You are my heroes! Looking for my first chair.

[Twinpanther]

Burger, this site is amazing!!! Thank you (and everyone here) for this. It has definitely helped me answer a LOT of questions I could not find answers to anywhere else.

Brief description of me. I'm a 45 y/o guy in Florida. I'm 6'2" and 252lbs. I was diagnosed with two rare forms of Muscular Dystrophy five years ago. Distal Myopathy and Hereditary Inclusion Body Myopathy. I am now to the point that I need a Power Chair. Unfortunately, I have to rely on Medicare to cover the majority of the cost. My doctor has said to let her know what she needs to do to get me whatever I need. Just a couple quick tips on Medicare. They care nothing for the outdoors. They will allow nothing on the chair that isn't "specifically" asked for and requested by the doctor. So basically I need to be very specific while trying to get as much chair for indoor/outdoor ability while fitting into their guidelines of medically necessary indoor use.

So, here is my dilemma. I'm working with a company for a chair. They have directed me towards Quantum (Pride) and although they won't say which specifically they are leading me towards the Q6 Edge. As this is new to me I have no preference of rear wheel or mid-wheel. In my mind I've narrowed it down to the R-4400 or Q6 Edge. Not sure if there is the kind of seating available on the R-4400 I need so I need to ask about it. Below is the basic "Manufacturer" info direct from Pride with my confusions between the ().

Quantum R-4400 Specifications
Weight Capacity 300 lbs
Maximum Speed 6 MPH
Ground Clearance 2.625" (3/8" less than the Q6 but neither are really acceptable)
Turning Radius 23.5"
Overall Length 33" (I know I know. Without legs but still shorter than the Q6)
Overall Width 25.5"
Drive Train Rear wheel Drive, 4-Pole
Standard Electronics 100 amp Q-Logic controller
Standard Battery Charger 5 amp off-board charger (5 amp?!!! Seriously?)
Battery (2) 12v, Group 24 or (4) NF-22 (two 24's or four 22's? Am I reading this wrong? I prefer the 24's obviously but seat tilt was suggested due to leg edema but adding that requires the use of the 22's I think.)

Q6 Edge Specifications
Weight Capacity 300 lbs
Maximum Speed Standard: Up to 5 mph Optional: Up to 6 mph
Ground Clearance 3" at center of frame
Turning Radius 20"
Overall Length 35.5"
Overall Width 24" (Not once my big butt gets in this chair)
Drive Train 2-motor, 4-pole, Mid-Wheel 6
Standard Electronics 75A Q-Logic NE 75A Q-Logic NE+ 75A Q-Logic EX (No clue what the difference is in these but all are 75A so not impressed regardless)
Optional Electronics Q-Logic EX Enhanced Display (Awesome 'cause I want to discharge my batteries more rapidly)
Accepts Specialty Controls Yes
Standard Battery Charger 8A, off-board (OK, where'd I put my link to the Hyperion EOS1420i-NET3)
Battery Two 12 volt, deep cycle NF-22 (Ummmm, ya. Morons!)

So, after all this and having read the reviews here and elsewhere I was hoping for opinions from those who have used either of these or if you just have an opinion on which you feel would be the better choice. If there is another chair I need to look at that you believe is covered by Medicare I'll be happy to check it out.

As of right now my mindset is on the R-4400 due to the 100A controller and class 24 batteries (providing I can still use them with Tilt)

Thanks for any help you may have.

Paul

[Martin O Refurbisher]

Paul, Welcome!
Aside from the obvious comments that you appear to have thought it through pretty well so far, you have not explained your needs in terms of what you expect from the powerchair.

Also, having used all 3 types, I would follow Burgerman's advice and stick with RWD.

If you have tight internal turns in your home, or obstructions to overcome, you will need more torque. Medicare needs to be pressed hard over their internal/external descrimination. As a human being, you have a right to be able ot lead as normal a life as possible. Good that your doctor is with you.
There is quite a lot on this subject in the 17000 posts on the board, not all well tagged or labelled, so there is much for you to read!

Best,

Martin

[Burgerman]

A Q6 Edge is basically for skinny lightweights. The Q6000 is for normal sized adults.

Its a "skinny" Q6000 so has smaller batteries to allow it to be narrower, (and lower gearing so it goes slower and sucks less amps from the smaller batteries) and so it has the same (almost) range as a faster full sized chair. If you will be wider than it is when seated then that sliming down is pointless, so get a chair with full sized batteries. It will go further, or faster, or both. And the faster it is the bigger amp controller you need since taller gearing needs more amps all of the time.

Personally I wouldnt give either R4000, Q6000, Q6 EDGE houseroom. They have no main drive wheel suspension. And either skinny hard pneumatic tyres, or skinny harder "solid" tyres. The mid drive chairs all get stuck at the first sign of say loose gravel or get high centred as you enter a ramp and casters so small that oudoor use is a pain. They are baically front drive with rear casters (v small so get hung up, sink in soft stuff etc but run over everyones toes in the bar behind you as they swing about where you cant see them). The FRONT casters are sprung hard in contact with the ground to stop it falling over forwards on a slope but this causes the drive wheels to be "lifted" easily. So loose surfaces = stuck. ALL prides modern chairs use small amp electronics (cheap) and are NOT easily reprogrammed. They use firmware that doesent interface with generic programmers. As they come all prides chairs steer like a drunken sailer and need access to a OEM programmer that they wont let you have. And they have horrendous spares prices and practices.

Hope that didnt depress you.

[Burgerman]

As of right now my mindset is on the R-4400 due to the 100A controller and class 24 batteries (providing I can still use them with Tilt)

There will be someone along to confirm this but they are really nose heavy, steer terribly, and give a horrible ride. And look like they are giving birth from the rear. That rear is bound to get in the way. In my own chairs when I reverse to a wall my head touches first. It uses 8 inch narrowish casters and because its very nose heavy they sink in damp ground, carpets and make turning hard work. And the 100 amp controller is available as an option rather than standard I think. And with no access to an OEM programmer you will probably never actually see 100 amps used as its all mushy and delayed. Also avoid the 8mph version as it couldnt pull the skin off a rice pudding. Unless you are a lightweight. And you are not.

[LROBBINS]

Hi Paul,

One thing you might consider asking your doc to include in the letter of medical necessity is a statement something like this:

"given the progressive nature of this patient's condition, re-programming of the chairs operating parameters, including acceleration/deceleration and turning acceleration/deceleration paramaters, will be needed during the life of the chair. Hence, a programmer (computer-based or stand alone) able to adjust advanced parameters is required"

Try to think about EVERYTHING you want in a chair. Even such simple things as an extra set of cushion and back covers because the chair can be considered unusable while a cover is in the wash. A ROHO cushion, for example, depends on the anti-shear characteristics of the cover, so you really do need to have two to avoid skin breakdown on wash day. There is no reason that the letter of medical necessity can't run to several pages.

Do you need a headrest? Search out all the different ones available and see if you can judge which would be best for you (you may or may not be able to get to try them out or even see them "live"). Then specify which one you need and why so that this too can be put in the letter. Same for foot support - separate leg rests, center plate, articulating, powered - try to figure out what will serve your needs best and then put that explicitly into the letter.

Also, do not immediately lock yourself into one DME dealer or one chair brand, and do try get in home trials of more than one chair. Such trials may not be easy to get, but it can be done, and really good dealers will arrange with regional reps to get trial chairs to you for more than a few minutes each. Dealers are sometimes more sensitive to manufacturer rebates than to your needs, and many dealers just haven't a clue. In other words, unless you have something like a University Hospital mobility clinic, or a really good OT or PT that can help you (and my experience is that these are few and far between whether we're talking about Michigan where we used to live or Italy where we live now), figure on doing a lot of homework and not letting anyone rush you into a decision. Spend at least as much time on chosing a chair as you would spend on chosing a new automobile, or even a house. The costs of a chair and car are not all that different, and your relationship with your chair is going to be much more intimate than with a car.

I've attached a file of the letter of medical necessity used when we bought Rachele's current chair. Obviously, her situation is as different as night and day from yours, but perhaps this will give you an idea of how detailed such a letter can be. The documentation for her first chair was even more extensive - the insurance company we had then wanted separate letters from Orthopedist, Physiatrist, PT, and OT; I wrote drafts of all of them and then the "professional" had their office copy them onto their letterhead. The more complete and explicit your letter the more likely you are to get approved for what you want on the first go-around, and the better basis you have for an appeal should that become necessary. We never had to appeal on the chair, but we did have to fight tooth and nail for Rachi's speech prosthesis computer AND WON.

Ciao,
Lenny

[Martin O Refurbisher]

Dear Lennie,
How does one open the file please?

Best,

Martin

[Burgerman]

its a zip. Your PC can do it, or download winzip. Extract (drag it to your desktop) inside winzip and use your pdf reader to open it.

[Martin O Refurbisher]

BM
I tried that but it isn't working, hence my question to Lennie.

Best,

Martin

[LROBBINS]

Sorry Martin,

I have my WinZip for maximum compression so it's actually a zipx file and will not open with older decompression programs. For the moment you'll have to download the demo versio of the current WinZip because I haven't figured out how to make WinZip go back to compatabile-compression mode; may have to uninstall and re-install.

Ciao,
Lenny

[Burgerman]

Works fine here.

[LROBBINS]

John, You must have a newer compression/decompression program than Martin. Ciao, Lenny

[Burgerman]

Hail ISOhunt...

[Swan T.W.]

I have the R4000 with group 34 batteries, 8 amp charger, lift and tilt and 8 mph motors. Everything BM said is spot on. But having said that, it was the chair with the smallest footprint at the time of purchase. I think the Quickie P222SE with group 24 batteries and Amy tilt seating is now available and has a much smaller footprint. The build quality of the R4000 lift/tilt is pretty iffy. I weigh about 160 lbs and two of the four bolts holding the seating system to the seat tracks snapped. It's now bolted and welded.

[Twinpanther]

Thank you all for your responses. I appreciate every one. I don't think I've ever spent this much time on one forum in my life, lol. (and I'm not even close to done yet.)

Martin: Our apartment is fairly open. Getting to the bedroom has a fairly tight corner and forget about getting anything into the bathroom. So as far as what I would like from my power chair. Easy. Model BM MK3! I'd like to be able to take walks with my wife, get out and photograph (my passion for the last 4 years) anything I see whether it be in a park or the city, go through the Flea Market with my daughter, etc... You get the idea. However, reality says I need to rely on Medicare so I'm trying to get as much of that as possible while fitting into their guidelines. Speaking of which I just found out that I am not covered for anything over Class 3. Here, I found this on Medicare coverage:

Power Wheelchair Group 4—No Set Allowable
Coverage Criteria
Medicare considers Group 4 devices to have additional capabilities that are not necessary for use within the home
(e.g speed 6mph, curb climb 75mm, range 16miles/chrge… ) Group 4 products billed to Medicare – standard
(captain’s and sling/rehab seat), single power option, multi-power option and all weight ranges) will be down coded to
either Group 2 or Group 3, depending on which Group 2 or Group 3 coverage criteria are met.

John: Thank you for summing all that up for me. I'd read most of that in bits and pieces in your and others reviews but to have it all put together like that maybe it'll stick in my brain this time. As far as Pride goes (after finding the above quote) I'm basically stuck with the Q6000 if I want any chance to get class 24 batteries. I just need a reason to medically need them for indoor use. However, after I post this I'm calling to check into the Quickie S636. After reading the review and other posts here it falls into my category and seems a decent option. Everything from the batteries/controller to R-Net electronics which makes getting a programmer for it much easier than the Pride.

Lenny: Wow, what can I say. Thank you for all that. Especially the medical necessity breakdown. This is all new to me and although I have ideas of what would be useful for me honestly I have no clue what I need. So, as excited as I am to get out into the world again, I'm taking your advice and putting on the brakes a little for some extra research and not let Quantum (Pride) push me as they have been doing. Thank you from the bottom of my heart for showing us your necessity letter. That helps a TON. Real world examples are a huge bonus. Oh, my wife asked if you would give Rachele a hug from us.

Unless there is another decent chair manufacturer in the states it looks like I'm restricted to either the Quantum Q6000 or the Sunrise Quickie S636.

Oh, 7zip is great. It opens about anything.

~Paul

[Swan T.W.]

Lift/tilt on the Q6000 is the same as the lift/tilt used on the R4000. Shaky under 160lb load. Good luck at 250lbs.

[LROBBINS]

Rachi thanks you and "my wife" for the hug, but says "Come ti chiami?". That's addressed to your wife and means "What's your name". Ciao, Lenny

[Twinpanther]

Lift/tilt on the Q6000 is the same as the lift/tilt used on the R4000. Shaky under 160lb load. Good luck at 250lbs.

My thoughts exactly. Just got off the phone with a rep for info on the Quickie S636. Wow, night and day different between her and the Pride/Quantum rep. She was honest, extremely knowledgeable, seemed to genuinely want to answer all my questions and not try to sell me on the biggest seller. That kind of customer service may not make me more comfortable in a chair physically but it does mentally.

Rachi thanks you and "my wife" for the hug, but says "Come ti chiami?". That's addressed to your wife and means "What's your name". Ciao, Lenny

LOL, my apologies. My wife's name is Lori and my daughter's is Christina.

[ex-Gooserider]

I would agree with the negative comments on Pride, and would add the caution about dealing with hospital "Wheelchair Clinics" - I found out (too late) that the "clinic" that was in the hospital where I did my rehab (Spaulding in Boston, MA, supposedly rated #4 in the US according to some recent major survey...) is actually a showroom for one of the local DME dealers... This dealer has a very mixed bag for reputation, and has been less than impressive in dealing with service on my manual chair, purchased through them.

For whatever it is worth, my manual chair, a Sunrise / Quickie Q-7 seems to be pretty well built, solid, and so forth. I'm also in the process of rebuilding a 626 (ancestor of the 636) into a BM style chair, and it mostly seemed pretty well built.

You may well find that it is best to get whatever you can get out of Medicaid, and then look at "private market" sources for a rebuildable chair and make your own... (Less expensive than you might think, as used chairs don't go for a lot, and the rest of the costs aren't that bad.....)

ex-Gooserider

[Martin O Refurbisher]

I believe that your first chair will never be your last.

Most of us seem to go on improving what we have, as a continuous process. Of course this is in part due to changes in our condition, in part to our abilities and in no small part to following up on the work of others to see how we can do better for us. One of the greatest things I find about this forum is the willingness of members to bounce ideas around, and the ability to draw on the experiences and knowledge of others.

Best,

Martin

[Twinpanther]

*UPDATE*
Looks like my chair is going to be an altered Q600 with Group 24 batteries, 100 Amp Controller and 4-Pole motors. Will have Tilt/Recline, center post legs, rehab seating and "Companion Joystick". For now I'm happy as it is better than nothing and will get me out as I delve into my own home made creation. Not to mention Medicare will cover upgrades and battery replacements as needed.

Question on the "Companion Joystick". Is it or can it be "shut-off" when not being used? I wouldn't want some stranger/kid grabbing/bumping it while i'm driving my chair.

I have my final PT appt. on the 12th. My OT/programmer will be there as well and I'll find out which programmer she has. Dealer version I'm sure but ya never know. I've read and reread Burgerman's "Programming" page and have my idea of how I'd like my chair set and what I want my chair to do. That is an awesome/informative read, thank you!

Now, I found a Q-logic programmer software and cord but have no idea if it is Dealer level or Factory Level. Anyone know which it may be? Here is the link. Part #ELEASMB5216. Fifth down on the list.

[woodygb]

99.99% sure it's going to be dealer level.

[Burgerman]

One reason I advise anyone getting a powerchair is that a low level (factory or OEM level) programmer is absolutely essential if you are to program the thing in any way that may allow some proper control.

The problem with pride is that they often use their own modified firmware even on generic (pilot plus for eg). That means that easily available OEM level programmers will not work. So you have no choice but to use their own ones. And they will not sell one even to a dealer. They get the useless "dealer" / end user programmers.

That said, in the UK at least I have found at least three pilot plus systems that were not locked and a generic B or C programmer worked fine. So you may be lucky.