Finally, there is one more important consideration in maintenance of your skin – should you use natural skin care products or will any products do?

The answer is NATURAL, naturally. Think about it from this point of view: When you buy food, do you look for ‘no artificial colouring’, ‘no artificial flavours’, ‘contains not GMO’s’, etc., or don’t you care?

What about your drinks, do you not look for 100% natural, low in salt, no artificial this or that, no added sugar, etc. Of course you do. Well, your skin does absorb nutrients whether they are natural or not; it will absorb these chemicals into tissue and it will then be able to use them, or not. Natural substances are much more easily assimilated in your body and are also more easily eliminated, once they’ve performed their functions.

As scientific research is becoming more sophisticated we are discovering more and more information on how our body works, how foods interact in our systems and how some foods contain substances which are not able to be made synthetically – well, same of course stands true for plants. Phyto-estrogens are just one example of naturally occurring substances essential to wellbeing of our bodies. Similarly, herbal extracts, essential oils, fruit extracts, etc. all contain naturally occurring chemicals, which science is not able to make synthetically due to their complexity.

This means, that synthetic version of a plant extract (often in concentrated forms) is not same as natural version and can in fact have different and even side effects on your body. An old, but good example is Aspirin. We are all aware by now, that Aspirin can cause stomach irritation and even lead to stomach ulcers.

The active ingredient in Aspirin is salicylic acid. It naturally occurs in bark of White Willow tree. The big difference between taking Aspirin as opposed to herbal extract of White Willow bark, is that in herbal extract there are many more substances contained which have secondary effects – one substance for example is a mucilaginous substance, which has function of protecting your stomach lining! Guess what, there is nothing in Aspirin (from chemist) that acts to protect your stomach – That’s difference between using natural versus artificially manufactured substances.

So, choice is yours, natural or not, it’s your asset and it is up to you to choose whether you will invest in your asset or withdraw from it.

If you have a pressure sore, you can tie off individual balloons to reduce contact under that area, allowing you to spend more time sitting as sore heals. The Roho Quadtro allows user to inflate four quadrants separately for optimal positioning. Air cushions are relatively lightweight, and are waterproof, allowing for double duty in bathtub or on a boat.

Crown Therapeutics, maker of Roho cushions, also offers air floatation products for wheelchair back, supplemental lumbar or sacral support, full bed cushions, and even a product for a standard toilet seat. All are inflatable to adjust to your needs.

A longtime presence in disability magazines has been an ad for "Bye-Bye Decubiti" cushion. It is inflatable, comes in many different sizes and shapes, is made of heavy duty rubber, and--although different from Roho balloon design--is uniquely formed to minimize pressure at bony protrusions on which we sit.

Air cushions can be less stable for those who move around a lot in their chair, but recent designs offer either low profile or quadrant options that minimize this problem. The balloons used in air cushions can be punctured, of course, and leaks do occur, although a fairly heavy duty rubber is used. But patching them is easier than with gel design. The hard part is submerging cushion under water to find leak (look for escaping air bubbles).

The biggest drawback to air cushions is that they require more maintenance. It is necessary to check pressure frequently, especially if you have pressure sores.

Urethane honeycomb cushions Thermoplastic urethane honeycomb cushions are most recent development in world of cushions. Because there are many individual cells--like a beehive--these cushions are able to distribute weight evenly, but there is no risk of leaking gel or of an air bladder being punctured. The many open spaces in beehive structure of cushion allow air to travel more effectively. This design helps to protect against skin breakdown because your skin is kept cooler and moisture is prevented from collecting.

Urethane honeycomb cushions are very light, absorb shock, and a low profile cushion can provide significant support. These cushions can even be thrown into your washing machine and dryer, making them attractive for people with incontinence problems where cushion will be soiled from time to time despite best efforts at bowel and bladder management.

Supracor of San Jose, California, makes several honeycomb cushions based on their patent. One type uses multiple layers of varying stiffness to allow your sit bones to sink into cushion while deeper layers provide overall support and weight distribution. Another type is contoured to provide adduction and abduction, plus a rear dish for pelvic positioning. There is not much of a track record for urethane honeycomb cushions because of their recent development, but there appears to be good prospects for this type of cushion to evolve and become more widely used.

Alternating pressure The latest territory being explored in cushion design is use of an air pump to create alternating pressure, of particular interest to those with more severe disabilities who are unable to perform their own weight shifts to relieve pressure.

Sitting for extensive periods of time without pressure relief causes muscle and fatty tissues to separate, putting delicate skin layer in closer contact with bone. This creates even more pressure on skin. Lack of air circulation increases temperature between you and cushion. Moisture collects and is trapped against skin. All of this further increases risk of a sore.

One alternating pressure solution is ErgoDynamic Seating System from ErgoAir in New Hampshire. This system pumps air into and out of alternating portions of cushion. The product is contoured for pelvic stability, with a pre-ischial cross-bar design that prevents forward slipping--and therefore shear--on cushion. Special vent holes serve to allow flow of air and moisture. In a five-minute cycle, compartments are inflated and deflated to shift support alternately between ischial (sit) bones and hips. Both areas get regular periods of complete pressure relief. The manufacturer likens it to a massage while you sit, with resulting promotion of blood flow. In some cases, makers suggest, a pressure sore can even heal while you sit. This cushion system can be plugged into some power chair batteries or charged in a cigarette lighter in your car.

Alternating pressure products are of course heavier--given their use of batteries and air pumps--and, like air floatation cushions, prone to puncture. However, technology for these innovative systems is likely to evolve further in future, as new materials and batteries are developed.

Positioning systems Advanced needs such as significant spinal curvatures or asymmetries in your body require more complex kinds of trunk support. For example, Pindot system, recently acquired by Invacare and available from suppliers around country, is a support system which customizes seat and back cushions to your exact shape. First, a special chair takes an imprint of your body's shape. A therapist views a computer image of shape and can customize contours of your cushion. From your imprint and therapist's specifications, a foam cushion that gives you optimal support is manufactured specifically for you. The Pindot system is of most value to people who will not move around much in their chair. Since cushion is formed to your shape, you will only be comfortable in it when you sit in right relationship to customized contours.

Your needs might require services of a rehab engineer who custom designs your seating system. A rehab engineer might adapt existing products or build something from scratch just for you. Your therapist or dealer should be aware of such people in your area. Often they are working in a major hospital or university. The Veteran's Administration is also involved in research and engineering that addresses need for customized positioning systems.