Arthritis is a general term for diseases affecting the joints. There are over 100 different types of arthritis. The most common types include:
- Rheumatoid arthritis
- Arthritis associated with Lupus and other connective tissue diseases
- Arthritis associated with infection, psoriasis, inflammatory bowel disease
Osteoarthritis is considered “wear and tear” and is ubiquitous, affecting almost everyone with advancing age. Typically Rheumatoid arthritis affects 1% of a population and is an autoimmune disease with characteristic joint inflammation.
Traditionally, once diagnosed with arthritis, it was taken for granted that there was only a life of pain to look forward to punctuated with the administration of painkillers in the more excruciating times.
Sickle Cell Anaemia is a genetic disorder that leaves no family member unscathed. This condition is found in people whose ancestors originate from Africa, Asia, the Mediterranean Islands, South America and the Middle and Far East.
Where a couple both have the Sickle Cell Trait, each time that they are expecting a child, there is a:
- 1 in 4 chance that their child will inherit an usual haemoglobin combination
- 2 in 4 chance a Sickle Cell Trait just like the parents
- 1 in 4 chance Sickle Cell Anaemia, a serious blood disorder.
The red blood cells of people with Sickle Cell Anaemia, and other types of Sickle Cell syndromes, change into a ‘sickle shape’ when they give up their oxygen to the body’s tissues. These red cells are fragile, becoming hard, rigid, brittle and break easily.
People with this condition are anaemic because their red blood cells have a shorter life in circulation, only 15-30 days, instead of the 120 days life span of a normal red blood cell. Sometimes, due to their shape, these Sickle Cells can clog together and block the small blood vessels in the body. Due to this blockage, vital oxygen cannot get through to the affected part of the body. This leads to pain. If this blockage is not corrected the pain intensifies and can become excruciating. These episodes are called ‘Sickle Cell Crises’.
The frequency of a ‘crisis’ is unpredictable. The cause of each episode is often unknown although it may be triggered by certain situations such as cold weather, infection, stress or unemployment. Sickle Cell can make life very difficult for the sufferer, family and friends.
Systemic Lupus Erythematosus (SLE) simply referred to as Lupus was once considered a rare disease. With modern diagnostic techniques and greater awareness it is now considered to be more common than was previously thought, affecting 2.8 million Americans with more than 90 percent of these being women. According to Dr. Cindy Flower, the only Rheumatologist in Barbados, there are over 300 patients currently documented in the Lupus Registry with most individuals being followed through the Queen Elizabeth Hospital (QEH). An average of 15 to 25 new patients are diagnosed per year.
Lupus typically affects women between the ages of 15 and 44, the most productive and reproductive years and is three times more common in Black patients than in Caucasians. However anyone can develop Lupus with patients of any age group, any race and either sex being diagnosed.
Renal disease in Lupus is the major cause of hospitalization and the major cause of death. It is also one of the top 5 reasons for the need for dialysis on the island. In spite of these facts Lupus is not as well known to the general public than less prevalent diseases like Leukemia and Multiple Sclerosis.
Although it is not known how Lupus is contracted, research suggests an interplay of genetic and environmental factors. However, research has failed to identify, even remotely, any possibility that it is contagious. Perhaps this is why this condition fails to capture the constant attention of the media in much the same way as communicable diseases. This has
led, on the part of public health officials, to an absence of determination to bombard the media with information on recognition of the signs that are suspicious of Lupus and its early diagnosis.
The symptoms can range from complaints of painful and swollen joints, fevers, rashes on the skin and chest pains to more clinically obvious indicators such as protein in the urine. This condition has the propensity to affect any organ system and multiple organs concurrently.
Lack of awareness particularly among health care professionals, has resulted in late diagnoses which often result in high mortality rates. In 1994, Professor George Nicholson, then Consultant
Nephrologist, indicated that the mortality rate of the Barbados Lupus population was 23 percent and this could be compared to 5 percent in the USA during the same time.
The signs in Lupus differ from one person to another and one of the greatest complexities is that a person can be very ill and look extremely well. Lupus has been described as a great mystery and its propensity to mimic other conditions often makes it hard to diagnose.