One of my earliest memories, is watching a small figure hobble across the stones with disfigured feet and toes. This was my grandmother and as she dragged her body – riddled with what I now believe to be rheumatoid arthritis – I always wonder how her life might have been changed with proper treatment.
Just when I thought Internal Medicine was my field, I was introduced to Rheumatology. It was during my intern year when working in the Rheumatology Clinic. The core of my initial attraction was the very proximity between Rheumatology and IM. Even as the mode of treatment hinged on working with inherent uncertainty and innate complexity, you also needed to turn to IM fundamentals to determine a diagnosis. Moreover, I found myself highly intrigued
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In time, I discovered a constantly evolving field, one having made recent advances in biologic agents, thus opening up limitless opportunities for research. Moreover in managing side effects of immunosuppressants/biologic agents that are the mainstay of therapy in rheumatology produced its own set of challenges. These were but a few reasons why rheumatology held me …show more content…
In that osteoporosis is a huge societal problem, causing a large number of fractures in the elderly population and thus leading to a poor quality of life and worse, it was clear that education of healthcare professionals was a must. Since the USPSTF guidelines state that all women over age 65 should get dexa scans to screen for osteoporosis and start on appropriate therapy to prevent these fractures, it soon became clear that in our resident run outpatient clinics we were doing a very poor job in this area. As such, with two colleagues, we designed an intervention protocol based on provider education on osteoporosis for all residents, attendings, nurse practitioners and physician assistants. Succinctly, the intervention increased the rate of dexa scan ordering by 34% and this trial is now in its second phase.
There have been other equally important turning points to date. In my rotation at Georgetown, I sought to explore the field of rheumatology at a tertiary level and in doing so, gained experience in common autoimmune conditions and some rare ones as well all which served to solidify my interest in the field. One of the most pleasant aspects of my duties at Georgetown was the opportunity to work with children. In taking pediatric rheumatology consults, I realized that as a rheumatologist I may be able to care for patients of all age groups, leading to an interesting and highly diversified
Test results demonstrated dangerously low bone density levels that confirmed osteoporosis, which eventually led to a spinal fracture. Too old for surgery, she struggled through her day as she continued to shop, drive, cook, and clean for herself. Watching her health decline at such a rapid rate inspired me to explore the field of rheumatology as a Master’s student at Touro University Nevada. It was there that I shadowed a rheumatologist, an experience that not only improved my understanding of the physical complications endured by individuals with this condition, but also provided me with insight into the emotional struggles faced by both the patient and their families. Under the mentorship of this physician, I also completed my Master’s thesis on Joint Hypermobility Syndrome. It was engaging to be able to apply what I observed in the clinic with current research studies to create a tool to assist primary care physicians in the diagnosis of this condition. As research has always been an important component of my academic career, I hope to further explore aspects of clinical research as a
Rheumatoid Arthritis(RA) is the most common type of autoimmune arthritis. RA is a progressive and debilitating musculoskeletal disorder that affects the joints symmetrically, causing a range of systemic effects. What it causes is still not well known; nevertheless, findings of new research points towards a believe that it is triggered by a defective immune system, which causes the release of inflammatory chemicals. These chemicals cause damage to cartilage and bone, usually affecting the wrists, the joints of the hand, including the knuckles, the middle joints of the fingers and feet. While this condition can affect any joints, besides, important body organs such as the eyes and the lungs can also be affected by the inflammation that occurs as a result of this chronic condition. Only in America 1.3 million of people are affected by this ailment, and 75 % of them are mainly women. Its onset usually occurs between fourth and sixth decades; however, RA can occur at any age("Diseases And
Arthritis affects over 10 million people in the UK alone. There are over 200 types with the main types being osteoarthritis and rheumatoid. Osteoarthritis, the most common form suffered by 8.5 million in the UK, is a wasting of connective tissue between bones. Rheumatoid arthritis (RA), although less common, is more severe and accounts for less than 10% of arthritis sufferers in the UK (NHS UK, 2012). It is a painful condition causing swelling, damaging bone and cartilage around joints. Its progression and severity vary greatly between individuals but it can cause serious disability, having a huge impact on ability to carry out tasks in everyday life. For this
Olivia is a 48-year-old female of New Zealand/European ethnicity who currently works as a full time teacher aid for a special needs school. She is happily married, with three grown children. Olivia is currently living in her own home with her husband and daughter in Auckland. After the birth of her daughter in 1996 she began to get severe pain in her shoulders and hands to the point where the pain would wake her in the night. Initially, Olivia’s general practitioner (GP) believed the pain experienced was related to an increase of hormones and depression post labour. For two years, Olivia lived with this pain waiting patiently for a diagnosis. In 1998, she consulted a recommended GP and was immediately diagnosed with Rheumatoid Arthritis (RA).
Today in the United States there is an estimated 1.3 million people living and dealing with rheumatoid arthritis (Arthritis Foundation). One might ask, what exactly is rheumatoid arthritis? Well, rheumatoid arthritis, also commonly known as RA, is a form of inflammatory disease and an autoimmune disease. If the person is a minor, or below the age of six-teen, then the chronic disease can also go by the name of juvenile arthritis. The juvenile arthritis is, “Defined as chronic inflammation of the synovial joints, with unknown etiology, which starts before the age of sixteen and persists for at least six weeks” (Hink et al 1). This disease can affect anyone with a functioning immune system. Out of the 1.3 million people in the United States that have rheumatoid arthritis, 70% of that number is women (RA.com). Once again there are no certain reasons as to who receives this disease whether its children, elders, Caucasians, African Americans, etc. But once they do receive the illness, then it affects them immensely. “The disease is systemic, meaning it can occur throughout the whole body. It’s a chronic disease, so it can’t be cured” (Arthritis Foundation). The pain, stiffness and fatigue can affect the entire body. “RA occurs when your immune system, the system that protects your body from outside harm, mistakenly starts attacking healthy tissue” (RA.com). Rheumatoid arthritis is an incurable disease that is affecting
Developing this disease made it so that a major shift in my life occurred. When I first heard that the doctor had made a diagnosis of Juvenile Arthritis I didn’t know what to do. I felt like the world around me was coming down on me. I had to learn basic skills all
Rheumatoid arthritis is a chronic syndrome that is characterized by inflammation of the peripheral joints, but it may also involve the lungs, heart, blood vessels, and eyes. The prevalence of this autoimmune disease is between 0.3% to 1.5% of the population in the United States (Feinberg, pp 815). It affects women two to three times more often than men, and the onset of RA is usually between 25 and 50 years of age, but it can occur at any age (Reed, pp 584). RA can be diagnosed by establishing the presence of persistent joint pain, swelling in a symmetric distribution, and prolonged morning stiffness. RA usually affects multiple joints, such as the hands, wrists, knees, elbows, feet, shoulders, hips, and small
Rheumatoid Arthritis is one of the most common chronic inflammatory autoimmune disease that attacks joints. It affects women more than men. Rheumatoid arthritis that develops in children or teenagers is called
I had so many questions about what was happing to her. Why I could not see it on the outside. All the questions of a seven-year-old were so little to the questions I would have later in life now that I know what Rheumatoid Arthritis(R.A.) is. Rheumatoid arthritis or R.A. is a chronic inflammatory disorder that can affect more than just your joints.
Rheumatoid arthritis is a chronic syndrome that is characterized by inflammation of the peripheral joints, but it may also involve the lungs, heart, blood vessels, and eyes. The prevalence of this autoimmune disease is between 0.3% to 1.5% of the population in the United States (Feinberg, pp 815). It affects women two to three times more often than men, and the onset of RA is usually between 25 and 50 years of age, but it can occur at any age (Reed, pp 584). RA can be diagnosed by establishing the presence of persistent joint pain, swelling in a symmetric distribution, and prolonged morning stiffness. RA usually affects multiple joints, such as the hands, wrists, knees, elbows, feet, shoulders, hips, and small hand joints. RA is
Patients suffering from rheumatoid arthritis are advised by doctors to start treatment with disease-modifying antirheumatic drugs (DMARDs). DMARDs help relieve the symptoms as well as the progression from joint damage. A common DMARD used in relieving the symptoms and stopping the progression of joint damage is Methotrexate. “Although biologic agents were first established as combination therapy with DMARDs such as MTX, Gómez-Reino discusses data from clinical trials in which biologic monotherapy was used as an effective treatment for patients with RA”(Smolen & Keystone ,2012). DMARDs such as methotrexate is an effective treatment for treating the symptoms of Rheumatoid Arthritis. DMARDs are often prescribed along with nonsteroidal anti-inflammatory drugs (NSAIDs) to assist in reducing swelling and
This inflammatory incurable disease Rheumatoid Arthritis came as a surprise to John as he had never experienced such an ‘excruciating pain’ in his joints. Pain initially started in his left hand and the next day he suffered from the same excruciating pain in his right hand. This really disturbed him as he had no idea what to do with it. The pain was absolutely excruciating that he decided to see a doctor and seek medical advice. His doctor was also confused and just recommended him some Analgesic or Paracetamol tablets to mitigate the pain. This indicates that John has led a healthy life in his past and has good medical record, since he was experiencing this kind of disease for the first time in his life; his doctor was unable to learn about his condition in the first place (Charmaz, pp.976-993).
Rheumatoid arthritis is a disease that affects mostly joints, but can also spread to or affect vital organs such as the eyes, lungs, heart, and others. The disease is treatable to a degree, and if caught in early stages it can be easy to reduce inflammation and swelling in the afflicted areas. After reading this paper one should expect to better understand the symptoms of rheumatoid arthritis, causes of the disease, possible treatments, and ways to help prevent it. Nearly one and a half million (1,500,000) people in the United States are affected by rheumatoid arthritis, and three times as many women have the disease as men.
While the arthritis walk made it obvious to me that I was passionate about working in the medical field I wasn’t really sure about the field of medicine I wanted to specialize in. I was unsure about the field of medicine I wanted to specialize in until last year. Last year I was diagnosed with Myasthenia Gravis, which is an autoimmune neuromuscular disease that causes the fluctuating of muscle weakness and fatigue. Muscle weakness makes it difficult for patients to chew, talk, swallow, breathe, and control eye and facial movements. As of now, there is not a cure for this disease, but there are treatments. Some ways to treat Myasthenia Gravis are immunosuppressants, plasmapheresis, and the removal of the thymus gland. Suffering from Myasthenia Gravis has made me realize that after
Living on this Earth, humanity may encounter many different viruses, and infectious diseases which have the potential to jeopardize a well-being. In regards to autoimmune diseases, these types of conditions are due to your body’s immune system fighting off its own self. One of the more unfortunate autoimmune diseases attacks joints, and it is called Rheumatoid Arthritis. This disease can cause normal everyday activities to become almost impossible to perform. With being diagnosed with RA, there will be complications that a person will be more susceptible to due to RA. Rheumatoid Arthritis has a very rich history that will be