Mobility Devices: Canes, Walkers, Wheelchairs, Scooters, and the Like

Scooter

Mobility Devices Do I need one?

Deciding when to use a mobility device is often difficult – especially when your physician doesn’t mention it. You may often find yourself questioning as to whether you should continue to push yourself. After all, wouldn’t your rheumatologist suggest using a cane, walker, scooter, etc if you really needed it?

Canes

To determine if you need a cane or not, think about these things. Do you have pain on one side of your body? Weakness on one side? Do you need help with balance? 1http://www.aafp.org/afp/2011/0815/p412.html Or do you hold to furniture and walls as you walk? If you answered “yes” to any of these questions, a cane might help you.

Walkers

Walker

If you have balance issues, you may need a walker. When you’re off balance, a cane usually isn’t enough to keep you upright when walking, but a walker, either one like the one pictured or one with the four wheels may be what you need to help you keep your balance.2http://www.aafp.org/afp/2011/0815/p412.html Also, if you it exhausts you to walk very far, and the more you walk, the higher the risk of stumbling, you might opt for a walker with a seat.

Wheelchair or Mobility Scooter

Scooter

But I can walk? Isn’t it wrong for me to use a wheelchair or a scooter? No! If you have low stamina, difficulty walking distances, or if you have trouble managing a walker or cane, you may need a mobility scooter. This is also a good option for those on oxygen or with chronic joint pain.3https://www.verywell.com/do-you-need-a-mobility-scooter-1094636

When shopping for groceries, walking the mall, going to a museum, or going to a theme park with your family, are you relegated to waiting in the car, or sitting on the sidelines because you can’t walk distances? If so, you might want to think about using a wheelchair or a scooter.

Wheelchairs and scooters can provide incredible freedom for those who have fatigue and pain from autoimmune diseases. Bus systems and taxis must provide space for your scooter or wheelchair, so using public transportation is an available option.

Medicare and some insurances will pay for a scooter if your physician signs off on the paperwork. Most places that sell them can tell you what you need in order to file against Medicare or private insurance.

But My Doctor Didn’t Recommend It…

Remember when dealing with your health and autoimmune diseases, you must become your own advocate. Talk to your doctor about your symptoms. Explain that you think a mobility device would help you.

Of course, you do not have to have your doctor’s permission for a mobility device since they are sold over the counter. However, if you want insurance or Medicare to pay for your mobility devices, or you want to take the cost off on your taxes, then you’ll need to ask your rheumy to sign off.

 

 

Chronic Kidney Disease and Autoimmune Diseases

Chronic Kidney Disease and Autoimmune Diseases

Kidney
Image courtesy of hywards at FreeDigitalPhotos.net

Chronic Kidney Disease affects thirty million people. Think about that number. It’s equivalent to 9% of the population of the United States. Many more people are at risk of developing CKD.

The causes are varied, but the leading causes are hypertension (high blood pressure) and diabetes. For those who have autoimmune diseases, the causes can range from the disease itself (for example, Lupus Nephritis), to comorbid conditions (coexisting diseases) like hypertension or diabetes to the treatment for the autoimmune disease.

Types of Kidney Disease

There are two types of kidney disease. Chronic (CKD) and Acute. In this post, we are concentrating on CKD because that type of kidney disease has long-term consequences. Acute Kidney disease is treated in a hospital setting as an emergency.

Prevention

One in three adults is at risk for developing chronic kidney disease. This insidious disease can develop without the victim realizing it. If you have diabetes or hypertension, work with your doctor to keep those diseases under good control. Hypertension or high blood pressure damages the small blood vessels in the kidneys. It’s the second leading cause of chronic kidney disease. Diabetes is the leading cause.

For those who have autoimmune diseases, limit the anti-inflammatory drugs such as naproxen, ibuprofen, etc to the prescribed amount. These drugs are eliminated through the kidneys. Overuse of the drugs can lead to CKD.

Work with your physician to identify CKD early. Have routine blood pressure, blood glucose and/or A1C testing to identify these risk factors in addition to the autoimmune disease. This can be done by urine testing for ACR (Albumin Creatinin Ration) and blood testing for GFR (glomerular filtration rate).

Symptoms of CKD

Many of the symptoms of CKD are the same as those of Autoimmune diseases so they can be easy to ignore thinking they’re part of the same stuff you deal with off and on.

The symptoms include:

Image courtesy of photostock at FreeDigitalPhotos.net
Image courtesy of photostock at FreeDigitalPhotos.net
  • Fatigue and weakness
  • Difficult and/or painful urination
  • Foamy or frothy urine 1Lupus Foundation of American – www.lupus.org
  • Pink, dark urine (this is an indication of blood in the urine)
  • Increased thirst
  • Increased need to urinate especially at night
  • Swelling – puffy eyes, swollen face, abdomen, ankles, feet
  • Unusual weight gain – related to fluid retention.2National Kidney Foundation – www.kidney.org

Lupus nephritis

Approximately 40% of those with Lupus will develop Lupus Nephritis (or glomerulonephritis). In Lupus Nephritis, the nephrons (parts of the kidney that filter the blood become inflamed and the kidneys can no longer eliminate the toxins. They begin to build up in the bloodstream. The patient begins swell or gains unexplained weight.

CKD and Heart Disease

Heart disease is very common in CKD. If you have CKD, learn about heart disease and preventing it. Many of the same diseases that cause CKD also cause heart disease.

While the link between heart and kidney disease isn’t completely clear, it has been shown that damage to either organ affects the other one. If you develop CKD, you are much more prone to developing heart disease. 3National Kidney Foundation – www.kidney.org4National Institute of Diabetes and Digestive and Kidney Diseases – www.niddk.nih.gov

Heart disease is the leading cause of death in Chronic Kidney patients at all stages. In addition to normal cardiac risk factors, those with CKD have unique risk factors.

  • Protein in the urine (proteinuria or albuminuria)
  • Elevated phosphorus levels in the blood – in CKD the body is often unable to eliminate the excess phosphorus found in some food. As this build up in the bloodstream, it can cause de-calcification of the bones and hardening of the arteries.
  • Elevated calcium levels – Calcium and parathytroid often go hand in hand. When the calcium levels are too high, it can cause calcium deposits in the arteries.
  • High levels of parathyroid hormone (PTH) – Often in CKD the parathyroid gland produces too much of the hormone and causes elevated calcium levels.
  • Electrolyte imbalances (especially potassium) – Potassium levels must be kept within strict ranges. In CKD the kidneys are often unable to eliminate excess potassium resulting hyperkalemia (elevated potassium). Hyperkalemia or hypokalemia(low potassium) can result in the cardiac arrest (heart failure).
  • Fluid overload – When the kidneys aren’t working correctly, they fail to filter and excrete excess fluid. Excess fluid in the bloodstream places extra strain on the heart and causes elevated blood pressure)
  • Anemia – When a patient is anemic, their level of red blood cells becomes low. the red blood cells carry oxygen to the various organs including the heart muscle.
  • Malnutrition
  • Inflammation 5Davita Dialysis Centers – www.davita.com
Image courtesy of cooldesign at FreeDigitalPhotos.net
Image courtesy of cooldesign at FreeDigitalPhotos.net

In conclusion:

For more information on kidney disease, please visit the National Kidney Foundation – http://www.kidney.org

The NKF has local chapters that offer free screenings and education on kidney failure. The website contains a wealth of information on kidney disease and transplantation. They offer free memberships to the organization and online communities for those on dialysis or who have been diagnosed with CKD.

The NKF also provides information on clinical trials and how to find one that might be right for you.

Your kidneys are essential to your overall health. Know your numbers: glucose, blood pressure, and glomerular filtration rate. Know the symptoms of kidney failure, and don’t assume that any symptoms you’re experiencing are caused by your autoimmune disease. The earlier you catch kidney failure, the better the outcomes.

Disabled or Not? Part Two

In my last post, I discussed how someone can look fine, yet be profoundly disabled. I shared my story of living with autoimmune diseases for many years.

Church

Today, I would like to discuss what those disabilities cannot do. They cannot:

  • Steal my faith or my joy. Yes, I have days where I get down because of the changes in my life. However, I still have joy. The Bible tells us we’ll have troubles. Jesus never promised that our lives on earth would be pain-free, but He does promise to walk through the valleys with us. “I will never leave you, nor forsake you.” Since my trust is in Christ, my joy rests in him also.
  • Rob me of laughter. I choose to laugh every day. My husband cannot go a day without making a joke. Even in troubled times, we laugh together. No matter the situation, we can find a sliver of happiness and laughter.
  • Snatch love from me. I know people who’ve had spouses leave them over their diseases, and I’m not making light of that, but disabilities cannot steal the love of my family. Mostly, it cannot steal the love of my Lord. He’s promised to love me forever. In fact, “love” is one of the most used words in the Bible. Disabilities cannot steal my love for others. Jesus commanded us to love others – including our enemies. Having multiple health issues isn’t an excuse to not love others. Hurting and feeling bad doesn’t give me a pass on reaching out in love.
  • Change who I am. Health issues may change the things I can do. I may spend more time sleeping, and more time recovering from activities, but they cannot change who I am. My inner being. The part of me God created, illness cannot change.

Yes, I’ve lost much because of my chronic illnesses, but I’ve also gained much.

  • Patience – waiting for medical procedures and insurance is teaching me patience. While I’m still not nearly as patient as I should be, I’m learning.
  • Understanding – As nurse, when I first became ill, it gave me more empathy toward my patients. Now, I try to have more empathy towards those who don’t understand. When I have friends who make hurtful comments, I remind myself that they don’t understand what I’m going through. At times, my understanding flies out the window, but I’m trying to be more understanding and forgiving of others.
  • To be still. I used to stay on the go day and night. Being still was foreign to me. I didn’t know how to sit quietly and just be still. I didn’t want to be alone with my thoughts. Now, I’m learning to sit still and listen, but I’m better. God tells us to be still and listen to Him. I’m still working on sitting quietly and just listening to Him but having a chronic illness is teaching me to sit still.

I’ve been guilty of saying, “I have no life anymore.” Yet, nothing could be further from the truth. I have an incredible life. It’s changed drastically over the years, and I can no longer do many of the things I used to do, but I still have a good life.

Years ago we went on a cruise, and I chose shore excursions like climbing the Dunn’s River Falls or parasailing. ParasailingDunn's River Falls

Now, if we go on a cruise or a trip, I choose things that are easier. We took an Alaska cruise, and we didn’t go on any shore excursions. I used my scooter, and we explored the towns. While we didn’t spend long at any stop because I tire easily, we still had fun. Alaska

We spent a lot of time watching out our balcony windows and saw many beautiful sights like whales and icebergs.

IMG_1198 IMG_1648

My life has changed, but it is still a good one. God has richly blessed me in many ways. My prayer for you, if you find yourself with a chronic illness, is that you would look outside of the disabilities and see the good, beautiful parts of life that are left. The sunsets, the flowers that bloom in your neighborhood, the sound of the birds calling to each other in the trees – – find joy in the small things.