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Approved-By:  Bill McGarry <wtm@SHELDEV.SHEL.ISC-BR.COM>
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Date:         Mon, 11 Jan 1993 17:45:05 EST
Reply-To:     Bill McGarry <wtm@sheldev.shel.isc-br.com>
From:         Bill McGarry <wtm@sheldev.shel.isc-br.com>
Subject:      Handicap Digest # 3092

                             THE HANDICAP DIGEST

                                 Issue # 3092

                          Monday, January 11, 1993

Today's Topics:


                                ******


                               We are here now
                                    Tens
                              Anti-depressants
                                Chiropractors
                                Chiropractors
                            Re: Anti-depressants
                              Re: Chiropractors
                DOT proposed rules re: ADA - full text (long)
                    Jaron Lanier at CSUN March Conference


                                ******


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Subject: We are here now
From: Tandy.Way@f6.n377.z1.fidonet.org (Tandy Way)
Organization: FidoNet node 1:377/6 - T.A.B.B., Tampa Fl


[This is from the Chronic Pain Conference]

hello all t.a.b.b. has linked in to this conference. the old sysop
could use this group for support  as chronic pain is my middle name
and rules my life. I live on vicodeen e.s. just to get by day to
day but just barely get by. I have tried all the conventional and
some unconventional therapys. going to see if there is a
accupuncture person practicing in the area. does anyone know how
they would be listed in the phone book so my wife has a place to
start looking? after that I might have to consider the s.c.s. but I
am not fond of invasive surgery as I don't hink that gadget will
work for me. to borad an area to cover well enough for now my bbs
is here  and I might just lerk around watching the traffic and say
little. tandy sysop

 * OLX 2.2 * 1200 baud makes you want to get out and push!

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Internet: Tandy.Way@f6.n377.z1.fidonet.org




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Subject: Tens
From: Tandy.Way@f6.n377.z1.fidonet.org (Tandy Way)
Organization: FidoNet node 1:377/6 - T.A.B.B., Tampa Fl


[This is from the Chronic Pain Conference]

al you are lucky that yours worked. I had one of the fancy units
that had variable frequency and phase and all that jazz but it
didn't work. I wound up giving it away to someone. must have cost
five hundred dollars or so. thinking about the s.c.s. like linda
has but with only ten percent working for her and based on my bad
experience with the tens and the invasive surgery don't think I
want to go that route.

 * OLX 2.2 * GORBACHEX: Popular Russian Breakfast cereal

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Subject: Anti-depressants
From: Arthur.Saus@p160.f72.n376.z1.fidonet.org (Arthur Saus)
Organization: FidoNet node 1:376/72.160 - Mail Room, Columbia SC


[This is from the Chronic Pain Conference]

Hello Stefan!

24 Dec 92, Stefan Welch writes to Linda Cummings:

 LC>> With chronic pain
 LC>> people, the anti-depressants don't really keep you from becoming
 LC>> depressed if they are prescribed for you to take around bedtime.

 SW>  Linda, I hadn't heard of not taking anti-depresants at bedtime.
 SW>  That is the time of day recommended by the doc I'm working with,
 SW>  so I'm curious to know more.

Maybe I can help with this one.  There are many different drugs
that fall into the class of "antidepressant", and these drugs have
different side effects. With some of them, sedation is a side
effect.  Other antidepressants cause mental stimulation as a side
effect and will actually make it more difficult to go to sleep.
Many physicians try to prescribe medications so that the expected
side effects of a medication either don't interfere, or actually
enhance the desired therapeutic results.

If a particular antidepressant helps to make someone sleepy as a
side effect, it's a great idea to prescribe it to be taken just
befor bedtime, rather than in the morning when someone is just
starting the day.  Likewise, if an antidepressant makes you more
alert and awake as a side effect, it helps to prescribe it to be
taken sometime just after waking up, rather than just before going
to bed.

Arthur

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Subject: Chiropractors
From: Joe.Rhinehart@f320.n226.z1.fidonet.org (Joe Rhinehart)
Organization: FidoNet node 1:226/320 - Black Bag II BBS, Columbus OH


[This is from the Chronic Pain Conference]

JP>My question is should I or shouldn't I?

JP>Is the risk great in using a Chiropractor for something like this? Can they d
JP>more harm than good? I guess I'm looking for opinions, experiences to see if
JP>should try one.

Try an Osteopath (sp?) They do the same kind of thing, but are more
advanced types. I had one put a knee back in place when I was young.
Worked out well. I hear they are more knowlegeble about muscles & connective
tissue and so forth - not just bones & joints.

Joe

 * OLX 2.2 * If it isn't fixed, don't break it worse...

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Internet: Joe.Rhinehart@f320.n226.z1.fidonet.org




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Subject: Chiropractors
From: Linda.Cummings@f34.n375.z1.fidonet.org (Linda Cummings)
Organization: FidoNet node 1:375/34 - Batteries Included, Montgomery AL


[This is from the Chronic Pain Conference]

 > Is the risk great in using a Chiropractor for something like this?
 > Can they do more harm than good? I guess I'm looking for opinions,
 > experiences to see if I should try one.

Hi John!  Waldorf?  I used to live in Chesapeake Beach, and worked
in LaPlata at WXTR radio (midnight DJ) when it was country.
Anyway, I went to a chiropractor for something like 80 some-odd
visits before I had my second partial laminectomy.  I don't think
he did any harm, but even he admitted he didn't do any good.  I
think you have to get one that really knows what they're doing,
though, or they could possibly harm you.  Good luck.

Linda

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Internet: Linda.Cummings@f34.n375.z1.fidonet.org




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Subject: Re: Anti-depressants
From: Stefan.Welch@p0.f33.n125.z1.fidonet.org (Stefan Welch)
Organization: FidoNet node 1:125/33.0 - BODY DHARMA ONLINE, Oakland CA


 -=> Quoting Ruthie Hoffman to Stefan Welch <=-

 >  Linda, I hadn't heard of not taking anti-depresants at bedtime.
 RH> When I first started with the anti-depressant (imiprimine) at the
 RH> beginning of October, we had to have me take them (25mg to
 RH> start..increased to 50mg/day) in the morning because they kept me
 RH> awake...like I'd had a ton of caffine!!!  I slowly switched to taking
 RH> it (50mg) in the evening.  I usually take it around 8-9pm.  We had to
 RH> very slowly change it cuz of the jitteriness.  Wierd, but true!

 Perhaps not so unusual?: I also got buzzing jitteriness when I
 first started taking anti-depressants (including imipramine),
 but the doc wanted to give it a thorough testing, so we started
 very low (10 mg) and worked our way up over months (increase
 about 10 mg every 2 months) to 50 and gradually to 100. I'm yet
 to be convinced that it gives significant relief, but it is
 clinically evidenced to help over the long haul.

 H> Also wierd....I tried Flexeril last July.  Couldn't take it.  Made me
 RH> crazy with jitteriness...like more than a ton of caffine!!!  We tried

 Interesting .... These meds do so VERY different things for
 different people. A tribute to the diversity of biochemistry!

 Happy new year. How was your X-mas time? Since I live near my
 folks, we all gathered with a few other members of the family.
 Nice, low key, non-commercial affair. We tend to give books and
 music CDs and tapes. Got a CD I like: Bela Fleck and the
 Flecktones, Ufo Tofu--avant garde jazz banjo with bass, piano,
 harmonica, and percussion. Some truly esoteric stuff.

 I have the traditional post-X-mas blues, enhanced by a nasty,
 dark, cold (at least for California) rainstorm. (glad for the
 water though, we need it out here. So I've fired up the
 woodstove and tucked myself under a quilt in my couch nest. It
 really is a nest what with books stacked around, the computer
 setup, keyboard and mouse at hand, phone, TV-stereo-CD remote
 controls; life could truly be a lot worse than this. I've been
 doing some reading about writing, writing ineffectively, and
 find myself bogged down, avoiding it. "I'm tired, Mom, I don
 wanna, do I havta! <grin> Mo-O-om, are we there yet? <snivel> I
 don like this! I want it to be EASIER!"  :)  Well, that's a good
 start on a tantrum. I'd forgotten that throwing a fit makes it
 go away. I feel better already.  :)

 Hope things are at the very least reasonably well with you,

 Stefan

... SENILE.COM found . . . Out Of Memory . . .

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------



Subject: Re: Chiropractors
From: Stefan.Welch@p0.f33.n125.z1.fidonet.org (Stefan Welch)
Organization: FidoNet node 1:125/33.0 - BODY DHARMA ONLINE, Oakland CA


[This is from the Chronic Pain Conference]

 -=> Quoting John Polhemus to All <=-

 JP> My question is should I or shouldn't I?
 JP>
 JP> Is the risk great in using a Chiropractor for something like this? Can
 JP> they do more harm than good? I guess I'm looking for opinions,

 John,

 I've seen chiropractors help and hurt. My personal experience is
 comparatively neutral: I've had no improvement with chiropractor
 treatment; had one hurt me some when he was too rough. He then
 defended himself with the "Somethimes things get worse before they
 get better," line. One woman I know had 1 or 2 disks damaged in
 her neck by a chiropractor. She is now in severe chronic pain.

 A universal theme here may apply: Find a practitioner who
 listens to you, and who approaches the situation gently and
 without ego involvement. A practitioner with that stance stands
 the best chance of helping to heal someone.

 Best wishes in your hunt. Perhaps there is some way to get some
 references to hook you up with someone well qualified.

 Hope things work out well-- take care,

 Stefan

 The person needs to be able to acknowledge that
 even though he/she may be well trained, you, the patient,
 ultimately knows best about what is hurting and helping you.

... Reality-ometer:  [\........]  Hmmph!  Thought so...

--
Uucp: ..!uunet!bunker!hcap!hnews!125!33.0!Stefan.Welch
Internet: Stefan.Welch@p0.f33.n125.z1.fidonet.org




------



Subject: DOT proposed rules re: ADA - full text (long)
From: 34AEJ7D@cmuvm.csv.cmich.edu (W.K. (Bill) Gorman)

FOR IMMEDIATE RELEASE:


Consortium for
Citizens with
Diabetes
                    For more information, contact:
                    Marilyn Golden
                    Disability Rights Education & Defense Fund
                    (510)644-2555
-----------------------------------------------------------------


                      ALERT! ALERT! ALERT!

              DEPARTMENT OF TRANSPORTATION PROPOSES
                   TO WEAKEN ADA REGULATIONS:
           STANDEES COULD LOSE THE RIGHT TO USE LIFTS

     Your letters are urgently needed by January 19, 1993
informing the federal Department of Transportation (DOT) that a
proposed change in their Americans with Disabilities Act
regulations senselessly removes the right of many Americans with
disabilities to use public transportation.

     One of the ADA's most important transportation provisions
was that mobility impaired ambulatory persons (such as persons
using walkers, crutches, or canes, or who use no mobility device
but have difficulty walking, sometimes called "standees") must be
allowed to use the lift to board a bus if they need or prefer to
do so.

     On November 17, DOT published a proposal to change its ADA
regulations such that transit agencies would only be required to
allow standees to use lifts if the lift has a handrail, or if the
lift complies with the new ADA technical standards.  Many busses
on the road today have lifts, but most of them do not comply with
the ADA's tough new standards, and many have no handrails.  The
result is that many standees' rights to ride the bus will be
delayed for years until the buses wear out and are replaced by
new ones.

     The only reason for DOT's sweeping proposal is concern for
the safety of standees, but there has been no documentation or
even anectodal evidence of any threat to safety -- in fact, in
many cities, standees routinely use lifts with no problem
whatsoever.  It is crucial that unfounded allegations of a safety
risk not be allowed to create policy.  Most importantly, since
DOT has now raised this issue for public comment, letters from
the disability community are urgently necessary to counteract the
many letters from the transit industry urging DOT to make the
regulation even more restrictive than what is proposed.  Federal
agencies should preserve and protect the ADA rather than weaken
and dilute it!

     We hope that you and other disability rights supporters
write letters to DOT in large numbers, encouraging DOT to
maintain the requirement allowing standees to use any lift.
Enclosed are comments to help you.  Send your letters to:

          Docket Clerk
          Docket No. 48463
          Department of Transportation
          400 - 7th ST. S.W. Room 4107
          Washington, D.C.  20590



   COMMENTS ON DEPARTMENT OF TRANSPORTATION NOTICE OF PROPOSED
RULEMAKING, AMERICANS WITH DISABILITIES ACT (ADA), DOCKET NUMBER
48463, PUBLISHED IN THE FEDERAL REGISTER ON NOVEMBER 17, 1992. pp
                           54210-54215

The safety threat is only speculative; there is a complete lack
of documentation, in violation of the standards for demonstrating
risk which the ADA itself establishes.

     The biggest problem with DOT's proposal is the complete lack
of documentation or even anecdotal justification of a safety
threat posed by standees who use lifts.  Using allegations of a
threat to safety to exclude or segregate people with disabilities
has been a long-standing part of disability discrimination, one
that has accompanied every proposal to protect the right of
people with disabilities.  At one time, it was argued that people
who use wheelchairs should be disallowed from using elevators
because of difficulties with emergency evacuation, and while this
concern seems silly today, such arguments have resulted in
significant exclusion of people with disabilities for many years.
The concern about standees using lifts is a similar one in that
it is highly speculative and has no factual showing.

     A number of federal disability rights laws and regulations
have rejected speculative, undocumented threats to safety as a
valid reason for discrimination.  In fact, DOT itself, in
regulations for the Air Carrier Access Act of 1986, refused to
restrict the number of people with disabilities who could travel
on an airplane flight due to lack of documentation that a threat
was posed above any particular number.

     The ADA itself provides very rigorous standards by which
safety risks must be evaluated before they may be legally used to
pose restrictions on people with disabilities.  The Department of
Justice regulations under Title II of the ADA cover state and
local governments, and DOT has required public transit agencies
to comply with them.  These regulations state:


     Safety requirements must be based on actual risks and not on
     speculation, stereotypes, or generalizations about
     individuals with disabilities, 28 CFR   35.130(b)(8)

     Other parts of the ADA are even stronger.  The Title I
regulations governing employment and promulgated by the Equal
Employment Opportunity Commission only allow an alleged safety
threat to exclude a person with a disability of the person would
pose a significant risk of substantial harm to themselves or
others which cannot be eliminated or reduced by reasonable
accommodation -- it may not be a speculative or remote risk.  The
determination of risk must be made on a case by case basis and
must be based on objective evidence and facts about the
individual, not merely on generalizations about a disability.  42
USC   12113 (b) & 29 CFR    1630.3, 1630.15

     DOT itself has offered an example of a valid finding of risk
on another issue in the same Notice of Proposed Rulemaking that
includes the proposal about standees.  In discussing the need for
truncated domes to be used as detectable warnings on subway
platforms, DOT argues that they are necessary because, without
them, individuals with visual impairments have died in accidents
after falling off the subway platform.

     DOT's standee proposal, by contrast, falls far short of
meeting the ADA's standards for assessing a valid safety risk.
DOT cites only that it has received a number of inquiries from
transportation providers which prefer not to carry standees on
lifts without handrails for safety and liability reasons.  The
very same logic could be used to justify requiring standees to
use lifts at all times because there have been many accidents
when people climb tall steps boarding a bus.  The ADA, the very
law which DOT has been charged with regulating, poses standards
of proof which DOT is not meeting.

     Ironically, DOT itself funded a study, printed in May, 1992,
by the Volpe National Transportation Systems Center in Cambridge,
Massachusetts entitled "Suggestions for Implementing a Standee-
on-lift Program for Fixed-route Bus Service."  The researchers
found no evidence of problems with standees using lifts.  They
reported on successful standee-on-lift programs in six cities
across the U.S.  In several cities, standees accounted for 10%-
20% of total lift usage.  The cities reported that incorporating
standees into their existing accessibility programs was an
extension of what they'd already accomplished rather than a
revolutionary new idea.

     Without documentation, DOT's suggestion to limit standees on
lifts is itself discriminatory.  Certainly there are standees
with disabilities who can use any lift safely.  Given this fact,
any blanket exclusion of this class of people with disabilities
denies service to some persons whose disabilities pose no threat,
which is discrimination in the eyes of the ADA.  DOT must make a
valid finding of safety risk before imposing such a
discriminatory restriction.

Congress intended that standees be able to use all lifts.

     The ADA reports from the Senate Committee on Labor and Human
Resources and the House of Representatives Committee on Education
and Labor both include the following language,  which
demonstrates clear Congressional intent that standees be allowed
to use lifts:

     It is the Committee's intent that the obligation to provide
     lift service applies, not only to people who use
     wheelchairs, but also to other individuals who have
     difficulty in walking.  For example, people who use
     crutches, walkers or three-wheeled mobility aids should be
     allowed to use a lift.  (See Senate Report at 48, House
     Report at 89.)

     DOT alleges in its Notice of Proposed Rulemaking that
because this statement occurs near the section on new bus
purchase, Congressional intent appears to refer to standees'
rights in the context of new buses.  However, the Committee's
statements about standees appear in a paragraph discussing the
importance of serving all people with disabilities without
discrimination.  The sentence before the above quotation states:

     The obligation to provide public transportation in a non-
     discriminatory fashion applies to all persons with
     disabilities...

which begins a discussion of how transit agencies are required by
the ADA to provide non-discriminatory service, including such
considerations as inclusion of people with sensory and cognitive
disabilities as well as staff training.  DOT's ADA regulations
pick up on this idea by imposing extensive Provision of Service
requirements which transit agencies must comply with regardless
of whether they've been required to buy accessible buses yet or
not.

     Had Congress only wanted transit agencies to train their
staffs or serve people with sensory or cognitive disabilities on
certain buses, its reports would have so stated.  But as DOT's
regulations correctly recognize, it is critical that transit
agencies serve all people with disabilities in a non-
discriminatory manner on all vehicles.  There is clear
Congressional intent that standees be served under the ADA, and
this intent should be faithfully reflected in DOT's rule.

Many transit agencies' current policies allow standees to use
lifts without problem.

     Many cities, including New York City, Denver, and Oakland
and San Rafael, California allow standees to use lifts, even
lifts without handrails, with no incidents or problems.  In the
absence of any demonstration of risk, the experience of these
cities, in combination with DOT's own study mentioned above,
provides evidence that DOT should not change its regulation.

The proposed change could be very expensive because disallowing
standees on many fixed route buses places a high financial burden
on paratransit.

     Because of the vast number of elderly people who have
difficulties walking, standees comprise a very large group.
People of short stature (numbering 1.5 million in the U.S.) add
to the size of this group.  It is important for DOT to recognize
the harmful effects of removing any class of people with
disabilities, particularly a class as large as standees, from
fixed route buses, because they will then be eligible for
paratransit, an expensive service which is already strained to
the limit.  If standees must use paratransit, it could cause
many more cities to claim a waiver from the ADA's paratransit
requirements for undue financial burden.

It is inappropriate for federal agencies to weaken the ADA.  DOT
should maintain the requirement allowing standees to use any
lift.

DOT is no doubt receiving many letters from transit agencies
arguing that even with a handrail, standees cannot ride lifts
safely.  Suggestions are probably being made that standees'
rights to use lifts should only be ensured on buses meeting the
ADA technical standards.  Such a change would be an extreme
evisceration of this important civil right, far more serious than
the current proposal, particularly in light of the lack of
documentation.

     DOT had it right the first time - standees should be allowed
to use lifts.  Without strong justification, it is highly
inappropriate for federal agencies to go back and introduce
weakening changes in ADA regulations.




------



Subject: Jaron Lanier at CSUN March Conference
From: VFOAO073@VAX.CSUN.EDU (Harry Murphy)


                      Advisory Board Meets
                      for June 17-18, 1993
                          Conference on
                "Virtual Reality and Disability"

(California State University, Northridge (CSUN).  December 15,
1992).   On December 11, twenty-five (25) leaders came together
from the fields of virtual reality and rehabilitation and assistive
technology to plan the June 17-18, 1993 meeting, "Virtual Reality
and Disability," to be held at the Westin Hotel near the San
Francisco Airport.

Greenleaf Medical Systems, CyberEdge Journal, Pacific Bell, and
the California Department of Rehabilitation agreed to co-sponsor
the conference.  Dr. Walter Greenleaf has agreed to Chair the
Advisory Board.

A Call for Papers has been issued. Papers are solicited which deal
with applications in the field of disability, access issues, and
the potential of VR to assist persons with disabilities.

The purpose of the meeting is to bring together three groups:
the Virtual Reality community, the disability community, and the
rehabilitation/assistive technology community in order to stimulate
new applications of VR, insure that persons with disabilities have
access to VR technologies, and the integrate VR into the
rehabilitation/assistive technology field.

For a "Call for Papers" brochure, or other information, please
contact:

Dr. Harry Murphy
California State University, Northridge (CSUN)
18111 Nordhoff Street - DVSS
Northridge, CA 91330
Phone:  818 885 2578
FAX:    818 885 4929
EMAIL:  VR@VAX.CSUN.EDU





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                                ******

                  End of Issue # 3092 of the Handicap Digest

                                ******
Comments: Gated by NETNEWS@AUVM.AMERICAN.EDU