Kingsbridge medical practice clayton

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Case presentation Helen is 46 years old and has generalised osteoarthritis. Her hips and hands are the most severely affected joints. Helen's health problems started at the age of 11, following a fall on a cross-country run. She consulted her general practitioner and the accident unit multiple times with increasing levels of pain and disability before she was eventually diagnosed with Perthes disease, a diagnosis that has had a huge impact on her subsequent life.

Over the years Helen has tried the full range of pain medications. A review of her past prescriptions reveals trials of over 15 different analgesics and anti-inflammatory drugs, covering the full range of the analgesic ladder. Her current medication, oxycodone, has so far been the best choice, optimising pain relief whilst minimising side effects.

Helen continues to be under the care of local orthopaedic surgeons, who are contemplating further revisions to her failed total hip replacement. Helen remains independent and self-caring despite deterioration in her levels of pain and physical functioning. Helen trained as a radiographer, but following the failure of a hip replacement she became a wheelchair user, which was not felt to be compatible with her job.

This loss has had significant impact on Helen's identity: she describes it as being 'picked up from one life, where I could focus on me and what I wanted to happen, and put in another, where someone else was in control'. The issues of identity and social roles are key for Helen, in knowing how to define herself — 'Am I disabled? This meant radical changes to her social life, independence, choices, freedom of movement, interests and hobbies.

The nature of Helen's condition does not mean she has necessarily lost all other social roles. Helen's parents live close to her and suffer from a number of physical and mental health conditions. For Helen, being her parents' main carer is a source of positive identity and pride, although it also means she can be called to provide physical or emotional help at any time during the day or night.

Her father's illness also meant that Helen took on some of his caring responsibilities, in looking after her elderly aunt who had dementia. Relationships and friendships have been very important to Helen and have been affected by her condition. She had been engaged at age 21, shortly before a period of hospitalisation. She describes the problems with actually meeting people with whom to have a relationship, but also the dilemma and difficulty of attempting to "build an equal partnership, when somebody does have to take on a carer's role.

Helen describes the process of learning "to become disabled. Helen's relationship with her GP CDM is important to her, particularly as he is also her parents' GP and therefore has an understanding of the context in which she is managing her disability. She also feels strongly about the benefits of having a relationship with her GP in which she is seen as a person and is able to "be herself", without being concerned that she is seen as a problem or that people are worrying about her.

Discussion We have presented a case of a woman with osteoarthritis secondary to Perthes disease in childhood. We have described her emotional, social and psychological transformation using her poetry to illustrate different life experiences. Alternatively you can use Patient Access to book an appointment on line or call us on Please see our appointments page for more information. Accessible Information Standard It is a requirement of the Health and Social Care Act that our patients receive information in a way they can access and understand.

If you have any information or communication needs we would like to know so we can help meet those needs. For example, we want to be sure that you can read and understand information provided to you during medical appointments or in writing. Please tell us if you need information in any other format than standard print or if you have any special communication requirements. This does not mean that you have to see this specific Doctor nor does it mean that you will always be able to have an appointment with your named GP.

Your Doctors name can be obtained from reception. Help Us to Help You Our team work hard to offer the very best service we can to our patients in challenging circumstances. The demand for our services is very high so please let us know in advance if you are unable to attend an appointment — we can then offer it to another patient.

We aim to treat all of our patients with dignity and respect and our staff deserve the same in return. We have a zero tolerance approach to violence and abuse.

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Customer service remote jobs	Please call us first! It was thorough, sensitive and addressed all my concerns. Sign up for alerts or updates Get monthly alerts highlighting where you are an outlier, or have suddenly changed example. If you have any information or communication needs we would like to know so we can help meet those needs. Please see our appointments page for more information.
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Kingsbridge medical practice clayton	Accessible Information Standard It is a requirement of the Health and Social Care Act that our patients receive information in a way they can access and understand. Please call us first! If you have any information or communication needs we would like to know so we can help meet those needs. All messages are answered in business days, during regular business hours. Alternatively you can use Patient Access to book an appointment clayton kingsbridge medical practice line or call us on If your symptoms are serious or get worse, NHS has a coronavirus kingsbridge medical practice clayton service that can tell you if you need certain medical help and advise you what to do.
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Extended Access Appointments Evening and weekend GP and Nurse appointments are now available at local primary care hubs. Please contact the surgery to check availability and book an appointment. Alternatively you can use Patient Access to book an appointment on line or call us on Please see our appointments page for more information.

Accessible Information Standard It is a requirement of the Health and Social Care Act that our patients receive information in a way they can access and understand. If you have any information or communication needs we would like to know so we can help meet those needs. For example, we want to be sure that you can read and understand information provided to you during medical appointments or in writing. Please tell us if you need information in any other format than standard print or if you have any special communication requirements.

This does not mean that you have to see this specific Doctor nor does it mean that you will always be able to have an appointment with your named GP. Your Doctors name can be obtained from reception. Help Us to Help You Our team work hard to offer the very best service we can to our patients in challenging circumstances.

The demand for our services is very high so please let us know in advance if you are unable to attend an appointment — we can then offer it to another patient. This loss has had significant impact on Helen's identity: she describes it as being 'picked up from one life, where I could focus on me and what I wanted to happen, and put in another, where someone else was in control'.

The issues of identity and social roles are key for Helen, in knowing how to define herself — 'Am I disabled? This meant radical changes to her social life, independence, choices, freedom of movement, interests and hobbies. The nature of Helen's condition does not mean she has necessarily lost all other social roles. Helen's parents live close to her and suffer from a number of physical and mental health conditions.

For Helen, being her parents' main carer is a source of positive identity and pride, although it also means she can be called to provide physical or emotional help at any time during the day or night. Her father's illness also meant that Helen took on some of his caring responsibilities, in looking after her elderly aunt who had dementia. Relationships and friendships have been very important to Helen and have been affected by her condition. She had been engaged at age 21, shortly before a period of hospitalisation.

She describes the problems with actually meeting people with whom to have a relationship, but also the dilemma and difficulty of attempting to "build an equal partnership, when somebody does have to take on a carer's role.

Helen describes the process of learning "to become disabled. Helen's relationship with her GP CDM is important to her, particularly as he is also her parents' GP and therefore has an understanding of the context in which she is managing her disability. She also feels strongly about the benefits of having a relationship with her GP in which she is seen as a person and is able to "be herself", without being concerned that she is seen as a problem or that people are worrying about her.

Discussion We have presented a case of a woman with osteoarthritis secondary to Perthes disease in childhood. We have described her emotional, social and psychological transformation using her poetry to illustrate different life experiences.

The notion of biographical disruption[ 1 ] can be used to describe the identity changes experienced by Helen. This 'breaking down' of one's life is eloquently described by Arthur Frank, a medical sociologist who has himself experienced critical illness: "What happens when my body breaks down happens not just to that body but also to my life, which is lived in that body. When the body breaks down, so does the life.

Even when medicine can fix the body, that doesn't always put the life back together again. Creativity, through poetry, writing or art, can be seen as one way of trying to make sense of this disruption. This type of creativity may be actively encouraged as part of a healing process [ 4 — 6 ], although Helen's poems were originally written solely for and by herself.

This is not a traditional case report, yet we believe that our approach can be equally as informative, by allowing doctors and researchers to more fully understand the impact a disease has on all aspects of their patient's lives. Patient's perspective Where have I gone? Where's the woman who weighed less than 9 stone?

Who wore a dress size 12 and didn't need to wear shapeless clothes or jogging suits?