Swetha Boddeda, M.D., is quick to remind that her specialty, rheumatology, is much more than the name implies. In addition to rheumatoid arthritis, rheumatologists diagnose and treat as many as 100 different musculoskeletal and systemic autoimmune diseases commonly referred to as connective tissue diseases.
“I treat a wide variety of autoimmune and inflammatory diseases like lupus, Sjogren’s syndrome, scleroderma (systemic sclerosis), dermatomyositis, polymyositis, polymyalgia rheumatica, septic arthritis, sarcoidosis, gout and pseudogout gout, fibromyalgia and others,” says Boddeda, a rheumatologist with Conway Regional Health System.
Rheumatology is a field that works in close relationship with every specialty. “No presentation is straightforward. Referrals are passing back and forth between specialties to make a diagnosis,” says Boddeda.
Boddeda, a native of India, describes herself as a patient listener who thinks “outside the box” in a medical specialty that is filled with hard-to-diagnose diseases. “My patients tell me that they have found a doctor who is listening to them. That makes me feel good and motivates me to be a better doctor,” she says.
Once she interviews a patient, the diagnosis process begins. “It starts with blood work, depending on what symptoms the patient has, and sometimes we get x-rays or biopsies,” she said. Boddeda is often part of the treatment team and works closely with radiologists and laboratories.
Extensive education helped prepare her for a career as a medical detective.
Boddeda achieved her internal medicine residency training at the Indiana University Health Ball Memorial Hospital in Muncie. She went on to complete her Rheumatology Fellowship at the University of Mississippi Medical Center, where she received the SAFMR Fellow merit award. Boddeda was selected for the Young Investigator Research Travel Award in 2019.
After her fellowship, Boddeda was searching for a practice close to her husband, Neal, who is completing a medical fellowship in hematology/oncology in Shreveport, La. She learned that a number of rheumatology patients in Faulkner County were spending most of a day driving back and forth to doctors’ offices in Little Rock.
She moved the couple’s two daughters, Kriti and Vibha, to Conway and joined the Conway Regional Multispecialty Clinic. She already had several patients on her appointment schedule when she began practice in December of 2019. “I know I can make a difference here,” says Boddeda.
While searching for answers for their discomfort, many patients are unaware that they have a connective tissue disease or the disease is mistaken for something else.
There are a few general symptoms of connective tissue disease to watch for:
“I recommend for my patients to watch out for any symptoms like unexplained fevers or unintentional weight loss, skin rashes that are not easy to figure out, and swollen joints as potential symptoms for autoimmune disease,” adds Boddeda. “Timely diagnosis is important. These diseases are prone to cause significant organ damage if not caught in the early stages.”
She urges people with unusual medical symptoms to “take it seriously. Go see your family doctor.”
Fibromyalgia not a ‘made-up disease’
A common and painful connective disease is fibromyalgia.
“The clinical diagnosis for fibromyalgia is not challenging, but not every treatment works the same way for every patient,” says Boddeda.
She does have to overcome the myth that fibromyalgia is a “made-up disease.” Boddeda says fibromyalgia can be diagnosed based on certain clinical symptoms: Pain and tender areas, fatigue, sleep issues, concentration and memory problems called “fibro fog,” anxiety and depression, morning stiffness, numbness and tingling of the hands, arms, feet and legs and headaches.
Treatment can include exercise, weight loss, massage, yoga and Tai Chi. “Some of my patients are doing well with Tai Chi,” she says. “Recently, there has been evidence that cognitive behavior therapy is helpful.”
RA causes swollen, hot joints
Rheumatoid arthritis is another common disease treated by Boddeda. “People with RA have very swollen and warm fever-like joints,” she says. “If left untreated it can cause crippling deformities over a number of years.” The difference between RA and mechanical or standard arthritis is that it improves with activity. “People with RA need to be as active as possible,” she said. Treatment can include medication and lifestyle modification such as quitting smoking and alcohol abuse and weight loss.
From rare conditions to RA or fibromyalgia, Dr. Swetha Boddeda and fellow rheumatologists are thinking outside the box to find new ways of treating connective tissue disease. “I have no choice; they are trusting my diagnosis and judgment.”