Caring for a family member with rheumatism or rheumatoid arthritis presents significant challenges that extend beyond the financial strain of ongoing medical care.
Emotionally, the toll can be profound as family members witness their loved one's physical decline and struggle with chronic pain. The unpredictability of flare-ups and the gradual loss of mobility can lead to feelings of helplessness and frustration, not only for the patient but also for those who care for them. The constant need for assistance with daily activities can strain relationships, as the caregiver often must balance these demands with other responsibilities, leading to fatigue and emotional burnout. Moreover, the emotional weight of seeing a loved one endure such hardship can lead to anxiety and depression within the family unit, making the experience deeply challenging on multiple levels.
While some families in Oman, especially those with ageing parents, are familiar with this particular disease, its impact and causes are still not widely understood.
The experience of living with rheumatoid arthritis is marked by intense exhaustion and significant physical pain, often leading to sleep deprivation and a decline in both physical and mental health.
To clarify the difference between rheumatism and rheumatoid arthritis, Oman Observer consulted Dr Samson Premkumar, an orthopaedic specialist at Al Amal Medical Center in Muscat.
Dr. Premkumar explained that rheumatism is a broad term encompassing various diseases that affect the joints and muscles, including rheumatoid arthritis, which is often colloquially referred to as rheumatism. However, this term commonly refers to a subset of conditions, with rheumatoid arthritis being the most prevalent.
"Rheumatoid arthritis is a chronic inflammatory disorder that primarily affects the joints, but it can also impact other organs such as the lungs, heart, skin, nerves, muscles, blood vessels, and kidneys," Dr. Premkumar stated. "The condition causes pain and swelling in the joints, which is particularly evident in the fingers, toes, and spinal joints, leading to restricted movement."
Regarding symptoms, Dr. Premkumar noted, "The common symptoms of rheumatoid arthritis include morning stiffness, pain, swelling, and tenderness in the joints."
He further explained that the disease affects the synovium, the lining of the joints, leading to inflammation and periarticular arthritis. This inflammation can result in significant pain and impaired joint mobility. When small joints in the hands are affected, it can interfere with daily activities such as eating, mixing food, and holding utensils, potentially leading to malnourishment.
Diagnosing rheumatoid arthritis involves a combination of clinical examinations and various tests, including the Rheumatoid Factor (RF), CCP antibody test, C-reactive protein (CRP), Erythrocyte Sedimentation Rate (ESR), Anti-Nuclear Antibody (ANA), Complete Blood Count (CBC), and X-rays. Factors such as age, sex (with a higher prevalence in women), family history, smoking, obesity, stress, and genetic susceptibility (which accounts for about 60%) also play a role in the disease's development.
Dr. Premkumar emphasized that delaying treatment for rheumatoid arthritis could lead to severe complications, potentially necessitating surgical intervention. This is because the joints, particularly in the fingers, may deviate from their normal anatomical position. The disease can be effectively managed with allopathic medications, including NSAIDs and DMARDs. In addition to drugs, patients are advised to make lifestyle modifications, such as engaging in gentle exercises to strengthen the muscles around the joints, incorporating good stretching practices, and swimming regularly. These measures can help maintain joint mobility, along with following a nutritious diet, adhering to prescribed medications, and maintaining regular follow-ups with the treating physician.
Adhering to medical advice is critical, as many patients are influenced by conflicting information from social media and the internet, often driven by misinformation and the desire for quick recovery. This can negatively impact their condition and delay the treatment process. Early intervention, combined with appropriate medications and lifestyle practices, can help manage the disease and reduce complications, allowing patients to experience relief and peace of mind.
Dr. Premkumar concluded by noting, "Rheumatoid arthritis is believed to be an autoimmune disease, where the immune system mistakenly attacks the body's tissues. The main types are seronegative rheumatoid arthritis and seropositive rheumatoid arthritis."
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