Seating and Support One of most critical decisions regarding chair options, and one for which professional input is most crucial, is choice of a seating cushion.

"The basis for good seating posture starts in pelvis," Seiberlich says. "We're looking to distribute weight over as big an area as possible, for support, for comfort and to prevent skin breakdown."

She notes that pressure sores, or decubitis, are a critical concern with prolonged seating. For those who aren't in wheelchair for many hours at a time, a flat seat may be appropriate. For more prolonged use, or when stability in chair becomes an issue, a high-quality foam cushion becomes preferable. Other alternatives include air-filled or gel-filled cushions.

"Children with scoliosis (curvature of spine), whether or not it has been stabilized with spinal fusion, may have some left-right tilt in pelvis," Seiberlich says. "In such cases, we can use seating system to minimize effects of tilt. Some of kids are still flexible, so by raising lower side, we may be able to level out pelvis. On other hand, if tilt is fixed, we'll support higher side, so it takes up some of weight. Distributing that weight is key."

Scoliosis also figures into choice of back. "We can't always use a standard flat back or sling back. We may need a molded back to match up to spinal curvature. Again, we're trying to get more surface contact to lessen pressure," Seiberlich says.

Lateral supports may be an important element as well. "If child does not have trunk strength to maintain their upright posture, we need to do it with laterals. Even with spinal fusion, they may need them to help prevent tipping."

Becerril notes that a "tilt-in-space" chair may be appropriate for someone with very little trunk strength. This type of chair maintains sitting posture, but tilts back to relieve some of anti-gravity work for a while, combating fatigue. Recliner chairs, which allow a prone position, are used more often for those unable to tolerate normal angles of seated posture.

Final Fitting Once chair has been ordered, Becerril says, expect a couple months delay before it arrives. "Authorization takes time, and typically we're dealing with several different companies, and it's a custom product. Nothing related to wheelchairs ever happens quickly."

Once chair arrives, hands-on fitting process may take two to three hours, Becerril explains. "Things come up you can't foresee. Also, we want to show parents signs of an improper fit. It's not something you do once and it's done: Kids grow fast, and their condition can change fast, so you need to monitor fit constantly."

Seiberlich adds, "We always want parents to be checking for redness, because this indicates too much pressure. They need to check buttocks, back, feet, and back of legs. Anywhere chair is making contact, there's potential for too much pressure."

She offers an important rule of thumb: "There should be no more than three fingers worth of space between front of seat and back of legs. With any more than this, seat is not providing enough thigh support, and chair may dig into legs. It also makes sitting more difficult, as you don't get same amount of surface holding you up. Also, you need to make sure that footrests are low enough to get full contact for whole thigh." There should be at least half an inch between hips and side of chair. The laterals shouldn't be too tight, and shouldn't dig into armpits.

"Parents can make these adjustments, if they know what to look for," Seiberlich says. "But we like to see child in his chair at least once a year, especially if he's still growing. And anytime they think there's a problem they can't fix, we want them to come in."

Maintenance In addition to monitoring fit of chair, Seiberlich stresses importance of regular maintenance. "The chair should be washed regularly, using a spray cleaner. Most cushions are washable, or have washable covers. A thorough inspection of whole chair once a week is a good idea: Check brakes, look for loose hardware, and check tires and seat."

Becerril points out that change in temperature can change inflation pressure of tires and air-filled or gel-filled seats. Simple problems can easily be fixed at home. More involved ones can be taken care of by vendor, who will almost always do maintenance for free.

Finally, Seiberlich returns to transportation issue to stress an important safety rule.

"Chairs are generally not crash-tested, and pelvic strap that keeps you in seat is not as strong as a seat belt. We recommend that a child be on car seat, strapped in using car's seat and shoulder belts." If needed for lateral support, a chest harness can be used as well.

It is said that we need to have up to four (4) pounds of enzymes, in at least a ratio of 3:1 (good to bad), in our “guts” in order to facilitate proper breakdown of food as it passes through our stomach, small intestine and large intestine, and provides nourishment to our bodies.

Natural “greens” products are created to supplement that process, process of breaking down food into basic nutritional units to provide our bodies with essential nourishment. One of those supplements is Bio88+ (Plus), a pure enzyme product designed specifically to aid in digestion.

The producers of Bio88+ (Plus) use only very finest “certified” organic components in making of their highly nutritious food product. In itself it provides virtually all of added nutrition, in form of vitamins and minerals, that you need in your diet in order to maintain excellent health. Bio88+ (Plus) is produced in a government supervised laboratory using an ancient Native North American fermentation process. Feel free to contact author by email for additional information.