Disability

Disability 1. Consequence of an impairment that may be:- Physical Cognitive Mental Sensory Emotional Developmental Combination

Disability 2. Umbrella term:- Impairment, problem with body function or structure Activity limitation, difficulty executing a task or action Participation, limitation in involvement in life situations

Disability 3. Exclusion from mainstream society Eg deafness/ autism Disability? Or Developmental difficulty unfairly stigmatised by society?

Disability 4. Impairment in person’s ability to function caused by changes in various parts of the body

Disability 5. Inherited Congenital Acquired. Prison?? Unknown

Disability 6. Physical – lifting limbs Balance Intellectual Mental Pervasive Development disorder:- Autism, Aspergers and others Non visible Diabetes Fibromyalgia Epilepsy

The Law UK Disability Discrimination Act 1995, extended 2005:- Unlawful to discriminate (without justification) Equality Act Includes Disability, Age, Gender reassignment, Marriage, Race, Sex, Religion, sexual orientation Height, Thin, Fat, Not being nice?

Rheumatoid

Nice Rheumatologist

RA TREATMENTS Put up with it Advice on joint protection Analgesics Physio, OT, Hydrotherapy, Podiatry, NSAIDs Morphine? DMARDS Steroids Biologics Steroids Surgery Morphine etc Acupuncture if chronic change

RA Drug treatment (Morphine)

RA DMARDS- time to help 3 months

RA Asessement tool -DAS28 Disease Assesesment Score Number of swollen joints Number of tender joints Patient’s VAS out of 10 ESR 5.2 eligible for Biologics if hah 2 DMARDS including MTX ( Europe accept DAS of 3.4 –treating earlier and more aggressively)

RA Biologics-Time to help days to 3/6 mths

RA OA

Osteoarthritis

OA

Osteoarthritis

OA therapy

Acupuncture

OA Treatment Put up with it Paracetamol NSAIDs (?) Physiotherapy Glucosamine Alternative Cod liver oil Wheel Chair Surgery Lose weight Don’t play football, ?sport Morphine etc

Osteoporosis

Ankylosing spondylitis

AS BASDAI- Bath ankylosing spondylitis disease activity index 1-10 of Fatigue Spinal pain Joint swelling Enthesitis (morning stiffness) (MS Severity ) mean of these two Divide by 5, ie 1-10, >=4 bad

AS

AS drugs

AS Biologics

Fibromyalgia rheumatica

Fibromyalgia

Fibromyalgia treatments

Chronic fatigue syndrome

CFS

Gout

Cook: Mr Spiggott - you are, I believe, auditioning for the part of Tarzan.Tarzan Moore: Right. Cook: Now Mr Spiggott, I couldn't help noticing - almost at once - that you are a one-legged person. Moore: You noticed that?

Cook: Need I say with over much emphasis that it is in the leg division that you are deficient. Moore: The leg division? Cook: Yes, the leg division, Mr Spiggott. You are deficient in it to the tune of one. Your right leg, I like. I like your right leg. A lovely leg for the role. That's what I said when I saw you come in. I said, "A lovely leg for the role". I've got nothing against your right leg. The trouble is – neither have you.