Mobility Aids For CFS/ME & FM

November 22, 2009

Sometimes with Fibromyalgia or CFS/ME (Chronic Fatigue Syndrome/Myalgic Encephalomyelitis) physical movement and mobility is something that is a real problem. So much so that the sufferer may need the help of others to get around or may need mobility aids.

Mobility aids help you walk or move from place to place if you are disabled or have an injury. They include crutches, canes, walkers, wheelchairs and motorized scooters. You may need a walker or cane if you are at risk of falling. If you need to keep your body weight off your foot, ankle or knee, you may need crutches. You may need a wheelchair or a scooter if an injury or disease has left you unable to walk.

Choosing these devices takes time and research. You should be fitted for crutches, canes and walkers. If they fit, these devices give you support, but if they don't fit, they can be uncomfortable and unsafe. Select from the following links to learn more.

Table of Contents

• Which Aid is Right For You
• Get a Proper Fit for Your Cane
• Using Your Cane Safely
• Get a Proper Fit for Your Walker
• Using Your Walker Safely

• How To Talk With Your Doctor
• Will Medicare Pay for Wheelchair?
• Will Medicare Cover Mobility Scooters or Electric Scooters?
• How Do I Qualify For a Scooter Covered by Medicare?

There are many types of canes, walkers, and other assistive devices available. If you feel you need a cane or walker, talk to your doctor and/or a physical therapist to make sure you get the product that is best for you.

Canes
Canes provide support and balance and may help some people avoid falls.

• You can support up to 25% of your weight with a cane.
• Typical reasons for using a cane:
• Arthritis, especially of the knees and hips
• Mild balance disorders
• Injuries to the foot or leg

Walkers
Walkers provide support and balance and may help some people avoid falls.

• You can support up to 50% of your weight with a walker.
• Typical reasons for using a walker:
• Arthritis, especially of the knees and hips
• Moderately severe balance and gait disorders
• Generalized weakness of hips and legs
• In most cases, canes and walkers are reimbursable through Medicare and other insurers.

The correct length of a cane is measured from the wrist to the floor. To measure for a cane:

• Wear your normal shoes.
• Hold your arm with a 20-degree to 30-degree bend in the elbow.
• If necessary, adjust the cane to match your measurement.
• Ask someone else to measure the distance from your wrist to the floor. This measurement should be about equal to the distance from the point where your leg bone fits into the hip socket to the floor.

Wood canes can be cut with a small saw. Remove the rubber tip, measure the cane from the top edge of the handle to the desired length, cut the cane, and replace the rubber tip. Aluminum canes are adjusted by pushing the button in and sliding the tube to the new length until the button locks in place.

Unless instructed otherwise, use the cane on the opposite side of your injury or weakness. For safe use of your cane:

• Put all of your weight on your unaffected leg, and then move the cane and your affected leg a comfortable distance forward.


• With your weight supported on both your cane and your affected leg, step through with your unaffected leg.


• Place your cane firmly on the ground before you take a step. Do not place your cane too far ahead of you, or it could slip from under you.


• Non-skid rubber tips help keep you from slipping. Checks tips often and change them if they look worn. These tips are available through your local pharmacy or medical supply store.


• If your cane does not feel right, ask your physician or physical therapist to check the fit.

The correct height of a walker is measured from the wrist to the floor. To measure for a walker:

• Wear your normal shoes and hold your arm with a 20-degree to 30-degree bend in the elbow. (If your upper arm is at 12 o'clock, your hand points to 5 o'clock.)


• Ask someone else to measure the distance from your wrist to the floor. This measurement should be about equal to the distance from the point where your leg bone fits into the hip socket to the floor.


• If necessary, adjust the walker to match your measurement. Most walkers are adjusted by pushing in buttons on each side and sliding the tubing to the new length until the buttons lock in place.


• If your walker doesn't feel right, ask your physician or physical therapist to check the fit.

For safe use of your walker:

• Roll your walker a step's length ahead of you. Place the walker firmly on the ground. Do not place your walker too far ahead of you, or it could slip from under you


• Lean slightly forward and hold the arms of the walker for support.


• Take a step.


• Repeat the cycle: Place your walker firmly on the ground (or roll it ahead of you), then take a step.


• Non-skid rubber tips help keep you from slipping. Checks tips often and change them if they look worn. (On carpeted surfaces, tennis balls cut and placed on the rubber tips can be helpful for ease of movement.)

Does your doctor do all the talking while you do all the listening? Are you afraid to ask questions? Do you leave the office feeling like you just sat through a foreign language class?

Your relationship with your doctor, including how well you talk with each other, affects your care. A good relationship - where you and your doctor share information and work together to make the best decisions about your health - will result in the best care. You'll also feel more confident in your doctor and the quality of care you're getting. Here are some ways to make talking to your doctor more effective:

Be Prepared
Doctors are busy people and their offices are often abuzz with activity, like ringing telephones and crowded waiting rooms. When you actually see your doctor, your visit probably won't last more than 15 minutes. The best way to make the most of your limited time is to come to your appointment prepared:

• Write down all the questions you have for the doctor in advance and bring a pen and paper to jot down answers and take notes.


• Make and bring a list of your symptoms and how they effect your ability to get around un-assisted.

Many doctors have a problem with prescribing mobility aids for Fibromyalgia or CFS/ME, so you need to be detailed and specific when describing your need for mobility aids (cane - walker - forearm crutches - wheelchair) Phrases like..

"My balance has gotten so bad, I'm scared I'll fall! I think I would benefit from using forearm crutches or a wheelchair"

Or

"I need help getting around, I think I would benefit from having a mobility aid"

Don't Be Shy - Speak Up
Don't be put off by big words or a doctor's impatient manner. If you don't understand what the doctor is telling you, ask him or her to explain it again. Using different words, or drawing or showing you a picture can help. Don't leave the office without understanding everything the doctor told you.

Bring Someone With You
Sometimes, people like to bring a friend or family member to a doctor appointment for moral support. A companion also could help you relax, remind you of questions you forgot to ask, and help you remember what the doctor said. If you need personal time with the doctor, the person can sit in the waiting room. Having someone join you is especially helpful if you feel too ill to get around easily on your own.

Take Part In Your Healthcare
Ask your doctor what they recommend for assistance in getting around. Confidence and trust between you and your doctor are essential. Look for another doctor if you are having a hard time communicating or do not feel comfortable. Do not worry about protecting your doctor's feelings. Doctors and patients may have different styles, which are not compatible. Be straightforward and let your doctor know if you are planning on transferring your care to another doctor. This way, all of your records can be transferred to your new provider.

Medicare will pay for wheelchairs that are needed in your home but will not pay for wheelchairs that are used solely for comfort or leisure. In May 2005, according to USA Tech Guide, it was decided by Medicare that mobility was not a medical necessity, a regulation still in effect in 2009. If you are able to perform activities such as getting to the kitchen (even if it is difficult or requires a walker or crutches), dressing yourself or using the bathroom without a wheelchair, Medicare will not consider your case.

Certificate of Medical Necessity
Talk to you doctor about getting a Certificate of Medical Necessity. This will be the only way Medicare will accept your claim. On the form, the doctor will need to provide the dates of your disability, the type of disability and the medical need for a wheelchair, and he will need to sign and date it. Motorized or scooter wheelchairs can be ordered only by rheumatologists, neurologists or orthopedic surgeons. Your doctor will give you the completed Certificate of Medical Necessity to bring to the wheelchair dealer.

Medicare will cover electric mobility scooters. However, you must be able to show you have an honest medical need for one and the primary use must be for moving around your home. In other words, it just can't be something that would be nice to have or primarily for use outside the home. However, you must follow the steps below to ensure that Medicare pays for the equipment:

• Only your doctor can prescribe the equipment for you, so do not order anything until you have visited your doctor no matter what the sales person tells you.


• The doctor must document the need for an electric scooter in your medical records and give you a signed and dated order (prescription) for the equipment.


• The order must be received by the supplier before Medicare is billed and it must be kept on file by the supplier.

If you receive your Medicare through a Medicare Medical Advantage Plan (HMO, PPO) it is likely you will have to follow the plan's steps for approval and purchase of a scooter. Call your plan's customer service number and ask how you get coverage for an electric mobility scooter.

You must have Medicare Part B coverage and your doctor must have assessed your needs, documented the need in your medical records, and wrote you an order (prescription) for the equipment (scooter). The supplier must have the order on file before billing for the scooter. In addition, the need for the scooter must meet the following criteria:

• You cannot walk on your own, even with the support of other mobility equipment


• You have weakness in your upper body caused by injury or illness and cannot use a manual wheelchair because of upper body weakness


• You would have to spend most of your time in bed or a chair without the scooter


• You can safely get on and off the scooter, as well as sit on it and work the controls


• You must need the scooter to help you move about independently. Medicare will not cover a scooter if the stated need is to prevent an injury.