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Berks Rheumatologist Also Happens To Have Rheumatoid Arthritis

Reading Eagle: Tim Leedy | Dr. Amal Kebede

Dr. Amal Kebede examines patients for a living, guiding them on a path toward relief.

As a specialist in internal medicine and rheumatology, Kebede works with people who are dealing with pain, stiffness and swelling. She addresses complex problems when the immune system has gone awry or patients have aches that won’t go away.

“I don’t know that I chose rheumatology,” said Kebede, who works for Penn State Health St. Joseph. “I think rheumatology chose me.”

When Kebede says this in her office in Exeter Township, she is not just a young doctor waxing poetic about her passion and specialty. She’s telling part of her life story.

Kebede doesn’t just treat patients with rheumatoid arthritis; she has it herself.

“It’s huge for patients to know that their doctor knows what it’s like to sit on that crinkly paper and what it’s like to be examined, rather than just a doctor telling you to do this and this and this,” Kebede said.

Kebede, 35, is a Wilson High School and Albright College grad who completed her medical training at the Philadelphia College of Osteopathic Medicine. After practicing in Lancaster, she recently returned home to work at Penn State Health St. Joseph’s Exeter Ridge Health Complex.

As she continues her medical career in Berks, Kebede carries an optimism and a positivity that shines through.

For a patient receiving a scary diagnosis, that can make all the difference.

“If you work hard, you can overcome obstacles and you can do anything,” she said. “I want to empower patients who are in a similar situation to me that you can do anything.”

Early diagnosis

Kebede acknowledges that she is a bit of an exception to the rule.

Her rheumatoid arthritis was caught over two decades ago when she was just 13 years old.

Kebede remembers walking into a pediatrician’s office, thinking she’d get a clean bill of health. She told her doctor she couldn’t crack a knuckle in her hand, and that prompted an X-ray that got the ball rolling toward her diagnosis.

“It’s a different sort of experience because I didn’t start off with having pain,” she said. “Over the years, more joints became involved and pain became a bigger issue, and then it became about controlling that with medications and physical therapy and exercise.”

Kebede said the diagnosis could have felt scary at the time, but she was only 13, and she’s had a long time to come to terms with it.

At 35, Kebede says there are a few ways she notices rheumatoid arthritis in her life.

“There are certain things I can’t do because of chronic damage and weakness from inflammation,” she said. “Pumping a blood pressure cuff with my left hand, I can’t do that, turning door knobs with my left hand, clipping fingernails on my right hand.”

She takes stairs one at a time, and it’s a 30-minute process to get to the bathroom and back when she gets up in the morning.

“As a 30-something-year-old person, I should be able to run up and down those stairs,” she said.

About rheumatoid arthritis

Kebede’s symptoms from over two decades of arthritis may seem like a lot, but they are not the end of the world, she said. Her condition is well-controlled, and it hasn’t stopped her from earning her medical degree, getting married or having children.

For many patients, medicine has evolved to the point that rheumatoid arthritis is a chronic condition that is very manageable; it’s not a crippling or disabling one.

“Once treatment is initiated, you can slow and in most cases halt the progression of the disease,” she said. “You can prevent people from having disabilities or joint deformities in the future, which is huge. From a productivity standpoint, they can function in their home, remain independent, continue to go to work.”

The cause of the disease is not yet known, but it happens when the body’s immune system attacks joints and organs. That creates persistent inflammation that can break down and damage joints over time.

It affects the fingers and knuckles, hips and knees and shows up in the ankles, toes, wrists and elbows.

“Simple things that people take for granted I just can’t do,” she said. “But I feel fortunate that I had access to care, and I had an excellent doctor and we were able to keep things under control.”

When it comes to arthritis and being healthy, that access is crucial, she said.

“People who have untreated rheumatoid arthritis can have pain, swelling, decreased range of motion, increased difficulty doing simple tasks,” she said. “They can go on to develop premature heart and lung issues, heart attacks, strokes, cancers related to rheumatoid arthritis.”

Firsthand experience

Linda McCormick does not remember when she first started going to Kebede, but she’s been under her care for a few years.

The 69-year-old Reading resident said she has been dealing with mild arthritis in her hands and knees for years, but only decided to see a specialist when the pain started to increase.

McCormick said she was drawn to Kebede by her warm smile and got a sense that she would be a caring doctor. She had no idea about her backstory.

“She knows what it’s like to have pain in your fingers and knees and how difficult that is to deal with sometimes,” she said. “That means a lot. I think most doctors are not going to have that experience with such a disease. They may be knowledgeable about what medications to suggest or what treatment to suggest, but that real compassionate care comes out of her really knowing what that’s like.”

Kebede said her personal experience helps show patients that there’s plenty of hope after the diagnosis, but it also helps when discussing treatment options.

She knows the medications that halt the progression rheumatoid arthritis can come with some harsh side effects, and that is an important thing to consider.

“We never take prescribing medicine lightly,” she said. “Some of our medications can have some toxicities. We have to weigh those benefits and risks. We have to compare that with not being on treatment at all and the risk of the disease itself.”

The future

At 35, Kebede has a lot of years ahead of her, and she knows there will likely be other issues stemming from her rheumatoid arthritis.

As an example, she’ll probably need a knee replacement earlier than other people.

“Sometimes, knowing too much is also a bad thing,” she said. “I think about what the future holds for me. I know I have higher risk than the average person for heart disease because of long-standing chronic inflammation.”

But she also believes more work is happening to get to the cause of her condition and new therapies and medications could be on the horizon.

In the meantime, she carries that optimism and hope with her wherever she goes while encouraging patients to do the same.

It’s worked out pretty well so far, she says.

“I’m here to tell you it isn’t necessarily what you are afraid of,” she said. “You can have a good outcome from this disease, and I’m that example.

“A lot of patients respond really well to that.”

Types of pain

Osteoarthritis: The protective cartilage inside the joint breaks down, making movement of affected joints more difficult and painful. In time, bones of the joint may rub directly against one another, causing severe pain.

Rheumatoid arthritis: The joints and other organs are attacked by the body’s own immune system. The immune system primarily goes after the lining of the joints, called the synovium. Over time, the persistent inflammation breaks down the joint and damages it permanently.

Psoriatic arthritis: An autoimmune inflammatory disease in which the immune system attacks the body, causing inflammation and pain. Psoriatic arthritis affects the joints, causing arthritis; the connective tissue where tendons or ligaments attach to bones, causing enthesitis; and the skin, causing psoriasis.

Fibromyalgia: Is considered a central pain syndrome in which the brain and spinal cord process pain signals differently. A touch or movement that doesn’t cause pain for others may feel painful to you. Something that is mildly painful to someone without fibromyalgia may hurt you even more. It is characterized by widespread pain that may come and go or be constant. It’s also associated with fatigue, sleep problems, inability to concentrate and mood troubles.

Gout: A form of inflammatory arthritis that does not cause body-wide inflammation the way rheumatoid arthritis or psoriatic arthritis does. In gout, uric acid crystals cause problems, resulting in extremely painful joint inflammation. Gout usually affects the large joint of the big toe, but also affects other joints.

Source: arthritis.org.