Rare diseases, also called ‘orphan diseases’ are diseases that affect only a small number of people in the population at any one time. In the US, a disease is classified as ‘rare’ if it affects fewer than 200,000 people in a given time period, and in Europe if it affects less than one in 2,000. There are approximately 6,800 such diseases according to the National Institutes of Health (NIH).
Because most rare diseases can cause changes requiring major lifestyle modification (depending on the severity and prognosis), there are several steps you can take to find a solution or to help you cope better with your new situation.
Make sure your diagnosis is correct
The first and most important step is to make sure that the diagnosis is correct. Make an appointment with a medical clinic or a specialist who has knowledge and experience in diagnosing and treating your condition. For assistance in finding such a specialist you can go to http://rarediseases.info.nih.gov and click on ‘How to find a Disease Specialist’. The Mayo Clinic, Cleveland Clinic and University of Washington Clinic are three good options. Take a list of your symptoms, previous medical records (MRI, X-Ray, lab results etc.) and any questions you may have. Tell the doctors your whole story and don’t be afraid to discuss all of your symptoms with them (even the embarrassing ones). Sometimes the smallest bit of seemingly ‘insignificant’ information can provide the biggest clue to the rare disease mystery.
Work towards acceptance
Once you’ve verified that the diagnosis is correct, it is important to take a little time for reflection to come to terms with your new reality. Once you’ve been diagnosed, the disease is no longer ‘rare’ for you and it is not unusual for the mind to run a gamut of emotions like denial, guilt, anger, depression etc. This is normal, and it is necessary to make peace with these feelings. Work towards accepting and maintaining control over your situation. If possible seek help from the people you trust and respect such as your pastor/rabbi /priest, family members, friends, or try to get psychological counseling from a competent health care provider such as a psychologist or psychiatrist.
Educate yourself about your condition
Learning everything you can about your condition is the next important step in your journey. This is one of the times when the Internet is your friend. Never before has there been so much information available in one place about rare diseases and diseases in general. At first it is better to look for information on reputable sites such as the Genetic and Rare Diseases Information Center (GARD) GARDinfo@nih.gov, www.webmed.com or www.nim.nih.gov/medlineplus.
These sites provide the most accurate and recent scientifically proven data. They also provide a wealth of other kinds of information, and useful links to assist you in your search. GARD provides information both in English and Spanish. Other sites, such as Alternative medicine sites and patient chat rooms, are also good sources of information but you need to be wary since some of them contain inaccuracies that could contribute to unnecessary fear or cause harm.
List everything that pertains to your case and try to understand as much as you can, especially about the different treatment options, cost of treatment, and availability of insurance, prognosis and alternative course(s) of action. Once you have armed yourself with these, you will feel more empowered to develop a plan.
Some suggestions for the areas you need to focus on are:
- What is already known about the disease?
- What has been written about the disease in medical journals
- What Research studies are ongoing
- What advocacy groups you can contact
- Do the doctors or healthcare team treating you communicate with each other
- The next step in your plan
The National Organization For Rare Disorders (NORD) is an excellent organization that acts as an umbrella organization for rare diseases. NORD was founded on May 4, 1983 and provides help and support for all Americans affected. In 1987 NORD established a patient assistance program aimed at helping patients to get medications that they cannot afford. In 2000 the NIH created the website Clinical trials.org which provides an overview of drugs currently in clinical trials. These are important resources for people who are faced with the task of finding drugs that are difficult to obtain, or drugs that are too expensive.
Since rare diseases affect only a small number of people, patients often feel lonely and isolated after diagnosis. Joining support groups is a great idea since it puts you in touch with people who are dealing with the same issues, and are confronting problems similar to yours. The more people share information, the more knowledge about the disorder increases.
In addition to the comfort of knowing that you are not alone, members of support groups can provide pertinent information such as best doctors, treatment options, insurance plans and what to expect. Members often describe their own experiences and have real empathy for the newly diagnosed. The ability to remain anonymous is a plus since it ensures that you can participate in frank discussions and maintain your privacy at the same time. NORD has created an ‘Online Patient Communities’ portal with a comprehensive list of rare diseases from which you can select groups with the most relevant information that applies to your disorder.
The Future of Rare Diseases
The good news is that more effort is being made to address the subject of rare diseases than ever before. Because of advances in molecular medicine, many of the rare diseases caused by genetic factors are being better understood.
Molecular research on cystic fibrosis, sickle cell anemia, Niemann-Pick disease type C and Fragile X syndrome are currently in progress.
Celebrities are taking up the cause, for example actor Michael J. Fox created a foundation that funds research to find a cure, and to develop new and improved therapeutic interventions for Parkinson’s Disease. Robin Roberts (TV news personality) aired a video of her battle with myelodysplastic syndrome. Her treatment (bone marrow transplant) and subsequent recovery from this disease is believed to have caused an increase in the number of bone marrow donations.
On February 28, 2008 a special day was established by a group called EURORDIS in Europe to bring attention to rare diseases and to improve treatment for patients by encouraging investment and research in this field. Today, Rare Disease Day is celebrated worldwide and the 8th Annual Rare Disease Day was celebrated on February 27th, 2015 at the National Institutes of Health.
This is a huge step in the right direction since this problem is now viewed as a serious one and is being addressed on a global level. Hopefully, this new emphasis on rare diseases, advances in technology and molecular biology, and physician and patient empowerment will make it easier to diagnose and treat these disorders that have caused so much suffering for so many people, for such a long time.
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