Over a decade ago, I had the pleasure of hearing Michael F. Holick, MD, PhD, discuss his cutting edge research on vitamin D. At the time, Dr. Holick was a largely unknown researcher focused on very much a niche area. Since that time, however, he has become a much more...
Is there a more confounding lab test in rheumatology than the antinuclear antibody (ANA) test? It can lead us straight to a diagnosis or set us off on a wild goose-chase. Sometimes, ANA test results tell the truth and sometimes they lie, but they almost always give us...
Biomarkers have been an important addition to the toolbox of rheumatology healthcare providers, which was illustrated in my interactions with G.H., a recent patient of mine with rheumatoid arthritis (RA). When I met with G.H. for the first time, she told me that her...
Twelve years ago, I met R.T., a 35-year-old female patient who had previously been diagnosed with rheumatoid arthritis. Her rheumatoid factor was positive at 49. Her sedimentation rate and C-reactive protein were also elevated. Her joints were visibly swollen and...
Several years ago, I was involved in an early trial of adalimumab in pediatric patients with juvenile inflammatory arthritis (JIA). One precocious 12-year-old girl enrolled in the trial, who I will call Lucy, was the only child of parents in their late 50s. The...
Learning the science of rheumatology is, for me, an ongoing project. The immune cascade is amazing and yet daunting to comprehend. The exciting part is that science has not only found DNA markers to help make a diagnosis, but each year, more medications to put RA into...
When I first started as a rheumatology nurse, I got my hands on anything I could to help me learn about things that would help me to better serve my patients. Books, journal articles, you name it and I devoured it. Some things were easier to learn than others, and the...
Picture this: A 43-year-old nurse practitioner (that’s me) on the floor of her 8-year- old daughter’s Disaster Area bedroom, drawing different colored blobs with pointy things sticking out of them and rectangular-shaped objects floating towards them. A few triangles...
In the winter of 1994, I was working as a young nurse in the respiratory ICU at a hospital in Lansing, MI. Upon my arrival one morning, I reviewed the records of the two patients I would be responsible for that day. One of them was Mary, a 54-year-old Mennonite woman...
In the clinical setting, the topic of quality improvement (QI) is often met with groans. One more thing to keep track of. One more thing to be “dinged” for if it isn’t done to some faceless agency’s standards. More paperwork. However, if you think about it, “quality”...