Hi David, Bob Vogel here. I’m a T10 complete para, 31 years post injury and I’ve had experience in both questions you ask.
Per your ROHO question—the first and most important thing to do is have your sore documented by your doctor, either your primary care doctor or PM&R doc—meaning you get in to see the doc, and the sore is in your medical chart. From there it *should* be a slam dunk to get a ROHO. Usually the best way to go about it is can call your local DME provider (wheelchair and cushion store) and tell them you have a pressure sore, you are on an egg crate cushion and and need to move up to a ROHO at which point they *should* take you step by step through the process which is: 1. Document by doctor. 2. Set up an appointment with a seating clinic, either a physical or occupational therapist that specializes in seating. 3. The DME provider then does a great deal of paperwork contacting your insurance provider for approval, getting detailed chart notes from seating clinic as well as chart notes from your doctor, getting a detailed “letter of medical necessity” for your cushion etc. This is a lengthy and time consuming process, however in the case of a pressure sore you should be given top priority. An example of this—30 years ago—despite asking for a ROHO, I was sent home from rehab on a memory foam cushion. Despite constant weight shifts and mirror-skin-checks every night, about three months after I was out of rehab I developed a small pressure sore (about the size of the round eraser at the end of a pencil). It wasn’t deep, but it wouldn’t heal. I went to my PM&R doc, had them look at the pressure sore and they contacted my DME provider and my insurance (Medicaid) paid for a ROHO—which I got within a month. A combination of the ROHO, lots of weight shifts, spending lots of time off my butt, I was able to heal the sore. Per your question about a wound care nurse, they are vital! A wound care nurse works wonders helping heal a sore as fast as possible. A pressure sore needs very specific care and environment at different stages of healing—such as debridement, (removing dead skin in or around the wound), specific types of packing materials (stuff that goes in the wound to give healing cells something to hang on to), creams for specific PH, etc. etc. Wound care nurses know exactly what to do with a sore and when to do it to heal you as fast as possible. Hope this helps. Bob Vogel > On May 24, 2016, at 8:58 AM, DAVID LEWIS <[email protected]> wrote: > > Hiya, > I have a sore starting on my butt. It wont seem to heal. > They asked me if i needed a wound nurse. What do they do. > > And does Medicare cover the cost of one of those Roho Cushions? > I have been using those foam eggrcrate ones. > Thank you. Quad over 35 years.
