Category Archives: Awareness

Exhaust System Repairs on Wheelchair Vans – Repair work on rusted Exhaust Systems

Exhaust systems are one of those things you don’t notice (and shouldn’t have to). So long as it’s quiet and it does its job of routing the engine exhaust outside of the vehicle, you probably never even think about preventative maintenance for it. But, that only happens because the exhaust system on your wheelchair van has been properly designed and engineered to be reliable and worry-free.

We can repair or just take a look at how your wheelchair van exhaust system looks in your BraunAbility, Eldorado, Vantage Mobility or even your rollex van.

Wheelchair van exhaust systems are custom constructed and mounted – to make sure that they’re reliable and trouble-free its best to have them inspected at a full service mobility facility.

Even if the exhaust systems are made with stainless steel, the same material the original vehicle manufacturers (Dodge, Chrysler, Toyota & Honda) use, the connection can still corrode and rust.

Keep in mind that any wheelchair van with a lowered floor will have reduced ground clearance and an exhaust system that’s lower than your average vehicle. We encourage you to come in and have your van inspected every year to you get the best, most reliable, most durable ride possible.

Description of Wheelchair Van Exhaust System Repair
Located on the underside of your vehicle, the exhaust system is responsible for collecting and directing harmful emissions away from the vehicle, reducing the amount of pollutants released into the environment, and minimizing engine exhaust noise and force. The exhaust system is composed of pipes and tubing designed to streamline vehicle operation while maximizing vehicle performance and efficiency. Engines produce dangerous gases as a byproduct of the combustion process. The exhaust manifold collects the emissions from the engine and funnels the gases through the front pipe to the catalytic converter. The converter transforms these harmful gases, like carbon monoxide and nitrogen oxide, into less harmful ones, like oxygen, nitrogen, water vapor, and carbon dioxide. The muffler helps cancel out the noise created by the engine. The muffler dissipates sound waves while the tailpipe releases the converted gases into the atmosphere.

Benefits of Exhaust System Preventative Maintenance and Repair
Depending upon the problem, the exhaust system can affect both your vehicle’s performance and your ability to drive. For these reasons, it is important to keep current with maintenance intervals on your exhaust system. A repair service or inspection may be impending if you hear excessively loud noises during acceleration. These noises may be a sign of holes or cracks somewhere in the exhaust system. Rattling noises when starting the vehicle or excessive idling may be a sign of failed or broken hangers. If you feel drowsiness while driving, this may be a serious sign that fumes are leaking through the vents and into the cabin interior. Sharp odors are also signs that noxious fumes are leaking into the vehicle. Signs of rust or cracks in any component of your exhaust system indicate corrosion. If you experience any of these symptoms, you should seek a service sooner than later. Maintaining routine exhaust system services will help keep all your exhaust components, like the exhaust manifold, front pipe, downpipe, catalytic converter, and muffler, working efficiently. Routine maintenance on your exhaust system will save you from having to replace the entire exhaust system down the road.

VMi New England proudly offers Exhaust System Repair solutions for wheelchair van customers in Bridgewater, MA – East Bridgewater, MA – West Bridgewater, MA – Brockton, MA – Taunton, MA – Middleboro, MA – Berkley, MA – Raynham, MA – Canton, MA – Stoughton, MA – Randolph, MA, and all other surrounding areas in New England.

Fibromyalgia

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What Is Fibromyalgia?
Fibromyalgia is a disorder that causes muscle pain and fatigue (feeling tired). People with fibromyalgia have “tender points” on the body. Tender points are specific places on the neck, shoulders, back, hips, arms, and legs. These points hurt when pressure is put on them.

People with fibromyalgia may also have other symptoms, such as:

Trouble sleeping
Morning stiffness
Headaches
Painful menstrual periods
Tingling or numbness in hands and feet
Problems with thinking and memory (sometimes called “fibro fog”).

A person may have two or more coexisting chronic pain conditions. Such conditions can include chronic fatigue syndrome, endometriosis, fibromyalgia, inflammatory bowel disease, interstitial cystitis, temporomandibular joint dysfunction, and vulvodynia. It is not known whether these disorders share a common cause.

What Causes Fibromyalgia?
The causes of fibromyalgia are unknown. There may be a number of factors involved. Fibromyalgia has been linked to:

Stressful or traumatic events, such as car accidents
Repetitive injuries
Illness
Certain diseases.

Fibromyalgia can also occur on its own.

Some scientists think that a gene or genes might be involved in fibromyalgia. The genes could make a person react strongly to things that other people would not find painful.

Who Is Affected by Fibromyalgia?
Scientists estimate that fibromyalgia affects 5 million Americans 18 or older. Between 80 and 90 percent of people diagnosed with fibromyalgia are women. However, men and children also can have the disorder. Most people are diagnosed during middle age.

People with certain other diseases may be more likely to have fibromyalgia. These diseases include:

Rheumatoid arthritis
Systemic lupus erythematosus (commonly called lupus)
Ankylosing spondylitis (spinal arthritis).

Women who have a family member with fibromyalgia may be more likely to have fibromyalgia themselves.

How Is Fibromyalgia Treated?
Fibromyalgia can be hard to treat. It’s important to find a doctor who is familiar with the disorder and its treatment. Many family physicians, general internists, or rheumatologists can treat fibromyalgia. Rheumatologists are doctors who specialize in arthritis and other conditions that affect the joints or soft tissues.

Fibromyalgia treatment often requires a team approach. The team may include your doctor, a physical therapist, and possibly other health care providers. A pain or rheumatology clinic can be a good place to get treatment.

What Can I Do to Try to Feel Better?
There are many things you can do to feel better, including:

Taking medicines as prescribed
Getting enough sleep
Exercising
Eating well
Making work changes if necessary.

What Research Is Being Done on Fibromyalgia?
The NIAMS sponsors research to help understand fibromyalgia and find better ways to diagnose, treat, and prevent it. Researchers are studying:

Why people with fibromyalgia have increased sensitivity to pain.
Medicines and behavioral treatments.
Whether there is a gene or genes that make a person more likely to have fibromyalgia.
The use of imaging methods, such as magnetic resonate imaging (MRI), to better understand fibromyalgia.
Inflammation in the body and its relationship to fibromyalgia.
Nondrug therapies to help reduce pain.
Methods to improve sleep in people with fibromyalgia.

Everyday Mobility Aids

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Having a disability can make getting around and doing everyday activities difficult. Simple things like taking a shower, going to the store or even moving around your house can be a challenge for someone with limited mobility.

Getting a wheelchair or scooter is usually the first step, but there are several other mobility aids that either work in tandem or in addition to those to help you do the things you need to do. Once you have a wheelchair or scooter, there are upgrades you can make to your home to increase wheelchair accessibility there, but those don’t necessarily give you additional mobility. If you are looking to gain better mobility both inside and outside of your house, try any of the mobility equipment options below.

Transfer Board or Slider
While going out is often a major challenge, sometimes getting around within your house may be even more difficult. Getting onto a bed from a wheelchair, for example, requires strength, time and often another person. Luckily, there are transfer boards or sliders available to help facilitate the process. Wheelchair users place one end of the board under them on their wheelchair seat and slide across to the other end, which is set on their destination.

Bath Lifts
Bath lifts help those with limited leg mobility get into the bathtub. They attach to the tub and act as a seat for the wheelchair user to transfer to when they are ready to bathe. Once the user is sitting on the lift, it swings around and lowers within the tub. When the user is ready to get out, the seat can raise back up and out, preventing dangerous slipping. Other, simpler bath accessories include bath chairs, which act more as transfer seats that extend past the tub so the wheelchair user can safely slide across and under a shower head without using too much strength.

While living with a disability may make performing certain tasks more difficult, mobility equipment is available to help ease these challenges. Check online or with a mobility equipment dealer to find out where you can get these mobility aids.

Mobility Vehicles
If you use a wheelchair and don’t have a mobility vehicle, going anywhere can be a challenge. These are more expensive than many other types of mobility equipment, but there are plenty of options — and you may even be eligible for financial assistance. If you can’t afford to purchase a vehicle of your own, many dealers also offer rentals for much less.

Steering Aids
Whether you buy a mobility vehicle or simply transfer from your wheelchair to a car seat, you may need the ability to drive. There are different steering aids available to help you do so, depending on your abilities, including:

Steering Attachments: Extensions, such as knobs, gloves or balls, attach to the steering wheel to make it easy for those with limited arm function to turn the wheel with one hand or arm.
Foot Controls: Attachments on the ground give those with limited use of their hands the ability to steer and control the vehicle with their feet.
Loosened Steering: Drivers without adequate upper body strength can turn the wheel without requiring much effort with a simple steering modification.
Automatic Controls: A driver with limited leg mobility can steer, accelerate and brake with their hands using one piece of equipment that can be mounted in the driver’s area.

Osteogenesis Imperfecta

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Definition
Osteogenesis imperfecta (OI) is a genetic disorder characterized by bones that break easily, often from little or no apparent cause. A classification system of different types of OI is commonly used to help describe how severely a person with OI is affected. For example, a person may have just a few or as many as several hundred fractures in a lifetime.

Prevalence
While the number of people affected with OI in the United States is unknown, the best estimate suggests a minimum of 20,000 and possibly as many as 50,000.

Diagnosis
OI is caused by genetic defects that affect the body’s ability to make strong bones. In dominant (classical) OI, a person has too little type I collagen or a poor quality of type I collagen due to a mutation in one of the type I collagen genes. Collagen is the major protein of the body’s connective tissue. It is part of the framework that bones are formed around. In recessive OI, mutations in other genes interfere with collagen production. The result in all cases is fragile bones that break easily.

It is often, though not always, possible to diagnose OI based solely on clinical features. Clinical geneticists can also perform biochemical (collagen) or molecular (DNA) tests that can help confirm a diagnosis of OI in some situations. These tests generally require several weeks before results are known. Both the collagen biopsy test and DNA test are thought to detect almost 90% of all type I collagen mutations.

A positive type I collagen study confirms the diagnosis of dominant OI, but a negative result could mean that either a collagen type I mutation is present but was not detected or the patient has a form of the disorder that is not associated with type 1 collagen mutations or the patient has a recessive form of OI. Therefore, a negative type I collagen study does not rule out OI. When a type I collagen mutation is not found, other DNA tests to check for recessive forms are available.

Clinical Features
The characteristic features of OI vary greatly from person to person, even among people with the same type of OI, and even within the same family. Not all characteristics are evident in each case. The majority of cases of OI (possibly 85-90 %) are caused by a dominant mutation in a gene coding for type I collagen (Types I, II, III, and IV in the following list). Types VII and VIII are newly identified forms that are inherited in a recessive manner. The genes causing these two types have been identified. Types V and VI do not have a type 1 collagen mutation, but the genes causing them have not yet been identified. The general features of each known type of OI are as follows:

Type I

Most common and mildest type of OI.
Bones fracture easily. Most fractures occur before puberty.
Normal or near-normal stature.
Loose joints and muscle weakness.
Sclera (whites of the eyes) usually have a blue, purple, or gray tint.
Triangular face.
Tendency toward spinal curvature.
Bone deformity absent or minimal.
Brittle teeth possible.
Hearing loss possible, often beginning in early 20s or 30s.
Collagen structure is normal, but the amount is less than normal.

Type II

Most severe form.
Frequently lethal at or shortly after birth, often due to respiratory problems.
Numerous fractures and severe bone deformity.
Small stature with underdeveloped lungs.
Tinted sclera.
Collagen improperly formed.

Type III

Bones fracture easily. Fractures often present at birth, and x-rays may reveal healed fractures that occurred before birth.
Short stature.
Sclera have a blue, purple, or gray tint.
Loose joints and poor muscle development in arms and legs.
Barrel-shaped rib cage.
Triangular face.
Spinal curvature.
Respiratory problems possible.
Bone deformity, often severe.
Brittle teeth possible.
Hearing loss possible.
Collagen improperly formed.

Type IV

Between Type I and Type III in severity.
Bones fracture easily. Most fractures occur before puberty.
Shorter than average stature.
Sclera are white or near-white (i.e. normal in color).
Mild to moderate bone deformity.
Tendency toward spinal curvature.
Barrel-shaped rib cage.
Triangular face.
Brittle teeth possible.
Hearing loss possible.
Collagen improperly formed.

By studying the appearance of OI bone under the microscope, investigators noticed that some people who are clinically within the Type IV group had a distinct pattern to their bone. When they reviewed the full medical history of these people, they found that groups had other features in common. They named these groups Types V and VI OI. The mutations causing these forms of OI have not been identified, but people in these two groups do not have mutations in the type I collagen genes.

Type V

Clinically similar to Type IV in appearance and symptoms of OI.
A dense band seen on x-rays adjacent to the growth plate of the long bones.
Unusually large calluses (hypertrophic calluses) at the sites of fractures or surgical procedures. (A callus is an area of new bone that is laid down at the fracture site as part of the healing process.)
Calcification of the membrane between the radius and ulna (the bones of the forearm). This leads to restriction of forearm rotation.
White sclera.
Normal teeth.
Bone has a “mesh-like” appearance when viewed under the microscope.
Dominant inheritance pattern

Type VI

Clinically similar to Type IV in appearance and symptoms of OI.
The alkaline phosphatase (an enzyme linked to bone formation) activity level is slightly elevated in OI Type VI. This can be determined by a blood test.
Bone has a distinctive “fish-scale” appearance when viewed under the microscope.
Diagnosed by bone biopsy.
Whether this form is inherited in a dominant or recessive manner is unknown, but researchers believe the mode of inheritance is most likely recessive.
Eight people with this type of OI have been identified.

Recessive Forms of OI
After years of research, two forms of OI that are inherited in a recessive manner were discovered in 2006. Both types are caused by genes that affect collagen formation. These forms provide information for people who have severe or moderately severe OI but who do not have a primary collagen mutation.

Type VII

The first described cases resemble Type IV OI in many aspects of appearance and symptoms.
In other instances the appearance and symptoms are similar to Type II lethal OI, except infants had white sclera, a small head and a round face.
Short stature.
Short humerus (arm bone) and short femur (upper leg bone)
Coxa vera is common (the acutely angled femur head affects the hip socket).
Results from recessive inheritance of a mutation to the CRTAP (cartilage-associated protein) gene. Partial function of CRTAP leads to moderate symptoms while total absence of CRTAP was lethal in all 4 identified cases.

Type VIII

Resembles lethal Type II or Type III OI in appearance and symptoms except that infants have white sclera.
Severe growth deficiency.
Extreme skeletal under mineralization.
Caused by a deficiency of P3H1 (Prolyl 3-hydroxylase 1) due to a mutation to the LEPRE1 gene.

Inheritance Factors
Most cases of OI (85-90%) are caused by a dominant genetic defect. This means that only one copy of the mutation carrying gene is necessary for the child to have OI. Children who have the dominant form of OI have either inherited it from a parent or, when the parent does not have OI, as a spontaneous mutation.

Approximately 10-15 percent of cases of OI are the result of a recessive mutation. In this situation, the parents do not have OI, but both carry the mutation in their genes. To inherit recessive OI the child must receive a copy of the mutation from both parents.

When a child has recessive OI, there is a 25 percent chance per pregnancy that the parents will have another child with OI. Siblings of a person with a recessive form of OI have a 50 percent chance of being a carrier of the recessive gene. DNA testing is available to help parents and siblings determine if they are carriers of this type of gene mutation.

A person with a form of OI caused by a dominant mutation has a 50 percent chance of passing on the disorder to each of his or her children. If one parent has OI because of a recessive mutation, 100 percent of their children will be carriers of the recessive OI mutation. Whether any of these children will have OI will depend on their inheritance from the other parent. Genetic counselors can help people with OI and their family members further understand OI genetics and the possibility of recurrence, and assist in prenatal diagnosis for those who wish to exercise that option. For more information on OI inheritance, see the OI Foundation fact sheet titled “Genetics.”

Treatment
There is not yet a cure for OI. Treatment is directed toward preventing or controlling the symptoms, maximizing independent mobility, and developing optimal bone mass and muscle strength. Care of fractures, extensive surgical and dental procedures, and physical therapy are often recommended for people with OI. Use of wheelchairs, braces, and other mobility aids is common, particularly (although not exclusively) among people with more severe types of OI.

People with OI are encouraged to exercise as much as possible to promote muscle and bone strength, which can help prevent fractures. Swimming and water therapy are common exercise choices for people with OI, as water allows independent movement with little risk of fracture. For those who are able, walking (with or without mobility aids) is excellent exercise. People with OI should consult their physician and/or physical therapist to discuss appropriate and safe exercise.

Children and adults with OI will also benefit from maintaining a healthy weight, eating a nutritious diet, and avoiding activities such as smoking, excessive alcohol and caffeine consumption, and taking steroid medications — all of which may deplete bone and make bones more fragile. For more information on nutrition, see the OI Foundation fact sheet titled “Nutrition.”

A surgical procedure called “rodding” is frequently considered for people with OI. This treatment involves inserting metal rods through the length of the long bones to strengthen them and prevent and/or correct deformities. For more information, see the OI Foundation’s fact sheet on “Rodding Surgery.”

Several medications and other treatments are being explored for their potential use to treat OI. These include growth hormone treatment, treatment with intravenous and oral drugs called bisphosphonates, an injected drug called teriparatide (for adults only) and gene therapies. It is not clear if people with recessive OI will respond in the same manner as people with dominant OI to these treatments. The OI Foundation provides current information on research studies, as well as information about participating in clinical trials.

Prognosis
The prognosis for a person with OI varies greatly depending on the number and severity of symptoms. Respiratory failure is the most frequent cause of death for people with OI, followed by accidental trauma. Despite numerous fractures, restricted physical activity, and short stature, most adults and children with OI lead productive and successful lives. They attend school, develop friendships and other relationships, have careers, raise families, participate in sports and other recreational activities and are active members of their communities.

Coast Guard Day

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August 4 is celebrated as Coast Guard Day to honor the establishment on that day in 1790 of the Revenue Cutter Service, forebear of today’s Coast Guard, by the Treasury Department. On that date, Congress, guided by Secretary of the Treasury Alexander Hamilton, authorized the building of a fleet of ten cutters, whose responsibility would be enforcement of the first tariff laws enacted by Congress under the Constitution.

The Coast Guard has been continuously at sea since its inception, although the name Coast Guard didn’t come about until 1915 when the Revenue Cutter Service was merged with the Lifesaving Service. The Lighthouse Service joined the Coast Guard in 1939, followed in 1946 by the Bureau of Navigation and Steamboat Inspection. Finally, in 1967, after 177 years in the Treasury Department, the Coast Guard was transferred to the newly formed Department of Transportation.

Coast Guard Day is primarily an internal activity for active duty Coast Guard personnel, civilian members, reservists, retirees, auxiliarists, and dependents, but it does have a significant share of interest outside the Service. Grand Haven, Michigan, also known as Coast Guard City, USA, annually sponsors the Coast Guard Festival around August 4. Typically it is the largest community celebration of a branch of the Armed Forces in the nation.

In addition to celebrating their own day every year, Coast Guard members also participate as equal partners in Armed Forces Day activities.