Uncommon Chat with a Rheumatoid Arthritis Specialist, part 2

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Dr. Akerkar, Rheumatoid Arthritis specialist, part 2This is the second half of an interview with RA specialist Dr. Shashank Akerkar of India.

In Part 1, read the doctor’s enlightening remarks about Rheumatoid Arthritis, using the internet for healthcare, and an amusing theory from a patient. Thank you, Dr. Akerkar, for visiting RA Warrior.

Doctor, in America, there are not enough rheumatologists and they are not as well paid as some other specialties. Do you have the same problem in India? The same problem does exist in India, as well. There is gross shortage of rheumatologists. India being a populous country, all of us have a big patient load. Believe it or not, I must see about 60-80 patients every day! Maintaining quality in the face of such a patient-load is another challenge all of us face especially in this part of the world. India has a two tier system in place, with government-run hospitals, teaching hospitals, and private hospitals with private clinical practice in place. All Consultants are paid equally in the government system.

How long have you been a rheumatologist? Six years to be precise. I was a faculty in Rheumatology at the Seth GS Medical College & KEM Hospital, Mumbai. I have been a practicing consultant for four years.

Rheumatology is a field with fast-changing science. How do you keep up-to-date the flood of information? The internet has been the biggest messiah. I also use scientific journals & EULAR (European League of Rheumatism) courses. Conferences do help keep abreast of the latest developments.

Can I ask, what do you think of the Marshall Protocol or antibiotic therapy for Rheumatoid Arthritis? No scientific basis for any of these.

Well, what about dairy and gluten? Can diet be used to treat Rheumatoid Arthritis? No scientific basis for any dietary cures for RA. All claims regarding these are unsubstantiated.

You say you want RA patients to conquest over RA. What is the biggest challenge that you face with helping your patients to fight RA? The depression that is associated with a chronic disease like RA. Many patients have seen multiple health care professionals with varying levels of relief. Many or in fact most of them inform them that this is a chronic disease with no treatment and it’s something that they will have to live with. Getting them out of this mindset is one of the biggest challenges. However, nothing succeeds like relief of symptoms and this is what works in most of them once they are on DMARDs.

What other challenges do you see to fighting RA? One of the biggest challenges for any RA patient is getting the family members believe in the pain they are going through. “You don’t look so sick” is a common phenomenon. Counseling the family members is an important task and getting them to understand what the patient is going through and making them a part of the team is essential in overall success of therapy. One’s family is the first and nearest support system for the RA patient.

What can be done to help patients’ family members to understand RA? Do you think doctors should counsel with families? It is true that given the patient numbers, it is difficult to spare time to educate the family members. However, some basic counseling is a must and we cannot do away with this. Apart from this basic counseling, one can always give a list websites to the family members to understand what RA is and its treatment options. In fact, this is precisely how my own site came up… to educate the patient and the family members.

Do you like the idea I have been suggesting of a class for new RA’ers and families? We do have patient & family members’ seminars for the education purpose. However, efforts are needed at the society level to increase the arthritis awareness. The internet is another medium for the same use. I’ve numerous patients who started with the search query of “joint pain” which lead them to the term “rheumatism,” then to rheumatology & then to rheumatologist & then to me. RA public awareness definitely requires a dedicated work from rheumatologists as well as patients who have gone through the hardships finding the right consultant. WHO’s ‘let’s work together’ is a unique concept in this direction.

Doctor, it has been enjoyable and enlightening to hear how hopeful you are about the fight against RA. You emphasize that patients and doctors should be a team; I agree. But that made me wonder…

Can you tell us the strangest treatment for RA that a patient has ever suggested? Cow urine is considered holy by some and has mythological value in Hindu culture. I still remember one patient who used to bathe with cow urine as she was told that this would cure her RA.

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Kelly Young. All rights reserved.

This entry was posted on Wednesday, January 27th, 2010 at 7:07 am and is filed under RA Education. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.

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