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Thursday, April 24, 2008

Doctors Specialists Dubai

Patients in Dubai still have a really hard time finding the right doctors for a variety of conditions. The right Specialists exist and usually the best option is finding these doctors or finding the right primary care doctor or GP.

Choose your doctors with care. Research their credentials on the internet. Ask friends and colleagues for recommendations. Do not be shy about asking your doctor what his experience is with a certain condition or what their success rate is for a certain surgery. Think of your questions ahead of time and write them down. The Connector magazine is a good starting point for doctors names.

Back Pain Dubai UAE Specialist doctors

Yesterday I saw a lovely lady from the UK. She has been seeing her GP in the NHS system for many months with severe back pain radiating to her legs. She is unable to walk for more than 5 minutes, and unable to sleep at night. She has occasional stiffness and numbness in her left leg. She was only being given pain relief and no xrays, MRIs or exercises had been ordered..

Was this patient being managed appropriately in the UK? No. It is true that 95% of back pain is self-limited and usually due to muscle strain, and resolves on its own. We do not routinely order x-rays or MRIs for such patients. However, there are patients with certain ''red flag'' on history. A history of persistent back pain longer than a month, pain radiating to the legs with numbness or weakness of the legs, fevers, weight loss, pain which prevents sleep, inability to pass urine or other bladder or bowel symptoms, history of immune suppression should all raise alarm bells.

This patient had SIGNIFICANT symptoms, pain of several months, keeping her from sleeping at night, associated with inability to walk. She definitely needed an MRI, which we obtained on the same day and made the diagnosis of spinal stenosis. Hopefully she will be able to see a good Spine Specialist in the UK when she returns home with this information.

Saturday, April 19, 2008

Arthritis Diet. What to eat for arthritis

Often patients ask what they should eat or avoid to help their arthritis. There isn't an easy diet one can follow to cure arthritis. For people with gout it is helpful to avoid red meats, shellfish and alcohol. Cherry juice may be helpful for gout. With other forms of arthritis a healthy, balanced diet is helpful. There is no evidence that sour foods or citrus juices are bad for you. In fact pineapples contain an enzyme bromelain, which is useful for arthritis. Oily fish or omega or fish oil supplements, ginger, garlic, turmeric, soyabean, avocadoes are some foods which are helpful. Remember to get 1000 mg of calcium from dairy products and enough vitamin D through sun exposure, or else take a calcium supplement.

Friday, April 18, 2008

Arthritis Specialists Arthritis Treatment Dubai United Arab Emirates

This morning I received a call from the mother of a 24 year old girl who lives in Europe. This girl developed joint pains and swelling in May 2007 and had a blood test which showed a positive rheumatoid factor. She was diagnosed with Rheumatoid arthritis and saw a rheumatologist who advised aggressive treatment. As is so often the case, the girl and the family were afraid of aggressive management and decided to start on moderate treatments. The disease progressed, more and more drugs were added, all at low or inadequate doses and not controlling the disease properly. Would it not be better for this woman to be on 2medications at the right dose, than 5 at smaller doses? As our understanding of rheumatoid arthritis improves we realize that we should be treating this disease early and aggressively. In my practice several patients who have presented to me within the first year of treatment have been aggressively managed and are currently off all treatments. For the first time we specialists feel that we can cure arthritis. It is essential that the patient is well informed and knows that the medications are not worse than the disease. Fear of medication is not needed and the doctor always must monitor patients closely for side effects. Failure to treat early can result in deformities and disabilities.