There’s no cure, but Dr Sam is a pioneer in arthritis care

DGH feature on Rheumatology department'30/03/12
DGH feature on Rheumatology department'30/03/12

ARTHRITIS may tend to be dismissed as the sort of thing people moan about as they get older – the odd ache and pain when your grandparents stand up – but the reality of the situation is that not only can it drastically reduce what a sufferer is able to do, but it can also leave people in intense and crippling pain.

For that reason, the rheumatology team at the DGH are some of the unsung heroes of the local health service, helping almost 2,000 new patients get to grips with the condition ever year – as well as around 3,000 people already under their care who benefit from follow-up treatments.

And at the heart of the department is Dr Sam Panthakalam, who works with his colleagues Dr Andrew Pool and Dr Catherine Bevington.

The three consultants spearhead a vast range of treatments and projects on offer at the hospital, including a host of clinics, outreach projects and pioneering research.

Chief among them is the early arthritis clinic which aims to help those in the early stages of developing inflammatory arthritis and a rapid access service for people whose GPs are worried need immediate attention.

As Dr Panthakalam – or Dr Sam as he is known – explained, rheumatology treatment has shifted in approach in recent years.

“Nowadays we offer more of a one-stop shop for people,” he said. “We can get people in, assess them with an ultrasound in the clinic and get treatment started sooner.

“Rheumatoid arthritis involves accelerated wear and tear.

“It is an erosive arthritis and damages joints which is why we have been encouraged to set up this early arthritis clinic because the sooner you can get it [the condition] under control, the less damage is done.”

As with any medical intervention, the crux of the treatment is what medicine and antibiotics are prescribed.

But, unlike the overwhelming majority of diseases, there is no cure. For experts like Dr Sam the job is about managing the condition, rather than getting rid of them completely. But that can be costly.

Over the last decade significant strides have been made in the production of drugs, known in the trade as biologicals, which provide hugely beneficial results.

“They can be very expensive but they are also the most useful medicine. It would not be unusual for a year’s supply for one patient to cost around £10,000.

“For that reason they are given to people once conventional treatment have failed.

“We have to prove conventional methods have not worked before starting them [the patient] on them.”

As Dr Panthakaland’s colleague Dr Pool lamented, the situation is unlikely to change. “I can’t see the price of those drugs coming down in the near future,” he said.

“They are expensive to make and a lot of research went into their development.

“There are also other problems. For example they are less robust, so if you heat them up they will not work.”

The cost may be hard to swallow, but the benefits of the new drugs are obvious.

They do have some side effects and, as Dr Panthakaland explained, they are not suitable for everyone.

But, you only need to speak to one of the people using them to understand the difference they can make. Marie Cook has been a patient for five years and recently started on Mabthera, one of the new wonder drugs.

“It is fantastic treatment,” she said. “I have been on it for six months and, instead of having to take pills, I come every six months for a course of treatment.

“I could not take normal drugs and was on anti-inflammatories. This was offered to me. I was really lucky to get it.”

The DGH team has a keen interest in developing new techniques and getting involved in clinical trials and the consultants and their work regularly feature in journals and research papers.

However, according to Marie Cook, it is their personal approached to patients which makes all the difference.

“This department is second to none,” she enthused. “We are so lucky to have them. The support I have received has been fantastic.

“I can now do everything I could not do before. It has given me my quality of life back and I can spent quality time with my grandchildren.”

She reserved special praise for Dr Panthakalam.

“I feel very lucky to have had Dr Sam. He has been brilliant, I can’t praise him enough.

“And how many consultants let you call them Dr Sam?”