Another British weather record. "The sixth hottest July since records began in 1659"! Wonderful. A month of unbroken sunshine.
London is packed with tourists. The river cruise boats which ply up and down the Thames outside my window at London Bridge are doing a roaring trade. The sun really brings the best out of this glorious city.
Early in July, we had a weeks holiday in Kent - in St Margaret's Bay, the small coastal village where I used to do a GP locum each summer ('Tales of a Flying Doctor'. Hughes GRV. Hayward Medical Press).
This month saw two new booklets on Hughes syndrome. Three years' worth of my monthly 'Patient of the Month' blogs have been put together as a book, thanks to the generosity of INOVA, a biotech company in America. They plan to give all doctors attending Hughes syndrome and lupus conferences free copies. They are also providing our charity with a number to sell. Kate has the 'blog books' which are on sale for £5 on the charity website: hughes-syndrome.org/get-inv...
By coincidence, another small book has just come out - "Hughes syndrome - highways and byways", produced by Professor Khamashta and myself, and published by Springer (ISBN 978-1-4471-5160-9). This pocket-sized book is aimed at trainee doctors, health care workers and patients. It summarises in brief 1-2 paragraph form, eighty or so features associated with the syndrome - each section also including a guide to further reading.
Patient of the month
"I've got my life back."
Of course it can be tempting to give more space to successes rather than to failures, but this month's (and next month's) "cases of the month" are too important to miss.
Mrs R.B., 35, had recently got married. She had worked as a high-powered solicitor in an international finance company in the City of London.
For over twenty years she had been prone to migrainous headaches, but for the past 4-5 years, these had become more frequent. Over the same period, she had become fatigued, achy, prone to forgetfulness - and concerned about the future. She felt that her job was at stake and even contemplated putting off her wedding to her long-standing fiancé.
Needless to say, the two medical labels "depression" and "fibromyalgia" had been suggested. Fortunately her GP, and subsequently a consultant psychiatrist, had agreed that depression was not the diagnosis.
There were other symptoms - intermittent stomach pains for example. It was this latter symptom which led eventually to treatment success. She was seen by a gastro-enterologist, Professor David Silk - an outstanding physician, who suspected autoimmune disease and referred her to me.
On examination, she had two tell-tale findings - bone dry eyes on tear testing and mild livedo (blotchiness of the skin). The blood tests supported the two linked diagnoses of Hughes syndrome (migraines, memory loss and possibly the abdominal pains) and Sjogren's syndrome (dry eyes, dry mouth, fatigue, aches and pains).
She was started on the classical pair of treatments - aspirin (later changed to Plavix) and Plaquenil (a quinine derivative) for the Sjogren's.
Three months went by before I saw her again. "Thank you doctor. I've got my life back". The headaches, the aches and pains, the fatigue - gone! The silly memory problems - gone!
And, interestingly, the tummy pains - gone (something I see not infrequently in my Hughes syndrome patients).
One wonders how many patients with similar histories are out there, losing out on diagnosis - and on treatment.