http://www.newdisability.com/gloves.htm), the gloves designed for Active Wheelchair Users) we represent Colours Wheelchairs in Europe and the Middle East. We are seeking distributors and dealers for our products. Dealers are encouraged to contact us for more information.

Pain Management

Even the word pain hurts to those of us who endure levels of pain each day. Pain management is what the doctors tell us to do. This sounds great in theory, but what does it mean, and how does one go about doing it? These are excellent questions. It probably sounds logical, but the better you are at describing your pain to others, the better you can get help in managing pain. And, pain management is the key!

The best way to document and comunicate pain is to use what I call a pain scale. I set this up in what I call a matrix, where I have a chart with four columns as follows: The left column is for pain level, from 0 being NO PAIN (right, like that's gonna happen!) and 10 being so painful that NOTHING YOU DO seems to decrease the pain level.

In the next column, you describe the pain at different levels. I use the following: 0 = No pain; 02 = low levels of pain, an Over the Counter (OTC) remedy can get rid of it; 04 = moderate pain, need double the strength of the OTC remedy to dull the pain; 06 = heavy moderate pain, need double the strength of OTC remedy, but the pain isn't dulled, and activities are curtailed (decreased); 08 = heavy pain, need something stronger than an OTC remedy, and one must sit/lie still; and, finally, level 10.

The next column is the most important one, where you describe specifically what the pain feels like, and use many VERY SPECIFIC examples of how this specific level of pain impacts your normal daily living activities. I cannot stress how important it is to be as specific, and as complete with your examples as you can be. Also, you need to guesstimate the % of time a day/week that you routinely have this pain.

Here are some examples that I use:

02 - The low levels of pain are primarily headaches and backaches. I can take an OTC remedy, and rest for about 30 minutes, and the pain goes away. This level of pain comes about 2X a week, and only lasts for the 30 minutes until the OTC remedy kicks in. This level of pain does not keep me from doing my daily activities. BUT, I need to get on this level of pain immediately, or it will increase in level if not addressed and removed.

04 - This level of pain occurs in my hands, arms, legs, feet, and head. It is like the muscles are hurting, and the joints hurt. This level gets my attention; I take double the advised level of OTC remedy, and get some hot tea, and rest lying down. This level usually takes about an hour to manage, and I have to stop whatever I am doing to lie down until I get it under control. This level occurs about 10% of the time, every other day, usually in the evening. This level makes me depressed, and when depressed, the level of pain often increases to the 08 level.

08 - I usually go straight from 04 to 08, skipping the 06 level. This level is incapacitating. It feels like the worst flu you have ever had, where EVERY muscle and joint in my body hurts! Even my teeth and scalp hurt. Light hurts my eyes; sound hurts my ears; movement makes me nauseous. I take triple the OTC remedy, and a hot shower. I have a stool in the shower where I can sit and let the hot water shower down on me until I run out of hot water (I do this after I take the meds, and try to stay in the shower until I feel the pain beginning to receed). When out of the shower, I have room temperature ginger ale (hot or cold liquids hurt my head), and lie down with soft music - no words; with a cool washcloth over my eyes in a darkened room. This level of pain occurs 2 or 3 times a week, and lasts for about 20 - 30% of the day. I cannot function in any activity at this level of pain. When the meds kick in, the pain is only reduced to the 04 or 02 level.

10 - at this level, no OTC remedy helps; the shower doesn't help; nothing helps; the pain is just reduced to the 08 level. Need greater help than an OTC remedy. This level occurs about one time each week, and literally knocks me out. Now for the last column, and, this one is very important for long term pain management. In this column, you document what, SPECIFICALLY you were doing just before this level of pain was triggered! This will help both you and your Doctor determine what will help you.

For me, the doctor really noticed the comment about depression linked with pain, and the comments about taking above recommended levels of an OTC remedy. He prescribed for me an anti-depressant, and a pain medication in lieu of the OTC remedy. These meds, in conjunction with the meds for joint pain and for the tingling pains, allows for me to regain some of the normal daily living activities.

Good luck for you in documenting your pain levels!

About Disabilitykey.com & Carolyn Magura: Disabilitykey.com is a website designed to assist each person in his/her own unique quest to navigate through the difficult and often conflicting and misleading information about coping with disabilities.

Carolyn Magura, noted disability / ADA expert, has written an e-Book documenting the process that allowed her to:

a) continue to work and receive her ?full salary? while on Long Term Disability; and

b) become the first person in her State to qualify for Social Security Disability the FIRST TIME, in UNDER 30 DAYS.

Click here to receive Carolyn 's easy-to-read, easy-to-follow direct guide through this difficult, trying process. If you are disabled, don't let this disabiling process disable you. Read Carolyns Disability Key Blog.

Medicaid vs Medicare

Just like there's confusion over the difference between SSDI and SSI, there's confusion over the difference between Medicare and Medicaid.

So, here in a nutshell, is the definition of each.

Medicare - the very same health plan that retired people over 65 enjoy - can be obtained after receiving SSDI for 24 months. (NOTE: ONCE YOU QUALIFY FOR SSDI, YOU HAVE TO WAIT FOR 29 MONTHS BEFORE RECEIVING YOUR FIRST CHECK.) Medicare has two parts: Part A, which you pay for through your payroll taxes, and which covers overnight hospital bills, hospices, home health care and very limited, partial nursing home care. And Part B, three-fourths of which is paid for by federal income tax, and one-fourth ($84.00 a month in 2006, deducted from your SSDI check) by you. It pays for doctor, ambulance, emergency room, clinic and most other outpatient care (except drugs and nutritional products).

As of May 15th, 2006, Medicare now has a Part D which covers partial payment of prescriptions. Most people who qualify for Medicare select a Supplement package that covers additional things such as Doctor visits (minus the co-pay) and other things usually covered by a Health Insurance Plan. You have to pay extra for this. If you become eligible for Medicare after May 15th, 2006, you have to select a carrier for Part D. This can be included in your supplemental package, as mine is, or it can be a separate coverage.

Medicaid is run by the state and local governments. It completely covers hospitalization, clinic visits, emergency room visits, doctors' visits, hospices, home health care, nursing home stays, ambulance and outpatient prescription drugs. Medicaid has very small co-payments for prescriptions, doctor visits and some other care. While all hospitals and almost all drug stores accept Medicaid, most doctors don't, and many home health agencies, nursing homes, and hospices are also reluctant to accept Medicaid. People on SSI are eligible for Medicaid, and in most but not all of the states in the nation, SSI sends lists of recipients to the local government, which then automatically sends Medicaid cards out to them. But in some states, you must always apply separately for Medicaid at the welfare office, even if you're on SSI.

It's possible - indeed, sometimes it's absolutely necessary - to be on both Medicare and Medicaid. In that case, Medicare first pays medical bills up to whatever its rules allow, then Medicaid pays the rest. Always get Medicaid, if you can, to supplement Medicare, because with it, you'll have a way to pay deductibles and co-payments that you would otherwise face without it. Moreover, Medicaid pays for some things Medicare doesn't cover at all. Conversely, always get and keep Medicare (including Part B) even if you are already on Medicaid. Medicare pays doctors and hospitals more than Medicaid does, and therefore will make them more likely to accept you as a patient and devote adequate time to your case. Don't be afraid of the Part B monthly premium, either. Once you're on Medicaid, it will start paying the Medicare premium for you, and your SSDI check will go up by $84.00.

According to the Social Security Administration some assets are considered exempt (not countable) toward SSI eligibility such as:

? The house an individual lives in and the land it is on;

? Personal and household goods (depending on their value);

? Life insurance with a face value of $1,500 or less;

? Burial plots or spaces for the individual and immediate family; burial funds for the individual;

? A car with a current fair market value up to $4,500. The car may be of any value, however, if it has been modified to accommodate a person?s disability or if it is needed for necessary activities.

Some of an individual?s income is also not counted toward SSI eligibility such as: The first $20 of most income received in a month (from any source); the first $65 a month earned from working and half the amount over $65; food stamps; most food clothing and shelter from non-profit organizations; most home energy assistance. If the individual with a disability works, any wages used to pay for items needed for work related to the disability are not counted as income. (Source: Social Security Administration.) Since eligibility for government benefits is dependent on these financial restrictions, a person with a disability would be in jeopardy of loosing those benefits if he or she amasses any resources above the limit.

About DisabilityKey.com The Disability Key Website (http://www.disabilitykey.com ) is designed to assist each person in his/her own unique quest to navigate through the difficult and often conflicting and misleading information about coping with a disability.

Carolyn Magura, noted disability expert, has written an e-Book documenting the process that allowed her to:

a) continue to work and receive her ?full salary? while on Long Term Disability; and

b) become the first person in her State to qualify for Social Security Disability the FIRST TIME, in UNDER 30 DAYS.

To download Carolyn's e-book, click on the following link: http://www.disabilitykey.com/products.htm