Showing posts with label Devins Illness Intrusiveness Scale. Show all posts
Showing posts with label Devins Illness Intrusiveness Scale. Show all posts

Saturday, 3 August 2013

Illness Intrusiveness

Rheumatoid Arthritis is an intrusive illness that affects every area of your life.

There is a scale to measure just how much of an effect a chronic disease like RA can have. It's called the Devins Illness Intrusiveness Scale. As Dr. Arthur Bookman pointed out in his keynote presentation at the Sjogren's National Conference this year, Sjogren's Syndrome and Multiple Sclerosis are similarly intrusive.  I think RA also would rank up there with those illnesses but though I went through the questionnaire I am not sure exactly how to score the results.



                        Dr Bookman at the round table discussion. Sjogren's Conference 2013

Often all of your identities are affected, some more than others.

Spouse/Social being

Homemaker
Parent
Worker

As you go through the stages of RA some areas may take a smaller role, like work. Once you retire, if you get so far, work will become less relevant.  Of course your kids will mature and may make you a grandparent. Some of them will have learned to have a lot more empathy than their peers.

That still leaves you with making a home for yourself and your spouse if you have one, and all of the social interactions that are so necessary to keep you supported and healthy. Social networks are a strong predictor of longevity and good health.


I remember when my RA was out of control. I was so worried about being bumped or jarred because of the pain in my hands and feet that I formed a little wall down the center of the bed for protection.  Now that things are under better control I look at that as overkill thank goodness.


                        There's a wall between us          A.McKinnon

I'm sure it will leave you completely unsurprised to hear there are also fatigue scales. I read about one fascinating one today on Julia's Reasonably Well blog. It is always interesting to see where you fit when you look at them.


There's another one called the Medical Outcome Study Short Form 36 (SF-36) that is mentioned in this article about the way that fatigue affects quality of life in rheumatoid arthritis compared to fibromyalgia.





Saturday, 22 June 2013

Part 1 Immune System Gone Wild Sjogren's National Conference 2013,Dr. Arthur Bookman

The Sjogren's Society of Canada had the 7th Annual National Conference in May this year. It was a learning experience that Sjogren's patients look forward to all year.  For the first time this year the conference was also an Accredited Group Learning Activity for doctors and provided Continuing Education credit for dentists.



We started the day with Dr Arthur Bookman giving us an overview of the criteria for the diagnosis of Sjogren's Syndrome. He described it as an immunological storm.  Dr Bookman is also to thank for the inspired naming of the conference. 

He told us that hypertrophied salivary glands are often seen in Sjogren's.  If the salivary ducts are injected with a tracer dye you can see damage and abnormal arborization.  

He also talked about the length of time it takes to get a diagnosis of Sjogren's Syndrome based on experiences of people who attended the multidisciplinary clinic at Toronto Western Hospital. It takes 27 to 31 months for the diagnosis and from 2.9 to 3.2 different doctors. This leads to patients being unhappy with the medical profession.  On the Devins Illness Intrusiveness Scale  Sjogren's ranks very near Multiple Sclerosis.


ScienceDirect.com

He also said that systemic treatments such as prednisone, hydroxychloroquine, immunosuppressants and TNF inhibitors are ineffective, though Rituximab is sometimes effective. It has been seen to improve dry mouth/salivary symptoms and dry eye and fatigue. Future treatments may include Benlysta and allogenic mesenchymal stem cell transplantation (Sun, Nanjing abstract 2557, ACR 2012)