To Whom It May Concern:

(Your name) has been suffering with Multiple Sclerosis for many years. He has worked extensively with the physical therapy and rehab departments. From a urologic perspective he has been under my care for the past 5 years. He is presently 71 years old and has essentially been wheelchair bound for several years and has had several decubiti.

He now uses an intermittent catheterization schedule and reflex voiding habits intermittently as needed for his changing urinary condition. He finds that when he is more active and especially when he is able to stand erect, his spontaneous voiding habits improve such that he does not have to intermittently catheterize. When recumbent or seated for prolonged periods, he is more apt to have less spontaneous reflex voiding and thus has to institute self-catheterization.

He further finds the same problem with his bowels habits such that when he is seated or recumbent, he needs to digitally stimulate for bowel movements. He is also chronically suffering from abdominal distention when spending prolonged periods in the wheelchair so at this point his only alternative is recumbency.

Over the past several years he has developed a slumping posture with rounding of his upper thoracic spine and shoulders related to being wheelchair bound. Based on his assessment from a medical standpoint and with respect to his current physical abilities, the following wheelchair is hereby medically prescribed: LifeStand standing wheelchair, 18 inch 700 Newton with no flat inserts.

Sincerely:

Your Doctor