[Pete B]

can anyone give some sound advice please. I am in the process of adaptations thro DFG. I have been transferring onto a low toilet from my wheelchair ( I am a paraplegic) without any grab rails and it has led to one very weak arm needing 2 ops and now a third to my hand. I have told the OT that I need to alternate my transfers and need dropdown grab rails each side of the loo in order to alternate my transfers to retain whats left of both my arm strength. ( I am having injections in both shoulders at the moment) She is telling me that this is rubish and that I only need one, and the transfer will be just the same on each arm its the same movement. right and left. or left and right. I know what my body is telling me I want but she will not listen she is adament.Does anyone have any advice or better still facts that I can pass on to her please??

[wheels5894]

I'd say put the person in a wheelchair and tell them to do a couple of dozen movements on and off the loo and then try the other way. By then, the person will be quite tired and agree to anything!

more seriously, if you have medical advice to do this, say and get a letter from your doctor with the infomation in it. That should sort things.

[nomis]

With the info you give I haven’t got a clear understanding of your arm weakness – the cause, extent, future, etc.

Your push-off arm is supposedly doing the most work. That means from chair to toilet = the arm pushing from the chair. And conversely when returning to the chair it would be the hand pushing off the rail.

But (always a but), particularly when you are transferring to a lower level, the arm on that lower object might come into more than a guiding role if you hover your body before gently lowering.

So, is it the pushing movement that causes a problem or is it the hover holding?

Identify where the problem is in the movement. Then you can say to the OT that at this particular point you take a potentially damaging load and when you do the reverse transfer it is at this point. That should illustrate a similar stress going on the same arm both ways.

I hope you can work your way through that.

Here’s a scenario: You find that it is only your push-off arm that is potentially a problem. It doesn’t matter which transfer direction you going in if you have only one rail it will be the same arm doing the work and therefore a second rail would enable you to change arms one way.

If you can’t work out my logic and the OT won’t play, maybe you could consider to put in your own rail.

OR, give up on rails and use the edge of the toilet seat.

This post has been edited by nomis: 27 September 2007 - 10:01 AM

[wheels5894]

had a re-think. Is this more about the position of the toilet? To be able to transfer from either side you would need the toilet away from sidewalls both sides. Is the OT wanting to put the toilet against a wall so that you can only access from one side? Nomis' idea of putting in your own rail only helps is there is room for it.

[Pete B]

wheels5894, on Sep 27 2007, 11:06 AM, said:

had a re-think. Is this more about the position of the toilet? To be able to transfer from either side you would need the toilet away from sidewalls both sides. Is the OT wanting to put the toilet against a wall so that you can only access from one side? Nomis' idea of putting in your own rail only helps is there is room for it.

yes it is the position of the toilet and yes she wants to put it near the wall as there will not be room in the loo to transfer from either side with the plans she has in mind. If I insist on alternating the transfer then the local council have to extend and they dont want to do this although I will be entitled to a Disabled facilities grant they are quoting resources,( at my expense)!! Nomis is correct it is the push off arm that is the problem. thanks for the help.

[Pete B]

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[quote name='wheels5894' post='41491' date='Sep 27 2007, 11:06 AM']
had a re-think. Is this more about the position of the toilet? To be able to transfer from either side you would need the toilet away from sidewalls both sides. Is the OT wanting to put the toilet against a wall so that you can only access from one side? Nomis' idea of putting in your own rail only helps is there is room for it.
[/quote]

yes it is the position of the toilet and yes she wants to put it near the wall as there will not be room in the loo to transfer from either side with the plans she has in mind. If I insist on alternating the transfer then the local council have to extend and they dont want to do this although I will be entitled to a Disabled facilities grant they are quoting resources,( at my expense)!! Nomis is correct it is the push off arm that is the problem. thanks for the help.
[/quote]

[Pete B]

nomis, on Sep 27 2007, 10:59 AM, said:

With the info you give I haven’t got a clear understanding of your arm weakness – the cause, extent, future, etc.

Your push-off arm is supposedly doing the most work. That means from chair to toilet = the arm pushing from the chair. And conversely when returning to the chair it would be the hand pushing off the rail.

But (always a but), particularly when you are transferring to a lower level, the arm on that lower object might come into more than a guiding role if you hover your body before gently lowering.

So, is it the pushing movement that causes a problem or is it the hover holding?

Identify where the problem is in the movement. Then you can say to the OT that at this particular point you take a potentially damaging load and when you do the reverse transfer it is at this point. That should illustrate a similar stress going on the same arm both ways.

I hope you can work your way through that.

Here’s a scenario: You find that it is only your push-off arm that is potentially a problem. It doesn’t matter which transfer direction you going in if you have only one rail it will be the same arm doing the work and therefore a second rail would enable you to change arms one way.

If you can’t work out my logic and the OT won’t play, maybe you could consider to put in your own rail.

OR, give up on rails and use the edge of the toilet seat.

the arm weakness is severe it has been caused by lowering onto low toilet for years,tried side of toilet seat but they eventually work loose and go flying,been thro I dont know how many.toilet is now being highered. theres no room at present to put in own grab rail, this is the problem, getting the OT to understand.It is the scenario you stated it is the push off arm both pushing off and hovering, in fact Ive been clinging on to anything with the other arm. I will just have to keep on at her. thanks a lot for the help.

[gsp23]

I cant offer any help on the issue with the initial question about proving both arms are being bothered but just to give you another idea on a setup... In my house my toilet is a bit lower as well but my bathroom is setup in that my toilet is in between my bathtub and my counter. My transfer bench sits close enough to my toilet that I help to use that when transfering (ie directly from toilet to transfer bench and back for showers) and I use my counter and transfer bench for toilet to chair transfers too to help as well. So just a thought if you are changing some things... maybe consider altermate bars of slightly diferent setup.

[rolling J]

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can anyone give some sound advice please. I am in the process of adaptations thro DFG. I have been transferring onto a low toilet from my wheelchair ( I am a paraplegic) without any grab rails and it has led to one very weak arm needing 2 ops and now a third to my hand. I have told the OT that I need to alternate my transfers and need dropdown grab rails each side of the loo in order to alternate my transfers to retain whats left of both my arm strength. ( I am having injections in both shoulders at the moment) She is telling me that this is rubish and that I only need one, and the transfer will be just the same on each arm its the same movement. right and left. or left and right. I know what my body is telling me I want but she will not listen she is adament.Does anyone have any advice or better still facts that I can pass on to her please??
[/quote]

I am a physical therapy assistant by profession and am appalled by your OT. You know your body and how you want to do things. She needs to get a bedside commode with drop down arms and put it at the height of your toilet and have you tranfer onto it from both sides. You can place the toilet close to a counter or something that you can use as a grap rail. This will enable you and her to see if putting rails on both sides of the loo will aid in decreasing the overuse of one arm. You need to be able to try this so that the adaptations aren't in vain. Also, hopefully they will get you a chair height toilet that will also make transfers easier. Hope this helps.

[roo]

[quote name='rolling J' date='Oct 19 2007, 11:07 PM' post='43462']
--><div class='quotetop'>QUOTE(Pete B @ Sep 27 2007, 05:14 AM) <{POST_SNAPBACK}></div><div class='quotemain'><!--quotec-->
can anyone give some sound advice please. I am in the process of adaptations thro DFG. I have been transferring onto a low toilet from my wheelchair ( I am a paraplegic) without any grab rails and it has led to one very weak arm needing 2 ops and now a third to my hand. I have told the OT that I need to alternate my transfers and need dropdown grab rails each side of the loo in order to alternate my transfers to retain whats left of both my arm strength. ( I am having injections in both shoulders at the moment) She is telling me that this is rubish and that I only need one, and the transfer will be just the same on each arm its the same movement. right and left. or left and right. I know what my body is telling me I want but she will not listen she is adament.Does anyone have any advice or better still facts that I can pass on to her please??
[/quote]

I am a physical therapy assistant by profession and am appalled by your OT. You know your body and how you want to do things. She needs to get a bedside commode with drop down arms and put it at the height of your toilet and have you tranfer onto it from both sides. You can place the toilet close to a counter or something that you can use as a grap rail. This will enable you and her to see if putting rails on both sides of the loo will aid in decreasing the overuse of one arm. You need to be able to try this so that the adaptations aren't in vain. Also, hopefully they will get you a chair height toilet that will also make transfers easier. Hope this helps.
[/quote]hi pete i am also appalled by your OT.I also agree with rolling j {110 percent} WHY DOES THINGS THAT WE NEED ALWAYS BOIL DOWN TO COST NOT QUALITY OF LIFE ?????? DONT LET THEN GET THERE WAY .BEST OF LUCK ROO