Sunday, September 10, 2006

Poor Mr. Foot. He Needs a Scooter.

It must have been 2004 when I first got the scooter. The MRSA abscess and cellulitis episode with Poor Mr. Foot went from late April through August, 2004. They saved the foot - not to mention, the leg and my life - but although he looks remarkably great, there's a lot of invisible damage deep inside.

The tendons, blood vessels, nerves, muscles, everything in there is full of scar tissue, since MRSA'd infected almost the entire foot. You can't really tell by looking, but he's a bit de-fleshed - he weighs less than the right foot. The pulses are still good, but that may not last forever. He's already colder than the other foot - not enough blood circulating in there.

Realizing Poor Mr. Foot was permanently maimed is what finally inspired me to try to get a scooter. I'd actually needed one for years.

I elevate my feet constantly. They both have problems with edema, rheumatoid arthritis, a nasty painful inflammatory condition called plantar fasciitis, fibromyalgia, neuropathy, a blister disease, diabetes complications...I'm sure I'm forgetting something, but you get the idea.

Elevating them keeps the swelling down, using good old gravity. This is critical. Swelling constricts the blood vessels and all even worse than the scarring alone. Constricted blood vessels means less blood gets distributed. Not getting enough blood in any tissues is unhealthy, right? It starves them of oxygen, and keeps waste products in there that should be cleaned out during blood circulation, as our cells usually do. If I drive for several hours - one of my favorite pastimes - both feet swell, just because I have them down, de-elevated, to drive.

Worst of all: swelling creates more scar tissue in the bad foot. Cells deprived of oxygen die and make scars. The more scar tissue that builds up, the worse the circulation. Then MORE scar tissue builds up. The more internal scarring, the shorter his life will be. If and/or when the blood circulation is impaired enough - when those pulses aren't good any more - then he'll starve to death. After all our hard work, after the miracle of that surgeon saving the foot in 2004? I really, really don't want to get him amputated.

Walking, especially on a hard surface, is not good for bad feet. Standing is killer. If some situation leaves me standing up, after around 30 seconds I start leaning on one foot then the other, transferring the weight-bearing load. Swaying from side to side. Sure, some people misinterpret this as some eccentricity. I couldn't possibly care less. The pain I feel if I'm in that state removes my embarrassment real quick.

Oh! - and! On the scooter, I don't have to be afraid of falling. I'm SITTING DOWN. I can cover far more territory just on that freedom alone. For me, falling down means more bruising, fractures, cuts that get MRSA infections, tendonitis...Not safe.

Short version? If I walk on that foot, it swells up, and hastens the day it gets amputated. Meanwhile, it causes serious pain. A scooter means I don't walk, I ride. I get a longer foot life, need less narcotics, and I'm much more safe from injury.

I won't go into the full story of Poor Mr. Foot here yet. I'm trying to be just thorough enough to make it clear why using a scooter - such a ripe target of derision! - can be critical to a person's health. If I show you how it went with me, then hopefully it'll help you understand how it would go with you, in the context of your own health and mobility issues.

The pain of a MRSA infection is stunning. When it involves bone, even peripherally, it's worse yet. After the infection finally cleared, and the drain healed closed, it still hurt bad. So between the pain, and the very real danger posed by walking on it, I was definitely immobilized.

As you may have gathered, I greatly prefer to be active when I can. My other disabilities already cut way down on my activity level. Not being able to get around was a bad thing.

My rheumatologist's office advocated for me with Health Options, my *Medicare HMO.* It got approved shortly before Thanksgiving, 2004. I was finally able to cook again. Slowly, still way weak, and clumsy. It took me two days, but I made Thanksgiving dinner for Walter and me. Everything we wanted, and more. Turkey, stuffing, gravy, mashed potatoes, asparagus, acorn squash, cranberry sauce, corn I think? - but the whole nine yards. I sweated half to death with the effort, I burned myself by accidentally leaning on the stove from this unnatural height, but I did it. Remembering that dinner can still make me cry.

That was the last year scooters were free under my Medicare HMO. The next year, there was a $500 deductible. I made it, just under the wire.

The total cost as billed to the HMO, however, was only $195 - both then and also last month. So a person applying today would most likely NOT have to pay a full $500; they'd get the discount price.

Mine is a *house scooter.* I was told that the only way to get it into a car, to take to the store for some shopping, was if one installed a lift or a trailer hitch and scooter platform. The cheapest arrangement at the time was around $1200. And Medicare would never, ever, most adamantly not, pay for that.

What the medical supply company my HMO uses never told me was that they're made to come apart so you can put them in your car.

The battery pulls out. That's often the heaviest part. The seat pops off. The handlebars get lowered. This all takes about three minutes. The heaviest piece to lift into your car is often less than 30 pounds. Ideal? No. But certainly workable.

NOT being told this at the time caused a lot of problems in my life. Walter and I agonized over some way to find that $1200, and it just could not be done.

It never occurred to me, back then, to surf the net for scooter info. That's how I finally found out it was transportable. When I called recently to get the old scooter fixed, and was told if they couldn't fix it they'd get me a brand new replacement, I surfed. When I learned I could have been transporting it all along, I tell you, I was outraged. Ballistic.

But that's another story, too.

So, in answer to anyone's question about how to get a scooter - here we go.

If you must buy one out of pocket - if there's no way you can get it covered by insurance - let me know and we'll see what else we can do. But since it's usually covered under the right circumstances, find out what those circumstances are. Remember you may still have to meet a big deductible. Even so, going through the insurance company can save you a significant chunk of change.

First, call your insurance company. Ask what their requirements are for getting one. Do you need a Letter of Medical Necessity, for instance? If so, must it be from your primary, or your specialist? Ask them what, exactly, that letter needs to say to get a *Yes.*

Then, talk to whichever doc needs to do the request, whether it's a prescription, a LMN, or something else. Ask outright if the doc will help you get a scooter. If they hesitate or say no, ask any other doctor you can. It's easier to get approved if the doc doesn't feel hesitant.

The commonest negative reaction you'll hear is this one: *Oh, but if you get a scooter, you'll be less active! You'll rely on that to get around, when you should be exercising!*

This is complete and utter bullshit. It comes from the Old School Stiff Upper Lip Theory of: More Suffering. As in, *More Suffering is Good For You! It's Better For Your Health!*

When I got my scooter, I made that Thanksgiving dinner. That was exercise. When I shop at Sam's or Walmart or wherever, using the store's electric scooter, I get FAR more exercise than without it. Why? Because without a scooter I sit at home. I can't fucking walk right. I can walk a little. When I go shopping, I MOVE. I get in the car, I get out of the car, I walk to the scooter. I get in and out of it when reaching for high shelves in the store.

In other words, I'm active.

Every scooter person I've talked to says exactly the same thing. We have a life again. We're busy again. This *assistance makes you LESS active* theory was never, ever, based on any fact or study I've ever found. It was just a bunch of patronizing bullshit, spooned out by people more satisfied by scorning us than by the truth.


So here I'm hoping this post can help someone take hold of the truth and of this aspect of their health, and get themselves scootering about.

Seriously. It matters. So feel free to stop by with a comment, or send me an email, if I can help you in any way with this.

1 comment:

Nancy said...

Thank you K. I think I'm going to end up with a scooter. When I go in, I'm gonna ask YOU what to tell them I