Blogs
CNS Lupus (NPSLE)
29 yr. old woman with SLE and transverse myelitis. Is this NPSLE; how to diagnose?
Hydroxychloroquine for Everyone
Nearly 25 years ago, while lecturing on best therapies for rheumatoid arthritis (RA), I loudly stated that hydroxychloroquine was “useless” and, deservedly, I was “boo-ed” off stage. My point then was that rheumatologists needed to be aggressive, if not overly aggressive, in treating all RA patients. And my view was that HCQ was representative of under-treatment. I have reconsidered the use of HCQ in RA substantially in the last few years, based on its merit.
The War Rheum
The effects on rheumatologists and their patients living in Ukraine largely have been unseen by the world. At ACR Convergence 2024, I met Dr. Marta Dzhus who practices at St. Michael's Clinical Hospital in Kyiv; she shared her story with me about the humanitarian crisis in rheumatologic care in Ukraine because of the ongoing war. Here is an excerpt of our conversation.
Rheum to Travel
One of the benefits of attending conferences aside from scientific exchange is meeting new people. At one symposium, I met a unique rheumatologist. This chance meeting turned into an interview, that turned into a blog. Holly Bastian, MD is a rheumatologist practicing without the restraints of being tied to a place. She is a nomadic rheumatologist, a rheum on the road who embodies Johnny Appleseed as she spreads her knowledge and skills to multiple places in need of rheumatologic services. This is her story.
Overlap Syndrome with ILD
How would you manage a patient with Overlap (anti-synthetase) syndrome, ILD, polyarthritis and myositis?
Karoshi - {Japanese 過労死: Death by Being Overworked}
Over the last few decades, Japanese workers were collapsing dead at their desks or committing suicide due to the high stress stemming from their jobs; Japan coined this phenomenon, “Karoshi.” In 2021, the World Health Organization and International Labour Organization issued a warning: working 55+ hours a week is a serious health hazard and increases the risk for death from heart disease and stroke. But since the pandemic, I see many colleagues working hard at the expense of their health, family life, mental and emotional well-being. I never thought I would be burned out because I had passion for my job.
Teaching and Academic Burnout
RheumNow recently highlighted a publication that reported about a third of physicians in academia intend to leave. To our colleagues in non-academic situations, this may seem incredibly high. I think an important contributor to the intention to leave academics is that something that used to be a benefit has now become a challenge: namely, teaching.
Choice Overload (and the Way Out)
I recently overheard a very good practicing rheumatologist complain, “why do I need yet another drug for psoriatic arthritis? I have more treatment choices than I have actual PsA patients who need a new or better drug”.
When PMR Strikes Young, It Hits Hard
Narratives around polymyalgia rheumatica (PMR) often centre around “older people” or even “elderly”. And, indeed, the peak of the age distribution is in the mid-70s – not that everyone that age considers themselves old. Treating “young PMR” can be a very different proposition to treating someone in their seventies or eighties. It’s worth taking time to think this through.
