Tag: disease

Monday, July 19th, 2010

Misdiagnosed with Rheumatoid Arthritis (RA): My Lyme Disease Story

As some of you may have heard, I just recently found that I was misdiagnosed with rheumatoid arthritis (RA). I have Lyme Disease.

Anyone who has followed this blog probably knows that I thought that I had Rheumatoid Arthritis (RA) for over 9 years. I have always had some doubt about what was going on with my body and the effectiveness of the treatments the doctors were prescribing. But I trusted my doctors more than I trusted my instincts. My story is a cautionary tale for anyone who has been diagnosed with an autoimmune disease.

Let me start by saying that we live in rural Rhode Island. We have a small 3/4 acre wooded lot. All sorts of wild life can be found in our yard at any given time and there is no shortage of deer that visit our property. We moved out here to raise our family in a quiet, serene place with good schools and friendly neighbors. Unfortunately, with the good comes the bad, and the deer carry ticks that carry Lyme Disease.

Each member of my family at one time or another has had Lyme Disease. It is not uncommon to be outside for only a few moments and pick up one of the poppy seed-sized ticks. For the most part we have all either tested positive with Lyme Disease or the tick if we were able to keep it tested positive with the disease.

9 years ago I had been bitten by a tick. At the time, I was tending to my newborn son, and had two older boys to watch over as well. In prior exposures to the disease, I had felt “flu like symptoms” and that was my cue to get tested. I don’t know if it was adjusting to three boys and 2 jobs or if I was just too busy to notice, but I really don’t remember any “flu like symptoms”.

It started with my ankle. It hurt and was swollen so I went to the urgent care center where they X-rayed it and told me they could find nothing wrong with me. The doctor prescribed an anti-inflammatory and gave me and air-cast. We were going with the assumption that I must have sprained my ankle even though I couldn’t remember doing anything out of the ordinary.

The swelling did eventually go down on my ankle but shortly after my knee on the opposite side started swelling. Ice, rest, and ibuprofen seemed to help with the swelling in my knee. Then, my wrist on my left hand began to swell. My husband and I were discussing the weird joint issues I had had over the previous few months when he suggested that I go get a Lyme test. I thought that it couldn’t hurt, so off I went back to urgent care for a Lyme test. The Lyme test came back positive and the doctor gave me zythromax.

Unfortunately I did not get better after taking the antibiotics, so I went back to the same doctor who gave me another course of the same antibiotic. When after finishing the second course of medication and I was not improving, the doctor said to me that this was beyond his level of expertise and I needed to see either an infectious disease specialist or a rheumatologist. He felt that I should start with a rheumatologist because if it was Lyme or something joint related a rheumatologist would be the best choice. He gave me the name of a rheumatologist and sent me on my way.

The rheumatologist seemed nice; he listened to my story and took a medical history. It may be my perception of what happened next, but it seemed to me that the minute he heard that my mother had rheumatoid arthritis (RA) his mind was made up. He told me that more than likely it was RA. He examined me and put me on prednisone immediately. When I asked about the Lyme he said that it was very unlikely that I had Lyme and that he was fairly certain it was RA. He told me the steroids should get the inflammation under control and ordered some blood work.

The blood work came back and showed that I was positive for RA. What I did not know then that I know now is that an active infection like Lyme Disease can affect the test results for RA.  He gave me a prescription for methotrexate, talked to me about Enbrel, and sent me home with a handful of pamphlets.

To be completely honest, I never felt comfortable with the diagnosis, but I somehow talked myself out of trusting my instincts by comparing his knowledge on the subject with mine. His practice was a teaching practice with Brown Medical School and I felt like he should know more than me on the subject. I really trusted that he knew what he was talking about. I have beat myself up for not going with my gut many times over the years on this topic.

Over the next several years I just seemed to get worse. Every time I brought up the fact that I was not really improving he would tell  me that the first several years with the disease are the worse, when the most damage occurs and that we needed to increase the medication. For a while he really had me scared. He would say things like “We don’t want to see you in a wheelchair, do we?”. After way too long I decided to find a new rheumatologist.

I took my time looking for a new doctor. One I went to yelled at me when I told him why I was looking for a new rheumy. Turns out he was friends with the one I left. I finally decided on a rheumatologist who I was told was well versed in Lyme disease.  She had plenty of posters on the walls of the office with picture of both damaged joints and Lyme disease bulls-eyes. I discussed my story with her and she felt I had rheumatoid arthritis as well. She decided to add Plaquenil to the cocktail and that did seem to improve how I felt. The disease seemed to ebb and flow with the increased mtx and plaquenil combination. There was never a time when I didn’t feel sick.

Over the years I have had some symptoms that no doctor has been able to  explain. I have had extreme sensitivity to light and sound. It’s like having a migraine without the headache. I have ear pressure so it feels like I am in an airplane all the time. I have also had other more traditional RA symptoms (i.e.  joint swelling, pain, fatigue)

Last summer everything came to head when Kevin had a bout of the swine flu and I had to go off the methotrexate. I had to take antiviral medication for 3 weeks, and immediately following that I got bronchitis and was on antibiotics for two weeks, followed by 3 more weeks of antiviral medication because Nathan got H1N1, and finally 6 weeks of antibiotics because I got bit by another tick. I tested positive for an active Lyme infection and stayed off the mtx for another 6 weeks. After 14 weeks off methotrexate I felt surprisingly good.

The doctor told me to start back on the methotrexate, and being the dutiful patient I did what I was told. After 2 doses of the methotrexate I felt like I was back in Lyme hell. I went to the doctor and I told her I was not going to take any more mtx. She order more tests, including a new Lyme test. A few days later my primary care doctor’s office called to tell me that I tested positive for Lyme and I needed to start antibiotics. I was surprised that I had not heard from the doctor that ordered the test, so I called my rheumatologist office to find out what was going on.

She told me I did not have Lyme disease. She said that it was a cross reactive protein and ordered more tests. I again brought up the long ago Lyme test that started this RA nightmare and the look on her face scared me.  She looked frightened. She claimed that there was nothing from the previous doctor that mentioned Lyme disease. ( I know now that this was untrue because when I requested copies of my medical records from her office the previous rheumatologist did sent his notes on the Lyme and that he felt it was a false positive.) Over the next several weeks as I felt worse she ordered more and more tests, she managed to rule out quite a few different ailments and still could not explain the Lyme results. Finally, I got tired of being poked and went to see my primary care physician and asked her to put me on antibiotics. She agreed that there was no harm in trying antibiotics and if I felt better than it must be Lyme.

After 2 weeks on the antibiotics I started to feel normal again. After 3 weeks I felt better than I had in years.  The inflammation was almost gone. I walked with a spring in my step. I felt really really good. One day I was going about my daily routine and I stopped myself in mid-stride because it was as if I had been in the situation before. It was the most beautiful deja vu that I have ever experienced. As it occurred to me what I was reliving I began to cry. I felt the way that I did BEFORE. Before the rheumatoid arthritis diagnosis. It was as if time had melted away and that I was the old me, the healthy me. That moment will stay with me forever.

In that moment everything changed for me. I decided that I was going to investigate Lyme disease. I wanted to find out if this had happened to anyone else. What I found was that everyday people are diagnosed with chronic autoimmune diseases that really have Lyme disease because of the ignorance of some of the medical community about what Lyme Disease is and what it can do.

I took my time and thoroughly investigated several doctors. I knew after doing my research that I needed to find a Lyme Literate MD (LLMD). I got references and asked questions about each one. I decided that I wanted the opinion of someone who was respected in dealing with Lyme not only by his colleagues, but also by his patients. After quite a lot of research I found the doctor I felt comfortable with. It took me 2 1/2 hours to get to his office but I didn’t  mind the drive if it meant that I would get some answers. I figured if he told me that I did not have Lyme disease, I would believe him, and I would move on from there. I needed to know once and for all if I had Lyme disease or something else.

I spent 90 minutes with this doctor discussing the past nine years of my life. Every tick bite, every treatment, everything. When all was said and done, he said to me that it was no surprise that I did not feel better after the original doctor put me on a Z pack for 5 days and then repeated the process; it would not have done anything to fight Lyme Disease.  He felt very strongly that after I described all of my symptoms and heard all my treatments that I have Lyme Disease and never had Rheumatoid Arthritis.

I left the LLMD’s office overwhelmed. I could not hold back the tears. 9 years. 9 years that could have been so different. 2 of my children don’t even know what I was like before all this happened. I am angry and sad. I want as many people as possible to know my story because it could be there’s as well. I am not the first person to be diagnosed with Rheumatoid Arthritis that has Lyme disease and I am certain not to be the last.

My new doctor offered no guarantees. He told me that this is going to be a long, hard battle. The very last thing you want to do to treat Lyme disease is to weaken the immune system. We have a lot of work to do. I was prepared for that.

Today I have something now that I did not have 10 days ago.

Hope.

My final thought to anyone that ever had any doubt about whether or not they had been “cured” from Lyme disease,  or had concerns about their current autoimmune disease diagnosis is to trust yourself, trust your instincts, and if it feels wrong it probably is.

As a side note, as of this writing I have been on antibiotic therapy for ten days. The results are that at least half the inflammation if gone from my joints. I don’t need any more proof than that.

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Friday, June 18th, 2010

Innovative New Treatments for Rheumatoid Arthritis (RA)

Gary S. Firestein, MD,  of UC San Diego Medical Center speaks about innovative treatments for rheumatoid arthritis including promising new findings with inhibitors of signal transduction. It is good to know that there are new treatment options on the horizon for those whose current therapy is unsuccessful.  There is not a one size fits all remedy for this disease. I think that it is important to have choices and options.

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Thursday, May 20th, 2010

Rheumatoid Arthritis: How My Journey Began

When I started this blog the idea was to talk about what works for someone with rheumatoid arthritis.  I wrote a fair amount of posts about what foods and herbs help to fight inflammation and a few about the products that made my life with RA a little easier.  All in all I have been pleased with what I have shared and learned along the way about RA.  I hadn’t planned on all the amazing women and men that I have met through this blog that have given me strength and support. That was an unexpected blessing.  To all of you I am truly grateful.

It occurred to me that I really have not shared my story.  How I got to where in am now and the questions that I have been wrestling with lately.  I haven’t written much because I was hoping to have some answers to report instead of more questions.

So I want to take a step backward and start at the beginning, because  how I got here is important.   I didn’t know until recently how important.

About 6 months after Kevin, my youngest, was born my right ankle started to swell.  I hadn’t twisted it. I hadn’t fallen.  There seemed to be no explaination as to why it was swelling and why it hurt. So I went to an urgent care center where they took and X Ray and really could find nothing wrong with my ankle.  The doctor told me I must have sprained the ankle and gave me an air cast to wear for several weeks with some anti inflammatory drugs to take and sent me on my way.  I followed his instructions; I stayed off the ankle as much as possible, I iced it and I took the medication.  Eventually the ankle improved.

Almost as soon as my ankle improved, my left knee started to swell and hurt.  I thought maybe that I had been over compensating for the ankle and had somehow thrown my knee out of whack.  I iced the knee and took anti inflammatory medication and rested it as much as possible and it seemed to improve after about a month or so.

Shortly after my knee stopped bothering me my left wrist began to give me problems.  It really hurt and was swelling a lot.  I thought maybe that I had carpal tunnel because I spend a good amount of time everyday typing.  I went back to urgent care and they seemed to agree that this could be carpal tunnel and they gave me some wrist guards to wear.

I wore the wrist guards as instructed, took more anti inflammatory medication  and hoped for the best.

While my body was giving me all this trouble I was trying to raise a 10 year old, a 6 year old and a new baby boy.  I was exhausted all the time, but at 35 I figured that I was not as young as I used to be and now I had 3 boys needing my attention, a full time job and a business to run with my husband.  I certainly had a full plate and there were plenty of reasons for me to be tired all the time.

My husband works outside all the time and Lyme disease is something that I thought we were pretty familiar with.  It was Eric who thought that maybe it was Lyme disease that was causing this joint swelling.  It is typical for Lyme disease to kind of skip from one spot on the body to the next wreaking havoc. So a few days later I was back at the urgent care center asking for a Lyme test.  The doctor asked me if I remembered a tick bite and I really didn’t.  We live in a wooded area and there were many times that I have been bitten by ticks. We are really careful with deer tick and I am fairly sure that if I had seen a deer tick in me I would have been tested immediately.  The thing is some of these ticks are the size of a poppy seed.  It is within reason that I could have been bitten by a tick the size of a poppy seed in a location that I could not readily see and not know it.  It doesn’t hurt when they bite.  So it is completely possible that I could have been bit and not known it. That was really not what the doctor wanted to hear but I was able to convince him to give me a Lyme test.

Anyway to make a long story longer… after about a week the test came back positive for Lyme disease.  The doctor put me on zythromax for 5 days.

After two weeks I was still not feeling better.  My wrist was really bothering me and the swelling was so bad that I actually lost the ability to give a thumbs up.  There was so much swelling in my wrist that the ligament that moves the thumb was lifted from its initial location (because of the swelling) so that I could no longer give a thumbs up.

I went back to the doctor and he put me on another course of zythromax with some new anti inflammatory medication and sent me on my way.  He told me to give it another two weeks and I should be feeling better by then.

By the time two weeks had passed not only was my wrist swollen and painful but now my feet were swelling and my knee was back to giving me trouble again.

When the doctor took one look at me and knew that the current course of treatment was not working.  He said to me that this was beyond his level of expertise.  He said that he could send me to a infectious disease specialist or he could send me to a rheumatologist.  He felt that the rheumatologist was probably the best way to go because a rheumatologist could handle Lyme disease as well as any arthritis issues that I might have. He said that there was a new rheumatologist in Providence that he had heard good things about and he set up an initial appointment for me and wished me luck.

This is how my journey began.

Stay tuned to hear how we progressed to where I am today.

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Thursday, April 1st, 2010

Rheumatoid Arthritis: Survival Mode

These past several months have been an exercise in survival.  I am feeling better than I have in months, but I still have a way to go before I am at a place where rheumatoid arthritis is not in every other thought.  I have come to a place of survival.

All this down time has made me wonder how many of us are living with this disease and how many of us are in survival mode?

What is survival mode? For me it is getting through another day.  Surviving the day with rheumatoid arthritis.  Not exactly my idea of fun, but I am getting by. I wonder what survival means to everyone else with this disease.  While survival is better than giving up it is not where I want to be.

I am an optimist so I believe that this is just a temporary setback on my journey to living well with RA.  The idea that this survival mode is a permanent situation is not something that I am willing to entertain ever.  I have too much fight left in me to settle for half way.

I am grateful to be out of bed. Two months ago I was flat on my back all day long.  I am grateful that I am able to tackle small tasks on a daily basis so that I feel that I have accomplished something.  But this is not where I want to be.  I know that I have a ways to go and that this will probably take longer that I originally anticipated, but I am in this for the long haul and I am determined to find a new way to live with this disease without adding toxic chemicals to my body.

Here is what I have been doing so far and it seems to be having an impact on my overall wellness.

  • I am monitoring my diet and have eliminated dairy from my diet. I have found out the hard way that if I do ingest something that has dairy in it I will swell. I have been adding and subtracting different foods from my diet to see what is having an impact on inflammation. So far dairy has had the biggest impact.
  • I have been taking Flaxseed Oil (I can’t do fish oil supplements) and Vitamin D daily.
  • I have found that mediation helps me sleep better and makes mornings a little more manageable.
  • I am starting to be able to exercise ( I am using this term loosely because the rate of speed that I walk would hardly be called exercise, but it is movement and more than my body has seen in months.)
  • I am careful about what I eat and have lost over 25 pounds since January 1, 2010.
  • I spend time every day visualizing what it looks like to be free of stiffness and pain.

So far I am improving and I hope to be back to my old self soon.

In all honesty I have felt this bad on methotrexate.  I have had the same levels of pain, inflammation, and stiffness while on mtx so I have been pleasantly surprised at my progress and so far happy with my decision to look for an alternative solution to mtx.  It has made me wonder on more than one occasion how well the mtx was really working for me.

So for me, tomorrow is a new day with new hope for less pain and inflammation and life mode not just survival mode.

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Tuesday, January 26th, 2010

My Rheumatoid Arthritis: One Day Up, One Day Down

Lately I have been one day up, one day down.  One day I am experiencing very little stiffness and pain and the next day I am feeling dreadful.

I have been taking a close look at my diet and how it is effecting how I feel.  I know that there are certain foods that without a doubt have a direct relationship to the amount of inflammation that I am experiencing.  Within an hour or so of eating chocolate I start to swell.  The same holds true for dairy products. Sugar seems to be an issue for me as well.  I don’t know if I need to avoid all sugar altogether or if  there is a certain threshold that once I  go over that level there is a problem.  I don’t know if it is just refined sugar or if  natural sugars will give me the same trouble.  I know that things that have a high sugar content cause me trouble. The good news is that since I have stopped taking the methotrexate, it is easier for me to tell which foods are causing the inflammation. It was as if the medication was masking the effects that food had on my inflammation. It has been a game of hit or miss on what my body will tolerate and what it won’t.  I imagine that this will take some time to find every food that is causing me trouble.

It is hard to plan my life right now because I really don’t know from day to day how I am going to feel.  I am keeping a food journal and each day I write down everything that goes into my body and how I am feeling physically.  It is helping to make it easier to pinpoint what food is effecting me so that I can avoid it in the future.  I have done a lot of reading on the subject and I am very hopeful that once I get a handle on the foods that trigger inflammation for me I will be able to manage the disease much better.

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Thursday, January 21st, 2010

Rheumatoid Arthritis: What Six Months of Sickness Has Taught Me.

The past 6 months have been somewhat like a bad dream.  I never could never have imagined being sick for this long with so many different ailments.  I can’t help but wonder if all the years on methotrexate had such an effect on my immune system that everything kind of shut down for a while. With all this down time I have had the opportunity to learn somethings about myself.  I thought I would share some of what all this sickness has taught me.

  • Trust your instincts. When two of my doctors had conflicting opinions on whether or not I had a second or continuing Lyme infection I should have trusted my instincts.  I could have saved myself valuable time and pain and not have subjected myself to way too many diagnostic tests had I just trusted my gut.  I know my body better than anyone else and I knew that I still had Lyme Disease. I shouldn’t have allowed my rheumatologist to talk me into more tests to prove that her opinion was right when I knew deep down inside all I really needed was another treatment of antibiotics.  When I finally got the antibiotics was when the symptoms went away and I started to feel better.  Lesson learned. Again. I hope this time it sticks.

  • Lyme Disease is something to take very seriously. I have had Lyme Disease in the past.  I thought that I knew and understood what this disease could do.  I could not have been more wrong.  I have never in my entire life felt more physically ill than I did with Lyme Disease.  I can’t say whether or not the Rheumatoid Arthritis (RA) had an effect on the severity of the Lyme Disease but I know that the treatments for the RA had an effect on how well my body was able to handle Lyme Disease.

  • I need to nourish my body and my soul. I have always been the one who puts everyone’s needs before mine.  It wasn’t a conscience decision, but none the less other things took priority in my life. Now every day I am slowing down and taking time to do things that nourish my soul.  Things that bring me joy nourish my self. I find that I have more patience and energy for other things after making my self a priority. Before I put anything into my body I am asking myself will it nourish me or fill me.  They are two very different ideas. I have tried to eat responsibly in the past, but I haven’t always looked at what I am putting into my body as nourishment as opposed to something that will fill me up.
  • Don’t be afraid to ask for help. Being an independent person and a bit of a control freak I frequently would rather do something myself than ask for help.  Part of me just didn’t want RA to get the best of me.  I felt like it was a bit of a battle of wills.  I wasn’t going to let RA take over my life completely, I could do most things myself and I hated to ask anyone for help.  Being as sick as I have been, I have had no choice but to ask for help.  There were days when getting out of bed to go to the bathroom was an ordeal.  An extremely painful ordeal.  It was simply impossible not to ask for help with some of the most basic of needs.  I discovered that the world did not end and it was okay if things were not done “my way”.
  • A clean is nice but really not all that important. I used to care very much about how clean my house was.  I felt that how my house looked was a reflection on me and how I cared for my family.  I know that sounds a little nutty but that is how I felt.  I really felt like I could not physically do a great many things anymore but I could take care of my family and a clean house was part of that.  Of course now looking back I can see how crazy that whole idea sounds.  My house currently is picked up. No one is going to trip over anything in my house, but it is a far cry from clean and I really don’t care.  I could spend the next few hours cleaning, or I could spend the next few hours playing with Kevin or reading a good book.  Now I choose something that will fill me up instead of depleting my resources.

  • Connecting with other people that know and understand what it’s like to have RA is important. Knowing that I am not alone in the day to day challenges that this disease brings has helped me in so many ways.  There is comfort in knowing that there are people out there that completely understand what I am going through.  I am very grateful to all the new friends that I have found here and for their kindness and support.
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Wednesday, December 30th, 2009

Happy New Year!

As the end of this year approaches I can’t help but look back and reflect on all that has happened.  I have experienced some highs and quite a few health related lows this year.  I would much rather focus on the good things that 2009 brought.

This was the year that LivingRheum.com was born in earnest.

LivingRheum.com has enriched my life in ways that I never could have expected.  I am still in awe that anyone found my blog to read it in the first place. The fact that so many people have come here and read my words and shared their experiences has been such a blessing.  I am so grateful to have met so many amazing people.

Just knowing that there are so many good people in this world who completely understand how it really feels to have rheumatoid arthritis and the challenges that I face with this disease, has made me feel so less alone in this challenging  journey. I hope that in some way I have been able to give back all that I have gained.

I want to wish everyone a happy, healthy new year filled with much happiness and mobility. I am looking forward to what the new year will bring. I plan to use my energy to focus on the joy. I find the more I focus on the joy, the less I focus on the joints.

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  • Jo-Ann Colburn: Kelly, I will email you the name and address of my...
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  • Pam: Congratulations on feeling normal (even if was onl...
  • Lene: Wow! Just.... wow. So happy you've left RA behi...
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