Category Archives: Rheumatology

Medical Journalism, Rheumatology

Rheumatic Diseases aren’t just First World Problems – a TL;DR

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Last night, I took a long walk to clear my mind and gazed up at the night sky. On this moonless night, I saw the Milky Way in all its glory, something I only rarely get to appreciate nowadays. Seeing Orion, the Big Dipper, and the other constellations triggered some very fond memories of family vacations that we spent in India. I remember my grandfather pointing above to connect the dots and telling me the mythic stories of how they came to be in their positions in the night sky.

It also reminded me about how small our world is. The same stars that I viewed from the foothills of the Himalayas twenty-some-odd years ago are the same ones I can see from the plains of Midwestern America. And the same diseases that I see in clinic – Rheumatoid Arthritis and Systemic Lupus Erythematosus to name just two – are the same that afflict those throughout India and the third world.

But for some reason, we completely forget about those in the developing world who have these diseases. For some reason, we think that only the immune systems of those people in the First World are susceptible to dysregulation, and that, because we have effective treatments to induce remission in many of these patients, that poorly controlled disease is a thing of the past.

It’s not. The agents we use to induce remission are largely either unavailable or inappropriate in large swathes of the developing world. It’s unreasonable to use some of our potent immunosuppressants in areas where latent tuberculosis is rife. Monitoring for toxicity is often impossible, and so patients are left to suffer on their own.

This editorial is meant to help bring these issues to the forefront, and to highlight that our work, as rheumatologists and rheumatologists-in-training, is far from done. Immunologic and musculoskeletal diseases bear a disproportionately high rate of morbidity in these areas. It’s easy to get caught up in the excitement of new medications and diagnostic techniques, but we must never forget that we are also obligated to treat those with the greatest need.

Allergy/Immunology, Rheumatology

Introducing #RheumFacts and #AllergyFacts

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The first time that I ever felt old was when I heard about twitter.  I just didn’t get it.  It seemed just bizarre and alien.  I understood facebook.  I understood AIM. I understood mySpace, and Kazaa, and other social and pseudo-social networks of the early 2000s and late 1990s.  I even participated (and continue to participate) in a few.  But twitter seemed entirely different. After all, what worthwhile message can you possibly broadcast in 140 characters?  Stupid kids, I thought, ruining the internets with new-fangled emojis and punctuation-less lolspeak.

The ostensible stupidity aside, I still tried to get into twitter.  About a year and a half ago, I created an account, which I only used when when I had to, as an intern at ABC News.  It was admittedly fun to participate in their twitterchats, and help spread the news network’s pithy messages throughout the world.  However, after that internship ended and I headed back to work in Kentucky, it had no role and I largely forgot about it.  After all, if I had something to share, I could just do it through facebook, or, better yet, through the real world.

But I’m willing to give twitter a second chance, and, in the process, understand the full potential of micro-blogging.   So, I’m introducing two new hashtags, #RheumFacts, and #AllergyFacts, which are essentially like CatFacts, but more topical to the fields of rheumatology and allegy/immunology.  (Google Cat Facts if you don’t know what it is – and subscribe if you want to learn more about our feline companions.)  I hope that, in 140 characters, I can relay snippets of whatever I am learning in this fellowship to the world at large.

I will try to update my feed frequently – when I’m not on call.  But don’t hold me to that: chances are that I’ll fall behind the times, yet again.