Avril

This case study is an example of specialist knowledge and intervention by Nicola Hyslop, Cumbria.

Avril was diagnosed with Relapsing Remitting MS in 1998,  but her MS has now advanced to Secondary Progressive. She is 53 and lives with her husband, who helps to care for her.

• Avril now uses a wheelchair due to her reduced mobility and dexterity.
• Avril lives in a rural location, meaning there are fewer care agencies available to support her. This leaves her reliant on family to fill in any gaps.
• She has had allergic reactions to many medications meaning there are limited options to manage pain and spasticity. A trial of Sativex had been agreed, however no consultant was available to prescribe.
• Pressure sores have meant she has been bed bound, which has led to decreased mobility in her lower limbs.
   

• The AMSC conducted a full assessment of Avril's condition.
• They contacted Neural Physiotherapy and Occupational therapy for home assessment, plus a Rehab Consultant for botox therapy.
• She followed up the previous referral for Sativex.
• Facilitated multiple departmental meetings to support Avril.
• Established a good rapport with Avril and her carers, providing them with ongoing training and regular contact.

• Managed to secure a trial of Sativex on behalf of the patient.
• Prevention of unnecessary hospital admissions.
• Ensured more frequent reviews.
• Managed pain and pressure damage effectively to enable her to attend her daughter's wedding.