Day 229: The basement of Leeds General Infirmary

So how did I spend my Valentine's Day? Sat alone in the basement of Leeds General Infirmary with some patient case notes about kids with arthritis and a box of mini muffins for company, that's how. Could be worse though, at least I didn't get a Valentine's Day card from my dog like my friend Thom. 

I should probably explain what I was doing in the basement of Leeds General Infirmary... This is where the paediatric rheumatologists live. All 4th year medical students have to undertake a research project. Most people choose from a list of potential projects, but a few crazy people do what is known as a 'self design' - essentially you design your own project, find your own supervisor, and carry out the research by yourself. I am one of those crazy people. I am carrying out an audit of all children with any form of Juvenile Idiopathic Arthritis (JIA) under the care of the paediatric rheumatology team in Leeds, looking at the time interval between onset of symptoms and diagnosis of the disease. Studies have shown that if a person is diagnosed within 12 weeks of their first symptoms they are more likely to respond to treatment and go into remission, thereby limiting joint damage. I've wanted to look into this for a while now, not only to show that this rarely happens but also to look into reasons why it rarely happens. 

My supervisor warned me back in September that I would find this hard; I just didn't realize quite how hard it would be. Being told that there are around 300 patients with some form of arthritis being treated in Leeds is one thing; seeing the names of every single one of them written down in one folder is another. Unsurprisingly I've found that very few of these children were diagnosed within 12 weeks. In fact, some had had to suffer for up to seven years before their symptoms were finally recognized as JIA. This is unbelievably frustrating to read. It took six months for me to be diagnosed and to start treatment, and I wouldn't wish the pain and suffering that my family and I went through on my worst enemy. To know all these children are going through the same thing too is heartbreaking. 

Several times today I found myself drowning my RA sorrows in my box of mini muffins and wondering why the hell I had voluntarily put myself in this position. But every time I quickly reminded myself that this research could potentially help others in my position avoid the same fate as me and so many other young sufferers of the disease. 

With enough awareness one day we WILL live in a world where there is no late detection of inflammatory arthritis.