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QUESTION....Provide two examples of how different biological systems interact to produce disease
Topic 3: The Biological and Psychological Person
Books - Chapter 3 - Page 75
Study case one
Cheryl leg and head
Cheryl grew up in rural Idaho in a large extended fam-ily and enlisted as a private in the army just after shefinished her 3rd year in high school. After basic train-ing, she was first deployed to Iraq and subsequently to Afghanistan for active combat duty. Traveling en route to Ghorak base in southern Afghanistan, Cheryl’s Humveecontacted an explosive device, throwing Cheryl from the vehicle and causing massive injuries to both legs. Shesustained a blow to the head as well and lost conscious-ness for 30 minutes. As a result of serious injuries,Cheryl was taken to the intensive care unit of the closest military hospital by medevac. After she underwent sur-gery, Cheryl was informed by her physician and social worker that in order to save her life, both of her legs had to be amputated below the knee. To the delight of her medical team, Cheryl’s reaction to this news was not extreme.
Over the 10-month course of her rehabilitation,Cheryl was fitted with different types of prostheses,none of which restored her ability to run and engage in sports. She also experienced “phantom pain” in her right leg, a condition in which pain is experienced in a body part that is no longer present. Following her hon-orable discharge from the army, Cheryl traveled to a university medical center several states away where she was accepted into an experimental prosthetics program. She was fitted with two below-the-knee robotic prosthetics that are controlled by sensors. Althoughshe did well in her mobility training, Cheryl had a hard time with simple mathematical calculations, and her friends and family remarked that Cheryl’s affect seemed vacant compared to how she was prior to her accident.Cheryl was referred to a social worker for counseling for suspected depression. The social worker, who had extensive experience with clients who had head injuries,referred Cheryl for neurological and neuropsychological testing. Cheryl’s MRI scan detected injury to the frontal cortex, the region of the brain that controls affect.
Study case two
A diabetes diagnosis for Jenne
Jenna, a 12-year-old Franco American girl who lives in rural Maine, was doing well in school, riding in pony club in the summer, and alpine ski racing in the winter. Theyoungest of three children, Jenna also worked on her parents' blueberry farm raking berries to earn spend-ing money. Like many girls her age, Jenna had a sweet tooth, but her parents watched her nutrition, making sure that she was adequately nourished. Drinking suf-ficient fluids each day was easy for Jenna because it seemed that she was always thirsty for water. But whenJenna started losing weight and engaging in more after-noon napping, Jenna’s parents were concerned that she could be exhibiting an eating disorder. They made an appointment with their family health provider.On the morning of her appointment, Jenna did not come down from her bedroom. Because it was very unusual for her not to join her family at the breakfast table, her parents became alarmed and immediately went upstairs to find Jenna sitting on her bed, still in her nightgown, which was drenched with perspiration.Jenna was confused and unable to answer simple ques-tions with correct responses. Jenna’s parents immedi-ately took her to the local community hospital.In the emergency department (ED), after some blood work, a doctor diagnosed Jenna with type 1 diabetes. The ED social worker referred Jenna to thehospital social worker who is helping her with her new insulin pump, a small computerized device that is programmed to deliver insulin to the fatty tissue under the skin. Jenna hates to draw blood daily so the social worker has put her on the waiting list to test out a new cell phone app, Epic Health, which she can use to mea-sure blood glucose levels by placing her finger over the camera device
Study case three
Melissa’s HIV diagnosis
Melissa’s “perfect life” has just fallen apart. As a young urban professional who grew up in a middle-class suburb in New York, Melissa had always dreamed of a big wedding at her parents’ country club, and her dreams were about to come true. All the plans had been made,invitations sent out, bridesmaids’ dresses bought and measured, and her wedding dress selected. All that remained was finalizing the menu and approving theflower arrangements. Because Melissa and her fiancé,Ashish, planned to have children soon after their mar-riage, she went to her physician for a physical exam 2 months prior to the wedding. Following common prac-tice, the doctor asked Melissa for permission to conduct an HIV test.One week following the physical, the doctor’s officecalled and asked Melissa to return for repeat blood work and a follow-up visit. At the appointment, Melissalearned that she was positive for HIV. Melissa’s physi-cian started her on daily medication to prevent the dis-ease from exacerbating and advised her not to engage in unprotected intercourse.Melissa had no history of illicit drug use and was rel-atively conservative in her intimate relationships, having only one partner besides her fiancé. She recalled that this man did not share much about his history.After couples counseling, Melissa and Ashish decided to proceed with their marriage and their desire to have children. The social worker referred them to an HIVpregnancy clinic to explore their options. At that time,they learned that there are ways to fulfill their desire to have children and minimize the risks of transmitting HIV to Ashish and babies.
HIV Thomas hero
Thomas is a 6-year-old boy who lives with his parents.When he turned 3, he was diagnosed with leukemia.New research and experimental treatments are indi-cating that one’s own immune system can be used tofight and cure certain cancers, leukemia being one of them. The HIV virus has been manipulated as a hunter,one that can ferret out, activate one’s own immunity,and eliminate cancer cells, particularly in the blood. As Thomas continued to fail, showing no positive responses to conventional treatments, after consultation with his pediatric social worker his parents decided to enroll him in an experimental program in which HIV was a primary treatment agent. Thomas underwent the preparation ofT-cell protection and then was treated with the modi-fied HIV virus (chimeric antigen receptor T-cell therapy).Now, at age 6, there is no evidence of cancer in his body,
Louis and stewart huntington’s, obesity and cardiovascular disease
Louise is an 81-year-old Jewish woman who lives on the west coast of Florida in her own apartment. At the age of 49, Louise was diagnosed with Huntington’s disease,a genetically transmitted neurodegenerative condition affecting all aspects of function, including musculoskel-etal integrity, cognition, self-care, speech, and mood.Until the age of 70, Louise was able to walk with the assistance of a rollator (a wheeled walker), to engage in social interactions, and to do light chores in the house.As her disease progressed she became increasingly limited in mobility, fine motor skills, speech, and swal-lowing. Her husband, Stewart, who was grossly obese and thus unable to provide full care for Louise, found an agency that brought Haitian families into the UnitedStates to provide care for elders. Anne, the 39-year-old caregiver, came to work at Louise’s home each day sometimes bringing her 10-year-old daughter with her. When Louise’s husband died suddenly of a mas-sive heart attack, Anne and her daughter moved into the guest bedrooms of Louise’s home. Anne’s daughter has graduated from undergraduate school and plans to go on for her MSW. Anne remains with Louise at home despite Louise’s son’s attempt to put his mother in a nursing home. Louise’s daughter, now in her early 60s,has Huntington’s but benefits from the new drugs to reduce symptoms and from her exercise regimen that has been empirically shown to reduce the rate of neurodegeneration.
Juan and belinda sex life in retirement
Juan and Belinda, now both 67 years old, grew up in the same neighborhood of a southwestern city in the UnitedStates and knew one another because they attended the same church, St. Joseph’s Catholic Church. Over the years, they each went their way in life. Each had a family and children, and both have been widowed for several years. Until they met at the senior center two years ago,they had not seen one another since adolescence. Juanlives in an apartment and Belinda resides in a retire-ment village. Over the past few months, Belinda has become concerned about her heart health because she has experienced palpitations in the late evening. At her health provider’s office, she found that her blood pres-sure was elevated but not considered hypertensive yet.Juan, a distance runner, trains by running and joggingdaily.Both Juan’s and Belinda’s parents immigrated to the United States from Mexico, seeking to improve the opportunities for their families. Because of their common background and religion, Juan and Belinda have found companionship, now turning to love. After spending sev-eral months becoming reacquainted, Juan asked Belindato to spend the night at his apartment. Belinda thought her sex life was over but is excited by the potential for inti-macy once again. However, she is not sure how to be withJuan, is concerned that he will not find her attractive,questions how to dress for the evening, and is nervous about how to engage in satisfying sex at her age.
An Integrative Approach forUnderstanding the Intersection ofInterior Biological Health and Illness and ExteriorEnvironmental Factor
An Integrative Approach forUnderstanding the Intersection ofInterior Biological Health and Illness and ExteriorEnvironmental FactorsThinking about Cheryl, Jenna, Melissa, Thomas, Louise and Stewart, and Juan and Belinda highlights the important roles of biology in the social worker’s intel-lectual toolbox. Yet biology can no longer be consideredfrom a dualist perspective that separates the body from the world in which it functions. Biology is inextrica-bly intertwined with experience, behavior, objects, and environmental influences. As neurobiologist RobertSapolsky (2017) suggests, “It actually makes no sense to distinguish between aspects of a behavior that are 'biological’ and those that would be described as, say,‘psychological’ or ‘cultural.’ Utterly intertwined” (p. 5).Consistent with contemporary theory, social workers can best understand and apply biological knowledge to practice within an expansive proximal (most interior)to distal (furthest) environment continuum, with envi-ronment defined as the entire set of conditions under which one operates (DePoy & Gilson, 2012).Examination of the interior (proximal) environment involves the description and explanation of embod-ied conditions such as internal organ systems, genet-ics, interior psychological structures and processes, and so forth, perhaps with some inorganic objects such as pacemakers and other implanted activators embedded within the interior environment. Consider, for exam-ple, a knee replacement. Although it is not organic decomposition, the new knee is located in the organic property fenced inside the skin, restoring movement and mobility to the receiver. But the new body part is not organic, so do we classify it as a body part or con-sider the new knee as an interloper? And what condi-tions might influence the extent to which the knees even stays in one’s thoughts and awareness?
Book reference
Hutchison, E. D. (2019). CUSTOM: Grand Canyon university swk 515 human behavior in the social environment i: Conception through middle childhood custom electronic edition. SAGE Publications.