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Saturday, February 10, 2018

Using a New Wheelchair is a Long Learning Process

I expected my old wheelchair destroyed by United airlines to last the rest of my life. Forced to adapt to a new wheelchair since mid December only now am I beginning to feel comfortable and secure. Initially, I was worried about falling and in pain by the end of the day. Finding the correct seating position was and remains a challenge. My old chair was very long--elongated was the fashion long ago. Long ago, the idea was to prevent muscle contracture by having a long down slope angle at the front to of the wheelchair. My rear wheels on the old wheelchair were wider and the front wheels were large by modern day standards (rear 24 1 3/4 and front were 8 1/2). All wheels were pneumatic. This gave me a soft ride and with my weight spread out I could navigate any terrain and up to a foot in snow. This was important to me in large part because my son was an outdoorsy kid and we spent a lot of time camping and kayaking. The back of my old wheelchair did not fold down and the frame could not be adjusted in any way. It was an elegant simple design and was rugged in the extreme.

My new wheelchair is sleek and uses the latest technology and materials available--most notably a carbon fiber frame. It is amazingly light yet feels a rigid as my old wheelchair. Modern day wheelchair manufacturing is all about component pieces that allow a great deal of adjustability. Wheelchair manufacturers claim they offer the best of two worlds. Great flexibility and rigid frame experience. I think this is a load of crap. Contemporary wheelchairs are adjustable because the professionals charged with selecting the right fit and size often make mistakes. Wheelchair sitting clinics have incredibly long waiting lists and providing a properly fitting wheelchair is far more complex than one would think. Indeed, it is a rarity when I see a manual wheelchair user sitting properly in a correctly fitted wheelchair. It does not help that many people buy wheelchairs online from discount houses such as Bike-on. I am not opposed to buying a wheelchair this way. One can save a fortune if they know exactly what they need.

Seating specialists are a mixed bag--some are great at their jobs while others are not competent. The range in quality even within a single company can be significant. I was fortunate in that I dealt with a competent seating specialist. Many are not so lucky and far too many people end up getting a wheelchair that is less than ideal and ill fitting. An ill fitting wheelchair is at best useless and at worst a significant danger to one's life and well being. Getting the perfect wheelchair fit is a risky and expensive proposition. Far too many people end up with a pink elephant--a wheelchair they cannot use and cannot be returned. The resale value is low. In short, you better get it right the first time or thousands of dollars will have been wasted.

I selected an Apex carbon fiber frame rigid wheelchair. I chose this over the TiLite line of wheelchairs. Based on my observations, the TiLite line of wheelchairs is the go to product line for most men who are paralyzed. These wheelchairs did not appeal. While the design was acceptable the TiLite wheelchairs are not built to last. Under rigorous use an aluminum frame TiLite can be expected to last two to five years (a titanium frame will last longer but significantly raise the price and would not be covered by most health insurance companies). The TiLite wheelchairs feels cheap to me. So why does the TiLite line of wheelchairs abound? They meet insurance industry price points. The other wheelchair I considered was the Panthera X. It is by far the lightest wheelchair manufactured in the world (it weighs under 5 pounds). It is also the most expensive manual wheelchair made. It is a gorgeous wheelchair. It also has Panthera branding all over the shiny carbon frame. Panthera has virtually no presence in North America. It is an exotic wheelchair for the 1%. It took me about two minutes to dismiss the Panthera. Despite its light weight and glossy carbon fiber frame with Panthera written all over it the wheelchair is wildly impractical. The Panthera will be the first wheelchair stolen (and yes wheelchairs are stolen all the time). Forget about getting spare parts. Forget about working on the wheelchair in the event a part fails--it has a host of proprietary parts. I could never permit such a wheelchair in the cargo hold of an airplane. Do I really want to put a $10,000+ impossible to insure wheelchair in the belly of a plane knowing that airlines break thousands of wheelchairs a year? Not a chance.

I went with the Apex wheelchair made by Motion Composites despite the fact I am wary of this company. They are based in Quebec and are the fastest growing wheelchair company in North America. I was concerned such explosive growth could lead to quality control problems. The Apex wheelchair frame weighs 9.2 pounds. It has integrated impact guards, front bumpers, and a rigidizing system that makes the wheelchair feel rock sold. Like other wheelchairs, it is fully modular and adjustable. The back angle, seat to floor height, upholstery, and more can be adjusted. In addition, it has laser etched markings that allow one to adjust key components so that they are level without measuring. It even has dual bubble levels in the front wheel housing to insure the ideal adjustment.  Each screw and allen wrench is printed with its size making it user friendly. Essentially, each chair given its adjustability, is a one off custom fit for the individual user.

Here are some photographs of the Apex from images available on line. Below the entire wheelchair. Note the amount of branding is not over the top. In the center back bar is the word Apex. Built in the upholstery is the Motion Composites logo, a feather in a circle at the top of the upholstery.

Below is the bubble level in front wheel assembly and laser etched markings at rear axle. 

Below illustrates how the seat to floor height can be changed as well as rear wheel position ability to mover forwards or backwards. One's weight should be directly on the rear axle. 

Below is the folding back mechanism. This feature is critically important and will be subjected to the most intense pressure from daily use. 

There are a few things I do not like about the wheelchair. The back creaks and does not feel as rigid as I had hoped. However, the benefits of the folding back are significant. The frame takes up little space in a car. The backbar above with the word Apex on it makes the frame easy to lift. The other thing I dislike are the push rims. The carbon fiber frame does not get cold nor does the upholstery. Only the push aluminum spinergy push rim gets cold. I went to downtown Denver yesterday and in my 20 minute wait for the train the rims got quite cold. The major draw back to date is transferring from the wheelchair into a car is awkward. I am sure over time I will be accustom to the transfer. I also do not like how the back upright adjusts (it can go from 15 to 18 inches). To move the back upright requires an odd tool that reminds me of Ikea furniture. 

I have no idea why this special tool about 10 inches long is required. I do know adjusting the back uprights is awkward. To me, this is a design error. Regardless, I am quite please with the fit and feel of the wheelchair. I get a sense the founders of Motion Composites saw a market niche for affordable adjustable light weight wheelchairs. Motion Composites released their first wheelchair in 2008 and as such are new to the wheelchair industry. The growth rate of Motion Composites is remarkable. Between 2008 and 2013 sales grew 2241% I hope the founders are making a healthy profit. The better they do the more secure I will feel. There is nothing worse than the feeling I had when United Airlines broke my wheelchair and I knew the frame could never be replaced. This brings up my overwhelming concern. When carbon fiber fails it is usually a catastrophic failure. Catastrophic failure and wheelchairs are words that should ever be in the same sentence. If this wheelchair fails my life comes to an immediate and sudden stop. I try to ignore this harsh reality. In the meantime, I have a serious case of new wheelchair enthusiasm. I clean my wheelchair every day. I mourn the few nicks on the wheelchair rims and front forks. 

Sunday, February 4, 2018

Absolute No According to the Wheelchair Manual

My new Apex wheelchair came with a tool kit. Motion Composites is not screwing around (pun intended). The little kit is not only useful but of surprisingly good quality. Any basic repair can easily be performed and more than a few major components can be worked on as well. The tool kit even has a belt loop holder. The kit is absolutely perfect for traveling whether by plane, train or car. I was also pleased to learn that Motion Composites will continue to provide any part for a period of ten years. It is my hope this wheelchair will last me the rest of my life.

Note I did not include bus travel above. Motion Composites states the wheelchair cannot be used on any paratransit or mass transit bus. The inclusion of the kit is ironic because the warranty in the owners manual is clear the wheelchair can only be adjusted by the manufacturer or a "qualified service agent". I am not sure why the tool kit was included. The warranty outlines the "repair procedure". According to the manufacturer the "parts that could be repaired by the owner: Rear tire and inner tube".  That is it. That is the only part of the wheelchair I as an owner can work on. I am more than a bit puzzled. Motion Composites was all too willing to sell me a tool kit to work on the wheelchair but the manual that came with the wheelchair prohibits me from making any adjustments. The glossy brochure that came with he wheelchair even advertises and praises how adjustable the wheelchair is.

If anything noted in the section on "Adjusts to your Life" is done by the expert rider or owner the warranty is void. Only the manufacturer or a certified service center can adjust the wheelchair. Any part that can be removed must be returned to the manufacturer. Thus any service or repair to the wheels, arm rest, upholstery, and cushion must be performed by Motion Composites. A certified technician employed by an authorized service center can work on "broken bearings, loose spokes, wheel not aligned, loose bolts, abnormal vibrations, noise or any deviation in the frame, front stem is not perpendicular to floor, broken parts like anti tippers, back canes, rips or tear on upholstery and for yearly inspection" I am confused. This list includes removable parts such as wheels and beloved anti tippers.

Other emphatic no's include disposing of the wheelchair. Yes, I am not permitted to throw out the wheelchair. "In case of disposal, return device to your dealer or rehabilitation center".  Wow, the medical model of disability reigns supreme. The manual warns me that motor vehicles and all busses represent significant risk. The wheelchair is "NOT" designed to be used in any motor vehicle. The wheelchairs manufactured "DO NOT meet Federal Highway standards for motor vehicle seating". As always, the exclamation point inside a triangle proclaims:

NEVER transport your chair in the front seat of a vehicle. Movements of the vehicle may cause the chair to shift and interfere with he driver's ability to control the vehicle. When transporting your chair in a moving vehicle, ALWAYS secure your chair so that it cannot roll or shift. In most cases, stowing it in the trunk is the safest alternative.

Another warning relate to the optional push handles. "The stroller-handle is not designed to lift or pull the weight of the user. It is designed to push and guide the wheelchair user". Stroller handle! Am I an infant or an adult?

Sporting activities are prohibited. The wheelchair is not designed to be used in any sporting activity. Weight training and stretching are not permitted as well. I am cautioned to never stand on the wheelchair or any part of the frame. I must be sober at all times. Yes, no drinking is allowed.

DO NOT use while under the influence of alcohol or medication or drugs. This may impair your ability to operate the wheelchair. Please consult your physician regarding the use of your medication. The wheelchair is not intended for visually impaired people. 

The wheelchair manual informs me that the wheelchair is not designed to be used in extreme temperatures. Hypothermia and severe burns can occur if the wheelchair is exposed to extremes of heat and cold. Under the section CAUTION I am informed Do not expose product to any extreme temperatures (e.g. direct sunlight, sauna, extreme cold) in order to prevent injuries by contact with some parts of the wheelchair". I never knew direct sunlight was so dangerous. It also looks like skiing or going outside in the winter is out of the question. And no summer activities. I can only assume temperature in the 90s are extreme. This says nothing about the dangers of humidity

I have thoroughly enjoyed deconstructing the wheelchair manual. I was also prompted to read other manuals,. The manual that came with my hand cycle contains no such ridiculous warnings. The manual is simply of little use and the warnings are relatively limited. I read multiple typical bike manuals as well. They contain few ridiculous warnings. For me, the larger issue is the wheelchair manual assumes a complete lack of independence on the part of the person using the wheelchair. How does a company that manufactures a wheelchair designed to make a person independent write such a a manual? Concern for liability only goes so far. As I read the wheelchair manual I thought of the newly paralyzed person or therapist charged with teaching such a person how to adapt to paralysis. What sort of life long skills are being taught? While curb cuts abound, they are not at every street corner. Popping up and down a curb is an essential skill. The fact is wheelchair should be designed to meet the most extreme environmental conditions one is typically exposed to. The refusal of wheelchair manufacturers to acknowledge this reality adversely affects people with a disability. This is a significant problem that compromises the daily life of people with a disability. Many power chair users have written to me expressing frustration over controllers that are not waterproof. I can find waterproof cameras, phones, computers, tablets in any given electronics store. Wheelchair manufacturers surely can make a power chair controller that is water tight. As for my wheelchair to expect it to be removed from the bathroom while showering is just silly. Yet beyond the silliness are ever present assumptions about the quality of life. We people reliant on wheelchairs have no life beyond an institution or home. Hence, strangers often comment to me "It is so good to see you out". The wheelchair manual is the 24 page equivalent of this comment.  

In the spirit of fairness, in the days ahead I will outline why I chose this wheelchair over others manufactured. I am truly pleased with the new wheelchair. It is incredibly light and easy to push. I am eager to zoom through an airport and suspect I could go a mile in under five minutes if the concourse is relatively empty. I have a serious case of new wheelchair enthusiasm. I clean the wheelchair daily and it remains as shiny today as the day I picked it up.