Hi Tracy,

Yep, cocktail of drugs is a reality for peeps with RA. Those diagnosed many years ago have often had a raft of surgery. The main advances in drug treatment were about 10 years ago and now with the right combo can effectively put the disease process into remission so many people with RA will not have the typical visual deformities.

Does she have an occupational therapist in her local team (provision and availability really varies across the country) that she knows or if not has she ever seen one? If not, I would suggest that she requests a referral to an RA specialist OT via her local RA NHS team who may be able to do a workplace assessment (wouldn't cost the company much and would give tailored and probably more useful practical advice and reassurance (including 4P's advice and splints etc) than a FCA or OHP opinion.) If OT not able to come to the factory I suggest you supply to your employee to take to OT some photos of the lady working from different views - side, behind, above etc and some background info and questions, maybe have a chat on phone with OT before appointment. Could something like a perch stool assist (OT can advise), if using hand tools are they sprung on jigs etc so your staff are not taking the full weight of the tools....

The 6/10 pain score is a good tool to use. Have a think about what you will be advising her to do though if she admits to this?

Also, if the expert patient programme is running in your area this may be of benefit for her and in some places NRAS were piloting a RA specific one.

Where are you based?
Feel free to email off-list if you want to have a chat sometime.

Good luck,
Catherine

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Date: Wed, 18 Jan 2012 21:22:32 -0500
From: Tracy Turner <[log in to unmask]>
Subject: Re: Painful joints

Thank you for your advice. Catherine
Thank you for this information. The lady in question was diagnosed
'years ago' she states and is now in her 40's. Her attendance is 100%
and she is a very good worker. She has been advised she cannot have
anymore injections in her wrists and that surgery will be the next
option. She has been advised that it is best to delay surgery for the
shoulders as long as possible. She could have had days off for the
injections but chose to take annual leave - this is something I will
bring up with the Busienss. I was concerned that working in a
repetative although not heavy role may exacerbate symptoms and she
would therefore requrie surgery earlier in life. I have recommeded that
she does not work on cetain tasks for more than 30 minutes and to
report when she is feeling 5-6/10 pain and to refrain from the
particular activity she is undertaken. I was just concerned that
although she can work very well today and perhaps for the next few
years (on a cocktail of medication) that this type of work may have an
effect on what she will be able to do in the future and that she has 20
more working years ahead of her.

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