January 2003

New Faces in ASCC Central Office

Cindy Krebs and Doug Fish join Little Rock staff

Over the past few months the Arkansas Spinal Cord Commission has seen several old friends leave the agency and new staff arrive. In mid-November we had two new arrivals in the Little Rock office.

New ASCC Case Manager Doug Fish

Doug Fish began his duties as Case Manager, replacing Rose Trosper who left due to ill health. He will be covering North Pulaski and Faulkner counties. Doug is a long-term state employee, having worked for eleven years with the Little Rock Area Parole Office prior to joining the Commission. He graduated from Northeast Louisiana University with a Master’s degree in Criminal Justice. Doug looks forward to meeting the individuals on his caseload.

Doug and his wife Jo Ann and their two children, Benjamin, age 7, and Elizabeth, age 4, reside in Sherwood. When asked about what activities he enjoys, Doug said, “Well, not that I have much free time with two very active children—but when I can manage it, I enjoy gardening, reading and traveling.”

Cindy Krebs is the new Administrative
Assistant in the ASCC Central Office

Cindy Krebs joined ASCC’s staff as Administrative Assistant and will be responsible for payroll, staff leave and client purchasing. She, too, is a long-term state employee, having worked eight years with the Arkansas State Hospital. Cindy has extensive experience with the AASIS computer system—which is a definite asset to the Commission.

At the December Central Office staff meeting Cindy introduced herself and told those present, “I am very excited about working with the Commission and look forward to meeting the rest of the staff.” Cindy described herself as “the second oldest in a family of four sisters.”

She lives in North Little Rock. In her spare time Cindy enjoys a variety of activities, especially cooking, crafting, yard work and four-wheeling.

The Commission members and staff feel very fortunate to have such qualified individuals joining our agency. Welcome, Cindy and Doug!

HHS Expands State’s Independent Choices

More direct control of personal care services allowed

On October 2, 2002, Department of Health and Human Services (HHS) Secretary Tommy G. Thompson approved an Arkansas request to expand its Independent Choices’ Medicaid demonstration project to allow eligible beneficiaries with long-term disabilities to directly control their personal care services and expenses.

As the first state to implement the “cash and counseling” program, Arkansas can now let Medicaid beneficiaries who qualify for personal care services because of long-term disabilities choose to receive a monthly allowance for those personal care costs instead of accepting traditional agency-provided attendant care services.

This will provide beneficiaries and their families greater choice and control over the support services needed to live at home and participate fully in community life. For example, beneficiaries can use the cash allowance to employ helpers directly, instead of relying on services provided by agency workers. They will be able to hire family members, friends and neighbors, those they trust, rather than allowing strangers into their homes to assist with intimate personal care tasks.

“People with long-term disabilities and their families know best what services will allow them to live at home and remain active in community life,” Thompson said. “This demonstration gives eligible beneficiaries in Arkansas the ability to exercise choice, control and responsibility—a major goal of President Bush’s ‘New Freedom Initiative’ to promote greater independence for all Americans with disabilities.”

Arkansas launched its Independent Choices program in 1998, with an estimated 800 beneficiaries currently receiving cash allowances. Thompson’s approval allows the state to expand the program to include all of its more than 1,600 eligible beneficiaries.

Electric Leg Bag Emptier

Dear Editor:

As an active quadriplegic, 28 years disabled, I have used an electric leg bag emptier for over 18 years. This device doesn’t require daily cleaning since urine never touches the emptier; instead the device stops the flow by pinching the leg bag’s tubing. It operates using wheelchair batteries (24 volts) and has been designed to be extremely durable, reliable and maintenance free.

This device has benefited me by allowing me to increase my fluid intake, thereby reducing urinary tract infections. Also it has helped me regain independence, allowing me to go to school, work or shopping on my own—no more asking others for help in the restroom.

If anyone would like more information about this electric leg bag emptier, please call me at 870-467-5139.

Dana Michael Wolf
Gamaliel, AR

From the Director
By Cheryl L. Vines, ASCC Executive Director

Happy 2003!!! I wish you health and happiness in this New Year! For most of us good health is a big part of our happiness. It seems when we feel good we are more active, our outlook is better and the world spins a little smoother. But, staying healthy is a challenge these days. There are two things that are certain to help stay healthy: eating well and getting physically active.

Eating well means different things to each of us. Most healthy folks will agree—it means increasing your intake of fruits and veggies (the recommendation is five servings a day), lean meats and complex carbohydrates, while limiting fats, sugars and salt. Sounds easy, right? We all know it’s not!

Losing one pound a week means cutting your food intake by 500 calories a day. But, it is easier than you think! Switch from two large cokes a day to two large glasses of water, or cut out an order of biggie fries and replace it with a side salad (with no dressing) and you have it!

Add in 20 or 30 minutes of exercise a day and you will feel a difference. Yes, it takes a little time, but it isn’t that hard. Take a 20-minute walk or push around the neighborhood, mop floors, shoot baskets—anything that makes you move. If you sweat a little, all the better!

Don’t believe me? Try it for a month or two—or longer! You may not notice a quick weight loss or sculpted muscles immediately, but I guarantee you it will make you feel healthier and, as a result, happier!

With Thanks

Donations this quarter from:

ASCC accepts tax deductible donations. The generosity of the many individuals and families, who over the years have made memorial donations, is greatly appreciated. Contributions are used to assist our clients through purchases of equipment and educational resources.

If you would like to make a contribution, please contact the Commission at 501-296-1788 / 800-459-1517 (voice) / 501-296-1794 (TDD), or send your donation to:

AR Spinal Cord Commission
1501 N. University, Suite 470
Little Rock, AR 72207

Health Promotion Program Coming to Central Arkansas

Nutrition and exercise courses to be offered

Are you ready to start eating right? Have you made a New Year’s resolution to start exercising? If you answered “yes” to either of these questions, then we have a deal for you!

Beginning in April 2003, ASCC will offer two short courses in Central Arkansas to help you get started on your way to healthier eating and increasing your exercise routine. The first course will deal with nutrition and the important role it plays in maintaining the health of persons with disabilities. The second course will be all about exercising and how it is a vital activity for persons with disabilities.

Both courses will begin with some classroom type lectures, but a lot of the time will be spent in hands-on activities. These activities will include fun things such as, preparing foods, trying different cooking methods, tasting foods, learning exercise routines while seated in your wheelchair, developing your exercise routine, trying out different exercise equipment and participating in group discussions and activities.

Each course will be limited to the first 50 adults (ages 18 and over). Applications will be mailed to all eligible persons in March. Look for yours to come in the mail!

Education Scholarships!

It’s time to start applying for scholarships to fund your higher education

The Arkansas Governor’s Commission on People with Disabilities scholarships application deadline has been moved up this year to January 31, 2003. Scholarships for $1,000 will be awarded at a reception on May 8 at the Riverfront Hilton. For an application or more information, contact Barry M. Vuletich at 501-296-1626.

The Spina Bifida Association of America (SBAA) offers an educational scholarship fund. The deadline for applying for the national scholarships is April 3, 2003. Recipients will be notified no later than June 1. To request information or an application form, call 202-944-3285 or 800-621-3141, FAX 202-944-3295, or e-mail sbaa@sbaa.org.

At the state level, the Spina Bifida Association of Arkansas (SBA/AR) scholarships application must be received no later than August 15, 2003. Recipients will be notified by September 1, 2003. Call 501-978-7222 to request an application and detailed information or e-mail sigmondr@alltel.net.

All scholarships require different documents to accompany the applications, so start early to ensure you have the completed applications with all necessary documentation turned in on time.

Bettie Tapp Retires

ASCC wishes Bettie the best!

Cheryl Vines presents Bettie Tapp with a
plaque recognizing her years with ASCC

ASCC Case Manager Bettie Tapp announced her retirement effective December 1, 2002. Bettie had been employed as a Case Manager in the Hot Springs office since 1988. Staff, as well as those individuals she served, will miss her dedication and professionalism. According to Client Services Administrator Patti Rogers, “Bettie was always willing to ‘go the extra mile’ to see that individuals with spinal cord disabilities received appropriate services.”

The Commission honored Bettie with a luncheon December 16 at Seasons in the Heights Restaurant. Her husband Charles, their son Tylar, his wife Shada and granddaughter Aryanna were present as ASCC staff, former coworkers and friends paid tribute to Bettie and wished her well. On behalf of the Commission, ASCC Executive Director Cheryl Vines presented Bettie with a plaque in recognition of her many years of service to the agency and to individuals with spinal cord disabilities.

Enjoying cruises as much as she does, we expect to hear in the near future that Bettie has signed on as the new cruise director for Carnival Cruise Lines! One thing we do know for sure is Bettie will be spending a great deal of time with her two grandchildren. Whatever her future endeavors might be, we are certain Bettie will be successful. Best wishes, Bettie!

Management of Bladder Dysfunction with Clean Intermittent Catheterization

By Tom Kiser, M.D., ASCC Medical Director

Dr. Tom Kiser, ASCC Medical Director

Urinary tract infections are a big problem in individuals with a spinal cord injury and neurogenic bladder. I work with patients every day in the clinic and the hospital who either have or are at high risk for urinary tract infections (UTI). At least one patient a month is admitted to our hospital because of a severe bladder/kidney infection.

Clean intermittent catheterization (CIC) is the preferred method of bladder management over the indwelling foley catheter, because it prevents development of a small bladder, and decreases the risk of bladder stones and urethral trauma if conducted appropriately. As long as the bladder empties fully, use of a condom catheter can decrease bladder infection, but if you are having recurrent bladder infections when using condom catheters, intermittent catheterization may be a better option.

In a recent review article on the use of intermittent catheterization, several methods are suggested that can decrease the incidence of bladder infections and complications. In this article I will outline these recommendations.

Bacteria in the urine is very common if a catheter is used to empty the bladder, but multiple studies have shown that this does not lead to symptomatic bladder infections as often, if the bladder is emptied frequently. In one study there was a five-fold increase in UTI if CIC was done three-times-a-day compared to six-times-a-day.1 Residual urine plays a role in infection and time must be taken to empty the bladder completely.2

Infection of the urethra and/or prostate can decrease the quality of sperm in males. If CIC is used to empty the bladder, sperm quality is improved and better pregnancy rates are found than in those individuals who use a foley catheter.3

Forceful manipulation during catheterization and significant bleeding contribute to the development of strictures of the urethra. Gentle introduction and substantial lubrication of the catheter is recommended. New catheters, which use a special hydrophilic coating to make them slippery, may prove to be beneficial in decreasing injury to the urethra.

Bladder stones are a frequent occurrence with an indwelling foley catheter, but are a rare occurrence with CIC.

In summary, more frequent emptying of the bladder can decrease the build up of bacteria to a critical mass, the development of over- distention of the bladder and development of an UTI. Use of good technique with good hand washing, clean technique, generous lubrication, complete emptying of the bladder and gentle introduction of the catheter can decrease urethral trauma and UTI. The incidence of bladder stones can be decreased, and improvement of the sperm count and sperm quality in males can be achieved by changing from a foley catheter to CIC.

_________________________

References

1. Anderson, R.U. (1980). Prophylaxis of bacteruria during intermittent catheterization of the acute neurogenic bladder. J Urol, 123, 364-366.
   
2. Shekelle, P.G., et al. (1999). Systematic review of risk factors for urinary tract infection in adults with spinal cord dysfunction. J Spinal Cord Medicine, 22, 258-272.
   
3. Rutkowski, S.B., et al. (1995). The influence of bladder management on fertility in spinal cord injured males. Paraplegia, 33, 263-266.

Ms. Wheelchair Arkansas—The First Time

The first Miss Wheelchair Arkansas Pageants began in the 70’s

The October 2002 issue of the Spinal Courier included an article about the 2002 Ms. Wheelchair Arkansas Pageant, which was referred to as the “first.” While the 2002 event was a great pageant, it was not the first—as many around the state who knew better reminded us.

The first Miss Wheelchair Arkansas actually reigned thirty years ago! The Arkansas chapter of the National Paraplegia Foundation met at the Hot Springs Rehabilitation Center (HSRC) back then. When they learned that a national Miss Wheelchair America Pageant was planned, they “drafted” Marilyn Cox (who says she missed that meeting!) to represent Arkansas at the 1973 pageant in Columbus, OH. Marilyn, a retired psychologist from Little Rock who has lived with polio most of her life, was the first Miss Wheelchair Arkansas.

Marilyn Cox was crowned Miss Wheelchair Arkansas in 1973

The following year a Miss Wheelchair Arkansas Pageant Committee was formed and the group raised funds and conducted pageants for nearly ten years. The pageants in the 70’s were large, staged events in Hot Springs (home of the Miss Arkansas Pageant each year), with military escorts, lots of publicity and as many as 20 contestants vying for the honor of representing the Natural State.

The committee, headed up by Buddy Carmack, Sue Osborne and others from HSRC and around the state, ran the pageants that promoted disability awareness and the accomplishments of people with disabilities in Arkansas.

Previous Miss Wheelchair Arkansas included Bettye Brown of Waldo, Tina Heath Saenger of Sheridan, Elaine Canady of Helena, and the late Donna McKay Grinder and Lucille Ruggles.

Donna McKay, Miss Wheelchair Arkansas 1975-76 (left), and
Tina Heath Saenger, Miss Wheelchair Arkansas 1976-77 (right).

As interest in the pageants declined in the early 80’s, the group disbanded and donated the proceeds of the Miss Wheelchair Arkansas fund to the Hot Springs Rehabilitation Center Service Fund to help needy students.

Nearly 30 years later in 2002, Ida Hagar Esh’t, an Arkansas State University student and Ms. Wheelchair Ohio of 1987-88, began organizing an Arkansas pageant. She had not been able to find any record nationally of the previous Miss Arkansas pageants. The 2002 Ms. Wheelchair Arkansas Pageant was the start of the present nationally affiliated Ms. Wheelchair America Pageant.

For those interested in participating in this year’s pageant, scheduled for June 19-21, 2003, at the Fowler Center in Jonesboro, applications are presently available from Ms. Esh’t by calling her at 1-870-335-9002.

President Calls for New “Single-Stop” Website

Access links to information about federal disability-related programs and services

In late August of 2002 President Bush signed an Executive Memorandum creating a new website to serve as a single-stop online site where people with disabilities, service providers and advocacy organizations can access links to information about federal disability-related programs and services. You can find this informative website at: www. disabilityinfo.gov.

“All our citizens deserve to live and work with dignity and freedom,” stated President Bush. “This website is an important step in our work to build an America where all individuals are celebrated for their abilities and encouraged to achieve their dreams.”

Federal agencies have also been directed to work with state and local governments in the collection of information concerning state and local government programs and access to services for people with disabilities appropriate for use on the website.

Central Arkansas Support Groups

Support groups in Little Rock and Sherwood now meeting

Two new spinal cord injury (SCI) support groups started up in October 2002. The Commission has been working with local hospitals in Central Arkansas to sponsor these support groups. The meetings are for individuals with SCI and their guests. SCI information sharing and socialization are the emphases of these group meetings. The time frame is similar at both locations.

Lunch is served from 11:30 am to 12:00 pm, followed by an informative presentation from 12:00 pm to 1:00 pm. Informal discussion takes place afterwards. You are encouraged to call and register in advance in order to reserve a lunch. Plan now to attend a future meeting.

Baptist Health Rehabilitation Institute SCI Support Group

The meeting at BRI takes place once per quarter at the In-Service Education room on the ground floor. In October Cynthia Elkins, OTR provided information on “Maintaining Your Shoulders After SCI.” The next meeting is scheduled for Friday, February 7, 2003. It will feature ASCC Medical Director Tom Kiser, M.D. answering questions about SCI submitted from the audience. Please write down your questions for Dr. Kiser before you come to the meeting or write them out during lunch. Attendees to the meeting are encouraged to stay and visit with each other after the presentation. Space is limited for Dr. Kiser’s presentation, so call now if you plan to attend. Alliance Home Care will provide lunch.

Rob Watson spoke at the November
support group meeting in Sherwood

St. Vincent Rehabilitation Hospital Sherwood SCI Support Group

St. Vincent Hospital in Sherwood is the location for this meeting, which takes place the third Thursday of each month. In October Twala Maresh presented “Seating Evaluations and Pressure Mapping.” Rob Watson talked about “Adaptive Hunting and Fishing” in November. At the December meeting Mike Fangue spoke to the group about “Getting Back to Your Life: Utilizing Abilities After Disability.” Various interested sponsors such as Bird and Bear Medical, as well as National Seating and Mobility, have provided door prizes. Every month is different and the discussion lively.

Call 501-683-1124 to register for either of these spinal cord injury support groups.

Mike Fangue spoke to the
Sherwood group in December

Junior Rollin’ Razorbacks Coach “Most Caring Coach in America”

Doug Garner selected by USA Weekend

Junior Rollin’ Razorbacks Coach Doug Garner was selected one of three “2002 Most Caring Coaches in America” by USA Weekend. He was featured in the USA Weekend magazine and on the CBS Morning Show in October. As a “Most Caring Coach in America,” Doug received a $1,000 check and plaque, plus national recognition for his program.

Garner, who lives in Hot Springs with wife Becky and sons Tyler, age 16, and Mike, age 15, started the Junior Rollin’ Razorbacks in 1992, to provide an opportunity for Arkansas kids with disabilities to play basketball. It snowballed from there! Today, the Junior Rollin’ Razorbacks have three teams: Varsity, Junior Varsity and the prep team, the Ball Hawgs.

Garner’s teams have qualified for the Junior National Tournament every year but one since their start and have won two national championships. Five Junior Rollin’ Razorbacks have qualified for college scholarships and one went on to compete on the U.S. Paralympic team. In addition to the Junior Rollin’ Razorbacks, Garner has coached international junior wheelchair basketball teams and is scheduled to coach the U.S. team at an international tournament in Australia in April. Never one to shy away from something that needs to be done, Doug also serves as President of the National Wheelchair Basketball Youth division.

Doug Garner was selected “Most Caring
Coach in America” by USA Weekend

“Doug Garner is a great asset to our programs here in Arkansas and to the Junior movement nationally,” said Harry Vines, president of the National Wheelchair Basketball Association and long time Rollin’ Razorback Coach. “The Youth division is the fastest growing part of our organization, due in no small part to the work of Doug Garner. We appreciate all he is doing.”

The Junior Rollin’ Razorbacks are presently in the middle of their season. They hosted a regional tournament in November and will be playing a full schedule, heading into the National tournament in Birmingham, AL in March.

If you or your child are interested in the Junior Rollin’ Razorbacks, contact Doug at 501-525-4503.

New Loan Program Available for Persons with Disabilities

AAPD adds new credit union to membership benefits

The American Association of People with Disabilities (AAPD) and Digital Federal Credit Union (DCU) have initiated a new program to bring AAPD members a wide range of financial services for people with disabilities.

High medical costs and loss of income have negatively affected the credit history of many people with disabilities and their families. As a result, mobility and accessibility equipment needs or retraining for a new career may be postponed indefinitely. AAPD has recently added a new credit union (DCU) to its membership benefits.

As one of its services to AAPD members, DCU has extended its loan payback terms to accommodate people with disabilities. For example, a mobility loan can be arranged for up to 120 months instead of the standard 36 months without penalties or extra costs, resulting in smaller, more affordable monthly payments. This allows families to purchase the expensive equipment they need.

AAPD membership is $8 per year. Their toll free membership number is 866-241-3200 (V/TTY) or visit their web site at www.aapd-dc.org. Their address is AAPD Membership Services, PO Box 97045, Washington DC 20091-7045.

AAPD members can then become a member of DCU with a $5 deposit in a checking/saving account. Information about DCU and their service centers is available at www.dcu.org.

New Internet Sexuality & Disability Resource

The Wellness and Disability Initiative of the BC Coalition of People with Disabilities is pleased to announce the publication of its first web-based bibliography, Sexuality and Disability Webliography. Available in HTML and a 50 page PDF format, the webliography may be found at http://www. bccpd.bc.ca/wdi/sex&dis.html.

This extensive listing of resources available on the Internet includes curricula, articles, books, newsletters, magazines, videos, audiotapes, websites, discussion forums, organizations, programs, practitioners and researchers worldwide. Specialized topics include 16 types of disability, and resources on children and youth, women, gay and lesbian and sexual abuse and assault.

Featured Items in the McCluer Resource Center

New videos and books are now available

Going to School (video) is a documentary about special education—or the lack thereof—in the Los Angeles Unified School District. It explores the promise of the IDEA act (Individuals with Disabiliies Education Act) and how parents can make this act work for them.

The Real Race, The Skip Wilkins Story (book) is the real life, inspirational journey ofwheelchair athlete Skip Wilkins. When challenges in life seem too great to bear, read this story of triumph over adversity.

The Wheelchair Child (book) is a guide to activities for children, aids and appliances to make life easier, and how to meet the needs of disabled children.

There’s Always A Way (book) is the story of world-champion wheelchair athlete Kevin Saunders’ compelling story of overcoming pain to achieve his goals.

Three books are now available free-of-charge (as long as supplies last) to ASCC clients, compliments of St. Vincent’s Rehabilitation Hospital:

• Beyond Please and Thank You

• The Spinal Cord Injury Handbook

• Living with Stroke
  

If you are interested in any of the new resources, please call the McCluer Education and Resource Center on Spinal Cord Injury at 501-296-1792 or 1-800-459-1517.

SPINAL COURIER

Published quarterly by Arkansas Spinal Cord Commission

Cheryl L. Vines, Executive Director

Thomas L. Farley and Dee Ledbetter, Coeditors

Commission Members: Joe McNiel, Chair, Jimmy Ashley, Sheila Galbraith Bronfman, James Miller and Sandra Turner

The Arkansas Spinal Cord Commission does not discriminate on the basis of race, color, national origin, sex, religion, age or disability in employment or the provision of services.

Visit our website at: www.state.ar.us/ascc or e-mail us at: courier@arspinalcord.org