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

• Inherited
• Congenital
• Acquired. Prison??
• Unknown
Disability 5.

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 2010.
• Includes Disability, Age, Gender reassignment, Marriage, Race, Sex, Religion, sexual orientation
• Height, Thin, Fat, Not being nice?

Rheumatoid

Rheumatoid

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

Osteoporosis

Osteoporosis

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

Fibromyalgia treatments

Chronic fatigue syndrome

CFS

Gout

Cook : Mr Spiggott - you are, I believe, auditioning for the part of 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.