SD vs. power assist rims. anyone have one/the other/both?-long sorry

[mccoll95]

I'm not sure this belongs here. Mods please move it to an appropriate place if necessary.

Hello all, You are the most helpful people on the face of the earth so here's my question in a Nutshell with details below:


Power Assist wheels vs. A service dog. Pro's and Con's and which one should I choose?

For my long story you can find my post under "introduce yourself"
The short version is
L4/L5 SB and all the "good stuff" that comes with it medically.

I'm a full time manual wheelchair user who also uses a motorized reclining chair for pressure sores a very small percentage of the time.

at 31 years old (almost 32). I've already done PT on my right shoulder once. The motion of pushing a manual is finally hitting my shoulders. Not just the pop and crack that I'm sure all of us around my age and above have by now, but I couldn't lift my arm somedays for a minute there. PT totally fixed it and now I have my exercises to keep my shoulders a little longer.

I am avoiding full time motorized chair use for as long as I humanly possibly can. Nothing against motorized chair users of course. Heck I own one! But For me:
my manual is my exercise
my independence and
I just don't want to give that up.
I've managed to keep my weight at a manageable reasonable level because of my manual as well.

If I switch full time to a motorized I know I'll balloon up and potentially lose major movement ability. I'm incredibly independent in my movement and self care and am determined to stay that way for as long as I can. In light of this I was/am seriously looking into a Service Dog. I've owned dogs my whole life and am totally used to unwanted public attention and from my research thus far those seem to be the two biggest factors people who get SD's seem to struggle with. However I recently have come to learn of the existence of Power assist wheels. From what I understand they literally give you a little extra push when you use your chair. I understand these are probably created for people with lack of mobility or weakness in their arms/wrists and hands when it comes to pushing, but I'm wondering if they could save my shoulders a little longer as well? Either while I wait for my SD or in place of one So I dont' have to go that quite that far yet (although the idea of a dog is like heaven to me. I have a pet already but he's tiny and an SD would be big like I like dogs to be).
My concern is that the only real way to save my shoulders is from not having to use them quite as much, Which there are many ways an SD could help me with that in many ways such as:
open/close doors/ possibly do a bit of pulling/pick up/drop off objects in other areas of the building so I don't have to transfer in and out of my chair a million times a day.

I see that power assist rims could make the motion of pushing my manual less strenous on my shoulders, but I'd still be making the motion just as often wouldn't I? or would I eventually break the habit of constant pushing because I get to where I need to be with less pushing? I'm just not sure. Any insight would be amazing from anyone who has one or both of these options or is in the same boat. SO incredibly sorry for the long rant, part of this is me working it out for myself in my own head. For those of you that cant help but still "listened" thank you!
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[Angie]

Hi!!!!

Well, I can give you some tips as I'm in a similar situation. I'm a manual chair user due to Generalized Dystonia and I've developed the exact same issue with my right shoulder. If it flares bad I can't lift my arm up above my head. My shoulder usually hurts or is just sore. I had PT once for it and they used an ultrasound and ice which did help, but obviously pushing a chair, transferring, pulling open doors, manuevering carts and garbage cans make it worse and worse.

Power chairs have their own problems. I have a very nice one, but the batteries died and I haven't got them replaced (no medical insurance) so I'm back to  a full time manual chair user.

What I got told with my shoulder is to stop or greatly reduce pushing the chair, use ice and Advil. Mostly I have not stopped pushing the chair, use heat and Tylenol. lol.

Those power assist wheels for manual chairs are first off expensive, second I had looked into them myself for the exact same reason and discovered that users gave them poor reviews for various reasons. Because no one seemed happy with them I let it go and didn't get them.

Do you have a light chair? My current one is not a light chair and is more difficult and heavy to push. At some point I will buy a lighter sports chair that is much easier. That would be one thing that would help you. Switching between a power chair for long outings and a manual will also help you out. Honestly, I've dealt with the shoulder injury for years now and it hasn't gone away. There isn't really a way for me to save my shoulder. I have to get around. Even steering my van (with my right arm of course) makes it hurt. There isn't really much you can do.

So I would say things that help me are:
get a lightweight sports chair that is easier to push
rotate between a power and manual chair (if you are able to do other exercises that are low impact on your shoulder that would be good to keep your weight down)
use ice and Advil when it hurts

As for the dog, yes they can help you. I had a pulling dog for 10 years. I specifically got this dog for pulling. When you apply for dogs make sure to stress your interest in pulling. My Lab was big, strong and very driven and his strongest task was wheelchair pulling. I had a sports chair at them time and am a normal weight, he almost weighed as much as I did. He would pull my chair anywhere at anytime and our speed was usually a trot.

The harness I used had handles on the side that you would hang onto with (thankfully) my left arm and tell him Forward. It got to the point that no command was needed, including Left and Right. We were completely in tune with eachother after about a year.

This task also freed up my other arm to do other things like hanging onto stuff, talking on a phone, holding a drink, etc. It made me move faster, be more independent and save my shoulders.

After he retired I tended more toward a power chair. As a result I did not pursue another pulling dog. My current dog is not a hardcore puller and doesn't have the body frame or drive for it anyway. He can and does pull me on flat surfaces though, but nothing compared to my pulling dog.

So, you can research the power assist wheels, just make sure to look at the reviews for any given model. Other than that you just have to do your best to preserve your shoulder and hopefully you can get a dog that can help you with it.

If you have anymore questions I would be glad to try and help you out the best way I can

Welcome again I'm glad to see you back!

[Lizzie86]

I actually just finished going through the process to get power assist wheels but ended up not getting one due to several different factors (have a power chair on order now, sigh). I, too, have have grinding/cracking/achy shoulders and elbows (just in extensions) that come from a life time as using them as my "legs" (spastic cerebral palsy).

Angie - what brand were you looking into? And when?

I can PM you the brands that I was looking into, there definitely is a difference in terms of satisfaction and what company you go through. The main reason that I ended up not getting one was due to the fact that I would have to get an entirely new manual wheelchair, which the insurance company wouldn't go for, even though the benefits would be cheaper in the long run I have a folding one, which the axles cannot support with the weight of the power assist wheels. What brand of manual chair do you use? Is it a rigid frame or folding?

Have you tried out a power assist? When I was going through the process I tried it out and almost ran over the supplier. I hopped on and did a "normal" push strength and went flying straight ahead! It is a super easy and light motion to roll forward. However, it does require the same motion to move it, just a lot less force. I guess the question would be is does the motion hurt more or does the force required to move?

In terms of the question of SD v power assist, think about the other factors involved. Have troubles opening doors? Picking up dropped objects? What other sort of tasks are you looking for your SD to do? Just like Angie, mine is being trained to pull me in a wheelchair (I have a lightweight chair, TiLite, and am of average weight) but there are other tasks as well.

[mccoll95]

Angie, thanks for your reply. My shoulders are under control right now (thankfully, I got them back, for how long, who knows) that's why i'm looking into all this stuff now. I am pretty happy with the management of my shoulders right now and it seems you are too. hope that chair comes in for you soon!
Lizzie86- Thank you for your insight. On further reflection I realize it's the motion of the pushing, not the force. Although the force certainly makes it worse once it starts hurting. I think a dog that does some pulling is a better option for me. Can you PM me and tell me how much more "flack" you got from people when they saw your dog pulling you and how you handled it. I'm used to a lot of "flack" and comments since I already have a disability and lots of ways to handle them. And i'm not nervous about confronting anyone who questions me and my dog, but I'm particularly nervous about people getting extra hateful about the pulling thing. did people give you more flack when your dog was assisting you with pulling? how did you handle it etc.. Thankyou!

[state_of_nowhere]

I did a lot of research into a PA a few months ago, but opted for a power chair. I am still mobile, the chair is just to conserve energy.

I think for your situation, a PA sounds like it's a good idea. It will help save your shoulder and some energy, while being the "least restrictive" which is ideally what you want.

I definitely wouldn't look at it as a "PA vs SD". Look at your whole life and full range of limitations. If you just want the dog for pulling a manual chair, keep in mind that a lot of places are shying away from training that these dogs. If there are other things you would benefit from having the dog do for you - get both!

[Angie]

Lizzie- hi!

I looked into it I think last summer. I don't remember the specific brands I had checked into, but they did not get good reviews. It seemed it made the chair heavy, was difficult to break down and the batteries did not last long...making you push an even heavier chair around.

Plus the cost was upwards of $5,000 and I didn't go for it. I have not purchased my lightweight sports chair yet as I'm waiting for a job that is a longer term gig so I feel more comfortable spending the money. I've already priced out what I want and am going to spend about $3,000-$4,000 on the chair itself. Putting another $5K into it I won't do...because when it gets up around $10K I started wanting another car, ! I lose interest in spending money on a stupid chair and want something more awesome

So the chair I have now I don't think will work with the PA things. Its a folding Kuschall chair. I'd like to get a lightweight, rigid chair maybe from TiLite. I kinda like their chairs, but would like to see and try them first. You say you have one...like it? Which one do you have?

It does sound easier to push a chair if they work (and STAY working) although I think injury wise the shoulder problems are caused more from the repetitive motion of pushing, but a light easy chair to push requires less of that motion so it should help.

Mccoll- Cool, I'm glad your shoulders are under control right now and hope you can keep them that way. I'm glad you are looking at all kinds of things to keep you independent that is awesome.

As far as "flack" about the pulling dog I can't speak for the others, but in my case I never once had someone give me grief over seeing a dog pulling me around. Never. It was exactly the opposite and people thought it was awesome. Plus, we moved so fast most people wouldn't be able to catch us anyway. I had people pull over from driving or stop in the street and tell me that dog is awesome.

If I was ever confronted by someone who didn't like pulling dogs I would just be polite about it. Its their opinion and that is fine. I did not train the dog, I relied on an experienced program to hunt this specific dog down for me with regards to being a puller. They cleared him medically, physically and trained him so I trust they know what they are doing. My dog lived until almost 16 years old and never had any health problems in regards to pulling a chair. His vets new he was a pulling dog and never had any problem with it, I never saw any problems with it. The dog loved doing it. When you got his harness he would start bouncing up and down and when you got it on him would take off in a pull. It was his thing for sure.

If you get the right dog, the right chair and are the right weight there won't be a lot of problems. Your dog can do others tasks for you as well as Lizzie said. When I got the pulling dog the program I used had a list of tasks. They asked that my first priority task wise be put at the top. I had very much stressed I wanted a strong puller and that was my priority task. He did do other things like retrieve, but because I used pulling so much thats what I labeled him as.

So, don't be nervous about people hating pulling dogs. Just be polite about it or just ignore them and keep going. Your program will (should) find the appropriate dog for what you want and will train you how to work with that dog.

State makes a good point to, you want to research your programs well. I got my puller in '97. The program I used is still training them as far as I know, but obviously that was over 10 years ago. My current program I would have to ask next time as their dogs tend to be very mellow and quiet. Most pulling dogs are driven dogs with more energy than not. Lots of places shy from this time of dog. Some programs also will not train pulling dogs for whatever reason.

So you just want to make sure you have the right fit for what you want. If you have some programs in mind I know you are allowed to ask here if someone has dealt with that particular program, we just can't discuss it in public. So you can always ask the group for help there as well.

 

[mccoll95]

Please PM me about your programs name and if you reccomend.

[FrostedAcres]

MY SD learned pulling a wheelchair at 6 years of age-- he will be 7 tomorrow-- I too, have major shoulder issues-- I use a manual chair-- part time-- for pain control and energy conservation. My left shoulder is far better off than my right-- Connor pulls on my left--
with your PT program, have you tried neck traction? The relief of constriction within the cervical and thoracic areas has helped my  right shoulder very much-- Use of cortisone was no help for me-- I got very sick..

 I don't think I would invest in  anything that would make it harder to use a chair if something failed--batteries only live so long- and the type used on chairs are super expensive, as well. Also, if you are maintaining as much independence as possible-- do you drive-- alone? if so, that much more weight to have to load and unload.
 Go for a pulling dog with added tasks And perhaps a lighter chair, so the dog can really enjoy himself.

 Oddly, when the SD is accompanying a person in a chair, and puling to boot, I have experienced little to no confrontation-( only confrontation is with transport-- the local bus system- refuses to load dog, chair, and me on lift )- ambulatory, with cane, and the dog carrying packs-- loads of it. I think the chair makes people feel warm and fuzzy, but an ambulatory, non blind person makes them a bit jealous/angry...

[labs4ever]

I  have a manual chair and  have thought about  power assist wheels too.  although I haven't asked anyone about it.   Sophie   does guide work and  some pulling  with the chair, but since I want   her to last as long as possible,  pulling is  a very small percentage of her wc work.   

I haven't read the whole thread so hope I am not asking a question  that has already been asked.  my manual is a  rigid frame  with wheels  that pop off the axel by pressing the centre  of each wheel.  Do they make power asist whelels that do that?   I   could get a new wc  from  medicaid next year, but I really like this one   (a crosssfire fx or something  from invacare)  and   I am justg planning to continue to get   replacement  parts as needed. 
As far as my shoulders go,  they are doing fine.  I  think it is important to have the right  seating system,  back support  seat depth and   wheel  height compared to cushion  which helps body posture.   I   read a really good book  call "life on Wheels,  life for the  active wheelchair user"  It was written in the  late nineties,  but is a really good resource for all things   wheelchair and    is focused on spinal injuries.   Some of what that book has taught me  has kept me from getting things like preasure sores  (I have used a chair for seven years)   

As far  as   using an SD and   power asisst wheels,  I would say   go for it. 

[Lizzie86]

I haven't read the whole thread so hope I am not asking a question  that has already been asked.  my manual is a  rigid frame  with wheels  that pop off the axel by pressing the centre  of each wheel.  Do they make power asist whelels that do that?   I   could get a new wc  from  medicaid next year, but I really like this one   (a crosssfire fx or something  from invacare)  and   I am justg planning to continue to get   replacement  parts as needed. 

That was the main issue when I was looking into it. With a rigid frame, the axles are stronger and are able to hold the weight better of a power assist wheel. For the brand/model that I was looking at, each wheel is ~25lbs (so it's about 50lbs extra that's added overall) which can add a lot of stress to the axles. However, they are the standard pop-off with the press of a button in the center. As far as my knowledge goes, there are only two companies out there that make power assisted wheels - Frank Mobility and Quickie (or, at least those two are the most commercially available). In terms of compatibility with your current manual wheelchair, or the brand of wheelchair that provides you with the best seating, I suggest calling the supplier to locate a local vender and ask them specifically about that, maybe even see if you can test one out to be sure. By wheelchairs is a lot like buying a car; research and try it out behind the wheel. But I'm also crazy that way When it comes to insurance companies and approval for medical equipment, I always provide a plethora of information so that they understand. For my current chair, I basically told the Occupational Therapist (who was writing the letter of intent for the insurance company) what to write, being that it would be more cost effective to buy this model and this seating because of a previous experience when I didn't get the equipment I needed, and how much it cost them because of that (with copies of old medical bills).

[Angie]

Yeah, I don't think they will work for a folding chair. I went ahead and looked at it again and found they still do not have good reviews for 3 main reasons: Very short battery life, EXPENSIVE, and the replacement batteries are also expensive as well as parts. Leave it to the medical industry to stick it to you.

It will barely hold 6 hours of use. Ewe. And adds 53lbs...53 lbs! to the chair. The batteries don't last long and cost $800+ to replace. Times that by 2. The unit itself is $6,000. WTHBBQSauce.

Only 3 types are available and approved by the FDA in the USA. The users seem pleased with how it actually WORKS. It does help your shoulders and makes the chair easy to push. People seriously start balking at cost and battery life.

So for me, it wouldn't be worth it. Thats to much money I'm willing to spend on an accessory to an already expensive wheelchair. And knowing the industry they will force me to go thru one of their "vendors" who won't know how to fix the specialized unit, will charge me a ton in labor and everything meant for a chair will be at a 500% mark-up...just cuz. And 6 hours of use is pretty bad, considering you are going to get to push an extra 50lbs when they run out of life.

Anyway, its a good idea, but everything else just makes me scream not worth it.

[mccoll95]

Lizzie86 it's been so awesome meeting you  are so helpful to everyone I'm a very lucky person to have met you even over the 'net. I will most certainly look into everything you've said. Everyone on here has been amazing. I too am a strong self advocate. I research the heck outta everything (and sometimes scare/stress myself silly) but you can't ever say I'm not prepared. I'm not due for a new manual for a few years yet and my motorized reclining chair I really like. It just needs a new battery. So I think I may try out power asisst wheels the next time My new manual comes around but I'm pretty sold on the SD. Its not just about pulling and I should have made that more clear to everyone. I know we aren;t alloewd to talk about specific 'tasks" so i'm going to tread lightly here but some other hypothetical things I sure could use a hand with is balance during transfers, retrieve/give tasks. A perfect scenariio maybe is this:
I get in bed at night, realize i forgot to grab my nightie -so I transfer
Then i get back in bed (transfer) and realize I gotta powder my nose (transfer) and get back in bed (yet again trasnfer)
Then i wake up thirsty (transfer twice again
All this transfering is wearing on my shoulders yes, but another thing I feel I should and probably should have mentioned. I am an above the knee right leg amputee from a pressure sore turned bone infection gone awry. I dont' say this as a poor me thing (the amputation was the best thing for me, I got my life back  but the more I transfer, the more I mess with my-already- poor skin integrity on my um..how do you say back side? and thighs. So less transferring means less chance of tearing my skin to shreds from pressure/shearing/tearing. Also, Yes I have people that can help me, but waking my poor wife to help me so I don't have to transfer when she works a full time job and goes to grad school full time is not exactly fair of me when she can't get a nap during the day like I could give to an SD If i have particularly bad night. (I'd never sacrifice my dog's need for sleep either, but I can give an SD more sleep time during the day while I rest. I can't call my wife's boss midafternoon and say "excuse me I woke my Wife up 3 times last night can she take an hour nap in the breakroom because it's my fault? 

So anyway those are some hypothetical ideas that would assist me with my dog.
In addition. I have anxiety and although I wouldnt' get a multi-service dog, the very idea of him/her being around I think would calm me and help me be even more brave about doing new things like pursuing a new job. The anxiety from my last one shook my confidence a bit. I can see a Canine partner grounding me without eeven trying.

[coombzy]

I'm not physically disabled so I hesitated to comment for fear of it being unwelcome but I thought I'd take a shot anyway! The ideas you listed in your original post, and in the one I'm just below, sound like fantastic ways to help you out. If it's the motion rather than the force, well, that's all it took to sell me on "Get an SD!" Everything else just further solidified my (uneducated) opinion on that. You've mentioned an anxiety disorder so I can speak from that angle. It truly sounds as though you know yourself - not just your physical needs and what the dog can do for you but your own capabilities of managing the flack we all face sometimes when bringing a dog into a human-only area. What I mean to say is, I know you could handle that part, and it really sounds like the benefits outweigh any cons (did we even find any for you?). Canada doesn't have ESA's but if Cider could be one, I'd much prefer that. You're right, the simple presence of a dog at your side can deescalate anxiety symptoms so there's another huge point in the "pro" list!

I'm so glad so many members are able to help you out here. I hope you find the right dog soon!

[mccoll95]

coombzy your opinion is absolutly welcome and valid especially on these boards. sometimes even if we can't relate to another persons situation because we are not in it/haven't had it happen to us a little offer of hope, love and sympathy goes a long way! Thanks.