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    DME Etiquette Question

    Hello,

    I'm starting the process of getting a new chair, and I want a tilite ZR. Tilite shows 2 dealers in my area. One of them I worked with on my last chair five years ago, but I was out of state and my folks did most of the back and forth. They report that the DME was very effective in getting insurance to cover costs. Now that I'm in state and going through the process again, I've spoken to this DME and their sales guy, and I really don't care for him at all. My folks and I agree he's extremely rude and disinterested. Aside from that though, if he knows what he's doing and the billing department is on top of their game, maybe his attitude won't be a factor.

    Here's my question, how common is it to shop around at DME's? Should I go through the whole process with this DME and the other one? How do I evaluate who is likely to work hard to save me money on the final bill? I hate to make people work for things they won't get paid for, so I'm just not sure what's proper. Any advice or experiences welcome. Thanks!

    #2
    you're going to have to go with your gut feeling. If he is genuinely "disinterested" chances are you won't have a good relationship. But you've also got to look at what matters most - getting the chair you want and, most importantly, need. If he is the most knowledgeable in your area regarding the TiLite order and insurance process then use him, he does not have to be your best friend. A over-friendly salesperson is usually covering for their lack of knowledge/experience. Seems to me if he seems "disinterested" it could just be because he is over-worked because he is in such demand from being the most experienced. That being said, if you can't stand the guy then it makes after-sales and service more difficult. Like I said, listen to your heart.

    My advice - fill out the TiLite order form yourself. Get to know all the options/dimensions/geometry of the chair you need. The folks here will answer any questions you need. After that, shop it around. You will have done all the legwork, it becomes easy for them to pencil-whip the order through and they make a "new" client.

    Hopefully you are not in dire need for a new chair ASAP. Taking your time will serve you best. Just don't let on to the salespeople that you are not in a rush. I have friends locally that have waited 6-8 months for chairs because the dme sat on their order form.

    Again, get knowledgeable about what you need. An informed consumer is a happy one. And- MAKE SURE YOU ARE THE ONE THAT SIGNS OFF ON THE CAD DRAWING. It's your butt that has to sit in it for another 5 years.

    Comment


      #3
      I don't know anything about his qualifications actually, my last chair was a colours (ugh) I just know he's either a jerk or quite possibly has high functioning autism. His people skills are non-existent. I would be nervous ordering a chair without being measured by a "professional" though, I did that last time and I'm not sure it worked out that well for me. I think i'm going to at least stop by this other place and talk to them a bit.

      Thanks for your thoughts!

      Comment


        #4
        Originally posted by tooley View Post
        you're going to have to go with your gut feeling. If he is genuinely "disinterested" chances are you won't have a good relationship. But you've also got to look at what matters most - getting the chair you want and, most importantly, need. If he is the most knowledgeable in your area regarding the TiLite order and insurance process then use him, he does not have to be your best friend. A over-friendly salesperson is usually covering for their lack of knowledge/experience. Seems to me if he seems "disinterested" it could just be because he is over-worked because he is in such demand from being the most experienced. That being said, if you can't stand the guy then it makes after-sales and service more difficult. Like I said, listen to your heart.

        My advice - fill out the TiLite order form yourself. Get to know all the options/dimensions/geometry of the chair you need. The folks here will answer any questions you need. After that, shop it around. You will have done all the legwork, it becomes easy for them to pencil-whip the order through and they make a "new" client.

        Hopefully you are not in dire need for a new chair ASAP. Taking your time will serve you best. Just don't let on to the salespeople that you are not in a rush. I have friends locally that have waited 6-8 months for chairs because the dme sat on their order form.

        Again, get knowledgeable about what you need. An informed consumer is a happy one. And- MAKE SURE YOU ARE THE ONE THAT SIGNS OFF ON THE CAD DRAWING. It's your butt that has to sit in it for another 5 years.
        I totally agree!!

        Originally posted by Locke30 View Post
        I don't know anything about his qualifications actually, my last chair was a colours (ugh) I just know he's either a jerk or quite possibly has high functioning autism. His people skills are non-existent. I would be nervous ordering a chair without being measured by a "professional" though, I did that last time and I'm not sure it worked out that well for me. I think i'm going to at least stop by this other place and talk to them a bit.

        Thanks for your thoughts!
        Your profile is virtually empty, so we cannot see your needs, but unless you have special circumstances, it's relatively easy to determine your basic measurements, especially since you're already in a chair. If you have special needs, the vast majority of DMEs have insufficient skills to measure you, and I strongly recommend a seating clinic. Only if your DME clinician is in a chair would I trust his skills.

        I'm in my first chair, and had the order form completed when I visited the DME. I just had him review/verify the measurements. And I myself signed off on the CAD - super important. I've read numerous reports of a DME signing off things that were unacceptable to the user; by then it's too late - your stuck with what the DME did.

        PS: you might also consider getting an Icon wheelchair, which is reconfigurable on almost all the basic measurements. But it is brand new on the market. Here's a CCC thread about the Icon; here's a Youtube video. What the video doesn't show is the seat width and depth or also adjustable. Attached to this CCC post is a preview of the Icon's order form; it's much simpler than TiLite's.
        Last edited by chasmengr; 20 Aug 2011, 4:25 PM.
        Chas
        TiLite TR3
        Dual-Axle TR3 with RioMobility DragonFly
        I am a person with mild/moderate hexaparesis (impaired movement in 4 limbs, head, & torso) caused by RRMS w/TM C7&T7 incomplete.

        "I know you think you understand what you thought I said, but what I don't think you realize is that what you heard is not what I meant."
        <
        UNKNOWN AUTHOR>

        Comment


          #5
          No real special needs, just L4/L5 spina bifida. My last chair was a cluster you know what, the order form got lost, I waited a year, got the wrong chair, got the right chair but no idea how closely they followed what was ordered, frame cracked, took six months to get it replaced, so I'm just paranoid about the whole thing.

          That Icon looks like a spaceship. I think my heart is set on the tilite.

          Comment


            #6
            Originally posted by Locke30 View Post
            I'm just paranoid about the whole thing.
            you have to get over this. Don't even go near a dme person with an unsure attitude or they will rape you. You asked our advice, we gave it. What you do now is your business.

            Comment


              #7
              TiLite makes a fabulous chair - it's my personal favorite.

              We'll be glad to help with obtaining measurements where we can. I'm unfamiliar with the subtleties of SB; I have MS, and stand and walk a bit, so my chair is set up for that.

              Assuming your heart is set on a ZR (titanium, rigid, minimally adjustable, cantilever-frame chair), and you would like some help with measurements, I'll start by asking do you stand up from your chair? (Your answer has an effect on seat width, front seat height, and footrest style.)

              (Be aware, I'm an amateur - a seating clinic remains your safest bet. My guidance will just help you get educated for a visit to your DME supplier of choice.)

              If you wish to continue, the next steps include determining your Seat Width (SW), Seat Depth (SD), desired cushion thickness, Rear Seat Height (RSH), Front Frame Angle, Footrest Length, and Front Seat Height (FSH).
              Last edited by chasmengr; 20 Aug 2011, 7:37 PM.
              Chas
              TiLite TR3
              Dual-Axle TR3 with RioMobility DragonFly
              I am a person with mild/moderate hexaparesis (impaired movement in 4 limbs, head, & torso) caused by RRMS w/TM C7&T7 incomplete.

              "I know you think you understand what you thought I said, but what I don't think you realize is that what you heard is not what I meant."
              <
              UNKNOWN AUTHOR>

              Comment


                #8
                I'm unable to really stand up, but I suppose sometimes if I'm reaching for something in front of me I may partially stand. I figured I would go with the titanium with flat abs cover.

                Comment


                  #9
                  Originally posted by Locke30 View Post
                  I'm unable to really stand up, but I suppose sometimes if I'm reaching for something in front of me I may partially stand. I figured I would go with the titanium with flat abs cover.
                  So, titanium with flat ABS cover it is then. (We're already filling out the order form!!)

                  (Because I stand frequently, I have the flip-back footrest, which I love because my feet go flat on the floor close to the front of my seat.)

                  Also, because I stand frequently, my seat width is almost an inch wider than my hips. People who can't stand, but still have sensation often like their seat width snug to their hips so they feel like they're in their chair not on it. (I've seen a video showing a young lady doing chin ups with her chair going along for the ride -- now that's a tight chair -- although I suspect she had a seat belt on.) I have sensation, so I know nothing about pressure-relief needs or pressure-sore prevention. So you'll need to decide how tight/loose you want your seat to be.

                  To measure my hip width, I sat dressed on the floor with one hip against a door and a large, coffee-table book upright against my other hip at the widest part. Then my wife measured the distance from the door to the inside of the book. Make the measurement several times after getting up and sitting down again just to make sure you get about the same width every time. My hips measured 16.25", so I ordered a 17" wide seat with side guards, which I highly recommend to protect your clothes while keeping your chair as narrow as possible for maneuverability.

                  Seat widths are available in 1" increments. If you want a tight chair (remembering winter clothes), choose a width almost equal to or just a smidgen narrower than your dressed hips (again, I am presuming side guards, which bend just a smidgen). If you want a loose chair add about an inch like I did. Conventional wheelchair-fitting guidelines say to add 2+" to your hip width to "allow for growth" (a.k.a. gain weight). Don't add that much width; you'll slop around in your chair until you do gain too much weight.

                  Next we'll determine your seat depth.
                  Last edited by chasmengr; 21 Aug 2011, 1:44 AM.
                  Chas
                  TiLite TR3
                  Dual-Axle TR3 with RioMobility DragonFly
                  I am a person with mild/moderate hexaparesis (impaired movement in 4 limbs, head, & torso) caused by RRMS w/TM C7&T7 incomplete.

                  "I know you think you understand what you thought I said, but what I don't think you realize is that what you heard is not what I meant."
                  <
                  UNKNOWN AUTHOR>

                  Comment


                    #10
                    If the DME is a jerk before you buy, imagine what he'll be like if ohe ordered wrong or you have a problem with it.

                    Chas is right on, we can help bigtime with it or bike-on.com is good also.

                    Comment


                      #11
                      Yeah the manager of the other place actually used to work at the place where the jerk is (sorry for the confusing language, I'm trying to be diplomatic on the internet) and we got along well, so we're pretty much just jumping ship.

                      Okay so my present seat dimension is 15.5 wide by 16 inches long. Personally I feel like this is snug in both directions, though I imagine if I changed the dump or the front angle, that could change. But I think I'm good with those settings as they are.

                      Comment


                        #12
                        With your being a L4/5, I doubt you would need any dump or in the most 1". Not sure how tall or big you ar but I doubt I would go any more than a 85 or 90o front angle. There should be around a two finger space between the back of your knees and front edge of the seat.

                        You aren't jumpin ship, you're saving yourself a lot of headache. If he asks, tell him why. There is a large, huge, mark up on chairs, why give the money toa jerk lol/

                        Size of tires?

                        Comment


                          #13
                          Originally posted by Locke30 View Post
                          Okay so my present seat dimension is 15.5 wide by 16 inches long. Personally I feel like this is snug in both directions, though I imagine if I changed the dump or the front angle, that could change. But I think I'm good with those settings as they are.
                          [NOTE TO ALL READERS: It appears I have taken the lead in guiding Locke30 through learning about wheelchair measurements, but I am an amateur, so please jump in as you see fit to correct me or to add something I've missed.]

                          OK (that's another couple entries on the order form - as you say, we'll double check the seat depth when we get to the FSH and front angle).

                          Next, because you don't need much dump (you have good trunk control), let's determine your Rear Seat Height (RSH). When dump is not critical, I like to place the RSH priority on obtaining a high pushing efficiency. (Like Patrick said, you don't need much dump for stability, but that doesn't mean you can't have more. I don't need much dump, but I have 3" because of my relatively low RSH and my solid seat pan.)

                          We need to know (as Patrick said) your preferred rear wheel size. (Standard adult is 24"; some experienced users prefer 25"; sport chairs are often fitted with 26"; wheel size can be a whole discussion in itself. We can go there if you want; otherwise just choose 24".)

                          Now is a good time to ask how tall you are, and confirm your weight is comfortably under the ZR's gross limit of 265#, which includes things like your clothes and a backpack with its contents.

                          To determine my RSH, I took two measurements, then did some math.

                          I sat straight but relaxed in a hard-seated kitchen chair with my arms hanging limply at my sides . My wife then made two measurements: 1) from the floor to the center of my middle finger nail (measure both sides to make sure you're sitting straight) and 2) from the floor to the back of the chair's seat top (bottom of your bottom).

                          The goal for a good pushing efficiency is to pick a RSH at which the center of your rear-wheels' axles align with the center of your middle fingers' nails when you're sitting with good posture. (Technical research exists <attached> stating the best elbow-angle range a user should have when his hands rest at the apex of the handrims, but it translates roughly to aligning your finger tips with your axles.) You need not be super accurate; +/- 1/2" is plenty good. Now with math and seat-pan awareness, we will translate your kitchen-chair measurements to seat height. (I need a break, so I'll edit more in later.)
                          Attached Files
                          Last edited by chasmengr; 21 Aug 2011, 2:08 PM.
                          Chas
                          TiLite TR3
                          Dual-Axle TR3 with RioMobility DragonFly
                          I am a person with mild/moderate hexaparesis (impaired movement in 4 limbs, head, & torso) caused by RRMS w/TM C7&T7 incomplete.

                          "I know you think you understand what you thought I said, but what I don't think you realize is that what you heard is not what I meant."
                          <
                          UNKNOWN AUTHOR>

                          Comment


                            #14
                            You seem to be right on Chas. Keep it up.

                            Comment


                              #15
                              I'm 5'5" and I weigh 180.

                              I think I'd like to try to 25" I've been using 24" My rear seat height is currently 16" as such the beginning of my palm covers the quick release button when my arms are down. I have long arms and I also think my cushion has compressed somewhat.

                              The seat was 18" and my fingernail was 8" off the ground.

                              Comment

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