A frustrating and never-ending cycle of infections is often where the journey begins. For example, sinusitis can turn into pneumonia, bronchitis can require round after round of antibiotics, and you may always feel sick. This pattern finally leads to a diagnosis of Common Variable Immune Deficiency (CVID). This answers a question that has been bothering them for a long time, but it also starts a journey that will last a lifetime. If you have a primary immunodeficiency, you need a very specialized team and, most importantly, a "home base" that is always on the lookout, ready to help, and caring for your daily needs. Direct Primary Care (DPC) is the only type of care that can fill this important role.
CVID is the most common serious primary immunodeficiency in adults, affecting about 1 in 25,000 people. This is a disease in which the body's immune system doesn't make enough antibodies (or immunoglobulins), which are proteins that fight infections.
The main signs of CVID are: Infections are not the only thing that defines the condition. The "variable" in its name means that it can cause a lot of different problems:
Recurrent infections are the most common sign. Patients experience recurrent and frequently severe infections of the sinuses and lungs, including sinusitis, bronchitis, and pneumonia.
Complications that are not infectious: CVID is a complicated disease that affects the whole body. Patients are also very likely to get autoimmunity (when the immune system attacks the body's own tissues), chronic lung disease, digestive problems (enteropathy), and granulomatous disease (groups of inflammatory cells).
Higher Risk of Cancer: People with CVID have a much higher lifetime risk of getting some types of cancer, especially lymphoma and stomach cancer. This means that regular health checks are an important part of management.
The Most Important Part of Treatment: The main treatment for CVID is lifelong immunoglobulin (Ig) replacement therapy. This treatment gives the body the antibodies it needs to fight off infections. It can be given through an IV in an infusion center or under the skin at home.
Direct Primary Care (DPC) is a membership-based model that lets patients see their doctor whenever they want. Your immunologist is in charge of your Ig therapy, but your DPC doctor is your main point of contact, care coordinator, and health advocate.
This is why DPC is the best way to treat CVID:
Quick response to infections: your first line of defense: This job could save someone's life. When someone with CVID gets sick, even a small infection can get worse very quickly.
Access Right Away: You can call, text, or see your doctor the same day with DPC.
Quick Care: This lets you quickly check out a new cough or fever and start taking antibiotics right away. This can keep a simple infection from becoming life-threatening and keep you out of the hospital.
Playing quarterback of your Team of Multidisciplinary Care: A group of experts is needed to help people with CVID live well. Your DPC doctor is the leader of your team.
They make sure that you, your immunologist, pulmonologist, gastroenterologist, and oncologist all talk to each other clearly so that your care is coordinated and nothing gets missed.
A Central Hub: They help you make sense of the complicated healthcare system and are the only provider who knows everything about your health.
Watchful, proactive monitoring and care to prevent problems: DPC is set up perfectly for the lifelong monitoring that CVID needs.
Coordinating Cancer Screenings: They make sure you keep up with all of your recommended cancer screenings, such as endoscopies for stomach cancer, and they are always on the lookout for early signs of lymphoma.
Important Vaccinations: They keep track of your vaccination schedule and make sure you get all the right inactivated (non-live) vaccines to give you extra protection.
Listening for new symptoms and ordering the right lab work to keep an eye out for complications.
Jessica, 48, has CVID and wakes up with a fever and a cough that makes her feel better. She sends a text to her DPC doctor, who sets up a telehealth appointment right away. The doctor thinks she might have pneumonia early on, so he quickly calls in a prescription for a strong antibiotic to her pharmacy. This quick action helps Jessica get better at home and keeps her from having to go to the ER and stay in the hospital.
David, 60, has CVID and goes to his DPC doctor for his full annual physical. His doctor spends an hour going over his whole medical history, setting up his next appointments with both his immunologist and gastroenterologist, giving him his yearly flu shot, and having a long talk about how he feels and how hard it is to live with a chronic illness.
Q: Does my DPC doctor give me prescriptions for and keep track of my immunoglobulin (Ig) therapy? A: No. Your clinical immunologist will prescribe and manage immunoglobulin replacement therapy, which is a very specialized treatment. Your immunologist and your DPC doctor work closely together. Your DPC doctor is in charge of your overall health, treating your acute illnesses, and coordinating your care.
Q: I get my Ig infusions on a regular basis. Why do I keep getting sick? A: Ig therapy is great at lowering the number and severity of serious bacterial infections, but it doesn't make the immune system completely normal. People with CVID can still get viral illnesses and are still more likely to get bacterial infections than most people. This is why it's so important to be able to see your DPC doctor right away when you start to feel sick.
Q: What is the most important thing my DPC doctor does for my CVID care? A: There are many, but two of the most important are: 1) Being the first person you call if you have a sudden illness so you can start treatment right away. 2) Being your long-term care coordinator and health advocate, making sure you never miss your important cancer screenings and follow-up appointments with specialists.
DPC gives patients with this complicated immunodeficiency a clear edge by:
Giving a critical first line of defense: DPC's quick access makes it possible to treat infections right away, which can save the life of a patient with a weak immune system.
The DPC model is perfect for managing the big, multidisciplinary team and the proactive monitoring needed to live well with CVID.
Providing real holistic and long-term care: Helping you not only with your infections, but also with your cancer risk, your autoimmune problems, and the huge mental and social burden of having a serious chronic illness.
If you have a primary immunodeficiency like CVID, you need a healthcare partner who is always on the lookout, always available, and who sees you as a whole person. Direct Primary Care is the medical home you need to help you deal with the complexities of your condition and live your life with more security and confidence.
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