Wendy
Wendy has granulomatosis with polyangiitis (GPA), an ANCA associated vasculitis affecting her lungs, eyes, nose, mouth, ears, nerve endings and joints. Her vasculitis is difficult to control, and she has given a lot of thought to living and dying well.
Vasculitis has changed Wendy’s life completely. It flits around her body, flares up and dampens down, and relapses (gets worse). A range of powerful drug treatments bring periods of relief in parts of her body but come with serious side effects. She has to take great care to avoid infections, and the instability of her vasculitis means that surgery which might be helpful feels too risky.
To cope, Wendy draws on all her experience as an occupational therapist. She organises her time in a regimented way, breaking down activities into a series of tasks, limiting the number of activities in a day, and building in rest periods. She has a large support network to draw on and conserves her energy further by identifying what could be done by someone else. Wendy feels it is important to give back to her community, which she does through painting, crocheting, and growing seedlings.
Although Wendy looks well, she finds the ongoing activity of vasculitis and hospital visits traumatising. She has experienced suicidal thoughts and benefited from super counselling. Wendy says she didn’t realise how mentally unwell she was, both as a reaction to prednisolone (steroids) and to losing her existing life, work and idea of the future. Drama therapy has helped her use her imagination to understand her reactions and think through situations creatively. She felt empowere to make a Living Will (through Compassion in Dying) and arrange to donate her body to medical research.
For Wendy, vasculitis began with a mix of weird and fluctuating problems with exhaustion, her nose and eyes, shoulder pain, pins and needles, a rash, being too cold, and coughing up blood. Early concerns were around cancer, but Wendy also asked for a referral to rheumatology, through which she got her diagnosis of Wegener’s vasculitis (now known as granulomatosis with polyangiitis (GPA)). She suggests that, if someone has this kind of mixed pictur of symptoms, a rheumatologist should be involved.
Wendy feels that the idea of self-management needs to be explained to patients, so they understand how important it is to tell healthcare professionals about the problems they are having. She says the self-management process would be eased by improvements in pharmacy services and changes to how services are structured and funded, as this is currently an absolute nightmare for people like me who need more than one service
In practical terms, Wendy is grateful for the support of specialist nurses, and appreciates the involvement of allied health professionals. This includes the physiotherapy assistant who helped her explore what was possible with pilates, and the dietician and speech and language therapist who helped with strategies to manage choking and swallowing. She feels that healthcare professionals could learn much from each other about engaging people in their care and making it feel personal rather than a conveyor belt.