Tag Archives: roho cushion

Groundbreaking Research Uncovers New Insights for Reducing Deadly Pressure Ulcers in Wheelchair Patients

Study shows air cell cushions are 10,000 times better than standard foam for preventing deep tissue injury 

ST. LOUIS, December 10, 2014 ROHO, Inc., a leader in wheelchair seating solutions since 1973, today announces research findings that recognize adjustable air cell cushions as medically superior for reducing deep-tissue injuries and skin breakdown1, which can lead to deadly pressure ulcers and costs the American healthcare system billions of dollars per year.2

The study, conducted by Dr. Amit Gefen of Tel Aviv University, provides new clinical data to guide recommendations for the best cushions to protect people who use wheelchairs for mobility. The new study is the first to offer a comparison between two commonly used wheelchair cushion technologies – foam-based (representing the largest number of cushions in use) and ROHO’s air-cell technology.

The Issue: 

Pressure ulcers are a serious public health issue: fast to develop, extremely expensive, hard to heal and potentially fatal. In the U.S., nearly 60,000 patients die each year from complications linked to hospital-acquired pressure ulcers3 – almost twice as many deaths as from motor vehicle accidents.4 The cost to treat one single full-thickness pressure ulcer is about $70,000.2

As deadly and costly as pressure ulcers can be, they remain a daily concern for the 3.6 million Americans who use wheelchairs for mobility.5 But Gefen’s groundbreaking research is changing that.

Dr. Gefen and other leading researchers around the globe found that cell deformation was the cause of deep-tissue injury (DTI), starting deep and invisible – from the inside out. Prior research pointed toward skin breakdown and constricted blood flow as a leading cause. This study was the first to apply this knowledge to a direct comparison between different types of wheelchair cushions.

“Our study revealed an important insight about the best ways to minimize these deformations – and therefore DTIs – in wheelchair users,” said Gefen. “Adjustable air cell cushions were far superior over foam and could be the key to helping avoid pressure ulcers. The findings are significant not only because of the size of the wheelchair users’ population, but also because of the healthcare system’s cost in treating pressure ulcers – more than $11 billion annually in the U.S. alone.2

Study Methods and Results: 

The study used seated MRIs and “finite element” computer modeling to unlock a new picture of the damage that causes deep- tissue injuries.

  • Gefen’s team compared the ROHO® QUADTRO SELECT® HIGH PROFILE® cushion and two flat, foam-based cushions with varying stiffness properties (7 kPa and 10 kPa) for individuals with a spinal cord injury (SCI).
  • The study used an MRI slice from a 21-year-old SCI patient to develop an anatomically-realistic model of the patient’s left buttock.
  • For all three cushions, immersion was calculated as the percentage of skin surface in full contact with the cushion. Higher figures represent more surface area for load transfer, and potentially lower internal tissue loads.
  • The different mechanical stresses – compressive, tensile, shear and effective stress – were calculated.
  • Measures were recorded for each individual model, in the muscle, fat, and skin tissues under the ischial tuberosities during sitting, to determine the risks for the specific internal conditions.
  • For ROHO’s air cell cushion, immersion was consistently in the 91-93 percent range; for the foam cushions, the range was 58-65 percent.

Results demonstrated significant evidence that skin breakdown risk is much lower for ROHO adjustable air cell cushions compared to non-adjustable foam cushions. In fact, the study revealed that air cell cushions are 10,000 times better than foam in reducing tissue damage that can cause death.

Moreover, bone flattening led to higher peak stresses on muscle tissue in the foam cushions, but lower stresses for the air cell cushion. Likewise, muscle atrophy substantially increased fat and skin stresses on foams, but substantially decreased them on the air cell cushion. Both of these sets of results demonstrate that as the patient’s condition advanced, the air cell cushion decreased the risk even further in comparison to a foam support.

“The Gefen study proved what ROHO has believed for 40 years: Air cell cushions that ROHO pioneered prevent deformation through immersion and envelopment,” said Tom Borcherding, president of ROHO. “ROHO is committed to leading the industry in developing the science to improve the lives of people that use wheelchairs for mobility, and we drive U.S. and international standards that our competitors do not. This new and groundbreaking work is already providing the evidence for a critically needed change in direction, toward prescribing better and safer sitting solutions. ”

About ROHO ROHO, Inc. is a leading global wheelchair cushion manufacturer. Specializing in seating solutions with shape fitting technology® since 1973, ROHO manufactures and distributes a variety of standard and custom-size wheelchair cushions and accessories, back systems, and support surfaces. Made in the United States for over 40 years, ROHO provides outstanding manufacturing controls for proven and consistent quality. For more information, visit www.roho.com or contact customer service at 800-851-3449.


1   Ayelet Levy, Kara Kopplin, Amit Grefen. An air-cell-based cushion for pressure ulcer protection remarkably reduces tissue stresses in the seated buttocks with respect to foams: Finite element studies. Journal of Tissue Viability (2014) 23, 13-23.

2   Duncan KD. Preventing pressure ulcers: the goal is zero. Jt Comm J Qual Patient Saf 2007;33(10):605e10.

3   Lyder, C. (2003). “Pressure Ulcer Prevention and Management.” Journal of American Medical Association 289: 223-226.

4   National Highway Traffic Safety Administration (2012, January 1). Retrieved September 11, 2014, from http://www-fars.nhtsa.dot.gov/Main/index.aspx

5.  U.S. Census Bureau, Americans with Disabilities 2010.

ROHO Helps Honor Disabled Veterans with Custom-Designed Cushion Donation

SAN ANTONIO, TEXAS, November 17, 2014 – During a Veteran’s Day commemoration ceremony at the historic Alamo, 40 wounded service members were honored with the gift of custom-built Segway® transporters.  Of those, four were Ally Chair Adapted Segways outfitted with ROHO® cushions and ROHO® AGILITY™ backrests.  These donations were made possible by Segs4Vets to improve their mobility and independence.Segs4Vets ceremony 4

The honored veterans served in either Operation Iraqi Freedom or Operation Enduring Freedom in Iraq and Afghanistan. Twenty five of the 40 veterans lost limbs during their service. They now carry a permanent reminder of their military service and will for the rest of their lives.

Segs4Vets is ranked as one of America’s best charities by the Independent Charities of America and has received the prestigious Spirit of Hope Award from the Office of the Secretary of Defense. Jerry Kerr, President and Co-Founder of Segs4Vets presented the specially adapted Segways on Wednesday, November 12, 2014 at 10:45 a.m. at a public ceremony during the San Antonio Chamber of Commerce’s annual Celebrate America’s Military week.

This year’s presentation is the fourteenth time specially adapted Segways have been presented to recognize veterans. Four of the 2014 recipients received an Ally Chair Adapted Segway. The Ally Chair is a new, universally designed recreational device, which is currently only available through Segs4Vets. The Segs4Vets program transforms the traditional Segway transporter into a seated mobility device for individuals who cannot use prosthetic devices.  Plans are underway to expand the offerings of Ally Chairs utilizing ROHO technologies for eligible veterans.

ROHO_SEGS4VETSThe Ally Chair utilizes ROHO’s seat cushions and AGILITY™ Backrests to provide skin protection, positioning and comfort for the user. ROHO’s unique cellular-air design constantly adjusts to an individual’s body movement and adapts to their changing shape. The adjustment and conformity of the cells accommodate and meet the one-of-a-kind skin integrity needs for each veteran throughout the day. This year alone, ROHO has donated $32,000 in engineering and customer manufactured products in support of Segs4Vets’ mission.

In addition to those who lost limbs, other recipients either sustained spinal cord injuries, traumatic brain injuries, severe burns, developed cancer, or suffered severe orthopedic, neurological and soft tissue damage which makes it difficult or impossible for them to walk without assistance or pain. Studies show the lack of mobility is a greater obstacle to employment than blindness. Many are being treated at the Brooke Army Medical Center at Fort Sam Houston. Military medical centers have incorporated the Segway into rehabilitation since Segs4Vets began awarding the transporters nine years ago.


Segs4Vets is a program of Disability Rights Advocates for Technology (DRAFT). The program is dedicated to restoring independence and productivity to severely injured service members as part of DRAFT’s core mission to expand and improve access for all disabled people. Segs4Vets has awarded more than 1,300 Segways since 2005 and plans to continue the program to meet the ongoing needs of the thousands of worthy applicants who served in Iraq and Afghanistan.  As a charitable organization, $0.94 of every dollar goes towards providing equipment and services to veterans.


ROHO is the worldwide leader of seating solutions that prevent and treat pressure ulcers and tissue deformation. ROHO’s technology provides skin protection and positioning in a variety of applications; from wheelchair cushions, to therapeutic mattresses, to wheelchair backs and more.

ROHO’s products deliver life-changing benefits, offering comfort and protection to people relying on wheelchairs for mobility.  ROHO is the pioneer of air-cell based cushions, and created DRY FLOATATION TECHNOLOGY® mimicking the pressure-redistributing properties of water. With over 1 million ROHO products in use in over 80 countries worldwide, clinicians can be confident in prescribing ROHO products.  Plus, all ROHO products are backed by an unmatched level of clinical evidence from leading researchers around the world.

With the increasing focus on patient outcomes and safety, ROHO’s established technology is paramount in treating the over 2.5 million patients suffering pressure ulcers annually and reducing the $11 billion in annual healthcare cost for the treatment of pressure ulcers.


Susan Lynch


Q & A with Jamie Goodwin

Blogging via Facebook.com/Wheelin’ Weightloss

Why did you start blogging?

I started writing and sharing my story to inspire others to lose weight and to have accountability partners in return.

Jamie Goodwin - Interviwe

If you could give your page a permanent hashtag what would it be?


Gadget/”trick” you use that makes life in a wheelchair a little easier?

Ask for help. People are always willing to help.

What would your followers be surprised to learn about you?

I grew up on a farm and milked goats until I was 12 years old.

Finish these sentences:

I wouldn’t have believed you if you told me ten years ago that…. I would be the mom of 3 boys and a pastor’s wife!

In the next 10 years I really hope… To have reached my goal weight (45 more pounds to go) and to have written a book.

If no one read my blog/posts I would… keep posting! Seeing my progress and setbacks always help when you are on a weight loss journey like this.

Visit my blog/page if you….want to be inspired to lose weight and get healthy!

I get happy when I… go camping with my husband and 3 boys!

ROHO Elite Interview: John McRoberts

John McRoberts - Elite LiveRoho

John’s Video

Meet John McRoberts, a medal-winning Paralympic Sailor for Canada.  John splits time between Victoria, British Columbia and St. Petersburg, FL.  Always an active person, John participated in everything from wheelchair rugby to racing before finally settling on sailing. To John sailing has longevity, “Other sports have a shelf life because of your age. Sailing can be done until the day I die.”

Disability or Age Doesn’t Matter

Unlike other sports that require being able to move a wheelchair around aggressively or upper-body strength, John points out that with sailing disability or age doesn’t matter, it’s mentality. “The beauty of sailing is that you can compete with a high level disability. Anybody can do this. [On the water] it’s about being faster and smarter – it doesn’t matter about the chair. I get to leave my chair behind. It’s really good mentally to be free from it, you know?”


As part of John’s training he spends time both on the water and in the gym. Four days a week he spends 3 hours on the water practicing. At the gym John is stretching and working with a trainer on machines.

Paralympic Sports

We asked John if he weren’t sailing, what Paralympic sport would he want to compete in? “Rugby. I played when I was younger but since then the chairs have evolved; the whole sport has evolved. Rugby is the ticket everyone wants at the games.”

Security is Peace of Mind

John is equipped with a ROHO cushion both in his chair and on his boat. “You can be as talented and adventurous as you want but if your health isn’t good you can’t do anything. Sitting on a ROHO is a huge peace of mind. I know I’m going to be fine. It allows me to check off one of those precautionary things that I have to worry about each day. It’s my security blanket. “

The Future

After meeting his wife Jackie sailing, they got married in 2010.  Jackie also enjoys staying active and is John’s sailing partner.  Together they are committed to going to the 2016 Paralympic Games in Rio de Janeiro. Best of luck!

To see more ROHO Elite members ROHO Community!

Is It Time To Replace Your Cushion?

“How do I know when it’s time to replace my cushion?” This is an important question that frequently comes up at consumer shows, a question that has a several answers.

Continue reading

Monica Bascio Balances Family Life and Career in Her Quest for Paralympic Gold in London

Monica Bascio on her way to victory in a hand cycling road race.Guest blog post by Bob Vogel

Monica Bascio will be representing the U.S. in handcycling time trial and road race events in the upcoming 2012 Paralympic Games in London that kicks off in six weeks. For Bascio, 42, handcycling in the Paralympics is the culmination of a 14-year journey of dedication and hard work. Bascio is a natural athlete and extremely competitive, however sports is just one aspect of her multi-faceted life—she is the proud mom of her 5-year-old son, Henry, dedicated wife with her husband, Ian, and an Occupational Therapist specializing in geriatrics.

Bascio became a T12 paraplegic in 1992 as a result of a skiing accident.  Following SCI rehab she pursued a degree in Occupational Therapy.  She got her first handcycle in 1997 as a way to stay fit and enjoy the outdoors with Ian, a former bike racer, and quickly developed a passion for the sport.

Bascio started handcycle racing in 1998 and was ranked the number one handcyclist in the world over the next five years, winning more that 30 handcycle races. In 2004 handcycling made its debut as a Paralympic sport in Athens, Greece, but unfortunately there was no women’s division–a huge disappointment for Bascio, who was arguably the top woman handcyclist at the time.

Undeterred, Bascio decided to try adaptive cross-country skiing (sit skiing). Once again her natural athletic ability, competitive nature and work ethic enabled her to quickly rise through the competitive ranks earning her a six-year run on the U.S. ski team where she represented the U.S. as a cross-country sit skier in the 2006 and 2010 Paralympic Winter Games.

In the off-season Bascio continued handcycling as a form of cross-training.

Bascio took much of 2007 off from competing in order to embark on a new adventure. On July 8 of that year, she gave birth to her son Henry and she and Ian proudly adapted to the world of parenthood.  By early 2008 Bascio was ready to start competing and the family created a balance of parenting, work and training that would enable Bascio to get back into ski racing.

Around the same time, Bascio’s dream of Paralympic handcycling seemed like it would come to fruition when it was announced that women’s handcycling would become an event at the 1998 summer Paralympics in Beijing.  Unfortunately in March she broke her tibia and fibula transferring out of a team van while at cross country race in Norway. Although her leg healed in time for her to compete in the Paralympic trials, she didn’t have enough time to get back into racing form and didn’t make the team.

After competing in the 2010 winter Paralympics in Vancouver, Bascio considered retiring from competition, but a rule change added an H3 class to the Paralympics. This meant she would be racing against athletes with similar function rather than an open class. Bascio quickly set her sights on the London Paralympics with the family agreeing to take it “One race at a time.”

Motherhood, family life, work and training at an elite level requires amazing balance and dedication. “On a typical day I’m up at 6:00am to put in a solid 3-hour workout on my handcycle. On some days it is a 4-hour workout.  In the meantime, Ian makes breakfast for Henry and gets him ready for the day.”  She says.  “By around 10:00am, I’m home. Ian heads to the office and I take over watching Henry and maintaining the housework.  We take turns making dinners.  Ian and I chuckle because most of our dinner conversation revolves around my training.”  Ian watches Henry on the days Bascio is working as an OT.  “The key to making it all work is we support each other, communicate and work together to balance the challenges of work, raising Henry and training for the Paralympics.”

Bascio says that although the family enjoys the hectic schedule, it can be draining.  “Ian cracks up because although I hardly ever watch TV, I love watching ‘The Biggest Looser’ (a show about weight-loss ‘boot camp’). She says. “I look at the show and think, ‘If all I had to do was stay at a campus and have a coach and do workouts all day it would be like a vacation!’”

Bascio says the other challenge in balancing family life with competition is the travel schedule. “My last trip in June was pretty crazy.  I was racing at a World Cup race in Italy for two weeks, flew back to the States, was home for two weeks, then flew to Spain to race in a World Cup race.” She says.

“Then I flew to London for 36 hours to ride the race course, then flew straight to the Nationals in Augusta, GA, and of course the plane was delayed so I didn’t get in until about 9:00pm and met Ian and Henry and Henry hadn’t seen me in so long and wanted to go swimming at the pool at the hotel, and I still had to put my bike together—then had a race the next day.”

Bascio has been an avid ROHO user for the past 15 years.  “I love ROHOs” says Bascio. “When I was first injured 20 years ago, the equipment vendor I had in rehab had the ‘old school’ mentality that a ROHO cushion was for people with higher level injuries or people that already had problems with skin breakdown so they ordered a gel cushion. I didn’t like it because it was heavy and I didn’t want to take the time to massage the gel the way I was supposed to.  When it was time to order my next cushion I switched to a ROHO and I’ve been using them ever since.”

As an OT and an athlete, Bascio is aware of how quickly a pressure ulcer can happen. “I know wheelchair users that have had pressure ulcers and I’ve seen what they go through and the great length of time it takes to heal.  I’m not willing to take that risk.” she says. “When I broke my leg it cost me a spot on the Paralympics and a pressure ulcer can take much longer to heal.  I’m always sitting on a ROHO.  I use a ROHO QUADTRO SELECT LOW PROFILE on my chair and I sit on a LTV ROHO Seat Cushion in the car.  I keep an ADAPTOR Pad in my backpack for travel and use it in the tub or shower bench, or when I’m sitting on the side of a pool or sitting on the ground working on my bike.  And of course I sit on my QUADTRO SELECT on long plane flights.”

Ian and Henry, along with other members of Bascio’s family will be in London to cheer for Bascio.  “Henry gets to travel to a lot of competitions.  He has become a member of the handcycling community.  Everybody knows him and a lot of the other athletes have kids so he has friends to play with. He has his own frequent flyer card and is already on his 2nd passport.”

Says Bascio.  Proof of the saying, “The family that plays together, stays together.”race.


Bob VogelBob Vogel, 51, is a freelance writer for the ROHO Community blog. He is a dedicated dad, adventure athlete and journalist. Bob is in his 26th year as a T10 complete para. For the past two decades he has written for New Mobility magazine and is now their Senior Correspondent. He often seeks insight and perspective from his 10-year-old daughter, Sarah, and Schatzie, his 9-year-old German Shepherd service dog. The views and opinions expressed in this blog post are those of Bob Vogel and do not necessarily reflect the views of The ROHO Group. You can contact Bob Vogel by email at online.relations@therohogroup.com.

Dan Buchanan, International Airshow Performer, Mentor, ROHO User

Guest blog post by Bob Vogel

Dan Buchanan. Photo courtesy of Dan Buchanan.

Friends and mentors are priceless. In 1985, while still coming to grips with my spinal cord injury in the rehab hospital, a fellow hang-glider pilot named, Dan Buchanan, who is also a T8 complete para came to visit me. Dan’s visit helped me a great deal, mainly because in between dolling out tidbits of SCI survival wisdom he kept looking out the window. Within a short period of time he said “Man, the weather is looking really good for flying, so I gotta go. I’ll catch you later.” This was the perfect thing to say! The light went on! Dan’s life revolves around flying hang gliders! Paralysis wasn’t even on the radar screen.

Dan helped show me the ropes of thriving with SCI, everything from advice in ordering equipment: “Order the smallest chair you can fit into, and tell your therapist you want a ROHO cushion,” to helping me rig my hang glider and get back in the air. Over time we’ve become close friends and shared many adventures.

As I said, Dan’s life revolves around in flying hang gliders, so much so that in 1989 he left a successful career in mechanical engineering to pursue a path as a professional airshow hang glider pilot.

Dan devoted years into honing his routines, methodically developing, refining, and marketing his airshow performances. These days he is one of the most sought after air-show acts in on the circuit!

One of the many cool things about Dan’s airshow act is that it enables the general public to see beyond a wheelchair. His chair has nothing to do with the act. That is, until the finale.

To get airborne, Dan launches from a moving trailer driving down the runway at 35 mph. Once he is in the air, a winch on the trailer pays out line as Dan steadily tow-climbs to altitude as the trailer is towed down the runway. He has long colorful streamers and smoke from canisters trailing his glider. He has crafted several different routines, from an opening act flying with an American flag while the Star Spangle Banner plays, to night routines complete with lights and bright pyrotechnics.

Dan’s day show is a comedy act where he “mistakenly” launches during the middle of another performers aerobatic routine. The announcer, the other performer and Dan all exchange banter on the PA and “pretend” it is a mistake, but Dan refuses to leave the sky. Soon a police car is on the ground chasing the tow trailer and the aerobatic airplane tries to chase Dan out of the sky by buzzing his hang glider. Dan tries to chase the plane away by shooting special effects rockets and pyrotechnics, his version of a “3rd world warbird impression.” At this point Dan’s altitude is about 1,500 feet and he releases the tow rope and the announcer introduces him. He gently swoops, turns and glides down and rolls to a stop front of the audience.

An aerobatic airplane tries to "chase" Dan Buchanan out of the sky during airshow performance. Photo courtesy of Dan Buchanan.

This is when the announcer explains that Dan is a paraplegic, while overhead a helicopter delivers Dan’s wheelchair which is dangling from a cable. The aerobatic plane lands and tows Dan in his wheelchair over to the crowd where Dan shakes hands, answers questions and signs autographs.

Each year during the airshow season  —  April through October  —  Dan’s performances are seen by millions of people around the world as he travels to over 25 cities. To get from show to show requires driving more than 45,000 miles each summer. It is not uncommon for Dan to drive thousands of miles in a single week to get from one show to the next.

In addition to North America, Dan has performed in Australia, Japan, Thailand, El Salvador, The United Arab Emirates, Canada and Mexico  —  an exhausting travel schedule requiring lots of windshield time as well as sitting on very long commercial flights often across many time zones.

In December, Dan was honored by his peers on the airshow circuit when he received the Art Scholl Award for Showmanship at the International Council of Airshows (ICAS) convention banquet  —  one of the highest honors an airshow pilot can receive.

Last week I was fortunate enough to catch up with Dan via phone while he was doing a “short” 700-mile commute from North Carolina to Tennessee for his next show.

Bob Vogel (BV): Congratulations on the Art Scholl Award. Did you know it was coming?

Dan Buchanan (DB): No I didn’t. It was a complete surprise and a great honor  —  also a bit embarrassing. All the other pilots are flying planes, jets and helicopters that cost hundreds of thousands, if not millions of dollars, and here I am flying a hang glider that cost around six-thousand dollars. But mainly it was a great honor.

BV: So I’m trying to do the math — how old are you and how many years have you been injured?

DB: I’m 56-years-old and this is my 31st year as a para.

BV: Wow! I’m 52 and 27 years post injury. It seems to me having a SCI ages us in dog years, how do you manage to keep healthy, especially with all of the travel, days of driving and overseas flights?

DB: Part of it is I come from the old school rehab where they drummed into you the how to take care of myself. I manage to keep myself thin so I’m not stressing my shoulders. I also do a skin check with a mirror every day. So far, so good.

BV: What kind of cushion are you sitting on these days?

DB: I’m sitting on a ROHO® QUADTRO SELECT® LOW PROFILE®. I love these things, I’ve been sitting on a ROHO ever since I was hurt. I wouldn’t sit on anything else. I’m not sponsored by them. I don’t even get a free cushion. In fact, I paid cash for my last cushion because I was about to head out of the country and didn’t have time to mess with prescriptions and insurance.

And I always make sure my ROHO is under me — on my car seat, on the seat on the airplane, you name it.

BV: So even with all of your travel, no pressure sores?

DB: Nope, I’ve never had a pressure sore. But I’ve dodged a pressure sore bullet. Years ago I got careless and was sitting on a seat without a cushion for a while and got the start of a pressure sore. Fortunately, I caught it during my mirror check the same day. I was on a ROHO HIGH PROFILE® Single Valve at the time…Sure enough it worked, and the area got a little better every day. Within two weeks it was gone.

I learned my lesson and always keep a cushion underneath me. And like I said, I check my skin with a mirror because I can’t afford to miss a show and I don’t ever want to end up on my stomach for a couple months trying to heal a pressure sore.

BV: Thanks Dan! Safe travels!

Thinking back to when Dan first visited me in rehab I remember asking him if he thought there would be a cure for SCI — something I secretly hoped for. He replied. “I don’t think so. But here is the deal, let’s say there is a cure in say 25-years. Project yourself 25-years in the future and think back on what you would have wanted to do. Live an amazing life full of adventure, or mope about waiting for a cure?” I took those words to heart. Here I am 27-adventure-filled-years later. Grateful for good advice from a good friend!



Bob VogelBob Vogel, 51, is a freelance writer for the ROHO Community blog. He is a dedicated dad, adventure athlete and journalist. Bob is in his 26th year as a T10 complete para. For the past two decades he has written for New Mobility magazine and is now their Senior Correspondent. He often seeks insight and perspective from his 10-year-old daughter, Sarah, and Schatzie, his 9-year-old German Shepherd service dog. The views and opinions expressed in this blog post are those of Bob Vogel and do not necessarily reflect the views of The ROHO Group. You can contact Bob Vogel by email at online.relations@therohogroup.com.

ADA Drive-By Lawsuits — Enforcement or Extortion?

Guest blog post by Bob Vogel

A handful of lawyers and people with disabilities are using well intentioned ADA (The Americans With Disabilities Act) accessibility laws in several states including California and Florida to rake in huge amounts of cash by filing hundreds, and in some cases thousands, of ADA-access lawsuits. In these states it is not uncommon to read about a single person filing more than two dozen ADA-access lawsuits a week, articles often refer to these lawyers as frequent filers.

Why are ADA-access lawsuits so common in California and Florida?

Federal ADA access law says places of public accommodation (businesses) must be accessible and can be sued for access violations (such as steps but no wheelchair ramp or lack of accessible parking spot). The person filing the lawsuit must have a disability that has been affected by the violation. Under federal ADA law the person suing is entitled to recover court costs and lawyer fees and that’s it. However, in an attempt to encourage better accessibility compliance, some states including California and Florida, allow for compensatory damages. For instance, in California a person can sue for at least $4,000 per violation, on top of court and lawyer fees.

The term “drive-by” lawsuits is often used to describe a person that files a great deal of ADA access lawsuits, the idea being that rather than sue a business when they run into an access problem, people filing these cases spend their time driving from town to town, business to business looking for any violation they can find to file a suit.

Armed with a list of businesses and violations from a new area, the lawyer cranks out lawsuits and sends notices to the businesses that they have been sued, usually offering to drop the lawsuit if the business settles by paying between $2,000 and $6,000, in some cases much more. Doing the math, if a lawyer files, say 12 lawsuits a week and settles on $4,000 per case, the money adds up quickly. Businesses claim this is extortion — plain and simple.

Lawyers that file these lawsuits claim they are crusaders for ADA access. The lawsuits may improve access, but at what cost to wheelchair users?

These type of drive-by lawsuits create animosity toward the ADA and leaves business owners with suspicion and mistrust of wheelchair users. I recently drove to a small industrial business park to get a car seat repaired. After I had transferred out of my car into my wheelchair my cell phone rang. As I was talking on the phone, people from surrounding businesses came out and were nervously staring at me. Weird. When I went into the seat-repair business, the owner also seemed nervous until I explained that I wanted a seat fixed— then he seemed relieved. After he fixed my seat, he apologized if he had seemed on edge when I first wheeled in and proceeded to explain that the business park owners had recently been sued because they didn’t have the proper striping and signage on their accessible parking. After consulting with an attorney, they found it was cheaper to pay a demand for something like $18,000 to drop the lawsuit than go to court. They said what really made them mad is nobody recalls the person that sued their businesses ever going to any of their businesses , in fact I was the first wheelchair user they recall seeing in the business park. They also thought it was odd that there was no follow-up to see if they had fixed the parking — which they had. To them, it felt like nothing more than extortion.

In a similar situation, I just heard from a friend that runs a spinal cord injury support group in Pollock Pines — a small, tight-knit community in the California foothills. She said a notorious ADA drive-by attorney had recently papered their town with ADA access lawsuits that ended up costing local businesses a huge sum of money to have dropped. It also forced three small businesses to close permanently. The lawsuits left an atmosphere of alienation toward wheelchair users. The support group has taken it upon themselves to organize a handcycle/bike ride for wheelchair users and non-disabled riders to create an opportunity for positive interaction to try and get back the community and understanding that was there before the lawsuits.

There are non-disabled lawyers that see the dollar signs in this area and recruit people with disabilities to file ADA lawsuits. A website for one such attorney reads “Confined to a wheelchair in California? You may be entitled to $4,000 each time you can’t use something at a business because of your disability.” One of the examples of access violation the site provides is,  a mirror in a restroom that is too high to use. If so, the site says, “You may be entitled to $4,0000!” The way the law is currently written, even if a business fixes the violation right away, the person filing the suit has already been harmed by the violation and can still sue and no warning is required.

Another area I find troubling is the way these lawsuits are worded for the court. The wording does as much perceptional damage to the image of wheelchair users as the worst telethon. Wheelchair users are described as “confined to a wheelchair,” and if you are suing because of an access violation — something like not being able to use a bathroom mirror, or lack of proper signage — the court documents describe things such as “Plaintiff [wheelchair user] suffers emotional and/or mental distress because of such discrimination…” Really? Lack of access sucks, but does somebody really suffer emotional and/or mental distress because they can’t use a mirror? While I understand legalese is a different language, but still, according, to these lawsuits, wheelchair users must be extremely emotionally fragile.

A good friend of mine argues that the ADA has been around since 1990 and businesses should know better, and should have changed by now.  She also argues that California and Florida have the highest level of accessibility, and perhaps this is because of the compensatory lawsuits, and I agree to a point. The problem with the argument is that when it comes to collecting money on ADA access grounds, everything is technically the same. If a business has stairs and refuses to put in a ramp or refuses to provide accessible parking, I’m all for a lawsuit if that is the only avenue. But let’s say a business has a van accessible parking spot out in front — well-marked crosshatch space for the lift, accessible levers on their doors, fully accessible bathroom, but they forget to put a sign on the bathroom that says it is accessible, or the access sign is the wrong color. The business is still liable for an ADA lawsuit and pursuant shakedown.

What do you think? Are these lawyers doing the dirty work for us? Is the access worth it? Or are these lawsuits doing more harm than good?


Bob VogelBob Vogel, 51, is a freelance writer for the ROHO Community blog. He is a dedicated dad, adventure athlete and journalist. Bob is in his 26th year as a T10 complete para. For the past two decades he has written for New Mobility magazine and is now their Senior Correspondent. He often seeks insight and perspective from his 10-year-old daughter, Sarah, and Schatzie, his 9-year-old German Shepherd service dog. The views and opinions expressed in this blog post are those of Bob Vogel and do not necessarily reflect the views of The ROHO Group. You can contact Bob Vogel by email at

“Paraplegic” feels trapped in a non-disabled body

Guest blog post by Bob Vogel

Chloe Jennings-White, a Ph.D., chemist living in Salt Lake City, Utah, lives her life as a paraplegic — and wheelchair users, she also wears long leg braces that lock at the knee to enable her to ambulate with crutches. She is comfortable and happy as a paraplegic. However, when she needs to use the flight of stairs in her house, she gets out of her chair and walks up and down the stairs, with the leg braces unlocked, enabling her legs to bend at the knee. She drives, but rather than the slow cumbersome task of taking her chair apart and transferring it into the car, she stands up and walks to the back of her car and puts the chair into the trunk. The car she drives doesn’t have hand controls.

Like many wheelchair users, Jennings-White enjoys outdoor activities. While most wheelchair users employ adaptive equipment and arm power to engage in these activities, Jennings-White simply removes her leg braces and goes on 12-hour hikes in the woods and climbs 11,000-foot mountain peaks.

When she wants to go snow skiing, Jennings-White stands up, clips into her ski bindings and spends the day on the slopes as non-disabled skier — at the top of a ski lift she will hike a considerable distance in order to get to the best snow on distant, very steep expert runs or chutes — runs with rocks or cliffs on each side.

If this sounds confusing — it is — because Chloe Jennings-White is only pretending to be a paraplegic. She chooses to live her life as a paraplegic because she has a rare condition known as Body Integrity Identity Disorder (BIID) — characterized by, in her case, by an overwhelming desire to become a paraplegic. For her, using a wheelchair and pretending to be a paraplegic helps ease this desire.

As of late, Jennings-White has been making rounds on the media circuit, first in January, appearing in Taboo on the National Geographic Channel in the episode titled “Secret Lives,” then as a guest on the February 27th episode of Anderson — the Anderson Cooper talk show. On the shows, Jennings-White explains that using a wheelchair helps her deal with her BIID.

Jennings-White says she appeared on these shows to bring attention to BIID and to help others with the condition to let them know that they are not alone. For that, I applaud her efforts. I can’t begin to imagine how difficult it must be to have BIID. According to an article in Newsweek, MRI studies of people with BIID suggest the disorder stems from a problem with the right sphere in the brain’s parietal lobe, the part of he brain that constructs body image.

The term that people with BIID often use to describe themselves is transabled. In the Newsweek article, Dr. Michael First, a professor of clinical psychiatry at Columbia University in New York, says there are parallels between BIID and gender identity disorder (GID) in which people feel that the gender they were physically born with is not their true gender.

As a side note, Jennings-White used to be a man — something she openly discusses in her blogs at transabled.org.

In Taboo “Secret Lives,” Jennings-White explains that she truly feels like she is a paraplegic and feels like she is faking it when she isn’t in her wheelchair. “It (using the wheelchair) is like a temporary stopgap,” she explains. She goes on to say, “in order to live a completely fulfilled self-actualized life is — for me — is to be paraplegic.” She explains she has a desire to have surgery to become a full-time paraplegic. “When I have an operation to become paraplegic I think the eventual outcome will be that I will feel like a complete authentic person and very happy.”

That’s a terrifying thought.

In a chilling clip on Anderson, Jennings-White explained that in a 2006 she inured her back and a doctor told her she needed to get rods to stabilize her spine. She refused to get the rods, and skis aggressively in hopes of having an accident and re-injuring her spine enough to become a complete paraplegic!

The TV audience’s reactions and the comments on the website toward Jennings-White are incredibly angry. Although I think of myself as open minded and empathetic, I felt angry, as well, and I couldn’t figure out why. She is a person with very real psychological and neurological disorder, and using a wheelchair makes her feel better. Why should this bother me? It’s not like she is using accessible parking spot or anything. There are others with the same disorder, and she is putting herself out there in the media to help them. This is a good thing. Yet, I couldn’t put my finger on why this upset me.

To try and find my answer, I carefully re-watched Taboo “Secret Lives,” pausing to take notes. Then I went on the web and spent some time reading Jenning’s-White’s blogs and her responses to comments. Upon re-watching the Taboo “Secret Lives” episode, the first thing that I noticed was Jennings-White IS parking in accessible parking spots, complete with a parking placard! WHAT?!? The segment says she has a slight limp, and shows clips of her walking up and down stairs, and shows her hiking in the woods with no leg braces. Jennings-White describes going on 12-hour hikes. From blog entries and the web it is clear that she scrambles over boulders, she hikes up mountain peaks, hikes to, and skis down very steep, expert only ski runs. Yet, she needs a parking placard?!

Jennings-White’s “portrayal” of a paraplegic also creates misconceptions and reinforces stereotypes of paralysis, including the idea that being paralyzed is all about the wheelchair and not being able to walk. Using a wheelchair and walking doesn’t even make the “top ten” list of difficulties that paralysis presents. A glaring example of this is her “paraplegic disguise” consisting of a wheelchair, leg braces and crutches, but NO CUSHION! Without a proper cushion, a real paraplegic would be hospitalized with a life threatening pressure ulcer within days!

Moreover, Jennings-White’s media portrayal of somebody that uses a wheelchair, but can walk when they “really need too” adds more confusion and misinformation about paralysis. The next time you or I need a wheelchair lift, or an aisle chair and we are asked “can’t you walk ‘just a little bit?,’” we can thank her.

I got further angered at Jennings-White because, for a person who insisting that she “feels like a fake” anytime she is out of her wheelchair, and feels like a paraplegic trapped in a non-disabled body, she sure manages to get over these “feelings” quickly when she wants to go hiking, skiing, go up and down the stairs or load her chair in the car. I believe her BIID is real — but using a wheelchair and leg braces only when it suits you isn’t “being a paraplegic,” it’s just playing dress up.

In terms of being paralyzed, using a wheelchair and not being able to walk is just the tip of the iceberg. I suggest Jennings-White try experiencing the full paraplegic experience. If she wants to go up and down stairs, she should drag herself up and down with her hands. No walking her chair to the trunk to load it into the car. No walking, hiking, mountain climbing, skiing, “when she feels like it.” Get a professionally fit wheelchair cushion, do mirror-skin checks twice a day to avoid pressure ulcers. It is good practice—she will need it. She should manage bladder with intermittent cathing, or use an indwelling Foley. She should have a bowel accident or two — preferably at work — and see how “self actualized” she feels.

But the most egregious part of the National Geographic Taboo segment — the one that got me furious — is the suggestion that letting children see a person in a wheelchair may cause BIID! In the segment — at around 20:20 — the narrator says, “At Cambridge University Chloe has a successful career developing antipsychotic drugs. She has over two dozen patents to her name. So how does such an intelligent and successful women end up leading such an extreme double life?” Then we hear Dr. Michael First say, “The most common experiences — and this applies to Chloe — is early childhood exposure to someone with that disability. It’s very common for children to identify with roll models of a family member or a relative.” While this is being said, viewers see a close-up of Jennings-White’s face on the left side of the screen and a close-up of Dr. First speaking right side of the screen. Next Jennings-White says, “My aunt was paraplegic and, um, I would always be fascinated by her leg braces. She would come in to me and say these are silly things aren’t they? And I, what I wanted to say is, ‘No, I think they are lovely. I want them, too.”

WHAT?! If kids see us in our wheelchairs it might cause BIID?! Does that also mean that if a little boy sees a woman, he will want a sex change?

I hold a bachelor’s degree in communications, so I understand that there is no way of knowing what Dr. First or Jennings-White meant, but the way the show is edited sends a clear message, “Keep your kids away from people in wheelchairs, especially friends and relatives. If a child sees a wheelchair, it might cause BIID!” This is a horrible and damaging message. Imagine being a wheelchair user trying to adopt a child and the adoption agency or mother of the child up for adoption sees this!

Speaking as a wheelchair user that became a T10 paraplegic at age 25, I think about all of hard work and time it took to learn to live and thrive with paralysis. — even more importantly, the time and work it took to accept it, and move beyond it. It is unfortunate that Jennings-White’s condition appears to make her to constantly focus on the wheelchair and on paralysis because she feels fake when she is out of her wheelchair.


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Bob VogelBob Vogel, 51, is a freelance writer for the ROHO Community blog. He is a dedicated dad, adventure athlete and journalist. Bob is in his 26th year as a T10 complete para. For the past two decades he has written for New Mobility magazine and is now their Senior Correspondent. He often seeks insight and perspective from his 10-year-old daughter, Sarah, and Schatzie, his 9-year-old German Shepherd service dog. The views and opinions expressed in this blog post are those of Bob Vogel and do not necessarily reflect the views of The ROHO Group. You can contact Bob Vogel by email at

5 lessons learned from 27 years of having an SCI

Guest blog post by Bob Vogel

This Friday, March 2, marks the 27th anniversary of my SCI (spinal cord injury)—T10 complete para—the result of a crash while performing aerial acrobatics on skis at age 25.

Each year when the anniversary rolls along, I honor it by taking a few moments to reflect on the amazing life and adventures I’ve had since my injury, as well as, odds and ends I’ve learned along the way. Here are a few random thoughts on life with SCI—things that have worked for me and things I wish I had known and/or would have done differently.


Random Thoughts—Things That Have Worked

1. The most important tool for healthy skin is a mirror-check twice a day.

An example of how a mirror check helped me avoid skin problems happened back in the mid 90s—a new cushion manufacturer offered me a demo of one of their cushions—a unique design that looked and sounded really cool and worked well for some people.

Before using the new cushion I had a pressure map reading (a system that displays areas of high and low pressure points—typical high pressure points are usually bony areas) done on it. From the pressure map reading, it looked good, so I gave it a try.

I did a mirror skin-check that evening and the skin on my butt was bright red—a serious warning sign. By the next morning the skin color had returned to normal so I figured I’d give it another try. While sitting on the cushion, I double-checked to make sure that I wasn’t bottoming out—and I wasn’t. After a few hours, I did a mirror check, and sure enough my skin was bright red and looked even worse than the previous night. I returned the cushion. If I hadn’t been in the habit of doing daily mirror checks, I wouldn’t have known the cushion wasn’t working for me. The first sign of trouble would have been a major pressure sore.

Another important reason to do a mirror check is because pressure sores usually occur with within the first years of the SCI, or 15 or more years after the SCI. The reason pressure sores often occur 15 years or more after SCI is that skin gets thinner and weakens as we age.

Too often I’ve heard of a friend that has gone years with healthy skin and no redness, and becomes complacent about checking. Without daily mirror-checks they don’t notice any areas of redness—a warning sign that skin, or posture has changed—and the red area continues to worsen. The first sign of trouble ends up being a major pressure sore and a hospital stay. Something that could easily be avoided by a simple mirror check.


2. Document medical issues for reimbursement purposes.

Often we wheelers become so adept at managing small SCI problems like minor pressure ulcers, or back or shoulder pain that we neglect to mention it our physicians. But we should. By making sure your physician documents—writes it down in your charts—any and all pressure ulcers, however minor, or back or shoulder pain, you have a written record in your medical charts, something that can make all the difference when it comes to time to request reimbursement for a specific cushion or wheelchair.

In my case, when I first got out of rehab I was sent home on a memory-foam cushion despite asking for a ROHO® HIGH PROFILE® Single Valve Cushion. Even though I was diligent about doing weight shifts, I got a small pressure sore within three months. Fortunately, I caught it during a mirror check and went to the doctor right away. After the pressure ulcer was documented, I was immediately approved for a ROHO and managed to heal it at home.


3. Connect with others with SCI.

Connecting and networking with other people with SCIs has been vital for me on many levels. It has helped me learn tricks and tips to living and thriving with an SCI. Being able to share thoughts and feelings, and get feedback from other people with SCIs helps put things into perspective.

Since I first attended SCI support groups in rehab, mentors with SCIs have had an important impact on my life. At the support groups, I was still trying to grapple with the idea that there is life after SCI, mentors would wheel into the support group and share their lives and what they were doing and show that life goes on after SCI. It is every bit as rich and exciting as ever.

When I first got of rehab, a hang glider pilot acquaintance, Dan Buchanan, who is also a T6 para, became a mentor to me and helped me with things from how to set up hand controls in my car and how to modify my hang glider with wheels, to suggesting foods and strategies to help avoid bowel accidents, and what to do when the inevitable accident did happen. Dan and I became lifelong friends and we still bounce thoughts and ideas off of each other.

Over the years, I’ve been very fortunate to form close friendships with others that have SCIs, to this day we often touch base to ask about or trade information on some type of SCI subject, or just check in to exchange thoughts and feelings. A perspective from a friend that has experienced similar feelings and or circumstances often makes all the difference.

Good places to meet friends and mentors with SCIs are at various adaptive sports and recreation programs in your area. Local Centers for Independant Living (CIL) often have this information, or simply do an online search for an adaptive activity you are interested and your location.

There are also plenty of online options and chat rooms share SCI thoughts, stories, ask questions and get mentoring advice and feedback from other folks with SCI. (See Resources)

A word of caution—just like anything else online, do not provide personal information for safety reasons.


Important Lessons Learned—Things That Didn’t Work

1. Get a second opinion for important medical issues

When it comes to important medical issues, it is very important to get a second and even third opinion. This is another area where networks of friends with SCIs can offer advice.

In 1989, I hurt my lower back while mono-skiing. A few days later it still hurt and I went to the ER. An X-ray confirmed that I had severely fractured my sacrum. I was advised to take it easy and the sacrum would heal on its own. Over the next few weeks my back got worse, I went back to the hospital to ask if I should be put in traction, I was advised it wouldn’t be necessary. I asked about getting a second opinion and was advised that wouldn’t be necessary that the doctor on my case was “the best in the business.”

Having a wide circle of friends with SCIs—like I do now—or the ability to bounce the question off an online group like CareCure Community or another chat room would have led me to seek a second opinion. Instead, I listened to the first doctor and didn’t pursue any further treatment.

It turns out I should have gotten a second opinion and should have been in traction—by not getting a second opinion, my spine fused in a crooked position. It’s something that could have been avoided by a second, or third medical opinion.


2. It’s important to ask a physical medicine and rehab (PM&R) physician to weigh on medical advice

In 2000, I fractured my right hip—the result of rolling over in bed with my feet caught in the corner of the covers, combined with osteoporosis—from 15 years using a wheelchair (see resources below)

I went to the ER and had surgery—four screws to secure my femur to the ball (trochanter into the ball). The surgery went perfect and I was released the next day. I asked the surgeon if I had any restrictions while healing. He said “Nope, it should be solid.” Unfortunately, he didn’t have any PM&R experience; he wasn’t thinking that with SCI the muscles surrounding my hip wouldn’t pull the hip together like they would in a non-disabled person.

Within a month, the screws pulled out and the hip came apart. My lesson—I should have asked a PM&R doctor to weigh in on the healing process. If I had, I wouldn’t have done transfers that pulled on the hip during the healing process and it would likely have healed just fine.

When the hip pulled apart, the surgeon said I could get an artificial hip. Not knowing anything about artificial hips I figured it would be a good option and scheduled surgery to remove the screws and put in an artificial hip the next week.

Luckily, I was learning my lesson about getting a second opinion. Two days before surgery I consulted with a PM&R doctor. He immediately referred me to surgeon versed in PM&R. The surgeon said that in my case an artificial hip would severely limit the mobility of my leg and cause a high probability of severe complications including hip dislocations and high potential for fracture in the middle of the femur. The artificial hip could have cost me the leg.

Instead I had a girdlestone procedure—the ball of the hip was removed. The procedure went well, and 12-years-later my leg is fine. Learning to get a 2nd opinion from a physician versed in PM&R saved my leg!



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Bob VogelBob Vogel, 51, is a freelance writer for the ROHO Community blog. He is a dedicated dad, adventure athlete and journalist. Bob is in his 26th year as a T10 complete para. For the past two decades he has written for New Mobility magazine and is now their Senior Correspondent. He often seeks insight and perspective from his 10-year-old daughter, Sarah, and Schatzie, his 9-year-old German Shepherd service dog. The views and opinions expressed in this blog post are those of Bob Vogel and do not necessarily reflect the views of The ROHO Group. You can contact Bob Vogel by email at