Bone woes hit survivors due to steroid treatment

THEY might have survived fei dian, as Sars is known in Chinese, but the nightmare continues for about 300 former patients based mainly in Beijing.

On top of losing their loved ones to Sars, some of these men and women can hardly walk and are plagued by pain, likely the side effects of a treatment they received for the respiratory disease a decade ago.

Doctors believe that the heavy use of steroids to treat Sars contributed to a condition called osteonecrosis, in which bone tissues die as a result of decreased blood flow.

It affects mainly bones in the joints, like hip, knee or shoulder bone, and can cripple sufferers.

"We didn't have much experience then. We found that using steroids helped in rescuing critically ill patients but heavy dosages lead to osteonecrosis. Was it more important to save lives or prevent this problem?" well-known physician Dr Zhong Nanshan, who heads the Guangzhou Institute of Respiratory Diseases, told the Southern Metropolis Daily in an interview in February.

At hospitals in Guangzhou, capital of southern Guangdong province, the steroid dosage per patient used was not more than 240g daily, he noted.

Only 2.4 per cent of Sars survivors in the city had side effects, but hospitals in other cities saw as many as 30 per cent of patients developing the bone illness as they used higher dosages, he added.

Mainland China, which had 5,327 Sars cases with 349 deaths, is known to have the most number of patients suffering the side effects. Cases have also been reported in Hong Kong and Taiwan.

In Singapore, there have been no reports of such cases so far.

Among the sufferers in China is IT professional Thomas, 41, who asked that his real name not be used as he works for a state organisation and is not authorised to speak to the media.

He was warded in a hospital in the Beijing suburbs in April 2003 after getting Sars.

Soon after he was discharged in June that year, he started to feel pain in his pelvis.

He also later developed diabetes, which doctors say could have been hastened by the steroids.

Ten years on, he still needs to take 700 yuan (S$145) worth of medicine a month to keep his bone illness under control.

"I worry about what will happen to me. If the condition becomes serious, I won't be able to walk and may have to go for an operation," the divorcee told The Straits Times. But he can consider himself lucky. Many others have become disabled.

Besides the bone disease, Sars survivors suffer side effects such as pulmonary fibrosis, or scarring of the lungs, as well as depression.

Some have lost their jobs, others say friends shun them.

In 2005, the Beijing municipal government started offering free medical treatment for these former Sars patients; in 2008, it also started giving monetary aid of up to 8,000 yuan a year.

But some feel this is not enough and want the authorities to better compensate them.

In Hong Kong, an ex-Sars patient who developed osteonecrosis later sued the hospital; in China, there are no lawsuits so far but some hope to petition the authorities to start a trust fund for Sars survivors.

Thomas, though, says he doesn't need aid for now and doesn't feel bitter.

"I feel that I have grown as a result of this and learnt more about society and human-to-human relations," he said calmly.

hoaili@sph.com.sg