‘India has only 1,000 docs to treat 1.2 cr Rheumatoid Arthritis patients’
| Date :11-Jun-2019 |
Principal Correspondent:
Therapy can give patients dignity, and protect them from getting disabled
A man made a call to Dr Smruti Ramteke, well-known Rheumatologist of Central India and told her that her wife was suffering from rheumatoid arthritis due to which she became bedridden. Everybody in the family almost lost interest in life which was but obvious. When a woman in any family gets disabled, the life of that home becomes horrible. Dr Ramteke treated her and she got recovered. She no more remained bed-ridden. In fact she is now in search of job and asked favor from Dr Ramteke.
With a smile of curing that woman and converting the life of the family from hell to heaven, Dr Ramteke expressed, “I don’t want to take any credit. It is the miracle of advances in medicines. Biologic demards are doing excellent jobs. It worked on the woman. I just want to pass the message, if people come to doctor at right time they would never get disabled.” Though only one percent people of total population in India suffer from Rheumatoid Arthritis, it comes out roughly 1.2 crore. For those 1.2 crore patients there are only 1,000 doctors which is the irony. In the past there were fellowships only and no Post Graduation but now DNB has begun which is a good thing.
Explaining about the disease, Dr Ramteke said, “Rheumatoid Arthritis (RA) is an autoimmune disease in which the body’s immune system – which normally protects its health by attacking foreign substances like bacteria and viruses start attacking joints causing inflammation resulting in damaging the tissue that lines the inside of joints. This tissue gets thicken, gets swelled and develops pain in and around the joints. The tissue called synovium makes a fluid that lubricates joints and helps them move smoothly.”
“There are several misconceptions about the disease and people living with those misconceptions approach doctors very late. If one has joint pains, swelling in the joints, waking up in the morning becomes painful, not able to get up quickly, limited movements, early morning stiffness, fatigue during walking, weightloss, oral ulcers, hair loss, skin rashes then one must approach rheumatologist. These are mostly Systemic Lupus Erythematosus (SLE) features commonly seen in patients with Rheumatoid Arthritis. However, their frequency and clinical significance are uncertain. We examined the frequency of SLE features in RA and their impact on overall mortality,” explained Dr Ramteke. “Women are more prone to the disease. In percentage, say 70 to 80 per cent women suffer from this disease because of harmonal things. Twenty years ago we did not have medicines except only pain-killers or steroids which have less curing effect and several side-effects.
People used to get bed-ridden gradually. Now the scenario is changed completely. We do give steroids but for a limited period. Then we start Demards which come in two types--normal and biologic. Biologic are more effective,” pointed out Dr Smruti Ramteke. “Biologic demards are anti- Tumor Necrosis Factor (TNF) and they are targeted. Though biologic demards are highly effective, they have side effects also as they accelerate Tuberculosis, pave way to infections. We have to vaccinate patients, conduct certain tests, in nutshell we have to be very careful.
Our motto is making patients’ living more dignified,” said Dr Smruti Ramteke. “Child bearing age women suffer from disease for whom we modify the medicines. We have to take pregnancy, child bearing, marriage into consideration. Young unmarried girls also approach us who can have normal productive life with the help of medicines. In fact the disease is severe in young age because otherwise lifespan of these patients is 10 years less than the normal age. Unproductive life of a single woman affects life of whole family. With therapy disability can be prevented,” commented Dr Smruti Ramteke. There are less chances of child inheriting the disease, added Dr Ramteke. Rhematologists like Dr Smruti Ramteke have to play two roles--1.
They treat the patients physically and also counsel them as patients start feeling low when undergo through tremendous pain. Many of patients have been brought in a disable state. There are co-morbidities and multiple organ failure gradually. Lifestyle modification can make miracles and can add value to medication. Good sleep, stress management are other factors that too have a role to play.
Health schemes should cover Rheumatoid Arthritis Pointing out one very peculiar lacuna, Dr Smruti Ramteke, nationally acclaimed Rheumatologist said, “One more aspect of neglect towards this disease is, it has not brought under any health scheme. Biologic demards are very costly so initially we avoid with the fear that patients may not afford them. If the disease is brought under health scheme it would a great boon for the patients. It is one percent till the age of 55 years. After 55, the percent of people suffering from disease go up to 5 per cent. If this statistics is taken into account, then there is a big chunk of people would heave a sigh of relief. They can avail the health benefits and we can have satisfaction of preventing more number of people getting disabled.”