Sunday, 16 April 2017

Initial Diagnosis, Scleroderma, Raynaud's, Autoimmune Rare Disease. Nicola Whitehill

Initial Diagnosis – Autumn 1997
Scleroderma, Raynaud's, Autoimmune Rare Disease.
#SclerodermaFreeWorld #RaynaudsFreeWorld #Research   





 


Initial Diagnosis – Autumn 1997
The month of September always prompts a trip down the memory lane / abyss of September 1997, for me. For, it was at this time, aged 24, when I first heard those three words – ‘You have scleroderma’. 
 
Resulting in my life being turned upside down, forcing me to abandon most of my dreams, and to be grateful for defying the medical statistics and long term outlook for most scleroderma patients. 

During the summer of 1997, I had started to feel very tired all of the time. 

This was quite out of character for me as I had an insatiable zest for life. 

Not only was I working as a medical representative for Bristol Myers Squibb, I was studying on a part time, distance learning basis for a postgraduate diploma in law, which would then lead me to pursue my childhood personal desire to be a barrister and professional advocate. 

By early September 1997, my hands had become swollen and puffy with shiny tight skin across my fingers. 

I had difficulty moving my fingers as they were stiff, as well as, I was having difficulty in gripping and making a full fist. 

I also found it difficult to open my mouth wide and to swallow. 

I wrote more about my initial symptoms on Day 4 of my June Scleroderma Awareness Campaign 2016  
 
 
As the summer season in 1997 started to change into autumn, not only did I feel exhausted, but I also noticed that I was starting to actually feel the cold. 

This was a totally new experience for me, as even in the winter, I would seldom be wearing thermal clothing, previously. I thought that the ‘thermal vest’ was something to look forward to, for when you reached late middle age! 


It was during Autumn 1997 that my internal thermometer ‘tripped out’ and it still remains very demanding. 

It took a few more months before the color changes would become visible in my fingers, presenting classic Raynaud’s symptoms, causing me to have to wear several layers even in the summer, which are then ‘bulked up’ in the winter. I wrote more about this, here 

Having observed the change in my hands, combined with the tiredness and swallowing difficulties, I booked an appointment to see my GP medical doctor. 

At the first consultation, the stiff puffy fingers were thought to be a form of arthritis, however, the blood test for arthritis returned a negative result. Which was a huge relief at the time, although, I knew that something was not right. 

I was then required to give another blood test which was used for a specific autoantibody test, and bingo, this test returned a positive RNA Polymerase result, confirming a diffuse systemic sclerosis diagnosis. 
 
The EULAR /ACR classification code is the current criteria used for confirming a scleroderma diagnosis. DAY 6
 
I was then referred to my local hospital Consultant medical doctor in Rheumatology, who advised me that I was looking at a 15month prognosis and to give up on my idea of being a barrister. 

I felt as though my whole world had ended and that the rug had been pulled out from under my feet. 

There was no way that I was giving up on my law studies, I had already paid a fortune in tuition fees, afterall!
After the blood tests, I was then required to take many different diagnostic tests to assess the level of internal damage, if any. See DAY 5 
 

By February 1998, my scleroderma disease was so aggressive with my skin involvement, that I was unable to stretch my arms or legs, and it was itchy, swollen and painful.

I returned to the hospital and commenced all of the different immunosuppressants  and disease modifying agents available, with little improvement on the disease, but horrendous side effects and continual nausea.
In December 1998 I went to see Dame Prof Black at The Royal Free Hospital in London.

Within 30 seconds of being in the consultation appointment, I knew that Dame Prof Black would do everything she could to help me, especially with me achieving my dream of being a barrister.   

15months of intense chemo drips (cyclophosphamide) combined with mycophenolate mofetil stabalised my symptoms, stopping the scleroderma in its tracks, thankfully. Otherwise, I was scheduled to be having a stem cell transplant, as my name was on the waiting list.  

By now, Prof Chris Denton had returned from his scleroderma studies in the US and I had the pleasure of becoming his patient. My local Consultant medical doctor, (the diagnosing doctor), would not entertain ‘shared care’.  

At the end of 2004 I returned to my family home town of Southport, and I am delighted that my local Consultant medical doctor here, Dr Hannah Sykes, is extremely supportive and co-operative with me having shared care with the expertise of the scleroderma unit at The Royal Free Hospital and Prof Denton’s medical expertise.  


This co-operation from the medics most certainly makes for an improved patient experience, especially given that medical appointments / tests and the like, become the long term scleroderma patient’s full time job due to the multi disciplinary care required. 

I wrote about the importance of expert specialist centres, here  

I wrote about the long term scleroderma patient’s annual check up, here  

As well as, I wrote about the Olympian effort and attitude needed to become a Scleroderma Olympian, here  

To view the UK treatment and management of scleroderma guidelines, Click here  

I know that I am a very lucky scleroderma patient by way of minimal internal organ damage, even though I have had my life and body hijacked by scleroderma.

This has made me be dedicated to using the remainder of my life to improve the scleroderma, Raynaud's, Autoimmune Rare Disease patient experience. Read more, here

I take huge inspiration from the scleroderma global trail blazer and pioneer, Prof Denton, who I am eternally grateful to, for his medical expertise and helping me realise my dream of qualifying as a self employed barrister on 1st March 2004.  

Although I am no longer physically able to continue with my 60 hour per week role, I have transferred my professional skills to the global scleroderma landscape- being a voice at all levels, including decision making body levels such as NHS England, the British Society for Rheumatology, RareDiseaseUK the European Rare Diseases Organisation and The European Medicines Agency, and my column at Scleroderma News. 
 
I am also delighted to have joined the ProVIDE Law team in Liverpool, with my first article focussing on 'patient best care/practice and clinical litigation'.
 
Clearly these roles are secondary to the priority of me attending to, and respecting my symptoms, as, I want to feel good.
 
I very much hope to develop this platform further, for advancing the scleroderma and rare disease patient plight, thereby improving the 4 main hallmarks of the rare disease patient: 

  
 
- commitment to research investment
 
- access to innovative medicines 


Scleroderma has made me have to tweak my original dreams, however, I feel truly honoured to be using my background qualifications and skills to being a scleroderma, Raynaud’s and rare disease patient on the global stage, as well as raising awareness and funds for the Scleroderma Unit at The Royal Free Hospital. 

I have a new dream now : 
a SclerodermaFreeWorld and RaynaudsFreeWorld,
imagine that. 



An edited version of this article was published here, in my Column with Scleroderma News. 
September 2016. 

To Read My 2019 Articles:   

Leaving a gift in my Will, Click here   

Planning for the Future, Click here  
 
Rare Disease Day 2019:  
 
Leaving a Legacy Gift, Click here     
 
8am Headlines 

9am Headlines 


11am Headlines
 
Celebrating 20 years of being a patient at the Scleroderma Unit, Click here

2019 New Challenges, Click here
 
Becoming a Patient Research Ambassador for the NIHR, Click here    

 
NIHR Video: 'My Experience of Clinical Trials', Click here  

If we only had more RESEARCH investment for Scleroderma, Raynaud's, Autoimmune Rare Disease, Click here   

The Importance of Medical Research and Awareness to the Scleroderma, Raynaud's, Autoimmune Rare Disease patient, Click here  

2018 Scleroderma Awareness Raising and Medical Research, Click here      



SCLERODERMA:  

Order your awareness t-shirt here    



June 2019


Huge Thanks to Ellen, Dianne and the Royal Free Charity team

Importance of an early diagnosis, Click here     

Unmet clinical needs, Click here
    
Taking Part in Clinical Research Trials, Click here     

The Importance of a Multi Disciplinary Medical ‘Dream Team’, Click here    

Expert Specialist Centres, Click here      
  
My Skin is Cured from Scleroderma, Click here     

UK Guidelines for Managing and Treating Scleroderma, Click here        

Fatigue, Click here         

Mobility, Click here      

Diet and nutrition, Click here     

Raynaud's- How to Diagnose, Click here      



Sept 2017

Prof Chris Denton and I, Sept 2017
This year, 2019, I am celebrating 21 years of being a patient at the Scleroderma Unit, The Royal Free Hospital - a world leading expert specialist, research centre.   
 

Read more, here.  
 
I am eternally grateful to the global scleroderma trail blazers Dame Prof Black and Prof Chris Denton, whose commitment and dedication to unlocking the scleroderma enigma, is nothing other than, superhuman. Along with the Raynaud's world trail blazer, Dr Kevin Howell.  

I am truly humbled and inspired by their work ethic and commitment to their patients.  

I am wholly appreciative for Prof Denton’s continued medical expertise and support, especially during my barrister qualifying years, 1997 - 2004. 
 
1st March 2004, I qualified as a self employed practising barrister. Further to having been told in 1997, by my diagnosing doctor, that I was looking at a 15month prognosis.  

Read more about me, here  



Chat Magazine 16.5.19
 

World Scleroderma Day 2018, Click here    
 
World Scleroderma Day 2017, 29th June, Click here    

World Scleroderma Day 2016, 29th June. Origins of the date, Click here   

World Scleroderma Day 2015, 29th June. 

James Carver, myself, Prof Chris Denton, at The European Parliament 2015.
I had the pleasure of being a presenter and part of the European co-hort who gave a presentation at the European Parliament, Brussels, in honour of World Scleroderma Day 2015.  

I am immensely grateful to James Carver MEP for organizing this event in memory of his late wife Carmen, who sadly passed from Scleroderma.  

To view the presentation, Click here 

Raynaud's
October: 
    

Raynaud's, Click here  

To view the UK treatment guidelines for Raynaud’s Phenomenon, Click here   

To view the EULAR treatment guidelines, Click here     

To view Thermograph Video, Click here     

To view Thermograph image, Click here   
   
My Raynaud’s reality, Click here    

The global Raynaud's trailblazer - Dr Howell and I, Sept 2017

To view Nailfold Capillaroscopy equipment (used to identify possible blood vessel damage), Click here   

To read My ‘Invisible Disability’ experience, Click here   


  



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