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Patients speak out on what it means to live with arthritis
Maria Aguti Atai (left), assisted by Phiona Katushabe, a media officer at Comprehensive Rehabilitation Services in Uganda (CoRSU), wears a hand brace. This helps her to keep the joints straight especially when she is working. photos by Rachel Mabala.
What you need to know:
Arthritis is a condition that usually affects the joints, and can lead to disability. Today, we share the stories of some patients who are coping with being arthritic, and how it can be managed.
“Of all the orthopaedic patients we receive here, 60 to 80 per cent usually have arthritis, a condition which causes pain and inflammation of the body joints,” says Dr Michael Mukasa, an orthopaedic surgeon at Comprehensive Rehabilitation Services in Uganda (CoRSU). The disease mostly affects the hip bone, knee joints, shoulders, spine and other jointed parts of the body. Dr Mukasa says although this disorder affects many people, public knowledge is still low, with many still associating it with witchcraft.
Atai’s story
Maria Aguti Atai, 59 an anaesthetist at CoRSU has lived with arthritis for the last 26 years. “It started in 1988 when I developed a painful left knee. Since I worked in a theatre at Nsambya hospital, I was close to doctors so I told them but they laughed,” Atai recalls.
The next day, the pain had shifted to her right knee. This time, the pain lasted for one week.
Doctors who she worked closely with recommended that she takes anti-inflammatory drugs. This reduced the pain and one month later, she decided to go for another test after doctors suspected a case of arthritis. “I went for a medical test used for diagnosis of rheumatoid arthritis as the pain had spread to all joints. I tested positive for auto immune arthritis,” she says.
Auto immune arthritis is usually associated with genetics. The doctor told me there is no cure, but all I had to do was try to reduce pain by taking anti-inflammatory drugs. Five years after the test, I used to suffer great pain, even while I was on medication,” says Atai.
Treatment
Atai recalls a time in April 2013, when she had to raise Shs16m for her young sister who also suffered from the same condition. Her sister had severe hip arthritis, and the only solution to relieve her pain was through a hip replacement surgery.
Through this surgery, the affected joint is removed and replaced with an artificial one. It took Atai and her family six months to raise the money for the surgery. Three months after the surgery, her sister got healed.
“The pain is no more. She has resumed normal life, and she can ride a bicycle,” says Atai. But even though Atai lives with the disability of arthritis, she prefers to look at the positive side of life. “I have learnt to live with it positively because it seems to be a family problem, yet there is no cure for it. What I do now is to keep myself active so that the disability does not get worse,” she explains.
Regular exercise
Christine Tumusiime, a physiotherapist and head of allied health services at CoRSU says, “Regular exercise is important for an arthritis patient because it helps reduce the chance of joint deformity and keeps the muscles functioning.” Atai uses hand braces, which are assistive devices that help keep her fingers in position at night, and she gets massage for her feet every evening, to keep blood in proper circulation and maintain joint flexibility.
She says she can do almost everything for herself without any assistance, and attributes this to the supportive staff that she works with. She, however, finds difficulty in squatting and kneeling, because this involves bending some of her joints. When this happens, she uses painkillers.
Atai also says she always feels cold, and thinks cold weather stimulates arthritis. But Dr Mukasa says there is no connection between arthritis and cold weather.
Nine-year-old Davis
Another patient, nine-year-old Davis Ainebyoona has lived with arthritis for three years now. His mother, Beneth Turyahebwa, a resident of Isingiro District says her son was normal for the first three years after birth, before he started feeling pain in his right leg.
“Whenever he came back from school, he complained of pain in the shorter leg, especially in the knee and hip joints and could not move the leg. It became stiff,” says Turyahebwa.
She took her son to Mbarara University Hospital, but after two years of severe pain, she was referred to Mulago. However, she could not afford the Shs500,000 that was needed to undertake an X-ray. “We then learnt of CoRSU, where they offered free treatment services for children so we came here in August and my child was operated on August 18,” Turyahebwa says.
Dr Paul Muwa, an orthopaedic surgeon at the hospital explains how the surgery was carried out. “The head of his right femur had been destroyed and this caused the shortening of the leg. I had to remove the head of the femur to reduce the pain and make the joint flexible. Thereafter, we shall make him a compensation shoe to help him walk normally again.”
Causes
Although the exact cause for arthritis is not known, it has been associated with genetic factors. Another possible cause of arthritis, according to Dr Mukasa is trauma, especially through accidents.
Types of arthritis
There are two major types of arthritis, rheumatoid and osteoarthritis. There are however, other types of arthritis depending on the cause, such as septic (infection) and systematic arthritis, which is caused by illnesses such as malaria and HIV.
Arthritis due to age (wear and tear of joints) as a result of drugs and trauma, and gout arthritis caused by crystals that collect in the joints, especially excess carbohydrates and proteins. Rheumatoid arthritis occurs when the body’s immune system does not function properly. In such a situation, the joints feel stiff and achy. “This type of arthritis is more severe than the osteoarthritis, as it occurs when there is a fault in a person’s immune system that makes the body attack its own tissues,” says Dr Mukasa.
The fault is usually genetically inherited from a family member.
Rheumatoid arthritis usually affects older men than women. Osteoarthritis on the other hand, is a degenerative joint disease, where the cartilage gradually wears away. As more damage occurs, the more cartilage is worn away.
This type of arthritis mostly affects the hands, spine, knees and hips. According to Dr Mukasa, this type of arthritis mostly affects people in their 50s, but can also develop at any age as a result of injury or any joint related condition.
The major difference between these two types of arthritis is that osteoarthritis usually affects a few joints, while rheumatoid arthritis affects all joints in the body.
During the surgical process, the surgeon inserts a narrow tube, consisting of a fibre-optic video camera through a small cut, the size of a pin-hole,” explains Dr Mukasa. The process is also used in draining pus and blood from joints, especially in cases where the person has tuberculosis of the joints.
According to Dr Mukasa, if arthritis is not treated, the person gets stiffness in the joints, sleep discomfort due to excessive pain, difficulty in walking and sometimes the limbs become non-functional. In severe cases, total disability in joints may happen.
Prevention and treatment
Proper diet that is rich in calcium and vitamin D, low salt, sugar and fat combined with proper and regular exercise is crucial to maintain healthy muscles and keep joints strong. “Avoid forceful stretching of the joints because ligament structures around the joints can tear, which may later cause pain in the joints,” says Dr Mukasa notes.
Regular health visits for bone density tests, may save an arthritis patient the costs involved in treating the condition when it is in advanced stages.ical procedure helps relieve pain, improve the function and movement of the joint and stiffness.
