Patient questions and answers
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I am an Italian citizen who moved to Hong Kong in 2023. I am employed here, therefore have a working VISA and HKID. I am contacting you because next year my girlfriend will move here from Italy too. She has a rheumatic pathology called "ankylosing spondilytis" for which, supervised by a rheumatologist, she's been under treatment with biologics Golimumab (Simponi) since 2018: 1 injection every 28 days. Nowadays the drugs are covered by the Italian National healthcare system. She will move here in February 2024, bringing along with her 4 doses of the drug to cover the potential period when she will not be HK resident yet. Our concern is how can she manage to obtain this specific drug afterwards? I guess it requires local prescription and then supply from a pharmacy / hospital? And are there any support schemes she can apply for once obtaining HK resident status?
To obtain Golimumab in Hong Kong, your girlfriend will need to visit an outpatient clinic in either the public or private sector. It is recommended that she consult with a local rheumatologist who can assess her condition and provide the necessary prescription. The rheumatologist will be able to guide her through the process and provide further details about the specific treatment options available.
Additionally, once your girlfriend obtains Hong Kong resident status, there are funding schemes available through public hospitals that can provide support for her. This support is subject to prior disease and financial assessment by a nurse and medical social worker.
To get started, we recommend making an appointment with a rheumatologist in either the public or private sector. They will be able to provide comprehensive information and guide your girlfriend through the necessary steps to continue her treatment in Hong Kong.
I just learnt that lupus has an increase cancer risk. Is it true? What is the types of cancer lupus have? Is there any early screening?
Lupus patients may have a higher risk of developing non-Hogkin's lymphoma. There are also recent studies showing an increased risk of hematological, lung, thyroid, liver, cervical, and vulvovaginal cancers in patients with lupus. However, other contributing factors such as the use of drugs or smoking may associate with the increased risks. Further study is required before having a solid conclusion. There is no screening program based on the above finding. In general, the adoption of cancer screening programs provided by the Public Health system or Government is suggested. Early report of any abnormal symptom to your doctor during medical follow-up may also be the best approach.
I have been taking 200 mg of hydroxychoroquine for ten years for the mixed connective tissue disease and have been arranged for eye test annually. I am not diabetes or hypertension. Am I at risk of retinol toxi? Can retinol toxicity be reversed if I am initially or early diagnosed?
Long history of taking hydroxychloroquine is one of the risk factors of developing retinal toxicity. Therefore, patient who is put on hydroxychloroquine for more than 5 years is recommended to referred to Eye doctor for regular screening of any retinal side effect. Moreover, it is recommended to keep the dose of hydroxychloroquine not more than 5mg/kg/day if long term use is needed.
The side effect of retinal toxicity may be reversible if it is detected early especially during diagnosis by regular screening. You are recommended to continue the regular eye test and consult your doctor in-charge for your concerns. It is not advisable to stop the drug without any medical consultation.
I am a SLE with skin being the presenting problem. Can Aspirin prevent the heart disease arising from vasculitis ?
Aspirin may have a role in the prevention of coronary heart disease in patients with SLE. Its effect is mainly on the anti-platelet function i.e. prevention of blood clot formation on main blood vessels in the heart.
However, it is only recommended to use aspirin in patients with underlying high cardiovascular risk profile such as smoker, high lipid level, Diabetes Mellitus, poorly controlled SLE, long term use of steroid etc. It is essential to consult your doctor for assessment before making the decision of the use of aspirin.
Why am I so sensitive/frequent(7 to 10 days) getting gout attacks now even when my uric acid level is low below 250. I barely eat meats and my diet is mainly vegetables, fruits, bread, salmon, boiled eggs but I am still getting frequent gout attacks. I wasn't getting gout this frequent before my major 5 months long gout attack last year. Since then I was getting gout attacks every 4 to 5 days for 3 to 4 months, presently I am getting gout attacks between 7 to 10 days. How are my liver/kidney functioning, will I eventually face kidney/liver problems(failure/renal disease, liver disease)? It's been over a year since my 5 month long gout attack both my feet are still stiff/sore, my knees are stiff/sometimes burn. When I stand for more than 15 to 20 mins my feet start to ache, the pain would propagate up my legs. when I walk for a mile or more my feet aches and the pain propagate up my legs. I get so tired/exhaustion at the end of the day now. Are my nerve/tendon/joint in both my feet damaged or something?
I would like to reassure you that your liver and renal function tests are all normal. It is quite unusual that you got frequent "gouty attacks" despite of having an absolutely normal urate level. Indeed, your blood urate level is in the low normal level. Your description of symptom of lower legs are not too typical of gouty attack such as stiffness or propagation of sore/pain as well as tiredness or exhausation at the end of day. Gouty attack usually means rapid onset of pain, swelling, mild erythema as well increase in temperature i.e. warmth over a joint. It usually involves joints over big toe, feet or ankle first. It may progress to involve other joint such as knee or even in upper limbs in subsequent attack.
I suggest you to seek further medical consultation to look for other conditions which may better explain for your symptom and discomfort.
Hello! I'd like to learn more about ergonomic tools that people with arthritis tend to use. Are there any tools that are very useful when living with arthritis, and what about those tools make it so useful? Thank you very much.
I am not sure whether you are asking about the ergonomic tools for work or in household use.
There are certainly some kinds of tools which are useful for patients with arthritis, such as kitchen utensils or gardening tools etc.
In general, doctor may make referral to the occupational therapist is an expert on giving such advice. Occupational therapist would assess the impact of arthritis on a patient's daily activities and functioning. The recommendations on various kind of tools to improve patient's function will also be made during the assessment.
My son at age 24 is diagnosed Behchets' Syndrome and his symtom has been lasting for some years. Currently he is residing in Canada and receiving Colcichine for 1 year. Doctors currently is not changing medication but Colchichine is fairly mild for treatment. Is there any other alternative medication/treatment, or my son returns to HK for treatment. Thank You.
Patient suffers from Behcet's disease may have a different kind of symptoms. The choice of medication depends on what kind of symptoms the patient is having.
Colchicine is usually given for patient with oral ulcer or some kind of skin problems. If it is not helpful, other medications are available such as steroid treatment but side effect is one of the concern. Your son is more appropiate to be seen by a specialist for further assessment. I am sure that specialist would be available both in Canada and Hong Kong.
Please could you send me a list of Doctors who specialise in treating Rheumatoid Arthritis? Thank you
If you are searching for registered Hong Kong doctors, please visit The Hong Kong Doctors Homepage (http://www.hkdoctors.org/) for more details. Thank you very much.