Coordination and organisation of systemic vasculitis care
This page is about: Coordinating systemic vasculitis care Thoughts about systemic vasculitis teams Bringing in systemic vasculitis specialists For ideas to support service improvements for...
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For ideas to support service improvements for people with systemic vasculitis, see our ‘catalyst film’.
Some of the people we spoke to were admitted to hospital when they were very ill with vasculitis. As part of their rehabilitation, they saw allied health professionals such as physiotherapists, occupational therapists, speech and language therapists and dietitians.
Allied health professionals also saw people who were living at home, although it appeared that referrals were not always suggested or easy to get. Due to nerve damage from vasculitis, Isabella saw an occupational therapist who gave her exercises such as stretches and using tins of soup as dumbbells. Some people had physiotherapy from specialists in heart or lung rehabilitation, and Wendy had a series of one-one pilates sessions with a physiotherapy assistant. Through speech and language therapy, Charlie tried an electronic device when he lost his voice, but it sounded “robotic” and was “incredibly challenging” to use.
Once people were recovering from vasculitis and felt more confident about exercising again, we often heard that they found personal trainers and fitness services useful. However, they sometimes needed referrals or support from healthcare professionals to do this.
With vasculitis, people sometimes described having suicidal thoughts, depression, or a more general need for support and understanding. Nicola asked to speak to a psychiatrist for support when she was first diagnosed, but we more usually heard that people looked for help further down the line. As Wendy said, “the problem with vasculitis is that you’re continually re-traumatised by it, it’s so unpredictable.”
We heard that waiting lists for support could be a problem but that help with mental health came from a range of sources. People accessed psychological services and counselling via the NHS, local authorities, employers or other organisations, and Mo had used online self-help resources. Both Wendy and Angharad felt it was important to have individual rather than group support, and to recognise that it would not be a quick fix.
People who found mental health support useful often talked about the value of talking to someone outside their family. Lynn, for example, said, “the thoughts and feelings that come into your head, you don’t want to burden people that you love with those, you don’t want them to truly understand the depths of your despair about what is happening.”
Not everyone we spoke to was offered support for their mental health and not everyone felt they would benefit. Nicky believes that “you’ve just got to get on with it yourself” and is happy that this has “got me through so far.”
People whose hearing was affected by vasculitis could be referred to NHS audiologists. This has worked well for Pete, but Mo now goes privately because “the technology is quite good.” Wendy is frustrated by the complicated referral process to get her hearing aids adjusted.
Eye care services were important for people whose vasculitis is a threat to their eyesight. Wendy gets scleritis (painful inflammation) so attends an eye clinic, although it can be difficult to know when her symptoms are scleritis or something less serious such as dry eye. Isabel and Graham have a type of vasculitis called giant cell arteritis (GCA), where specialist eye clinics and high street opticians can both be involved in care.
This page is about: Coordinating systemic vasculitis care Thoughts about systemic vasculitis teams Bringing in systemic vasculitis specialists For ideas to support service improvements for...
This page covers the key messages the people we spoke to had for other people who have - or might have – systemic vasculitis: Seek...