Tell Me Why anyone can get arthritis
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00:00So generally overall in the world population about one in five people will have some type of arthritis
00:06So that's like almost 20% will get arthritis at some point of their life
00:10So if you don't have an autoimmune is less common, so the osteoarthritis especially with our aging population
00:17We see more of the wear and tear type of arthritis
00:21So it's actually quite a high number of people and it leads to a lot of
00:25Disability a lot of lost days at work a lot of economic burden on society. So, you know people get disabled
00:32It's a lot of burden on society
00:47Welcome back. This is tell me why your gulf news original podcast
00:51We are a weekly podcast and as always and as promised
00:55we always bring you the topics that people send the seldom talk about or seldom address and today we're talking about
01:02arthritis bone health and
01:05We're talking about misdiagnoses. We're talking about
01:10Misconceptions about arthritis and we're talking about prevention methods with me in the studio is dr
01:15Humera Bacha who is a consultant rheumatologist
01:19Rheumatologist we were just speaking about that. I don't think a lot of people know what a rheumatologist is
01:24Not many people know what or who is a rheumatologist? Yes, so they're like, what's the rheumatologist?
01:30I'm like who is a rheumatologist? So we take care of bone and joint problems arthritis
01:35So we're not orthopedic doctors and many people when they have a bone and joint or an arthritis or joint issue
01:42Get to see an orthopedic surgeon who's a surgeon and basically they need to
01:47Operate on you or do a surgical intervention, but we as rheumatologists we take care of arthritis
01:52There are 50 types of arthritis, but you also take care of autoimmune diseases
01:56So our speciality is really autoimmune types of arthritis Wow 50 types 5-0 5-0, right? That's insane
02:04I never do that 5-0 Wow at least okay
02:07So to begin since you know
02:09We're taking baby steps and we're trying to explain it. I mean to me as well because I'm here to learn what is arthritis
02:15So arthritis is basically anything which affects a joint and did you know that 200 joints in your body? No, I had no idea
02:22Starting from you know, they're fixed joints in the scalp and the skull and then you have your jaw
02:27You have so there are many joints in the body. There are 200 joints
02:30So anything which affects a joint with pain or inflammation or swelling is arthritis
02:35So there are two main categories of this now, you know, your grandmother would have arthritis her bone
02:42Cartilage has worn off the cushion between the bone wears off
02:45That's the wear and tear degenerative arthritis and that's called osteoarthritis
02:49Which comes by time by age and maybe even extra excess use like people have been very
02:55Heavy athletes with high impact sports. They could get arthritis an early age or if they had an injury to the cartilage
03:02They can get it in an earlier age
03:04But other types of arthritis are mostly autoimmune and then there's a third category
03:09Which is gout which is due to a high uric acid in the blood
03:13So that's the third one, but most of the middle category is autoimmune such as rheumatoid arthritis
03:20lupus
03:21Ankylosing spondylitis and other autoimmune conditions scleroderma, etc. So there are many in that category Wow
03:27It seems like we're gonna be here all day because I feel like you said so much and we need to explain those
03:32So let's begin with what causes I mean, we're gonna talk about the autoimmune right aspect of arthritis
03:39So because we know that we already spoke about osteoarthritis, which is the wear and tear that's caused by age and by injury
03:45So the autoimmune arthritis is a part of autoimmune diseases. There are many types of autoimmune diseases
03:51So where your immune system for some reason turns on itself?
03:55There is a genetic component and an environmental trigger. So you've heard of little kids getting diabetes
04:01For instance, those are juvenile diabetes patients
04:04And that's because their immune systems attack their pancreas and doesn't produce insulin anymore
04:09So similarly in arthritis the immune system attacks the joints. Okay, so there is a genetic predisposition
04:16We've done studies and we found different genes which are responsible and then there's something which triggers it
04:21So the trigger can be a virus or bacteria and infections. We saw a lot of post COVID
04:27Triggered rheumatoid arthritis for instance interesting. Yes, and then we see
04:32injuries
04:33Sometimes we see just a stressful event can trigger it
04:36so it's a something like there's a pile of wood dry wood and a matchstick which lights the fire and
04:41Then the immune system is chronically active and it should not be it's like the policemen
04:46I've been let out of the police station and they're attacking your own body. They don't go back into the police station
04:52So it's a constant attack
04:54Okay, and in terms of prevention can someone actually prevent getting rheumatoid arthritis arthritis?
05:00Even if they are genetically predisposed
05:03So if you're genetically predisposed and carry the gene you may not get it
05:07if you didn't have that environmental trigger if you didn't get that particular virus or bacteria that particular stress or
05:13You know, you may not get it. But how do we prevent getting it as generally being healthy?
05:18So we know a lot now with the gut microbiome, you know
05:22We have trillions of bacteria in our intestine and these protect your immune system and and you know promote a healthy environment
05:28So even if you get that infection or that trigger your gut bacteria may protect you your whole microbiome
05:36It's not just in your intestine actually. Yeah starting from your mouth your mouth downwards
05:40So you're in your microbiome may protect you secondly, there's things like vitamin D
05:46We think it's only for healthy bone and joint, but it's really important for for the immune system
05:51So again going back to COVID we found that people who had good vitamin D levels did better
05:56With COVID and so it also protects immune system
05:59We find people with autoimmune diseases do better when their vitamin D levels are good. That's fascinating
06:05I mean, I want to go back to that COVID point. Is there a correlation like why was there a rise?
06:10Because they're different viruses. This is that we saw a lot of COVID at one time
06:15So we saw a lot of these COVID induced arthritis, but there is so many other viruses
06:20But their power virus Epstein-Barr the different types of viruses which can trigger arthritis and we know that okay
06:27so in terms of treatment and and you know
06:31Recovery, can people actually be cured from arthritis or is it lifelong? Yeah, so there are certain types which can be cured
06:39There's one particular one called reactive arthritis where you have a particular
06:44Bacteria then you get sick you get a lot of joint swelling and inflammation
06:48It can last anywhere from three weeks to three months or more and then people recover. So that's reactive
06:54Then there is there is milder forms of rheumatoid arthritis
06:58If caught early and treated early people can actually be off medication and be cured for a very long time
07:04We call those long-term remissions
07:06It's just like maybe having cancer and catching something early and you can cure it if it's got really early
07:12Okay, so those can be cured and then there is the third which can be
07:17severe types of rheumatoid which can be lifelong and need to be a long-term medications and people are always asking and so when can
07:24I come off my medication and I know this cousin went for this treatment and they got cured or that relative told me so
07:31People don't understand that there are some you know benefits of certain types of alternative treatments as well
07:38But it depends on the type of arthritis you have. Yeah, you know, you may not even have arthritis
07:42You may have chronic pain due to a different condition like fibromyalgia
07:46And in that case, you might have got cured by an alternative medicine, but you have if you have a very inflammatory
07:53Arthritis, which is autoimmune like rheumatoid
07:57It could lead to a high risk of joint damage, right?
08:00so the best bet for you is to be diagnosed early by a
08:04Rheumatologist and to be treated early to get yourself into disease remission and prevent joint damage
08:10I was just gonna say it's so important to go to the right people or the right person to get a specific
08:15Treatment because it's not a one-size-fits-all with anything in the medical field. Absolutely. I feel so
08:21That's gold advice
08:23I just wanted to
08:26Maybe dig deeper. I have so many questions. Maybe dig deeper into like prevention methods
08:31So like let's say, you know, I still don't have it. But how can I avoid it then?
08:36I mean you spoke about catching it early and you know
08:39Actually getting cured for life if you catch it early, but then how can I prevent it from happening?
08:45so a few things as I said again our diet and what we put in our diet and what's happening in your gut is very
08:51Important for your immune system and people really downplay the importance of this and we're just understanding more and more
08:57we have like now ability to
08:59Print your gut microbiome and or to to actually analyze it and know exactly what kind of you know
09:07Composition of bacteria there. So first of all eating healthy having a good prebiotic diet
09:13We say which is not a fiber, you know, lots of vegetables green stuff fruits are getting enough sunshine vitamin D
09:21I can't emphasize that enough
09:23So creating the right environment in your body and the right mix of good bacteria can prevent you from getting autoimmune disease
09:30The second thing is avoiding stress. It's very hard
09:34But I've seen people when there's a sudden trigger with a stressful event. I saw a woman
09:40I used to work in the United States and her son was deployed to war and the very next day
09:45She developed an explosive onset of lupus, you know, like the stress of him going to war
09:51So so these stressful events so we see that often an
09:55Injury also if you're stressed about an injury and then there's a chronic stress
09:59There's a stressful event and then this chronic stress and how you react to it. So managing stress
10:04we all know we have to do that in our day-to-day life because I think that's such a huge trigger of so many different diseases from
10:11obesity to
10:13To you know autoimmune conditions too. So it plays a big role
10:16So it's something like asking how can we prevent cancer again eating healthy?
10:21No processed foods taking care of your microbiome and the good bacteria in your system. And of course, no smoking
10:30Smoking is a big trigger of autoimmune diseases, and I've been talking a lot about the things
10:34But if you don't if you're predisposed to it if your family history, especially
10:38You need to stop smoking avoid that at all costs
10:42I love that you mentioned stress because it is the number one silent killer
10:47I feel everyone that I've had on the show talking about, you know
10:50So I call it whether it's mental health or physical health or anything of that matter
10:55Stress it always goes back to stress like with a lot of these conditions and with a lot of autoimmune diseases comes
11:02Psychological distress and comes a lot of like I mean it does result in stress as well
11:07Which is ironic because we're trying to avoid the stress, you know
11:11So we don't make the condition worse
11:12But what are some of these psychological effects that that have on the person from these conditions?
11:18So Maria as you can imagine someone is not able to perform their daily activities
11:23Sometimes we have people who can't put on their clothes. Those are the extreme cases, but even treated patients may have a flare
11:30They can't walk someone may be a football player can't play the game, which they love
11:35They may be a child who wants to only who has juvenile arthritis and loves football and yesterday
11:40I saw a kid like this and they can't do it because their ankle is swollen
11:45so it leads to a lot of distress because they can't do things they want to do and
11:49The second thing is they feel like they're putting
11:52burden on their family a lot of women who have this have to ask their husband to open the bottle for them or
11:57To to help them with the cooking or chopping and they feel like they're not full fully
12:03Presentable or capable of taking care of their families
12:06So we say it's okay to ask for help when you need it
12:10And also these are temporary disabilities if you're if you are again treated
12:15Well, we don't feel like there should be any limitation on you, right?
12:19We have rugby players or go back to playing rugby. We have
12:23examples of tennis players who won Wimbledon who has
12:27rheumatoid arthritis
12:28Venus Williams has an autoimmune disease, you know, so there are many many people who have autoimmune disease
12:34And so we show them these examples
12:35These are the top tennis player golf player and they have autoimmune disease and they're doing it and you can too
12:41We just need the right treatment. We need to persist
12:43We need to be positive and you need your support of your family and friends and we also have these support groups
12:50Oh, we have regular programming for people to sit around and chat about what they should eat how they should exercise
12:56We do this regularly to support our patients as well. I agree because support is crucial
13:01I mean when when any of us gets injured temporarily
13:05I mean we always worry that we're a burden on our loved ones and that we you know
13:09They have to be at our calling 24-7 for a short period of time
13:13So I can only imagine what you know arthritis patients have to go through
13:18And I mean there there certainly has to be certain adjustments that need to be made
13:23So, what are some adjustments that people can make for to make their daily routine easier so well I
13:31don't believe that anyone should be so disabled that they should need to use crutches or
13:37You know or bottle openers. We do try to get them back into full full performance and full capability with proper medication and treatment
13:46But there can be adjustments for instance, you may not be able to climb stairs for some time
13:51Or you may need you may be a fall risk because you're not fully balanced
13:56So then you may need to use a walker or crutches for some time so they can be temporary adjustments
14:02We call them but I wouldn't like them to be permanent and I always tell them and my sometimes my patient come in a flare
14:07In a wheelchair and I'm like next time you need to be walking in here
14:11It's like their goal to they want to make their doctor happy
14:14And so they work on that too that they're going to walk walk in there with the right treatment the right exercise and the right
14:20encouragement is it true that
14:24Arthritis as a whole is a condition that only affects older people or can it also affect younger?
14:30Absolutely not. So you have 50 types, right? Okay, so we talked about the one which affects older people
14:35So there's juvenile arthritis which affects kids
14:38So I often have we have kids who are like one year old two years old who have arthritis and wow as young as one
14:44Yes, two years old. They're taking chronic medication sometimes for their whole lives
14:48Sometimes they grow out of it
14:50Then we have middle-aged people and then some types of arthritis affect women more and sometimes more common in men
14:58But overall autoimmune diseases are more common in women. Okay, so that's a very interesting area as well
15:05Because women it's the hormonal balance in the women as well as I don't know women have more stress
15:11I am not sure so or they stress themselves more good. So, um, so
15:17There's there's these factors but definitely age is not a factor
15:21You should not people often come to me and said, you know
15:24I never thought I would have arthritis and that's why I never you know
15:27sought this type of treatment or went down this path because I'm so young only 25 I'm only 22 and
15:33You know, it is quite distressing to get a diagnosis when you're so young you have your whole life ahead of you and you're being told
15:41You have arthritis. I have a 17 year old girl right now
15:45She needs to go away to college or she's 18 and she has really bad swollen joints. And you know, she's she's amazingly stoic
15:53Young people
15:55Especially a very stoic. They don't
15:57Children also they're like casual about it. Yes something they grew up with but yeah like older people
16:02I think we get a bit more anxious and stressed about things
16:07Is there a reason why children get it other than being predisposed?
16:11Yeah, it's the genetic factors and maybe they get a virus again, which also the virus, okay, so it's the same factors as adults, okay
16:19Now we spoke about the prevention, but I actually want to go back to what do I look out for?
16:23Like what if I don't know I have it and I should be looking out for certain symptoms certain signs
16:29So first of all pain, okay, so pain, which is persistent
16:33Obviously if you have pain for two or three days forget about it, but pain which is persistent for more than a couple of weeks
16:39Okay, so they could be anywhere so we can have pain in the small joints of the hands and feet and that's rheumatoid arthritis
16:45But something which people often neglect is back pain young men
16:49Especially neglecting this chronic back pain and that's a type of autoimmune arthritis and they just think oh, it's because I'm sitting long at the computer
16:56it's because I have
16:58Not exercised, but they don't understand that there is an inflammatory type of arthritis called spondyloarthritis
17:05Or ankylosing spondylitis and it can affect young men from the age of 14 onwards
17:10So they sit for long they get stiff and they sit up or they find it hard to get out of the chair or in
17:16The morning when they wake up they have morning stiffness if you have pain in your back, which is worse with rest
17:23Seek the help of a rheumatologist because that could be arthritis
17:27Then they can be skin conditions like psoriasis and that with nail changes and maybe something funny in your fingertips
17:34That can be arthritis skin tightening changes in your skin or rashes ulcers the mouth rapid hair loss
17:41these are all autoimmune types of arthritis like lupus and scleroderma, but pain in a joint with swelling and
17:49Inflammation and stiffness in the morning. Those are the hallmark features
17:53Is there a case where surgical intervention or procedures are necessary? Are there severe cases? Absolutely
18:00So if it's an osteoarthritis where there's no cartilage between the bone at all
18:04Right, then we say please go to the orthopedic doctor
18:07There's not much we can do for you. And then some people refuse to do that
18:12They say I don't want to surgery at any cost that we try things like injecting
18:17oily substance called hyaluronic acid like fillers into the knee that sometimes helps or
18:23Steroids, which we don't do anymore or platelet-rich plasma stem cell. They may help but if a patient at end stage
18:31Arthritis they need to have surgery. Okay. Okay. And what does that require? Like do they just yeah, they just make a
18:38Not a little cut a substantial cut in your knee and they replace the bone
18:44Tops, they cover it with metal and there's a like sort of a plastic bit
18:49So, you know, you're just like sort of a bionic person, but it's actually very successful and very easy these days
18:54So I really when I see patients who need it
18:58I'm not a surgeon, but I encourage them to go to the surgeon because that's the best thing for them and they're like
19:0455 year olds and they're like, okay or 60 year old and they say I'm 60 already
19:08I'll live with this knee and I'm like actually the lifespan of people is 80 or 90
19:13Yes, so at this do you really want this quality of life for yourself for the next 20 or 30 years?
19:19You know, these are the best years of your life. Maybe yeah, and you need to have the surgery
19:24So they they understand then and they go yeah, and it goes back to the point of the lifestyle as you said
19:29I mean you change your lifestyle. This could help you in turn make you more active
19:34Help you with mobility and all those sorts
19:37Okay
19:38So do you have any statistics on how many people because I know that rheumatoid arthritis or arthritis as a whole
19:44Is under diagnosed and I think it's misdiagnosed as well
19:48I think a lot of people get the diagnosis, but they don't necessarily suffer from the condition and vice versa
19:53So do we have any statistics?
19:55Yeah, so generally overall in the world population about one in five people will have some type of arthritis
20:02So that's like almost 20% will get arthritis at some point of their life
20:06So if you don't have an autoimmune is less common, so the osteoarthritis, especially with our aging population
20:12We see more of the wear and tear type of arthritis
20:16So so it's actually quite a high number of people and it leads to a lot of disability a lot of lost days at work
20:23A lot of economic burden on society. So yeah, you know people get disabled. It's a lot of burden on society
20:30Of course
20:31Do you see that awareness is increasing though?
20:33Absolutely. Yes, it is and in the UAE we are happy that I've been here 19 years now
20:39So we had set up the Middle East arthritis foundation
20:42And so when I first came to you the UAE we found that the delay to diagnosis for rheumatoid arthritis
20:47For instance was almost two years people were wandering around not treated and then after all these awareness
20:53campaigns after the media after talking to people like yourself who really are increasing awareness, we found that the
20:59Delay to diagnosis has gone down delay to treatments gone down
21:03The acceptance has gone up a lot and we do regular programming for this. Love it. Thank you so much
21:09Okay, my last question. I know that you are a busy woman, but what's your advice for people overall?
21:15So overall besides having a healthy diet
21:18You also need to take care of your bones because as women age it goes to osteoporosis and there's a lot of misconception about
21:25Calcium we touched on vitamin D vitamin D comes from sunshine
21:28But if you're not getting enough sunlight, you need to make sure you have levels of vitamin D about 30 nanograms, you know
21:34So you need to take a supplement but calcium supplements people are really afraid of they think that these are gonna lead to heart attacks or
21:41Or kidney stones and there's a lot of misconception and myths around calcium supplements, but you really need it for your bone
21:48You need about thousand milligrams of calcium per day
21:50And if you're not getting that from your diet because in your diet the main foods which give you calcium are dairy products
21:57So one full cup of milk will have about 300 milligrams of calcium
22:02One full cup of yogurt is 300 milligrams and other great foods are sesame seeds and almonds, but not so much calcium as dairy
22:09So if you don't eat dairy for various reasons
22:12So many people don't eat dairy either because of allergies or lactose intolerance
22:16Then you really should take a calcium supplement to make up that deficit
22:20But if you have a if you have a diet, which is high in dairy, don't take that calcium supplement
22:25But you do need to take care of your bones because we are aging we are going to live longer
22:30Hopefully and then we need to not have osteoporosis and break our bones as we grow older amazing. Dr. Bacha. Thank you so much
22:37Is there anything else you'd like to add that we may have missed?
22:40Well get yourself treated now, you know what a rheumatologist is or who a rheumatologist is. Yeah, indeed. So get yourself checked soon
22:47Thank you. Thank you so much. Thank you for your time