South Africa: Everest climb proves that crippling autoimmune diseases ….

 need not be the end of the road – A sixty-three year old Capetonian who once laboured to walk 50 metres in Newlands Forest after a heart bypass operation, has just returned from successfully climbing up to Mount Everest Base Camp. Having suffered from rheumatoid arthritis (RA) for 27 years, Tim O’Hagan climbed to the iconic 8,848 metre-high mountain’s base camp to help raise awareness about the devastating effects of autoimmune diseases like arthritis, and to show that these diseases and coronary artery disease are not the end of the road.

Autoimmune diseases (AIs) develop when the body’s immune system mistakes healthy cells for harmful foreign ones and attacks them[2]. There are over 80 autoimmune diseases and this wide range of AIs makes it hard to establish exactly how many people are affected, but one of the largest international studies, which assessed 24 of the 80 diseases in the US, estimated that they affect between five and eight per cent of the population[3].

While there are no reliable figures for South Africa, if the pattern of prevalence matches the US, over four million South Africans are currently living with one or more of these crippling diseases. “We don’t have good figures regarding the incidence [of AIs] here,” confirms Dr Catherine Spargo, a physician and specialist rheumatologist at the Vincent Pallotti Hospital in Pinelands, “but we can probably assume the prevalence is similar.”

What are autoimmune diseases?

Under normal circumstances, the immune system works to defend the body from potentially harmful foreign antigens, such as germs, bacteria, viruses and parasites. The first line of defence includes antibodies to trap the antigens and white blood cells to digest them. If the antigens manage to evade these defences, the body produces lymphocytes (B and T cells), which aggressively attack and destroy the antigens. In general terms, an autoimmune disease has developed when either the antibodies or lymphocytes start attacking the body’s own organs, tissues or cells instead[4].

What causes the immune system to go wrong?

Although medical science doesn’t know conclusively what causes the immune system to mistakenly attack its own tissues and cells, experts believe that genetics plays a significant role. “It would appear that being genetically predisposed [to developing a particular AI] is the main risk,” verifies Dr Spargo, “but there also has to be a trigger and no one knows exactly what that is; it could be a viral infection, stress or a combination of factors.”

Devastating effects

Whatever the cause, the effects can be truly devastating. “I went from being a healthy ultra-marathon runner and long distance swimmer to someone who battled to get out of bed in the morning and walk,” O’Hagan attests. The condition he suffers from, rheumatoid arthritis, affects the lining of the joints, causing them to swell up painfully. It drastically reduces mobility and, if left untreated, can lead to joint deformity and bone erosion ⁴.

Dr Spargo is quick to point out that, while chronic pain is the main challenge sufferers have to deal with, the condition leads to an overall loss of quality of life. “The swollen joints are often accompanied by a broad range of flu-like symptoms and patients feel fatigued, lethargic and sapped of energy,” she explains. “It’s an extremely debilitating condition that also leaves sufferers anxious and depressed.”

An incredible achievement

The severity of the condition is what makes O’Hagan’s 21-day climb so remarkable — among other difficulties, he had to walk through the pain in his ankles every day. “It’s really exceptional,” enthuses Dr Spargo, “I wasn’t unduly surprised the day he walked into my office and told me his goal because he is such a determined, stoical and positive character.’’

It’s not that suffering from RA prevents an individual from attempting a challenge of this magnitude, but the condition makes it so much harder. “Provided the patient is responding well to treatment and the RA is under control, challenges like this can be contemplated,” Dr Spargo observes, “but patients lose a lot of muscle strength as a result of the inflammation and it takes a tremendous amount of effort and training to get those muscles back. In Tim’s case, he also had to prepare and train extra hard because of the deformity present in his joints.”

O’Hagan climbed to Everest Base Camp on behalf of the ‘Join the Fight against Autoimmune Diseases’ campaign – a global initiative by Abbot Laboratories that seeks to help raise awareness of autoimmune diseases and to unite and support sufferers, the campaign will be launching in South Africa shortly.

“It is an incredible achievement when you consider that many sufferers are wheelchair bound, and the severity of Tim’s condition deems him officially disabled,” concludes Dr Spargo. “Yet it’s also indicative of the wonderfully positive attitudes the majority of people suffering from these terrible, chronic diseases possess. It’s also an important message that there is real hope, thanks to the fantastic new treatments now available.”

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