For a 45-year-old UAE resident, persistent pain and swelling turned out to be rheumatoid arthritis. Early recognition and treatment helped her return to work, driving and the family life she feared she might lose.

For Dilini Ayesha, driving is much more than a job.

For the 45-year-old mother of two, who has lived in the UAE for 16 years, driving is a profession she has built her independence around. For the past eight years, she has worked as a driving instructor at Emirates Driving Institute, including as a VIP instructor training people to drive larger vehicles and four-wheel drives.

She is also a mother to an adopted daughter and a five-year-old son.

So when unexplained pain and swelling suddenly began affecting her hands, her greatest fear was not simply the pain itself. It was the possibility that rheumatoid arthritis might prevent her from continuing to work and caring for her family independently.

Her journey began with what appeared to be an unrelated injury.

In December 2024, Dilini fell and injured her knee while helping a recovery truck load her vehicle. Several months later, she suffered another fall at home, causing a more significant knee injury. Following an MRI, she underwent ACL reconstruction and meniscal repair and spent around two and a half months recovering.

She was looking forward to returning to her normal routine.

But shortly after returning to work, she developed severe swelling and pain in both hands.

“At first, I thought it might be connected to my surgery or that it would settle down,” Dilini recalls. “But the pain kept getting worse.”

She was prescribed different painkillers, but the symptoms continued to progress. She eventually found herself struggling to grip a steering wheel or use her hands normally.

“For me, the pain felt like 15 out of 10,” she says. “I know that isn’t a normal pain scale, but that is honestly how it felt.”

The physical pain was accompanied by something else: fear.

“What if I can’t drive anymore? What if I can’t work anymore? How will I take care of my children?”

It was at this point that Dilini was referred to Dr Muhammad Azhar Abdullah, Consultant Rheumatologist at NMC Royal Hospital Sharjah.

Rather than assuming that the symptoms were simply part of her recovery from the knee injury, Dr Azhar investigated the underlying cause.

Clinical assessment and blood investigations pointed towards rheumatoid arthritis (RA) — a chronic autoimmune disease in which the immune system mistakenly attacks the lining of the joints, causing inflammation, pain and swelling.

“Rheumatoid arthritis is not simply wear and tear of the joints,” explains Dr Azhar. “It is an inflammatory autoimmune disease, and if the inflammation remains uncontrolled, it can progressively damage the joints. It can also be associated with problems affecting other parts of the body.”

For Dilini, receiving a diagnosis of rheumatoid arthritis finally provided an explanation for what was happening to her body.

“Having an answer was important to me,” she says. “When you don’t know what is happening to your own body, the fear becomes even bigger.”

Why recognising rheumatoid arthritis early matters

Rheumatoid arthritis can present differently from person to person, but persistent joint swelling, prolonged morning stiffness, pain and difficulty moving the affected joints should not simply be dismissed as ageing, overuse or ordinary aches and pains.

One important distinction is that not all arthritis is rheumatoid arthritis. Osteoarthritis, gout, psoriatic arthritis and other inflammatory rheumatic diseases can produce joint symptoms, but their causes and treatments are different.

That is why identifying the underlying condition matters.

In Dilini’s case, identifying rheumatoid arthritis allowed treatment to be started without waiting for further progression.

“Once we identified that she was dealing with rheumatoid arthritis, the priority was to control the inflammation and prevent further problems,” says Dr Azhar. “The aim of treatment in rheumatoid arthritis is not simply to reduce pain temporarily. It is to control the underlying disease, protect joint function and help the patient maintain her quality of life and independence.”

Her improvement was gradual rather than an overnight transformation.

Over the following weeks, the inflammation and pain began to settle. Her hand function and mobility improved, and by around the third week, Dilini was able to return to work.

She could once again hold the steering wheel.

She could work.

And she could return home and care for her children independently.

“I felt like I had been given my life back,” she says.

When treating rheumatoid arthritis means protecting a person’s dreams

This year’s World Arthritis Day campaign theme, “Achieve Your Dreams,” highlights the aspirations and goals of people living with rheumatic and musculoskeletal diseases. For Dilini, her dream was not complicated.

It was to continue working, driving and being there for her children.

Her experience demonstrates why early recognition of rheumatoid arthritis matters. The disease can cause permanent joint damage if inflammation remains uncontrolled, while it may also have effects beyond the joints.

“Patients sometimes wait because they think joint pain is something they simply have to live with,” says Dr Azhar. “Persistent swelling, prolonged morning stiffness or unexplained joint pain deserve medical assessment, particularly when symptoms are affecting everyday activities. The earlier we identify rheumatoid arthritis, the earlier we can discuss appropriate treatment and work towards controlling the disease.”

Today, Dilini is back behind the wheel and back to the life she feared she might lose.

“I am driving. I am working. I am taking care of my children,” she says. “I don’t take any of those things for granted anymore.”

Her message to others is simple:

“If you are experiencing unexplained pain, swelling or stiffness, please don’t ignore it. Get yourself checked. Sometimes, getting the right answer can be the beginning of getting your life back.”

For Dilini, that diagnosis did more than explain her symptoms.

It helped protect the life she had worked so hard to build.

Dr Muhammad Azhar Abdullah is Consultant Rheumatologist at NMC Royal Hospital Sharjah.

By Dr. Mamata Bothra, Specialist Pediatrician and Neonatologist, International Modern Hospital, Dubai

With schools reopening on August 25, parents across the UAE are busy preparing uniforms, books, shoes and lunchboxes. But before the school bag is packed, it is worth asking one more important question: Is my child healthy and ready for the new academic year?

As a pediatrician and neonatologist, I encourage parents to use the remaining days before school as an opportunity for a simple health review. This does not mean carrying out a long list of unnecessary medical tests. Instead, it is about identifying any health concerns that could affect a child’s learning, energy, development or overall well-being.

Start with vaccinations and medical needs

Begin by checking your child’s vaccination record. Make sure all routine vaccinations are up to date and that no recommended doses have been missed. Parents should also speak with their child’s doctor about the seasonal influenza vaccine.

If your child has a chronic medical condition or requires regular medication, ensure prescriptions are current and that the school has the necessary medical information, medicines and emergency action plan.

A routine pediatric check-up can also be valuable, particularly if your child has not been assessed recently. During the appointment, the pediatrician can evaluate growth, height, weight, blood pressure, physical development, nutrition and general health.

It is also an opportunity to discuss concerns that may have been postponed during the holidays, including recurrent headaches or abdominal pain, constipation, frequent infections, breathing difficulties, snoring, fatigue, poor appetite or unexplained changes in behaviour and school performance.

Preventive pediatric visits should not focus solely on vaccinations. They also provide an opportunity to discuss a child’s learning, behaviour, development, emotional health and any age-appropriate screening needs.

Does your child need tests for iron or vitamin deficiencies?

Iron deficiency deserves particular attention because it can affect a child’s energy, concentration and neurodevelopment. However, this does not mean that every healthy school-aged child needs to undergo a large “vitamin panel” before returning to school.

The decision to perform blood tests should be based on the child’s age, diet, growth, symptoms and individual risk factors.

Children who follow restrictive, vegetarian or vegan diets, have poor nutrition, consume excessive amounts of milk, have a chronic illness or are not growing as expected may require further assessment. Persistent tiredness, pale skin, weakness and difficulty concentrating can also indicate the need for medical evaluation.

When testing for possible iron deficiency is clinically indicated, particularly in adolescents, a complete blood count and serum ferritin test may be useful.

Similarly, testing for vitamin D, vitamin B12 or other nutritional deficiencies should be guided by the child’s medical history, diet, symptoms and clinical examination—not performed routinely for every child.

Do not overlook vision and hearing

A child who cannot see the board or hear the teacher clearly may appear inattentive when the real problem is sensory.

Possible signs of a vision problem include squinting, sitting very close to screens, rubbing the eyes, experiencing frequent headaches, holding books unusually close, struggling to read, turning the head to one side or showing an unexplained decline in school performance.

For hearing, parents should watch for frequent use of the word “What?”, increasing the television volume, difficulty following instructions, failing to respond when called or a history of recurrent ear infections.

Not every concentration problem is an attention disorder. Before labelling a child as inattentive, we should first make sure the child can see clearly, hear properly and sleep well.

Dental health affects learning too

A dental check-up is worthwhile if your child has not visited a dentist recently, particularly if there is toothache, sensitivity, bleeding gums, persistent bad breath or visible tooth decay.

Dental pain can interfere with eating, sleeping, concentration and school attendance.

Parents should also remember that a school lunchbox does not need to become a travelling sweet shop. Encourage children to brush regularly with fluoride toothpaste and limit frequent sugary snacks and drinks.

Reset the body clock before school begins

If your child’s bedtime has gradually moved towards midnight during the holidays, do not expect them to fall asleep at 9pm on the night before school.

Start adjusting bedtime and wake-up time gradually before classes begin. School-aged children generally require nine to 12 hours of sleep each night, while teenagers usually need eight to 10 hours.

Insufficient sleep does not always appear simply as tiredness. In some children, it may cause irritability, hyperactivity, poor concentration, mood changes or behavioural difficulties.

Prioritise balanced food and hydration

A nutritious breakfast and balanced diet can help children begin the school day with energy and concentration. Aim to include a variety of protein, whole grains, fruits and vegetables while reducing highly processed food and sugary drinks.

Hydration is especially important in the UAE’s climate. Send your child to school with a water bottle and encourage regular drinking throughout the day rather than waiting until they feel very thirsty. Water should remain the main drink.

A practical back-to-school health checklist

Before August 25, parents should consider the following questions:

• Vaccinations: Are all routine vaccinations up to date?
• Growth: Is my child’s height and weight progressing appropriately?
• Iron and nutrition: Is there a dietary risk or unexplained fatigue that requires assessment?
• Vision: Can my child see the board and read comfortably?
• Hearing: Can my child hear clearly and follow instructions?
• Dental health: Is there any pain, sensitivity or untreated dental problem?
• Sleep: Has my child’s routine returned to school timings?
• Food and water: Is my child eating a balanced diet and drinking enough water?
• Chronic conditions: Are medicines, prescriptions and school action plans updated?
• Development and behaviour: Have there been changes in learning, concentration, mood or behaviour that require attention?

Parents do not need to panic or turn the back-to-school season into a medical examination marathon. The objective is not to find a problem in every child. It is to ensure that an existing concern does not go unnoticed.

A new uniform may prepare a child for the classroom, but adequate sleep, balanced nutrition, clear vision, good hearing, healthy teeth and timely medical care prepare that child to learn.

This year, before asking, “Have you packed your school bag?”, perhaps ask one more question:

“Are you healthy, rested and ready for the year ahead?”

Returning to the UAE after spending several weeks in a cooler destination can leave some travellers feeling unusually tired, sluggish or generally out of sorts. According to a family medicine specialist, this is often part of the body’s natural process of readjusting to extreme heat and humidity.

Dr. Renuka Ramasamy, Specialist in Family Medicine at International Modern Hospital Dubai, explains that spending time away from a hot environment can temporarily reduce some of the body’s heat adaptations.

“When someone spends a couple of weeks in a much cooler climate, some of the body’s adaptation to extreme heat can begin to diminish,” she says. “Heat acclimatisation influences how efficiently we sweat, regulate our core temperature and manage the cardiovascular strain caused by hot weather.”

These adaptations can start declining within days or weeks when a person is no longer regularly exposed to high temperatures. When they return suddenly to the UAE’s summer conditions, their body must work harder to maintain a safe and stable core temperature.

More blood is directed towards the skin to release heat, sweating increases and the cardiovascular system must compensate for the additional strain. As a result, some people may initially feel unusually tired, physically heavy, less energetic or generally unwell.

“It is essentially a period of re-acclimatisation,” Dr. Ramasamy explains. “Fortunately, someone who was previously accustomed to the UAE climate will generally readjust more quickly than a person experiencing this level of heat for the first time.”

Heat, dehydration and disrupted routines

The sudden change in temperature is rarely the only reason people feel unwell after returning from holiday. Heat, humidity, dehydration, poor sleep and changes to daily routines can combine to make the transition more difficult.

In hot and humid conditions, sweating and fluid loss increase. At the same time, high humidity makes it harder for sweat to evaporate from the skin, reducing the body’s ability to cool itself efficiently.

Even relatively mild dehydration can contribute to fatigue, headaches, dizziness and difficulty concentrating.

“Travel may also disrupt sleep, meal times, exercise habits and normal daily routines,” Dr. Ramasamy says. “People can arrive home already tired or inadequately hydrated and then immediately expose their bodies to considerable heat stress.”

Certain groups are more vulnerable to the effects of high temperatures. These include older adults, young children, pregnant women, outdoor workers and people undertaking strenuous outdoor exercise. Individuals with chronic medical conditions and those taking medications that affect hydration, sweating or temperature regulation should also be particularly cautious.

Give the body time to readjust

During the first few days back in the UAE, people should allow their bodies to gradually readjust instead of immediately returning to a demanding routine.

Drinking water regularly throughout the day is important, rather than waiting until intense thirst develops. People who are sweating heavily may also need to replace electrolytes. However, those with heart or kidney conditions, or who have been advised to restrict their fluid intake, should follow their doctor’s individual recommendations.

Restoring a regular sleep and meal schedule as soon as possible can also support recovery. Fruits, vegetables and other water-rich foods may help maintain hydration, while excessive alcohol consumption should be avoided because it can worsen dehydration.

Exercise should initially be lighter, particularly when performed outdoors. Strenuous physical activity should be avoided during the hottest part of the day, and both the intensity of exercise and the amount of time spent outdoors should be increased gradually as heat tolerance returns.

“The body needs time to readjust,” Dr. Ramasamy says. “People who are not fully acclimatised should reduce the intensity and duration of outdoor exercise during their first week back in a hot environment.”

When symptoms require medical attention

Although mild tiredness and reduced energy may be part of normal re-acclimatisation, people should not automatically dismiss more serious symptoms as a consequence of returning from holiday.

Significant dizziness, fainting, confusion, persistent vomiting, severe weakness or other concerning symptoms may indicate heat-related illness and require prompt medical assessment.

“It is important to distinguish normal readjustment from possible heat illness,” Dr. Ramasamy warns. “Severe or persistent symptoms should not simply be attributed to coming back from holiday.”

For most healthy people, careful hydration, adequate sleep, lighter exercise and gradual exposure to outdoor heat can make the transition back to the UAE climate safer and more comfortable.

Dr. Renuka Ramasamy
Specialist in Family Medicine
International Modern Hospital Dubai