The Rheumatology Department at Burgas University Hospital celebrated its 15th anniversary. It was established on January 1, 2010, and before that there was no rheumatology department in Burgas. Initially, the department worked with only one doctor - its founder Dr. Ivan Kazmin and senior nurse Bisera Raycheva. On January 1 of this year, Dr. Ivan Kazmin took a well-deserved rest. The department is now headed by Dr. Irina Momcheva, MD, a specialist in internal medicine and rheumatology and chief assistant at the Faculty of Medicine of Burgas State University "Prof. Dr. Asen Zlatarov". What challenges are rheumatoid diseases… Dr. Irina Momcheva spoke to FACTS.
- Dr. Momcheva, the Department of Rheumatology at UMHAL Burgas now has all the specialized committees that issue and continue protocols for patients who are treated with biological therapy under the NHIF in outpatient care. What kind of success is this?
- Success has several sides. One of them is another step that the Department of Rheumatology at UMHAL Burgas is taking in its development and rapprochement with the university clinics in Plovdiv, Sofia and Varna. This is the logical move in the development of the department and its place in the history of Burgas healthcare. Secondly - this is a serious contribution to improving patient care. Before we had these committees, we treated patients, helped in the preparation of documents, but for the protocols themselves they had to travel to other cities. Let me explain to people who are not familiar with the procedure for prescribing biological therapy - This is a new, modern, expensive therapy that has been proven to improve the condition of patients. It is applied at home, i.e. the patient takes his medications from the pharmacy, as is the case, for example, with diabetes, cardiovascular diseases. Since the therapy is expensive, it is necessary for the patient to go through a committee and receive a protocol in order to receive his medications through the Health Insurance Fund. It was this committee that was the missing link in our department.
- What do you save patients from Burgas and the region?
- We save patients from traveling to Varna, Plovdiv, Sofia, where specialized committees for writing protocols for biological therapy were previously approved. Since April last year, we have committees for inflammatory joint diseases - rheumatoid arthritis, psoriatic arthritis, Bechterew's disease. Since the beginning of this year, we have also had a committee for systemic lupus. In this way, we also provide better access and communication with us, their treating doctors. The entire outpatient procedure for starting or continuing treatment for these people now takes no more than an hour. We have created an organization to save time, money and effort for patients.
- How many patients do you serve?
- We serve about 400 patients on biological treatment, but this number is growing every month. There are also people from other cities who, for one reason or another, prefer our committee. Over 1,200 patients undergo treatment in the department annually.
- Draw a parallel to how the number of patients with rheumatological diseases has increased over the years?
- The awareness of patients has been growing over the years, and with it the demand for rheumatological care, and therefore the patient turnover. Unfortunately, despite good access to a rheumatologist, there is a delay in making an accurate diagnosis in Bulgaria. The reason is, on the one hand, self-medication, especially among young people, and on the other - wandering between different specialists. It has been proven that in rheumatoid arthritis, the diagnosis is delayed by 8-9 months, and in Bechterew's disease it can take up to 9 years. And the earlier this disease is detected and treatment is prescribed, the greater the chance that the patient will have a good quality of life. If treatment is delayed, disability is inevitable. In addition to losing working capacity, a person cannot serve himself and someone from the family must take care of him. Very often, especially younger people, think that they can cope on their own with the help of over-the-counter painkillers. This is a serious misconception. The medications for these diseases are specific, in recent years medicine has made remarkable progress with biological therapy. Treatment is carried out depending on age, gender, and whether the woman has preserved her fertile functions. The rheumatological diseases for which these specialized committees were formed are immunomediated, occur with exacerbations and remissions. And they mostly debut at a young age and in the absence of treatment or inadequate treatment, with the progression of structural damage, they disable the patients.
- What triggers a rheumatological disease…
- Medical science has not yet discovered a specific cause for the occurrence of rheumatic diseases, but it is known that in patients with a genetic predisposition, symptoms may appear when exposed to a variety of external factors - including emotional ones. If there is a person with arthritis in your family, consultation with a rheumatologist is mandatory. A common myth is the belief that rheumatic diseases occur only in people who do heavy physical labor or are caused by humid air. What can prevent the disease? A natural lifestyle, eating natural products, avoiding canned food, smoked meats. Maintaining a normal weight ensures good condition of the load-bearing joints. Physical activity, avoiding infectious diseases and negative stress effects. And at the first complaints - pain, cramps, stiffness, especially in the morning, people should contact a medical specialist. This can also be the family doctor. In some European countries, it is considered a success if you manage to reach a rheumatologist 4 months after the first symptoms. Here, in Burgas, you can consult such a specialist within a week. It is very important that treatment begins on time, we are increasingly encountering patients with permanently deformed joints or spines, thanks to modern anti-rheumatic disease-modifying drugs.
- How do you deal with staffing?
- On January 1 of this year, the Rheumatology Department turned 15. It was established with only one doctor and one nurse. Today, it functions as an independent structure, well-equipped and with a full staff, a specialization base and a training base for medical students. We have four doctors with a specialty working here.
- Is there interest among young doctors in rheumatology?
- Three of the rheumatologists in the department are assistants in rheumatology and the interest of students in the discipline is definitely growing.