Rounded Versus Square Mattresses

Being adaptable is important for instances such as traveling or simply being away from home. I certainly notice when I am away from the very suitable circumstances of our home. I am very efficient in our kitchen with my island but put me in someone else's kitchen without a suitable surface for me to roll under, with a knife that is not easy for me to hold safely, and I do not look very efficient at what I am trying to do.

At times I grow complacent with the ease of my transfers at home in relation to other places and always find them especially easy when returning home after being away. The struggle of a more difficult transfer only serves to enhance my balance and strengthen muscles through the effort required.

One of the biggest challenges is sleeping and dressing in a bed that is not our own. Especially if that bed happens to have a queen size mattress with a rounded edge like the photo above. Ironically, that is the first mattress I used post injury and it was recommended by my occupational therapist because it uses an air bladder system which supposedly provides better pressure relief. In order to get that softer mattress it needs to be deflated a bit once in bed and re-inflated to be firm enough to complete my morning routine. The air pump is as loud as a vacuum cleaner which is not what I would call the first thing I want to hear in the morning after waking up.

Unfortunately, when the mattress is fully inflated it has a concave shape to it. This causes the edge to be far less usable at night or in the morning when it is time to sit up and it causes my hips to tend to want to slide off the bed. That means to safely sleep in the bed I need to have more than half to myself, which leaves my wife with far too little space for a comfortable night's sleep. When transferring in and getting undressed at night, and then getting back into my chair in the morning, it feels as though I am always fighting the tendency to slide off the bed. For these reasons it is a passable bed for the cabin and only needs to be endured a few times per year.

Below is our current bed. It is a combination of a firm bottom foam mattress and a medium density topper. The top portion of the mattress is about one third as thick as the bottom and is still quite firm. I have yet to have any problems with pressure areas, the sharp edge gives me a good sense of security for both sitting up at night and when transferring in and out. We ordered it from a custom mattress manufacturer who essentially makes each combination of mattresses on a customer to customer basis so it did not cost us a ridiculous amount of money. Coming home to this bed after being away reminds us that it was worth every penny.

As you can see above, I still use a sheepskin to keep my feet comfortable at night and prevent any pressure areas on my heels or ankles. It was time for the red one to be retired once I found this one at Costco around the middle to end of September, which is when they seem to carry these each year.

Source: Many mattress stores will help you find what fits your needs best, but I recommend going somewhere that they specialize so you are not getting the cookie-cutter sales pitch from a general furniture salesperson.

Eye Drops

It's not that eye drops are necessarily a common need for quads, it's that administering them is difficult to do independently for a few reasons.

First is simply the dexterity needed to control the bottle with two hands in order to squeeze it gently and precisely enough to apply just a drop or two. Both hands are occupied so forget using one, or both, to hold your eyelid open.

Second is the complication of the reduced range of motion in our necks. Many of us have had neck vertebrae fused as part of the treatment after our injury to prevent further damage by stabilizing the neck with hardware. This reduction in our range of motion makes it more difficult to tip our heads back far enough to administer the eye drop. As much as we become good at compensating for lost range by bending at the back or waist, being in a properly fitted wheelchair holds us in an upright position quite well. This struggle to overcome limited range can be eliminated by administering the drops while in bed, but many eye drops call for more than the two times per day when you'd definitely be in bed.

Holding the bottle two-handed, without dropping it in your eye, keeping your eyelid open, all while maintaining your balance is no small task. But practice makes perfect. Of course, I do not take for granted the times my wife has taken care of the application leaving the balance and eyelid to me.

Solution: Look away from the bottle to prevent blinking and back up to a wall or corner and lock your wheels then use the wall to lean on to help with balance. These tricks may help with or without someone else's help.

Wheelchair Cushion

The ability to feel your body is significant and should not be taken for granted. The ability to move your body is even more vital. When you cannot feel it and cannot move it, technologies like specialized wheelchair cushions can assist in the prevention of pressure sores and aid in maintaining proper posture and balance. Cushions have a role much more than just pressure relief.

There are cushions made out of dozens of little air pockets that can be pumped up or deflated as necessary to get the most comfortable fit. There are cushions made out of multiple layers of different densities of foam and combined with a gel top layer. And there are types made out of synthetic materials formed into a breathable, lightweight honeycomb shape like the cushion in the photo above. This is not an exhaustive list of the different types of cushions but what I would consider the three most common.

They can be simply a flat rectangular design, extra thin for sport purposes, and contoured like the one above to improve posture and balance. A cushion with a contour like this can be used on a standard wheelchair seat to simulate a newer design of wheelchair frame that incorporates ergonomic seating. That is one whose frame keeps your hips perpendicular to the ground. The standard wheelchair frame tips your whole body back a few degrees to bring your knees up to your chest slightly, improving your balance. This will be covered in a future article.

The best way to find the cushion that's right for you is to try many different kinds, see which minimizes pressure while still providing good balance, which helps with maneuverability and independence in your chair. When you find the happy medium between comfort and balance you will begin to trust that you are not going to fall out of your chair. That's when you will feel confident in trying things, such as wheelies, that will get you over obstacles you were not able to overcome before.

Source: Wheelchair dealers and many medical supply stores. For insurance purposes, an occupational therapist's approval may be required.