(LML) SW monofilaments and ball point pen

Leprosy Mailing List – 12,  2013 

Ref.:   (LML) SW monofilaments and ball point pen

From:  Robert Jerskey, Carlsbad, California, USA

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Dear Pieter Schreuder,

 

 

I am responding to the recent dialogue re: the filaments, including the invitation from Salvatore to contribute to the discussion. I am requesting that you include my correspondence here.

 

Over 20 years ago I had the privilege of meeting with Dr. Sydney Weinstein, co-inventor of The SW (Semmes-Weinstein) monofilaments [he adapted them from von Frey horse hairs] well over 20 years ago, at our National Hansen's Disease Program Headquarters in Louisiana during a weekend seminar.   And, I had the privilege of working under the mentorship of Judy Bell-Krotoski in the 1990s who has published a number of studies and findings with the use of the SW Filaments.   

 

I invite the interested reader to peruse the PUBMED website for a listing of several of the abstracts of articles she authored/co-authored that elucidate the SW filaments application, repeatability of testing, threshold detection, and more:

 

http://www.ncbi.nlm.nih.gov/pubmed/?term=Bell-krotoski

 

Along the lines of other tools for sensory testing, including Dr. Warren's reference to the ubiquitous ball point pen, and which Jean Watson has enthusiastically advocated and published of their utility through her experiences in field conditions worldwide,  I am confident there are readers of this forum who can share of their own investigations/research, e.g., comparative studies of the pen vis a vis SW filaments, and much more. There are certainly some pros and cons for each, e..g., field conditions, time element, etc.  Ultimately, over the years, visiting diverse urban and rural settings I have come to the conclusion that the solution is not a universal exclusive "either/or", but an inclusive "both/and" whereby the filaments, pens [and other tools such as for 2 point discrimination] would be selected according to the circumstances and sustainable resources available. 

 

During the course of several visits to India in the early/mid 1990s to assist in an ALM funded international, multi-centre study with Judy as chief investigator, I had the privilege of meeting with enthusiastic medical officers, therapists, paramedical workers, and others at a range of both participating and non-participating facilities throughout India, including Hyderabad.  I disseminated batches of SW monofilaments along with recommended protocol, e.g., mechanics of application of them to the hand or foot.

 

That said, locally, there should be ample filaments for the IADVL workshop attendees.   The caveat is that they are not assembled or in kits.  Outside of India: as Linda Lehman mentioned earlier, filament kits are available through SORRIbauru, but  they would be very costly to most.  There are also vendors in the USA with assembled filament kits, but the cost is even much more so.    The economical solution: the filaments will need to be assembled locally.   [I have been impressed with the ingenuity of how they have been assembled over the years--in non factory settings!---, whether in urban India or a provincial city in Mexico, etc; whether via modified ball point pens, modified syringes, or bicycle spokes, as some examples]  

 

I am plan on attending the Congress next month. I intend to take along a sizable batch of loose filaments; 2.83, 3.61, 4.31, 4.56, 5.07, and 6.65 indexed filaments.  I will be happy to disseminate all that I can.  No charge.   Interested readers are welcome to contact me.

 

Thank you for the opportunity to correspond and warm regards,

 

Robert Jerskey, LOTR

P.O.D. consultant, Regional Hansen's Disease Clinics in Los Angeles and San Diego

email: robjerskey@yahoo.com

 

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LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << editorlml@gmail.com