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    need ideas on new cushion. HIGH RISK

    i need ideas on a new cushion.
    about me. 6 feet 1. maybe 130 or 135. c6/7 incomplete.
    i have very skinny legs and verrry deep ischials, (the 2 bones that make your buttocks round). i bottom out a jay2 deep countour. im very thin and pretty much skin and bones

    exactly 1 year ago on the 8th of sept i went in to replace my j2 deep contour, the only cushion they had there that mapped even close to mine was a varilite meridian. BOTH cushions gave red indicators on my ischials, but i figured my j2deep had worked for years so i'd be ok.

    fast forward 2 months the meridian gave me a pressure sore. it was only 3 inches deep where my j2deep is more like 4, and i even bottom that out. my j2deep has 30pct gel overfill as well.

    i am thinking i need a cushion at least 3.5 high preferably 4. 16x16 or 16x18. i don't particularly like the roho high profile because when doing transfers i don't use a board, and my hand just sinks into it. also, i can't tell if i ever have enough air in it by myself. so i never mapped on that.

    i was really looking hard at the riddesigns custom cushion it seems like the only option left to me, but they are so expensive. if anyone has one tell me about them. is it made of foam? will it smush down a lot when i transfer? i read once that you must sit in it the correct way or it can be worse for you. if you've had bad skin problems did it help you? and how the heck will i pay for a 1300 dollar cushion heh. if there are any downsides i need to know. this thing is expensive.

    anyone have any other ideas? i've looked at most internet sites, there just aren't many cushions that tall.

    #2
    yup, a properly-inflated high-profile Roho is great for pressure relief at the expense of a decrease in stability.

    what kind of chair are you using? is your footrest set too high, thus putting more pressure on your ischials?

    Comment


      #3
      Are you a man or woman, Torval? Either way, 130 pounds sounds too thin for a 6-foot frame. Is weight gain possible?

      Comment


        #4
        torval,

        Regarding "... thinking i need a cushion at least 3.5 high preferably 4 ... there just aren't many cushions that tall ..." - the J2 Deep Contour is 4.5 inches thick. When you mention bottoming-out on a J2 Deep you are probably not referring to nearly touching the bottom of 4.5 inches of cushion (gel plus the foam base).

        Since you mention "... my j2deep had worked for years ..." it may be that a newly introduced factor is the root cause of the recent pressure problem - perhaps something like a posture issue or a footrest adjustment as suggested by Scott.

        If; after investigating newly introduced factors, it is evident that the J2 Deep is no longer a good option for you, consider one of the 3.5 inches thick Vicair cushions. The Vicair cushions easily accommodate substantial variations in pelvic topology as referenced by your "... verrry deep ischials ..." description. The Vicair cushion structure does; however, exhibit a similar "... when doing transfers ... my hand just sinks into it ..." behavior, albeit less so than a Roho cushion structure.

        Comment


          #5
          130lbs may be thin for a man, but i was only 158-160 before i got hurt. i have always had 5-7pct body fat and i have very small bones. this has not changed, so i've lost about 25 lbs of muscle from atrophy. i'll look at the vicair, thank you for the suggestion. i think i may try replacing the gel pack part that sits on top of my j2 deep also, that may be more economical. it doesn't seem to have the amount it used to somehow. it looks very different from the owner's manual. the owner's manual also says i should have at least 1/2 an inch of gel left when i get out after sitting in it and i cant say that i do. oh also, while the j2deep says it is 4.5 and the varilite says it is 3.5 they look more like 4 and 3 when i measure them with both a ruler and a measuring tape. i measure at the front part of the cushion. from seat to top of cushion.

          as for my footrest being too high that is not an issue, actually it is about a 1/2 inch too low imo. my shoes tend to scoot forward unless i wear really thick soles and my heels are off the footrest quite a bit with no shoes. i intend to put some grip tape on the footrest. i was very cautious of my measurements when ordering this chair and already had a quickie gps that fit nearly perfectly. i added 1 inch seat to footrest though. my knees never have that wobble back and forth you get from too high a footrest.

          anyone own a ridedesigns custom and want to comment? anyone know how a quad could go about checking if he has proper air in a roho? i can lean forward with my shoulders on my knees but that just unloads my ischials and lets air flow in. i also saw a type of countoured roho called the enhancer. that looked interesting. i guess i'll have to schedule a seating clinic again and try mapping some more cushions and i'll try mapping another j2 deep i guess.

          thanks for the replies and any input or suggestions are welcome.
          Last edited by torval; 5 Sep 2011, 5:17 AM.

          Comment


            #6
            I have a Ride Design Custom which works well for me. The cushion is shockingly hard when you 1st see it and the bowl in the center very deep making it hard to transfer out. However, the cushion suspends you so that sensitive areas do not make contact. It is essential that you get this cushion as part of a comprehensive seating eval. They pressure mapped me on one then once it was established it was helpful made a mold. I had to pull down into the mold material which was then sent to Colorado where the cushion is fabricated using the mold. Once the cushion comes back you are again pressure mapped to be sure there are no hotspots. If you slouch or move around on the Ride design you may get yourself out of the "sweet spot" suspended over the bowl. They warned me about this but when watching TV I move all over the place and have never had a problem. I tried all kinds of ROHO's, the Isch Dish and Varilite Classic and sweat on everything but the Ride design Custom.

            I had my seating eval done at U of M Seating Clinic, I would not trust a for profit DME to do this eval. Demand that Ride Design stay within width and length dimensions you provide. They tend to make the cushions too long which causes cushion to overlap the front of seat and screws up footrest angle.

            Comment


              #7
              Originally posted by -scott- View Post
              what kind of chair are you using? is your footrest set too high, thus putting more pressure on your ischials?

              As more dump more pressure too, ergo seats will reduce it.

              Comment


                #8
                Look at the defender II cushion from aquila. It is close to 4 inches tall and you can inflate all around the ischials and have the ischial cells inflated with less air. I think it has a pressure gauge built in so you will know how much air is in the cushion. It sells for around $600.

                Comment


                  #9
                  I have the same body type and skinny butt as you. I have been using Roho high profiles for more than 30 years and have been sore free. I am C-7 complete
                  You will find a guide to preserving shoulder function @
                  http://www.rstce.pitt.edu/RSTCE_Reso...imb_Injury.pdf

                  See my personal webpage @
                  http://cccforum55.freehostia.com/

                  Comment


                    #10
                    scifor55years, how do you tell if your air pressure is right in your roho? can you do it by yourself?

                    Comment


                      #11
                      Yes that is a huge problem for a roho cushion. A leak could mean that you sit all day long on a totally flat cushion and no way of knowing it is flat. How long does it take to get a pressure sore when sitting on a flat cushion? What are the consequences of a pressure sore? How can they put out an air cushion that has absolutely no warning system to tell the user if it goes flat?

                      Comment


                        #12
                        I, too, am 6' 1" and weigh about 130 - 135 pounds... and I thought I was the only one... I use a Roho Quatro Select and I have had no problems. I do, however, have very little dump (about 1 - 1 1/2") so that I am primarily sitting on my skinny thighs rather than on my butt (ischials). If I increase the dump I have real issues with pressure because of my thinness. I'm a T4-5 by the way and have a fair amount of obliquity.

                        Comment


                          #13
                          I use a home brew cushion with foam under my thighs, a 4" cell Roho under my right ischial, and nothing but air under my left ischial (my tender spot). I got the idea from the fact that sitting on a toilet seat does not produce red spots for me, and it was reinforced when I heard about Ride Designs and read that they had cured Barry Corbet of intractable pressure sores.

                          My wife is post polio and she has used a Vicair for several years. The Vicair is great if you have sensation, but it certainly did not work for me. It is a Dutch product that was originally marketed in the US by Johnson & Johnson. They quickly withdrew the product because of the number of folks getting pressure sores and consequent lawsuits.

                          I looked at Ride Designs custom and did not go that route because I am a complex case who sits reclined with HO in the hips and felt the DME dealer was not competent to do the evaluation. Especially after he said as much. As emphasized by ancientgimp, a proper evaluation and fitting is essential for the Ride Designs. It is a very interesting hard but porous foam, and if you don't get it the fitting right the results could be disastrous. If you do get it right, Ride Designs can work where nothing else can. If you can get a proper evaluation it may be the thing for you. Have no idea where you are at, but if you are in the US in Colorado then Ride Designs does fitting at their facility.

                          Back in the day, we sat on something for 15 minutes, checked for red spots, 30 minutes, checked for red spots, 60 minutes, cfrs, 2 hours, cfrs, ... You get the idea. The habit has never left me, and any time I make a change I am very careful to try and make sure it is not causing damage.
                          T4 complete, 150 ft fall, 1966. Completely fused hips, partially fused knees and spine, heterotopic ossification. Unsuccessful DREZ surgery about 1990. Successful bladder augmentation using small intestine about 1992. Normal SCI IC UTI problems culminating in a hospital stay in 2001. No antibiotics or doctor visits for UTI since 2001: d-mannose. Your mileage may vary.

                          Comment


                            #14
                            I got a Ride Designs custom a couple years ago. First mold was awful, andmade me feel so jacked up, cuz my rump was going deep in that hole area, so my spine curves even more. It's not supposed to make your posture worse, but it did. I got a second mold, and it was a tad better, at least feels like it should fit at first. But after about an hour, I start to mold to the hole in that one, too, and bottom out in it. The eval was good, but the guy shoved me so deeply, I think that's part of the problem. I'm not tall, I'm not SCI, and I have different curvatures. Not sure this cushion is right for me, but I feel like it works for pressure relief where none else have. So Catch 22. I use it at home if my butt hurts, but I can't go out and wheel in it. Sitting in a deep hole is so not good for my posturing and stability. I keep wondering though, if I had a third one made, and it wasn't as deep or too long, maybe it would work out....

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