More Than A Doctor: A Life Guide to Ankylosing Spondylitis Dr. Muhammed Khan has a more severe case of ankylosing spondylitis than most of his patients, and he wants to keep it that way. Few doctors understand their patients the way Muhammed Khan, MD, does. A rheumatologist at Case Western Reserve University’s MetroHealth Hospital, he treats patients with ankylosing spondylitis, or AS. He also lives with an advanced case of the disease himself. Ankylosing spondylitis is an inflammatory form of arthritis. The hallmark of the disease is the bony growths found between the vertebrae. They cause the spine to stiffen by degrees. There are treatments to slow the progression of the disease, but there is no cure. Most of Dr. Khan’s patients have better mobility than he does. He has struggled with a particularly severe form of ankylosing spondylitis for more than 50 years. “I have absolutely no mobility of my spine, including the neck,” Khan says. “I can’t even nod my head. If I have to nod my head while standing, I have to bend my hip joints.” He can’t bend over to tie his shoes or turn his head to look over his shoulder. He has almost no ability to expand his chest, so “when I breathe, I breathe through the diaphragm,” he says. But his condition allows him to offer advice and guidance to his patients that goes beyond medicine. He knows the patient he is seeing on this day cannot turn his head far enough to see if there’s anyone in his blind spot when he’s driving. Has he bought a wide-view mirror yet? No? He needs to, and if he doesn’t, Khan will lend him his own. Khan first started to feel pain in the back and hips when he was 12 and living in his native Pakistan. He told doctors it felt worse when he was still than when he was active, and worst of all at night. But the orthopedists he consulted did not recognize the illness. When he started to experience chest pain (because his spine could no longer tolerate the movement of a deep breath) doctors treated him for tuberculosis. When that proved ineffective, they started a year of intravenous infusions of imported honey, which was then believed to have medicinal value. “It didn’t have any effect on my illness, but I am ever so sweet,” Khan jokes. “The honey must still be running in my veins.” It wasn’t until he began his medical studies that Khan found a rheumatologist who gave him the correct diagnosis. Once he was being properly treated, his condition stabilized. He offers the same promise to his own patients. Medication can stop the inflammation, but patients still need to work to keep their mobility. “Sleeping on a firm bed, not smoking at all, doing deep breathing exercises, swimming is an ideal exercise, and avoiding contact sports,” Khan says. “All these things are important because once you control inflammation you have to maintain normal posture as best as one can.” Of course, the earlier the diagnosis, the earlier a patient can stop the progression of the disease, so awareness of AS is essential. Khan has written two books on ankylosing spondylitis, one for doctors and one for patients. He also designed a patient education website named after the HLA-B27 gene closely associated with the illness. For people with ankylosing spondylitis, late diagnosis means lost mobility, so Khan finds real purpose in his mission to educate others. Despite his own infirmity, Khan travels the globe to help medical professionals learn to recognize the symptoms of AS. “I have been to all the continents and every country in Europe,” he says, “though it’s not easy for me these days to travel.” Source
