Category: doctor patient relationship

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arthritis doctor patient relationship extra-intestinal manifestations extraintestinal

Extraintestinal manifestations in Crohn’s disease

I’ve been reminded recently — for several reasons and by many folks — of the unfamiliarity of extraintestinal manifestations (EIM or EIMs) in Crohn’s disease. Since I’m becoming a patient-expert on EIMs (through personal experience), I thought I’d share a bit more about what I know now.

whacamole_cat
Whac-a-mole cat (via Reddit)

EIMs occur in at least 25% of all patients dealing with Crohn’s and have been the primary focus of my care for going on 5 years now. My intestinal issues (knock on wood) have been mostly in remission. My EIMs though have been what my brother and husband call a game of whac-a-mole — just as one issue subsides (my knees), a new one seems to pop-up (my neck).

What’s been most helpful throughout the progression of this particular part of my disease course? Communication between my rheumatologist, my gastroenterologist, my dermatologist, my trainer, my perinatologist (when appropriate), my acupuncturist, and of course, me! Particularly with my knee-related inflammatory arthritis, I’ve found that low-impact exercise (biking, swimming, surfing, elliptical, and TRX), high-rep with low-weight exercises, and stretching are key for me.

Some more great resources on Crohn’s related EIMs here:

+ Extraintestinal Manifestations of Inflammatory Bowel Disease via the NIH
+ Extraintestinal Manifestations of Inflammatory Bowel Disease: Focus on the Musculoskeletal, Dermatologic, and Ocular Manifestations via Medscape
+ Arthritis complications via the CCFA

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advocacy doctor patient relationship empathy health loss patient care patients

Empathy and the human connection

My fearless leader Tim Brown shared this short film (above) via his LinkedIn and Design Thinking blogs last week and I couldn’t help but share as well. The Cleveland Clinic created the film as a way to share how top of mind empathy and patient care are as a part of their overall approach to healthcare. I walk around my life in constant wonder of what other folks are going through — it’s the reason I won’t even honk my horn unless someone is in great danger — and I thought this was an incredible way of illustrating that.

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diabetes doctor patient relationship health patient care patients

Matters of empathy

While I don’t know much about diabetes, I believe that any chronic illness and the care required of it demands empathy from all involved — most importantly the primary physician. In September, the Association of American Medical Colleges (AAMC) posted a study out of Parma, Italy which looked at nearly 21,000 diabetes patients. 242 doctors in the study were tested for empathy via a questionnaire.

Here is the really amazing part: the rate of complications for patients with highly empathic doctors was nearly 2/3 of those with less empathic doctors. “Although empathic engagement is important in patient care regardless of physicians’ specialty, it is more critical in the primary care setting, which requires long-term physician–patient encounters and continuity of care.” —Academic Medicine, September 2012

There is something nice about knowing that bedside manner matters as much as I’d always assumed. The New York Times Nicholas Bakalar did a great short piece on the study here too.

(Thanks Julie for pointing me to this study!)

Photo by Christiana Care / Creative Commons