WHAT-ology?

3

By Dr Irwin Lim, Rheumatologist

Thanks to my friend and colleague, Sam Whittle (@samwhittle), for taking this picture.

What-ology

I find myself increasingly trying to advocate for a higher profile for Rheumatologists.

While this may sound self-serving, and it probably is, there’s other good reasons.

Rheumatology is not a sexy speciality.

Regular folk don’t understand what we actually treat. When they hear that we deal with arthritis, various aches and pains, and autoimmune disease, some are interested but others politely change the topic.

Some go on to tell us about their painful bunion or that dicky knee.

Arthritis is not a high profile topic. It does not tug at the heartstrings in the same way cancer or diseases affecting children do.

You may be surprised to know that many doctors also don’t understand the breadth of conditions rheumatologists treat or the depth of our diagnostic and therapeutic skill.

Rheumatology as a specialty is not as lucrative as procedural specialties such as cardiology or surgery so many younger training doctors are also not looking at it as a career option.

With health systems tightening their budgets everywhere, an outpatient based speciality like rheumatology seems to be slowly being squeezed out of public hospitals in Australia. Given most training of doctors still occurs in hospital, this lack of visibility and lack of mentors for young doctors at a time they are making career choices is troubling.

We need more visibility. More exposure. The limelight.

We need to inspire the next generation of physicians. We need to educate and advocate, directed at both the public and our colleagues.

I believe that a higher profile for rheumatologists is a crucial step in improving the situation for our patients. It will help with quicker diagnosis, better access, more funding.

I’m not sure you agree but I’ll be interested in your thoughts.

Dr Irwin Lim is a rheumatologist and a director of BJC Health. You should follow him on twitter here.
Arthritis requires an integrated approach. We call this, Connected Care. Contact us.
This blog focuses on arthritis, healthcare in general, and Connected Care. Please subscribe to keep in touch:
 
Enter your email address:
Delivered by FeedBurner

Spondyloarthritis Word Soup

0

By Dr Irwin Lim, Rheumatologist

I’m welcoming delegates to a meeting tonight. We’re going to be talking about Spondyloarthritis.

Spondyloarthritis has always been confusing. Is it a group describing related diseases or a single disease entity leading to a variety of different manifestations? (click here to read about a particular patient history highlighting this)

Messy. Complicated. Lots of labels used to describe kind-of-the-same thing.

I wanted to convey this in a graphic way so I chose some word art.

Wordle SpA

I then wanted to convey that the last decade has seen attempts to improve our scientific understanding, our ability to treat, and our ways to classify this/these disease/s. Here’s the 2nd graphic:

Wordle SpA Ordered

It’s an exciting time for us in rheumatology. With improved knowledge and the strong will being shown, we will tidy up this area, meaning better outcomes for patients.

Dr Irwin Lim is a rheumatologist and a director of BJC Health. You should follow him on twitter here.
Arthritis requires an integrated approach. We call this, Connected Care. Contact us.
This blog focuses on arthritis, healthcare in general, and Connected Care. Please subscribe to keep in touch:
 
Enter your email address: Delivered by FeedBurner

How to treat a ganglion cyst

0

By Dr Irwin Lim, Rheumatologist

You may have one of these. A firm lump near a bony area, usually the wrists or around the foot or ankle.

The lump’s really quite firm and over time, it becomes less easy to compress. It can grow in size and occasionally, particularly after some trauma, it may become smaller and resolve.

Ganglion Cysts are not dangerous.

They can be removed surgically but most patients want to avoid surgery so these often come to our attention. Usually, when they become uncomfortable or annoying.

These pictures show one way to treat them.

Ganglion1

The cyst is punctured with a larger-bore needle (I usually make 2 punctures, using a 19G needle).

The fluid which is usually thick like jelly or toothpaste, can then be squeezed out.

Ganglion2

If it’s too thick to squeeze out, doctors may inject some cortisone (steroid).

It’s generally a satisfying procedure for both patient and doctor.

Have you had a ganglion cysts? How was it treated?

Dr Irwin Lim is a rheumatologist and a director of BJC Health. You should follow him on twitter here.
Arthritis requires an integrated approach. We call this, Connected Care. Contact us.
This blog focuses on arthritis, healthcare in general, and Connected Care. Please subscribe to keep in touch:
 
Enter your email address:
Delivered by FeedBurner

Don’t Turn Your Back On It: 2 months into the campaign

0

By Dr Irwin Lim, Rheumatologist

Trying to improve disease awareness is hard work, potentially unrewarding and frustrating. So, any attempt at a public awareness campaign is approached with a degree of hope and trepidation.

I’ve written about the Don’t Turn Your Back On It campaign (read Who’s Got Your Back? & The Back Cave).

It’ a campaign designed to get young males (and yes, I know females are affected to) with chronic back pain to visit a website where they’ll answer a few key questions to determine if they have Inflammatory Back Pain.

Inflammatory Back Pain Symptom Screener

Inflammatory Back Pain Symptom Screener

 

Having Inflammatory back pain may mean that the diagnosis is spondyloarthritis / ankylosing spondylitis so determining this is a key stepping stone to a correct diagnosis.

This campaign, supported by Abbvie (a pharmaceutical company), Arthritis & Osteoporosis NSW, a number of allied health professionals, rheumatologists and patient advocates has just entered its 3rd month.

I thought it worth sharing some milestones achieved:

  •  ~14,000 visits to the campaign website
  •  >3,300 positive screener results (approx. 38% of total screener submissions)
  • ~300 positive screener recipients electing to receive further information

An important part of the campaign involved attempting to engage GPs:

  • GP postcard mailer distributed to ~4,000 GPs in our state, New South Wales
  • The Back Pain Maze poster placed in ~900 GP waiting rooms
  • ~700 AS GP Fact sheets downloaded through an online portal

Traditional media & social media highlights include:

  • Media articles in >19 publications (mainly local community papers)
  • 113 Media clippings generated – including radio snippets, and national TV coverage (A Current Affair, estimated audience of 1 million viewers – watch “Michael Slater Reveals Secret Illness“)
  • >700 website visits from Facebook & Twitter

It’s encouraging. A good start. We hope there’ll be more interest and that we can keep the ball rolling.

Please help if you can. Share the links so we can get more people with chronic back pain screened, and hopefully, reduce the delay for some in getting the correct diagnosis.

Dr Irwin Lim is a rheumatologist and a director of BJC Health. You should follow him on twitter here.
Arthritis requires an integrated approach. We call this, Connected Care. Contact us.
This blog focuses on arthritis, healthcare in general, and Connected Care. Please subscribe to keep in touch:
 
Enter your email address:
Delivered by FeedBurner

Why do some find Pain difficult to describe?

5

Dr Irwin Lim, Rheumatologist

My mother was having some chest discomfort.

I wanted her to describe it to me but she found this very difficult.

It’s just painful. 

I will admit this frustrates me.

Is it sharp or dull? Does it ache, throb, burn? 

Is it intermittent or constant?

What brings it on? What makes it worse? What relieves it?

She found it very difficult to give me the details I wanted to help make a diagnosis. This is not an uncommon scenario in clinic. Some just find it near impossible to describe their pain.

I don’t quite understand it and that’s why I’m asking the question. Can you explain?

Dr Irwin Lim is a rheumatologist and a director of BJC Health. You should follow him on twitter here.
Arthritis requires an integrated approach. We call this, Connected Care. Contact us.
This blog focuses on arthritis, healthcare in general, and Connected Care. Please subscribe to keep in touch:
 
Enter your email address: Delivered by FeedBurner

Page 1 of 6512345»102030...Last »