Hope with rheumatoid arthritis
Published: Apr 14, 2010 20:43 Updated: Apr 14, 2010 20:43
Rheumatoid arthritis (RA) is a “chronic, progressive and disabling autoimmune disease” and affects about one percent of Saudi Arabia’s adult population. Autoimmune refers to the fact that the body’s natural immune system (the system which resists diseases) overreacts and attacks its own cells.
RA is an incredibly painful condition and can cause severe disability. The level of disability varies from person to person and depends on how severe or aggressive the disease is. RA ultimately affects a person’s ability to carry out everyday tasks and therefore reduces the quality of life for every member of the family, not only the patient.
Take the case of Ibrahim Mohammed Al-Alawi, a 28-year-old Saudi RA patient. He first experienced problems with the mobility of one wrist. Over a period of time, the disease spread to the other wrist and, after nearly three years, to all his joints. He consulted numerous doctors and went to several hospitals, but the disease was incorrectly diagnosed. He received conventional painkillers, which provided some relief, but for a brief while.
“Having RA proved to be an obstacle in doing the simplest things at home like: brushing my teeth, using the toilet and using ordinary kitchen utensils. Getting dressed was also a daily problem. Without the support of my family, I would not have been able to function normally at all. Working also became a difficult task as I had to take so much time off to consult one doctor after another,” says Al-Alawi. “Eventually, I found a doctor who did identify my disease as rheumatoid arthritis. However, it was only when I started my treatment at King Faisal Specialist Hospital & Research Center (KFSH&RC) that I saw significant improvement. I urge all patients with symptoms of joint immobility to seek an early and correct diagnosis.”
As experienced by Al-Alawi, RA severely hampers living a full life. However, with the correct diagnosis and treatment, it should not prevent patients from living a normal life. A number of effective treatments are currently in use in the Kingdom, although there is no known actual cure available locally or internationally. The mission is remission of the disease, and effective treatment allows patients to live a virtually normal life, without painful flare-ups.
One form of treatment is joint surgery, and it ranges from the less invasive arthroscopy procedure to partial and complete replacement of the joint. Arthroscopy is a surgical technique whereby an orthopedic surgeon inserts a tube-like instrument into the joint to see and repair abnormal tissues. Total joint replacement is a surgical procedure in which a destroyed joint is replaced with artificial materials. For example, the small joints of the hand can be replaced with plastic material and large joints (such as hips or knees) can be replaced with metals.
The second form of therapy, and the most common, is effective drug therapy. To date, the goal of treatment is to reduce joint inflammation and pain, maximize joint function and prevent joint destruction and deformity.
“Early diagnosis and effective drug therapy is the most important factor in promoting significant and sustainable remission,” says Dr.Mark Genovese, professor of medicine and co-chief of the division of Immunology and Rheumatology at Stanford University Medical Center. “Optimal treatment for the disease involves a combination of medications, rest, joint-strengthening exercises, joint protection and patient and family education,” he said at a meeting hosted by Roche Pharmaceuticals in Jeddah.
“For many RA patients, treatment with existing therapies does not resolve the painful and debilitating symptoms of the disease. However, the data from the clinical development program clearly establishes a new drug as a new option for RA patients who experience continued disease symptoms, despite treatment with existing therapies,” he added.
There is no special diet for RA patients. About 100 years ago, it was said that “night-shade” foods, such as tomatoes, would aggravate RA; however, this is no longer accepted as true. Fish oil may have anti-inflammatory beneficial effects; but, so far this has only been shown in lab experiments. Drug therapies aside, Dr. Hussein Halaby, head of the Rheumatology Department at KFSH&RC, emphasizes that the RA patients themselves could make a positive contribution in their daily lives.
The right kind of regular exercise is important in maintaining joint mobility and strengthening the muscles around the joints. Swimming is particularly helpful because it allows exercise with minimal stress on the joints. Physical and occupational therapists are trained to provide specific exercise instructions and can offer splinting supports. For example, wrist and finger splints can be helpful in reducing inflammation and maintaining joint alignment.
