On this week's Tell Me Why podcast episode, Maria Botros addresses the importance of early arthritis diagnoses with Consultant Rheumatologist, Dr. Humeira Badsha.
Dr. Humeira: Around 1 in 5 people will have some type of arthritis, that's almost 20% of the global population
We have kids as young as one year old taking chronic medications for arthritis, says Dr. Humeira
Dr. Humeira: There are at least 50 types of arthritis
There are certain types of arthritis that can be cured, such as those diagnosed with reactive arthritis, says Dr. Humeira
See more videos at https://gulfnews.com/videos
Read more Gulf News stories here: https://bit.ly/2HLJ2km
Dr. Humeira: Around 1 in 5 people will have some type of arthritis, that's almost 20% of the global population
We have kids as young as one year old taking chronic medications for arthritis, says Dr. Humeira
Dr. Humeira: There are at least 50 types of arthritis
There are certain types of arthritis that can be cured, such as those diagnosed with reactive arthritis, says Dr. Humeira
See more videos at https://gulfnews.com/videos
Read more Gulf News stories here: https://bit.ly/2HLJ2km
Category
ЁЯЧЮ
NewsTranscript
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 a 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. So our speciality is really autoimmune types of arthritis
01:59Wow, 50 types five zero five zero, right? That's insane. I never at least five five zero Wow at least
02:07Okay, so to begin since you know, we're taking baby steps and we're trying to explain it
02:11I mean to me as well because I'm here to learn what is arthritis
02:15So arthritis is basically anything which affects a joint. Okay. Did you know there are 200 joints in your body?
02:21No, I had no idea starting from you know
02:23They're fixed joints in the scalp and the skull and then you have your jaw you have so there are many joints in the body
02:29There are 200 joints. So 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 at 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 to dry wood and a matchstick which lights the fire
04:41And then 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
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 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
06:14So we saw a lot of these COVID induced arthritis, but there is so many other viruses
06:19I don't want to name them, but they're power virus Epstein-Barr the different types of viruses which can trigger arthritis and we know that
06:26okay, so 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
06:53Then 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
07:16Yeah, so there are some severe types of rheumatoid which can be lifelong and need to be a long-term
07:21medications and people are always asking and so when can I come off my
07:25Medication and I know this cousin went for this treatment and they got cured or that relative told me so people don't
07:32Understand 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
07:40Yeah, you know, you may not even have arthritis you 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
08:15Specific treatment 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 actually getting cured for life if you catch it early
08:42But 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
09:05you know
09:07Composition of bacteria there. So first of all eating healthy having a good prebiotic diet
09:13We say which is a lot of 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
09:39I saw a woman I 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 or 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
10:03So 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
10:10from obesity 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
10:29Hmm smoking is a big trigger of autoimmune diseases and I've been talking a lot of other 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, so 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
12:15We don't feel like there should be any limitation on you right we have rugby players or go back to playing rugby we have
12:23examples of tennis players
12:24Who won Wimbledon who has rheumatoid 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 that 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
12:56So we 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
13:05We 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. So I can only imagine what you know
13:15Arthritis 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 you know
13:38Or 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
14:05And I always tell them and my sometimes my patient come in a flare in a wheelchair
14:08And I'm like next time you need to be walking in here and it's like their goal, too
14:12They want to make their doctor happy and so they work on that too that they're going to work
14:16Walk in there with the right treatment the right exercise and the right encouragement
14:21Is 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 medications sometimes for their whole lives. Sometimes 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 they stress themselves more good. So, um, so
15:17So there'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
15:52Young people is especially a very stoic they don't
15:57Children also they're like casual about it. Yes something they grew up with but 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? Yeah, it's the genetic factors
16:13And 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 like
16:24What if I don't know I have it and I should be looking out for certain symptoms certain signs. So first of all pain
16:31Okay, 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
16:40So 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 along 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 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
17:26Then they can be skin conditions like psoriasis and that with nail changes and maybe something funny in your fingertips
17:34That can be arthritis
17:35Skin 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, right?
18:04Then 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
18:16injecting
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 cells. 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
18:57I'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?
20:34Yes, 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
20:51and then after all these awareness campaigns 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
21:24Misconception about calcium 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 going to lead to heart attacks
21:40Or or kidney stones and there's a lot of misconception and myths around calcium supplements
21:46But 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 so 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