Unraveling complex medical mysteries is the work of the rheumatologist
Many people think that rheumatologists are physicians who only care for people with arthritis, when in fact, rheumatologists treat over 100 different diseases, many of them chronic and life-threatening.
One patient's experience
An immune system gone haywire
Diagnosis takes detective work
Women as chronic targets
A team approach
An arthritis resource
One patient's experience
Take the case of Suellen Hancock, a patient of Sheldon Solomon, MD, Virtua rheumatologist. She says: "I was diagnosed with lupus in 1978 and have been with Dr. Solomon ever since. The disease has caused kidney problems; I had a mild stroke at 32. I also take four different kinds of medication every day, including a blood thinner. An illness like lupus takes a big psychological and physical toll. Dr. Solomon is my lifeline."
Rhemtaologists like Dr. Solomon are specialists who treat everything from connective tissue disorders such as osteoporosis to autoimmune illnesses like systemic lupus erythematosus (lupus), a chronic illness which can wreak havoc inside the body.
An immune system gone haywire
Richard Hymowitz, MD, chief of rheumatology at Virtua Memorial explains: "With lupus, the immune system which fights off infection, mistakenly attacks healthy tissue and organs throughout the body causing inflammation and swelling. This immune response is miraculous when it's fighting viruses or bacteria. But the consequences can be disasterous when an immune response is improperly aimed at healthy kidney tissue or blood vessels in the heart, liver or brain."
Diagnosis takes detective work
Dr. Solomon elaborates: "Rheumatic diseases often present with symptoms
such as joint pain, fever, fatigue, headache, even weight loss — all of which can suggest many illnesses. Getting to the bottom of what is causing a person's discomfort means taking a careful history, performing an in-depth physical exam and doing blood tests and radiological tests to rule out some diseases and rule in the one causing the problem. Even once diagnosed, these disorders can be difficult to treat because they are systemic and chronic."
Rheumatoid disorders can cause profound internal and external problems. With rheumatoid arthritis, the lining that covers the joints in the hands, feet, hips and knees becomes dramatically inflamed. To add insult to injury, blood vessels can become inflamed causing poor blood circulation to the skin, heart, lungs and nervous system making for a potentially very sick individual. Women in their 30s and 40s tend to develop rheumatoid arthritis most frequently.
Women as chronic targets
According to Adrienne Hollander, MD, Virtua rheumatologist, "The reasons are
not yet well understood why women are at a far greater risk for developing
rheumatic diseases than men. It is believed that estrogen and hormones may
play a role as well as genetics. Many rheumatic diseases are also chronic,
meaning symptoms can flare up suddenly and last for weeks or months. Then
just as quickly, they retreat or go into remission."
For patients with more severe forms of rheumatic disease, a newer
classification of drugs called disease-modifying antirheumatic drugs (DMARD)
is available. These include methotrexate and leflunomide, and they are designed
to help slow or prevent further damage to the joints. Relief for individuals with rheumatoid arthritis may also come in the form of a biological response modifier. These advanced medications such as etanercept and infliximab block the reaction of a substance called tumor necrosis factor (TNF), a protein involved in the immune system response. This blocking action helps lessen an inflammatory response and the damage it can cause.
A team approach
Dr. Hymowitz adds: "As rheumatologists, we consult with a variety of
physicians on behalf of the patient because, quite often, the diseases we
treat involve many systems of the body. We have ongoing communication with
primary care physicians, cardiologists, gastroenterologists, pulmonologists,
orthopaedic physicians, ophthalmologists, and endocrinologists."
To locate a Virtua rheumatologist near you or to make an appointment, call
1-888-Virtua-3.
An arthritis resource
The Bone Health and Osteoporosis Center at Virtua offers a total program of arthritis prevention, education and treatment options that include physical therapy at five convenient locations, occupational therapy, warm water exercise and conventional exercise.
For more information call 1-888-Virtua-3.