Haemochromatosis Self Management Plan _721_ by lanyuehua


									                     HAEMOCHROMATOSIS MANAGEMENT PLAN – 721                                             REVIEW – 725

                                  [LOC_NAME] Phone: [LOC_DAY_PHONE] fax: [LOC_FAX_PHONE]

Patient Details                 GP Details:             Patient agreement for the GP Management Plan proceed
[PAT_FIRSTNAME] [PAT_SURNAME]   [GP_GIVENNAME]          My GP has explained the steps & costs of the GP Management Plan & I agree to proceed.
[PAT_HOME_STREET],              [GP_SURNAME]
[PAT_HOME_SUBURB],                                      Yes
                                                        Where I am referred to other service providers as listed on this GP Management Plan, I
                                                        consent to my GP sharing relevant information about myself to that provider. I have advised
DOB: [PAT_DOB]                                          my GP of any information I wish to be withheld.                               Yes
                                                        I understand that [LOC_NAME] has one health record for patients and that this record is
                                                        shared by all [LOC_NAME] health team providers.                              Yes

What is haemochromatosis?

Haemochromatosis is one of the most common hereditary diseases. Around 1 in 300 people have a genetic predisposition to this
disease - that is they may get it.
Haemochromatosis is characterised by the excessive absorption of iron. Normally, excess iron is safely stored in various joints and
organs in the body, particularly the liver. In a person with haemochromatosis, iron stores keep rising and, over time, the liver enlarges
and becomes damaged, leading to serious diseases such as cirrhosis. Other problems that can be caused by excessive iron include heart
disease, diabetes and arthritis. Both sexes are at risk, but women tend to develop the condition later in life, since regular menstrual
periods deplete the body of iron. Haemochromatosis tends to be under-diagnosed, partly because its symptoms are similar to those
caused by a range of other illnesses.
A person diagnosed with the condition should notify all blood relatives so they can be tested for the HFE genes and treated if

What are the symptoms?
Early haemochromatosis has no symptoms. However, in its later stages, haemochromatosis presents a variety of symptoms, and not all
people will experience the same signs. Many symptoms are similar to those caused by other illnesses, which partly explains why
haemochromatosis may be overlooked as a possible diagnosis. Some of the symptoms include:
  No symptom                                                             Sexual dysfunctions, such as impotence and low sex drive
  Weakness and lethargy                                                  Disorders of the menstrual period, such as early menopause
  Weight loss                                                            Loss of body hair
  Joint pain, usually in the joints of the second and middle fingers     Skin darkening
  Liver complaints, such as fibrosis or cirrhosis                        Cognitive difficulties, such as poor memory
  Arthritis or Arthralgia (non-inflammatory arthritis)                   Diabetes mellitus, usually seen in advanced stages of the
  Upper abdominal discomfort                                           condition.
  Testicular atrophy                                                     Cardiomyopathy and arrhythmias
                                                                         Hepatocellular carcinoma in 30% of patients with cirrhosis

             What are my choices, options and goals?                     I will do the following tasks in this management plan:
  Iron Studies                                                         I will have all my iron test done as requested by my GP
   Maintain Transferrin saturation below 45%                           I will see my GP as requested in this visit.
   Maintain Serum ferritin levels below 100mg/L
    Venesection                                                        I will keep all my venesection (phlebotomy) appointments.
This is a procedure similar to blood donation, where around 500mls     I will be well hydrated before and after treatment.
of blood is removed until iron in the blood is reduced to normal       I will not perform rigorous physical activity 24hrs after
levels. Depending on the severity of the condition, this may take      phlebotomy
around one and a half years of twice-weekly visits. Once iron levels
are normal, venesection needs to be performed three or four times
every year for life.                                                   I will reduce the intake of red meat and iron rich foods
  Reducing or limiting iron-rich foods such as red meat                I will not take iron supplements
  Not taking iron supplements                                          I will not take vitamin C supplements
   Not taking vitamin C supplements, as vitamin C increases iron
                                                                       I will reduce my alcohol intake
   Reducing alcohol intake, as metabolising alcohol can stress an
already compromised liver.
Capacity to self manage
   I have explored readiness for change and barriers for self management
   I have checked that the patient has enough knowledge, confidence and family support to manage the condition

Contacts and further Information
• Your local genetic service, which you can contact through your nearest community health centre, public hospital or
health department.
• Australasian Genetic Alliance at http://www.australasiangeneticalliance.org.au
• Haemochromatosis Society Australia at http://www.haemochromatosis.org.au
• Better Health Channel at http://www.betterhealth.vic.gov.au
• MyDr at http://www.mydr.com.au
• The Centre for Genetics Education at http://www.genetics.edu.au
• HealthInsite at http://www.healthinsite.com
• MedicineNet at http://www.medicinenet.com
• For other related fact sheets, you can contact the Gene Technology Information Service on free call Australia-wide 1800
631 276 or email
gtis-australia@unimelb.edu.au or visit Biotechnology Australia's website at http://www.biotechnology.gov.au

A copy of this plan has been given to the patient.            Yes          This section is only to be completed at Review appointment
Charge item 721                                                            Review Date
Enter recall for review 6 months
Enter recall for new plan 2 years                                          Enter recall for review 6 months

DATE COMPLETED:              [MIS_TODAYL]                                  Claim item 725

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