All right, I am going to turn it over to Dr. Kevin Yip.
Hello, I am very happy to have the opportunity to talk to you today.
I am Dr. Kevin Yip.
I hope you don’t mind my Cantonese. Sometimes it's not very fluent.
And sometimes I don't have the best pronunciation.
Today I want to talk about rheumatic diseases
as well as the issues about joint and bone health.
I have to state that I have no financial disclosure nor conflicts of interest.
Let's continue.
Let me tell you a little bit about myself My family is from Hong Kong.
I was born and grew up in the UK.
I studied medicine in London.
Now I have been living in New York for a few years.
I used to be an internist doctor at Bellevue and Gouverneur Hospitals.
Now I'm a Rheumatologist at HSS.
I want to touch on several topics today.
What is rheumatology?
How to maintain bone health?
What is arthritis?
What is autoimmune disease?
What is rheumatic disease?
Are arthritis and rheumatoid arthritis the same?
If you have heard this question, please raise your hands.
Thank you. I saw some have raised their hands.
I have heard of this question many times.
Actually, rheumatology is a branch of internal medicine.
Usually, bone, muscle and joint problems or immune diseases are also our responsibility.
If there is a need, your family doctor should refer patients to us.
This picture is quite important.
When we get older, our bones become more fragile.
One reason being older people have problems with bone compression or shortening.
Many Asians have this problem.
Slowly, it will develop into osteoporosis, in layman's terms, that's called bone loss.
Bones are easily broken when they are brittle.
And broken bones will lead to long-term swelling and pain,
Lower back or hip joint are commonly affected areas.
So, how do you maintain bone health?
In order to prevent bone loss, we have to exercise.
Tai Chi, yoga, and weight lifting exercises are great for developing balance.
You won't fall easily if you often engage in physical activities.
Also, we need vitamin D for stronger bones.
We can get vitamin D from sunlight or food.
For example, you can get enough vitamin D and calcium
from milk, cheese and fatty fish.
Many of my patients are vitamin D- or calcium-deficient.
If you can't get them from food, doctors can prescribe vitamins for you.
We can utilize X-ray to determine if you have bone loss or not.
Like I said before, if you are frequently working out, it will benefit your bone health.
Many people mistakenly believe that joint pain equals arthritis.
There are different types of arthritis.
The joint has three parts. They are bones, cartilage and muscles.
Injury to any part can cause joint pain.
There are over one hundred kinds of rheumatic diseases.
There are joint pain and inflammation, which means joint becomes red or swollen.
The most common one is degenerative arthritis (osteoarthritis).
It is related to bone loss as well.
Do any of you have osteoarthritis?
Please raise your hands.
I saw many people have raised their hands.
Thanks.
Many people have osteoarthritis. Bones will get damaged if they are overused,
especially when you are older. Hips and knees are commonly affected areas.
since they are commonly used bones.
These joints support our whole body.
But there are things you could do to help.
I have seen many patients with hand osteoarthritis,
particularly in women or older people.
If you have hand osteoarthritis, it's difficult to finish even the easiest tasks,
such as opening a can or tie shoelaces.
But physiotherapy can help.
Now, what is autoimmune disease? And how is it related to joints?
The immune system is crucial to our body
If virus was our enemy, our immune system would be the army/superhero to fight &
protect us from getting sick.
However, when the immune system is overly active, it will hurt us in return.
For example, bone joints or internal organs can cause rheumatic diseases
You should seek help from rheumatologists.
Rheumatologists specialize in treating arthritis and rheumatic diseases.
Autoimmune disease is very common.
8% of the population have an autoimmune disease.
Mild symptoms include eczema, severe symptoms include asthma.
Most people have heard of these diseases.
Autoimmune diseases are not contagious They're not viruses.
You don't get this disease because of behavior problems.
Autoimmune diseases are not sexually transmitted diseases.
Some people are not aware of this fact. They feel ashamed or afraid.
But you won't pass autoimmune diseases to other people.
You can't prevent it because it is not preventable。
Also, the course of an autoimmune disease is hard to predict. It's vital to seek help from doctors from an early state.
Some people don't want to burden the family,
so they don't talk about it.
But you don't want to be late in seeking help from doctors.
People with chronic diseases often find themselves isolated and unhappy.
We need to have a positive attitude. Especially us Asians,
we don't like to talk about our feelings.
Some patients are seemingly normal on the surface.
They often feel tired and require rest and care.
Other people don't know their situation and mistakenly think they are just being lazy.
Thus, they lack support from family, friends, or co-workers.
Slowly, they become unhappy.
That is not good for their conditions.
Autoimmune diseases can occur at any age,
including young children and seniors.
But who get autoimmune diseases most often?
If we compare gender, age and race,
we find autoimmune diseases are more common in females.
Medically, it is unclear how genes and family history affect autoimmune diseases.
But we often discover that relatives of the patient have the same disease.
So, caring for your family members is important.
Tell your doctor your family medical history,
so your doctor can consider them.
Too much sun or too much stress
will trigger autoimmune diseases.
Most autoimmune diseases can't be cured, but can be controlled.
Regular checkups are vital.
Besides taking medicine, acupuncture or Qigong can reduce swelling, pain and pressure.
I have stated before, you have to eat well and exercise in order to maintain bone health.
Listen to your doctor and cooperate with them.
Many people are concerned about the side effects of medications.
Actually, it will only be effective if you take medications long term.
Here I will show you several autoimmune diseases,
such as asthma or eczema.
Rheumatic diseases include lupus, rheumatoid arthritis, and gout.
Asians are two to three times more likely to have lupus than Caucasians.
Lupus symptoms vary from patient to patient; the ratio of female patients to male is 9:1
especially in the 15-45 female age group.
It will damage different organs, such as skin, joints or kidneys.
Patients are usually sensitive to the sun. Getting too much sun will lead to skin rash or flare-up.
Different from osteoarthritis, rheumatoid arthritis is related to our immune system.
Women are four to five times more likely to have it than men, and most of them are middle-aged.
It affects different joints, most commonly affect hands.
You can't engage in daily tasks if your hands are in constant pain.
Sometimes the fingers will become deformed and the patient’s hands will become swollen and warm.
Early treatment can prevent it from happening, also, it is manageable.
Men are three times more likely than women to develop gout.
High-risk foods include meat and beer.
It causes pain in your joints, the most common location is the big toe.
Psoriasis makes the skin very itchy,
it can happen at any age.
Sometimes it will be accompanied by joint pain.
This is called psoriatic arthritis.
Sometimes it will even cause problems in your eyes.
You can see what a psoriasis rash looks like in this picture.
Women are three times more likely to get scleroderma then men.
There are many kinds of scleroderma, some of which can cause skin hardening.
It is very painful when touched.
Some will cause blood vessels, intestines, kidneys, lungs or heart issues.
Some people will develop joint pain.
Some patients' fingers will change color as the weather changes.
It would become white, blue or red when the temperature drops.
If you find your joints starting to develop problems or have abnormal symptoms,
you need to seek professional help.
Family doctors can refer you to a rheumatologist.
We will check your joints, take X-rays and blood test
to determine what kind of rheumatic diseases you have.
It’s important to cooperate with your doctor.
We can help to you manage your condition.
Talk to your doctor, ask questions.
It's better to get early treatment.
It's time to wrap it up. I am happy to answer your questions.
Do you have any questions?