Mark E. Smith’s great blog Wheelchairjunkie.com, has a great article about powerchairs — a topic which combines two issues I am passionate about: disabilities and technology.

I have seen some amazing powerchairs, from a super speedy model with an Herman Miller Aeron chair, running circles around people at Sam’s club, to a Dean Kamen Segway filled with a small bench (!) at Whole Foods letting the rider sit much higher that in a traditional chair, aiding in shopping and interacting with people at a common height. It is exciting seeing the developments in this area. These advances create an expectation of more than just simple mobility but also freedom.

So, do powerchairs chairs really cost as much as a car.

Not long ago, I saw a television news story about an amazing young woman who happened to use a power wheelchair. … However, just as I was enjoying the story, watching the young woman walk her dog through the grass at a park, the reporter uttered the very words that make me want to rip my flat-screen cable television from the wall every time I hear such statements: “Her power wheelchair cost $30,000, as much as a car,” the reporter said.Like a football fan whose quarterback just dropped the ball, I wanted to jump into the television and choke the reporter. “Power wheelchairs dont cost as much as cars – thats a $5,000 wheelchair configuration, not a $30,000 one!” I screamed, rolling close to the TV, trying to get in the reporters face.

via Cars VS. Chairs – WheelchairJunkie.com.  Also check out Mark’s other blog, PowerchairDairies.

Today’s guest article is contributed by Meredith Walker, who writes about the masters in public health. She welcomes your feedback at “MeredithWalker1983 at gmail.com” Enjoy the article and please make her feel welcome!

Complex partial seizures are epileptic seizures that affect one particular region of the brain. These seizures do not usually cause a tonic seizure more commonly associated with epilepsy, but instead affect thoughts and behavior.

Sufferers may go undiagnosed or misunderstood as this type of seizure is often not recognized as a physical disability and thought, instead, to be a mental disorder. Even when diagnosed, those with complex partial seizures may feel isolated as this invisible disability may not be recognized. The good news is that these types of seizures are often well-controlled by medication.

Here are seven facts to help you better understand complex partial seizures.

1. No control, no memory. During a complex partial seizure, a person cannot interact normally with others because she is not in control of her body. After the seizure, the person probably will not remember what happened during the seizure.
2. Not all seizures look the same. A person having a complex partial seizure may look like they are continuing with their activities or pursuing rather normal activities. Other people having this type of seizure may act strangely, crying, screaming, repeating the same words, or taking off their clothes.
3. What it looks like. When observing someone going into a seizure, it may appear that she is staring into space, but may then begin to engage in activities.
4. Early warning. Some people with complex partial seizures get early warning signals such as a visual aura, an odd sensation of fear or déjà vu, or a sensation of tingling or numbness. For others, however, the seizures can onset very rapidly with no warning.
5. Duration. These seizures can last from 30 seconds to several minutes. Many people are disoriented or sleepy and may not feel normal again for many hours.
6. Causes. Complex partial seizures may be caused by any number of factors. Commonly, brain injury, illness that affects the brain, or stroke can cause these seizures. There is also some evidence that children who experience prolonged or frequent febrile seizures are at greater risk for complex partial seizures.
7. Helping someone having a complex partial seizure. Stay with that person until the seizure has passed. Try to guide the person to sit quietly. Do not use force unless he is acting dangerously to himself or others or may be putting himself at risk.  Remove any objects from the area that may be dangerous.

How does Social Security look at children’s disability cases based on epilepsy or other seizure disorders?

Social Security first considers the Listing of Impairments. The Listings are a set of descriptions of medical conditions which can be disabling. The Listings tell you the what kind medical evidence you need and the medical findings to prove that the condition is disabling.  While the Listings are not the only way to be found disabled, they are very important in children’s disability cases.

For seizure disorders, there are two critical Listings.

• 111.02 Major motor seizure disorder
• 111.03 Nonconvulsive epilepsy
  

Listing 111.02 Major motor seizure disorder

This Listing primarily applies in convulsive seizure disorder cases.

A. Convulsive epilepsy. In a child with an established diagnosis of epilepsy, the occurrence of more than one major motor seizure per month despite at least three months of prescribed treatment. With:

1. Daytime episodes (loss of consciousness and convulsive seizures); or

2. Nocturnal episodes manifesting residuals which interfere with activity during the day.

B. Convulsive epilepsy syndrome. In a child with an established diagnosis of epilepsy, the occurrence of at least one major motor seizure in the year prior to application despite at least three months of prescribed treatment. And one of the following:

1. IQ of 70 or less; or

2. Significant interference with communication due to speech, hearing, or visual defect; or

3. Significant mental disorder; or

4. Where significant adverse effects of medication interfere with major daily activities.

To be found disabled under this Listing, you must show be able to prove either the

• “A” criteria: 2 or more convulsive seizures per month with loss of consciousness, during the day, or at night with side effects (residuals) that last into the daytime hours; or the
• “B” criteria: 1 convulsive in the last year and one of the 4 subparts.

111.03 Nonconvulsive epilepsy

This listing deals with non-convulsive seizures which may or may not include loss of consciousness.

In a child with an established seizure disorder, the occurrence of more than one minor motor seizure per week, with alteration of awareness or loss of consciousness, despite at least 3 months of prescribed treatment.

In both of these Listing, there has to be a well-established diagnosis, and the seizures have to continue despite 3 or more months of treatment.

If you are lucky enough to have an iBot, HiZook notes that service will continue on the iBot until 2013.

Here is a commercial for the now departed iBot:

HiZook also  has a review of the Segway RMP 50 robotic platform,  an omnidirectional powered platform that reminds me of something I read in comic books as a kid. Can you imagine using something like this as a base for a powered wheelchair?

Segway RMP Omni 50 from Cressel Anderson on Vimeo.

Can you imagine the therapeutic value of this? From phobia therapies like the one below, to helping people with social phobias, to even more complex therapies such as helping individuals with Asperger’s syndrome pick up on social cues, vocal inflections and body language. The possibilities are amazing!

It also opens the possibility of long distance and even multiple provider therapies: the patient interacts with a single avatar which may be “driven” by different therapists at different times (allowing 24 hour care and a consistent “face”), or even running on auto-pilot as in the “Milo & Kate” demo above.  I did not realize we were so close the the ‘ractors in Neal Stephenson’s Diamond Age.

Virtual Phobia Therapy:

Virtual therapies could be amazing, or they could be awful! What’s your opinion?

Alright! Dean Kamen’s prosthetic “Luke” arm is one step closer to helping amputess, especially injured veterans:

Last week, VA announced the start of a three-year clinical trial that represents the first large-scale testing of the arm, a critical step before it can be made widely available. The first patient was fitted with an arm in April.

The device was developed by Deka Research and Development, the New Hampshire company whose founder, Dean Kamen, invented the Segway and various medical devices. 

The robotic arm, nicknamed the “Luke arm” after the artificial arm worn by Luke Skywalker in the “Star Wars” films, allows those who have lost a limb up to their shoulder joint to perform movements while reaching over their head, a previously impossible maneuver for people with a prosthetic arm.

via VA Tests New Arm That Could Benefit Amputees – washingtonpost.com.  

Check out the video demonstrating the arm in my earlier post.

I recently wrote about the amazing difference a service dog can make for a child with autism.

Colleen Bell contacted me about getting the word out about helping their autistic son, Jude, receive a service dog.

Jude is an amazing 6-year-old boy who loves to laugh and to make other’s laugh.  He’s smart, handsome, funny, loving, lovable, clever, and honest.  He tries harder than most anyone you’ll meet.  He makes us proud every single day. He also has Autism.  

Jude has qualified for an Autism Assistance dog from 4 Paws for Ability, Inc., a 501c3 nonprofit organization based in Xenia, Ohio, which provides service dogs to families and children that struggle with life’s daily challenges and who would otherwise be turned away by many other agencies.

There are many ways a service dog would help Jude:

• In potentially dangerous situations, Jude will be tethered to the dog to prevent him from running away. 
• The dog will assist Jude with therapy, provide sensory input, interrupt undesired behaviors, and be a comforting and calming companion. 
• It would also act as a “social magnet,” making it easier for other children to approach Jude. In addition, the dog will be trained in search and rescue, to track and find him if and when he would run away. 
• Mostly, it would be a huge source of relief for Jude’s family, empowering them to lead a fuller, happier life.

While Jude has been accepted to receive a service dog, his family needs to raise $13,000 (which is only a small part of the cost of training).  I have contributed.  Don’t click away, step up and make a difference in a child’s life today.

Disability cases based on seizure disorders are a very special kind of disability case.

If your case goes in front of an Administrative Law Judge, you can expect to be asked these questions:

• How often do you have seizures?
• What happens during a seizure?
• How do you feel after a seizure?  
• What do you have to do after a seizure (lie down, sleep etc)? And for how long?
• Are you treating with a doctor?
• Are you taking your medications as prescribed? How long have you been taking your medications?

While seizure disorders (epilepsy, partial complex seizures, etc.) are often disabling, simply having a seizure disorder is not enough to be found disabled. In many cases, medications control the frequency or severity of seizures.

Of course, in many cases, they do not. 

But, to improve your chances of winning your case, you have to be ready to talk about your seizures, how often they happen and how they effect you.

I recently twittered about the surprising uses of service dogs. We are all familiar with service dogs used by individuals with blindness or other visual impairments. However, there are other ways these wonderful dogs help people with disabilities. 

One of my clients uses a service dog to help identify seizures before they occur and to provide protection during a seizure.

Service dogs can also help children with disabilities such as autism.  The Journal News recently covered this topic:

The dogs purpose is to provide safety and therapeutic companionship to children with autism, a neurological disorder marked by delays in speech and social interaction.

From a therapeutic standpoint, the dog serves as a point of focus for autistic children, enabling them to maintain calm.

From a safety perspective, the dogs wear a service vest to which the child is tethered while in public places.

The result is freedom for both parent and child.

Routine outings to stores or to the sports events … are made more manageable and more enjoyable…

Of course, there is a sizable cost associated with providing a service dog. 

Each dogs training costs roughly $45,000. As with the guide dogs that the nonprofit Guiding Eyes trains and places, its autism-service dogs are provided free, with the cost entirely offset by private grants and donations.

While autism-service dogs are becoming more prevalent, many organizations that provide them require families to pay $10,000 to $15,000.

For more information about service dogs for children with autism, see Guiding Eyes website.

It’s a great video!  Greg talks about seizures starting at 3:50.

A new device developed by researchers at the University of Wisconsin-Madison allows users to tell a computer what to do simply by concentrating on a letter or action on the screen.

via Twittering For Those Who Can’t Talk Or Type – Disability Scoop.

Here is a great video explaining sleep apnea, what causes it and the risks associated with sleep apnea.
The video starts with a lot of promos. Just zip to the 1:10 mark for the good stuff.

Former disability examiner, Timothy Moore, writes about his experiences with lower back pain and the Social Security Disability Process:

About one week ago to the day, I injured my lower back. And though I am now fully on the road to recovery, I can’t help but wonder what it would be like to be saddled with nagging lumbar back pain indefinitely …

… light jobs would be difficult because handling any amount of weight, let alone, say, 20 pounds, would aggravate a back problem. I rediscovered this reality yesterday as I, in a limited fashion, tried to help my wife with groceries. The simple weight of a gallon jug of milk was enough to make me wince. How about a sedentary job? Well, the problem with sedentary jobs has to do with…being sedentary.

As many claimants with chronic lower back pain will attest, being in a seated position can become very uncomfortable even after a few minutes. But even “sedentary jobs” are not entirely sedentary. Most sedentary work still involves having to get up and down from a seated position dozens of times during the course of a day. And this can obviously present a problem for someone with lower lumbar pain. …

Disability examiners, their supervisors, and the medical  consultants with whom disability examiners work all too often slap decisions on cases without allowing claimants reasonable consideration with respect to their pain.

Tim goes on to discuss why disability examiners do not give reasonable considerations to pain. Read the entire article here.

This makes me think of this saying:

The man who is warm cannot understand the man who is cold. 

Pain is by it’s very nature subjective. We literally cannot understand what another person is going through, even it is something we have gone through ourselves.

I recently had a knee injury, which resulted in excruciating pain, kept me from sleeping more than a few hours at a time, and severely limited my concentration. I was not able to walk without using a four point cane. Nights were worse as the pain became like fire on my knee and any movement would make the pain level jump. 

I wondered if I would be able to continue working, and if not, what would happen if I applied for Social Security.

Since I am under 50, I would have to show that I could not perform any type of work which exists in substantial numbers in the national economy.  I expect that Social Security would eliminate all jobs which are primarily performed while standing. But, would I be able to eliminate sedentary jobs like information clerk, or call-out operator, or dispatcher?

Certainly the pain I was experiencing affected my concentration and I felt I might not be able to do these types of jobs.  However, I doubt I would have been able to convince Social Security that a knee injury would keep me from doing any type of work. 

Pain is subjective. You don’t feel what I feel and I don’t feel what you feel.

Social Security is very conservative in how it evaluates claims for disability.  It looks for objective, measurable medical findings.  But, pain cannot be measured, except by the individual. That is what makes pain cases so difficult.

Fortunately, my condition improved and I am back to fighting for the disabled.

If you are disabled due to pain, hang in there! Social Security may never feel what you feel, but you can still build a winning case!