Reporter's Notebook: ISS, Friday, March 13, 2009

ORLANDO, Fla. - Continuing coverage of the 25th International Seating Symposium, day 2:

* After spending much of yesterday in the exhibit hall, today was dedicated to picking up those all-important CEUs. Among the highlights:

* Kendra Betz moderated a set of superb case studies that included David Cooper's "Technical Considerations for Seating Systems in Stand-Up Wheelchairs"; Kevin Phillips' "Transitioning an Aging Client to High-Tech Equipment to Maximize Function"; Joan Padgitt's "Custom Abdominal Support for a Bariatric Client"; Patrice Kennedy's "Mobility Solution for an Individual with Multiple Amputations and Severe Burns"; and Hayley Howells' Innovative Seating Solution for a Tetraplegic Client with Multiple Impairments."

• In addition to explaining the positional changes and challenges that occur when a client moves from sitting to standing in a wheelchair, David Cooper reminded us that ISS 2010 will occur right between the Winter Olympics and the Paralympics in Vancouver. Word to the wise, as Kendra said: Book those Vancouver hotel rooms soon!

• Kevin Phillips profiled a 40-year-old CP client with a wonderfully proactive mother... after years of relying on dependent manual mobility, this client transitioned to driving his own power chair. Pretty incredible story, complemented by photos of the client progressing from infancy to adulthood...and from being "tied up" in his chair, as his mother described, to sitting taller, straighter and more comfortably without relying on bunches of harnesses and belts.

• Patrice Kennedy's case study was of a husband and father severely burned in a car accident. Not only did he lose both legs and an arm, but his burns continue to compromise his skin's health to this day. This story testified to the strength of this client, his family and friends, and his seating team. The client now speaks to kids about the dangers of drinking and driving, and - thanks to his Frontier X5 all-terrain chair and his friends - is an avid hunter.

• As if SCI weren't enough of a challenge: Hayley Howells' case study involved a man who was a double amputee (both legs), had scoliosis, had tetraplegia, had pressure sores...more proof that seating & mobility needs and solutions for highly involved clients are equally complex.

• Word of the day: pannus. After going my whole life without hearing this term, I heard it in back-to-back sessions by Joan Padgitt and Stephanie Tanguay. The term means a hanging flap of tissue, sometimes referred to as an apron...and Joan's case study involved a customized "pannus lift" to better position her client's pannus tissue, estimated to weigh 120 lbs. The pannus lift not only reduced pain, it also improved the client's sitting posture and positioning.

• Stephanie's session was called "Mobility & Positioning Considerations for Lymphedema & Limpedema." The former is the collection of fluid in the lower extremities due to damage to the lymphatic system; limpedema, nearly always seen only in females, involves "bilateral swelling of the lower extremities from hips to ankles due to subcutaneous fatty tissue," according to Steph's presentation.

• Neither condition is well understood, relatively speaking, and neither is curable...the best hope at this time is early diagnosis and intervention, with consistent lifetime management. Both also produce serious seating challenges, starting with taking measurements...for instance, due to the swelling, lymphedema and limpedema clients typically have short seat depths. And of course, all that weight in the front of the mobility system can cause serious stability challenges for power bases.

• Special thanks to Lauren Rosen, my April issue Earning the ATP mentor, who managed to tutor me while literally driving between graduate classes in Tampa and ISS, where she's been a presenter. Not sure how she managed to juggle all this in the space of about 10 days, but I'm glad she did!

• And thanks to everyone else who agreed to mentor me as I continue to study for the ATP exam. Mike Babinec, Scott Lopez, et al: I'll be in touch!

• Check in for more updates!

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