COLUMN: What’s up Doc?

‘What’s Up Doc’ is a health column in association with Spire Gatwick Park, your local private hospital, which gives you the opportunity to ask questions regarding general health and wellbeing. Answers will be provided weekly from specialist consultants at Spire Gatwick Park Hospital. If it’s a long-standing illness or simply a worry which you would like to get off your mind then send your questions to Spire Gatwick Park is a private hospital located in Horley, Surrey providing a range of treatments, from orthopaedic to ophthalmic, ENT to cosmetic. You do not need private medical insurance to use Spire Gatwick Park Hospital facilities and patients can get appointments within 2 weeks.

I am 46 years old and have been diagnosed with rheumatoid arthritis. What’s my next step? What long-term plans should I be making for life with rheumatoid arthritis? Could surgery help me? Also, are my children likely to be affected by this illness? If so, how can I best help them? Hope you can help me.

Gill, Northgate

Thank you Gill, the most important next step is to see the rheumatologist who will assess the disease activity, explain the next step and plan your management. Rheumatoid arthritis is a chronic disease. The outcome is dependent on several factors which include the severity of the disease, the state of the joints at the onset, the general medical and mental health of patient and the early treatment.

Some patients (about 20%) have very mild course and may go in to remission with or without treatment while others would need treatment and frequent follow up. In general if you comply with the management plan and medications prescribed you will have the disease well controlled and most probably keep the same capacity and functions you had before the disease started.

Surgery has no or very limited role in the early stages of the disease but may be needed 20-30 years after the diagnosis when there is joint damage. Fortunately in the recent years RA patients are in less and less need for surgery and this is mainly due to the advances in the medical management and the development of new therapies.

RA like most clinical disorders with a genetic basis result from complex interactions between multiple genes (multigenic) and environmental factors, termed multifactorial inheritance. Therefore siblings of affected parents have slightly higher risk (3%) of developing RA compared to normal population (1 %). But it is important to realise that RA is not caused by one gene where the incidence of affected siblings is significantly high. Therefore is no real need to take any action in regard to your children, but should they develop symptoms they may need to be assessed by a rheumatologist without delay. I hope this will be of help.

Dr Raad Makadsi

Remember to keep posting in your questions to the experts at Spire Gatwick Park Hospital, who can help answer any health matters on your mind. Contact the hospital either by email:, or write to: ‘What’s up Doc’, Spire Gatwick Park Hospital, Povey Cross Road, Horley, Surrey RH6 0BB. Alternatively interact via twitter: @SpireGatwick or visit their facebook page: spire gatwick park hospital.