Tag: immune system

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, January 15th, 2010

Walnuts for Rheumatoid Arthritis (RA)

Walnuts are a tasty way to add crunch to your favorite yogurt or salad.

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They also have the added benefit of being loaded with omega-3 fatty acids which are great for fighting inflammation. Only 1/4 cup of walnuts provides you with almost 91% of you daily value of omega-3 fatty acids.  Walnuts also have an antioxidant compound called ellegic acid which supports the immune system. Walnuts are rich in manganese and copper as well. Walnuts are a good source of plant protein. They are rich in fiber, B vitamins and vitamin E. I love to just snack on just a handful. It keeps me feeling full and helps with inflammation; the perfect combination in the afternoon.

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Friday, December 11th, 2009

Aspartame and Rheumatoid Arthritis

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Before you reach for that diet soft drink, you may want to rethink what is in that beverage.  The sugar substitute aspartame, used in most diet soft drinks does not in fact help in weight loss and there is mounting evidence that it may actually cause weight gain.  More important to someone with rheumatoid arthritis, aspartame may cause inflammation and joint pain.

According to Woodrow C. Monte, PhD., Director of the Food Science and Nutrition Laboratory at Arizona State University, “when aspartmae is metabolized, it releases methyl alcohol (wood alcohol), a known toxin that is highly dangerous to humans.” Dr. Monte warns that “once in your cells, methyl alcohol converts to formaldehyde, a cancer-causing agent.  Recent studies in Europe suggest that aspartame consumption can result in the accumulation of formaldehyde in the brain damaging the central nervous system and the immune system.

Aspartame is found not only in diet products.  It can also be found in cough medicine, toothpaste and even some sports drinks and juice drinks.

Aspartame has been linked to several autoimmune diseases including lupus, fibromyalgia, multiple sclorosis and rheumatoid arthritis even at low doses.  It has been tied to migranes, chronic fatigue, asthma,  diabetes,tinnitis and depression.

According to the Aspartme Information Center, aspartame is approved by the US Food and Drug Adminstration and the Joint Expert Committe on Food Adititives of the World Health Organization. It is consumed in over 6,000 products and by 200 million people worldwide.  It is found in everything from cough medicine to soft drinks.

For me personally, I would rather err of the side of caution and avoid aspertame. My body has gone through enough turmoil. I want to nourish with food that will aid in healing and avoid ingesting anything that may potentially cause harm. You make up your own mind.

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Friday, October 16th, 2009

5 Tips for Dealing with Arthritis Pain

  • Meditation: Meditation can lower your blood pressure, enhance your immune system, relax muscles help you deal with stress. And lets face it pain is stressful. Start  with just 5 to 10 minutes a day and gradually work up to 20 to 30 minutes a day.   You will be surprised what a difference it will make in how you feel.  Find a quiet place where there are not likely to be any interruptions.  I try to get in some time before the kids wake up. Sit in a comfortable position.  Close your eyes.  Focus on your breath; the coolness as you breathe in and the warm exhale.  Try to keep the inhalation and exhalation the same length.  Start with your feet and focus on the sensation of relaxation.  Now move up to your legs, stomach, arms, and shoulders,. With each exhale feel the  tension leave your body.  Now relax the corners of your mouth, the outer corners of your eyes relax outward.  Stay like this focusing on the inhalation and exhalation, try to empty your mind.  It takes practice to be able to shut out the world for a little while, but it is well worth the effort.
  • Pamper Yourself: Sit down and enjoy a nice warm cup of tea.  Take a long soothing soak in the tub. ( provided getting in and out is not an issue )  Try a nice paraffin wax for your hands.  The warmth feels wonderful and your hands end up so soft and smooth when you are done.   Schedule a spa day with your best friend.  Indulge in an afternoon nap. Do something that makes you feel good.

  • Move your body: Exercise is a must to help with pain reduction.  Find an exercise that you enjoy and you are more likely to stick with it.  Start with something that you can do now. Begin with  some stretches and add a few isometrics to gain some strength gradually increasing the time and level of activity.   Be carefule to listen to what your body is telling  you.  Do not continue if you are experiencing pain.  Remember that consistency is the key.

  • Laugh: We’ve all heard that laughter is the best medicine.  Well it turns out that laughter is exactly what we need when dealing with pain.  Laughter causes the pituitary gland in the brain to release pain suppressing compounds.  So watch a funny movie or tell a good joke !   :lol:

  • Listen to your favorite music: Studies have shown a significant reduction in pain and depression for patients with arthritis who listen to music. So crank up the tunes and enjoy!

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Monday, September 28th, 2009

Rheumatoid Arthritis (RA): Which Treatment Option is Best?

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Over the past several months I have received comments that I think need to be addressed in a much longer format than a comment response.  The comments are related to treatment options for rheumatoid arthritis and which treatment is best.

We are fortunate enough to have many options available to us today to manage our rheumatoid arthritis (RA).   Traditional medicine offers everything from NSAIDs (Non Steroidal Anti-Inflammatory Drug) like Advil and  DMARD s(Disease Modifying Antirheumatic Drugs) such as Plaquenil, Arava, Methotrexate, Gold, and Cyclosporine to biologics like Remicade, Enbrel and Humira. There is a growing trend toward alternative medicine as a  solution to  deal with this disease.  Each option has its benefits, risks and side effects.

NSAIDs are a class of drug that are used primarily to treat inflammation and mild to moderate pain.  These medications vary in potency and  include the brand names Advil, Motrin, Naproxen, Anaprox and Celebrex.  Between 10% to 50% of patients are unable to tolerate NSAIDs because of their side effects. These side effects include upset stomach, stomach pain, and diarrhea.  About 15% of people on long term NSAID treatment develop ulcers of the stomach and/or the duodenum.

DMARDs cover a variety of different of drugs.  Anti-malarial drugs such as Plaquenil (Hydroxycloroquine) are considered a DMARD and were initially used to treat malaria. It was discovered to help  arthritis when patients noticed an improvement in their arthritis symptoms while taking plaquenil for malaria.  Plaquenil effects the immune system but doctors do not know how it works for rheumatoid arthritis. Arava (leflunomide) interferes with genes in developing immune cells. When taking Arava, liver monitoring for toxicity is required.  You should not take this drug if you are planning to get pregnant or are currently pregnant because of birth defects. The most common side effects for patients taking Arava are rash, nausea, hair loss, liver enzyme elevation and anemia. Methotrexate is a chemotherapy drug that initially was used to treat acute leukemia.  Methotrexate (MTX) has become the gold standard for treatment of rheumatoid arthritis (RA).  Methotrexate interferes with the growth of cells in the bone marrow.  The most common side effects from methotrexate include stomach upset, hair loss, diarrhea, and  mouth sores.  Folic acid is given while taking this medication to reduce the side effects.  Liver function monitoring is necessary to watch for toxicity. Methotrexate should also not be taken if you are pregnant or planning to get pregnant. Injectable Gold has been shown to improve symptoms of rheumatoid arthritis however toxicity is common and constant monitoring in necessary.  Side effects include rash, diarrhea, conjunctivitis and marrow suppression. Cyclosporine is a medication that is used primarily for the prevention of rejection of transplanted organs.  It is effective for the treatment of rheumatoid arthritis because it stops an overactive immune system from attacking the joints. Side effects can be severe and include hypertension, kidney problems, headache, nausea and diarrhea.

Biologic response modifiers (biologics) are the latest treatment option for rheumatoid arthritis pain and inflammation.  They work by blocking the tumor necrosis factors(TNF) components of the immune system.  People with RA have too much TNF in their bodies and it overwhelms the immune systems response to inflammation. Biologics such as Enbrel, Remicade and Humira are genetically engineered proteins that binds to and deactivates the TNF molecules before they can do damage.  The risks in taking this class of drug include serious infection including sepsis and tuberculosis, nervous system diseases such as multiple scholosis, allergic reactions, lymphoma and congestive heart failure.  Because these drugs are fairly new their long term side effects are not known.

There has been much debate on the effectiveness of complimentary and alternative treatments options for rheumatoid arthritis.  These treatments include GLA (Gamma Linolenic Acid), DHA (Docosahexaenoic Acid, Tai Chi, herbal supplements and acupuncture. There are many more complimentary and alternative treatment options that will be discussed in future posts.

GLA (Gamma-linolenic Acid) is an essential fatty acid found primarily in plant oils. It is found in borage  oil and black currant seed. In preliminary testing it has shown to reduce morning stiffness and swelling however studies have been small to date and additional research would provide more information. DHA (Docosahexaenoic Acid) is an omega 3 fatty acid found in cold water fish. Several studies have shown that DHA reduces inflammation but not the progression of the disease. The movements of Tai Chi improve strength, flexibility and balance. There is no indication that Tai Chi effects the progression of rheumatoid arthritis. Acupuncture in thought to stimulate the release of chemicals called endorphins that block pain. Acupuncture is very effective in treating chronic pain like that in rheumatoid arthritis. The list of supplements as an alternative solution to conventional medicine for the treatment of rheumatoid arthritis include vitamin E, MSM, copper, manganese, vitamin C, selenium, zinc, bromelain, ginger, turmeric and boswellia.  These alternatives have proven to help in inflammation and in some cases joint damage.

The benefits of using conventional medicine for the treatment of rheumatoid arthritis are that knowledgeable doctors using this method are readily available and the medications work for many people. These medications have significantly improved the lives of many with rheumatoid arthritis. The downside to this treatment option is the side effects can vary from mild to severe and some long term effects are not even known.

The benefits to choosing an alternative medical solution for the treatment of rheumatoid arthritis is that the side effects to these treatment are few and are less damaging to the body.  The disadvantage to complimentary and alternative treatments are that finding a qualified medical professional that can help guide you through all the options available can be a challenge and there is debate on whether or not they can help with joint damage.

Ultimately the choice for a treatment option is a personal one.  What matters is what works for you. Everyone has their own body chemistry.  What works for one person may not work for another. The advantage that we have today is that we have options, many options, and if something is not working for us we can try in another direction until we find our own solution. It is not up to me or anyone else to decide what is best for you and your body.  Trust yourself to figure out what is best for you.

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Saturday, August 15th, 2009

Pasta Primavera with Chicken

This is a nice light easy meal to make. This recipe is usually done without the chicken, but my boys tell me that they need their meat so this is my compromise. It takes only about 20 minutes from start to finish. Serves about 6 people.  The garlic is a good inflammation fighter. The peas are loaded with vitamin K ,C and B6, folate, thiamin, niacin, and riboflavin. The squash is rich in vitamin K, manganese, vitamin A, potassium, folate and copper. The vitamin K in this recipe is important for fighting osteoporosis and helps to prevent oxidative cell damage. The vitamin C in this dish helps to support your immune system and it tastes great!

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I whole boneless skinless chicken breast

1 Zucchini Cut into bite sized pieces

1 Summer Squash Cut into bite sized pieces

1 Carrot Sliced on the bias

1 Medium Onion Chopped

5 Cloves Garlic minced

2 teaspoons Extra Virgin Olive Oil

1 pound of your favorite pasta. ( I like Fettuccine  but I have used many different varieties of pasta for this dish)

1 teaspoon red pepper flakes

2 Cups fresh peas ( or I prefer using snow peas in the pod )

The juice of 1/2 lemon

Sea Salt

Fresh Ground Pepper

Fresh Grated Parmesan Cheese (optional)

Garnish: I like the taste of fresh basil with this dish, so I usually add a sprinkling of chopped basil on top of each serving.

Cook the pasta in salted water,follow the cooking  directions on the package. Reserve 1 ladle of the pasta water. The cooking  time will vary based on the pasta variety that you choose. In the meantime, cut the chicken into bite size pieces. Heat 1 tsp of the olive oil add 2 cloves of minced garlic and the red pepper flakes.  Add the chicken. Cook until the chicken is cooked thoroughly about 6-7 minutes. Remove chicken from pan. I know that this is not very Italian, but I use a wok to keep everything from spilling over onto the stove. Cut squash and onion and carrot. Add the remaining olive oil, onion and the remaining garlic. Cook over medium heat until the onion and garlic are translucent. Add the carrot, squash and peas. Saute until the colors of the vegetables become bright (about ten minutes) Add the pasta water and lemon. Toss with the pasta. Add salt and pepper to taste.Garnish with fresh basil and Parmesan cheese (optional) Serve and enjoy!

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Tuesday, August 11th, 2009

Rheumatoid Arthritis: Fight Inflammation with Strawberries

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Strawberries are at their peak of sweetness in this part of the planet right now. Strawberries are sweet and delicious and great for fighting inflammation as well. They are loaded with vitamin C and Manganese. Strawberries also have Iodine, Potassium, Folate and Vitamins B2, B5 & B6 as well as Vitamin K, Omega 3 fatty acids, magnesium and copper.

Strawberries lower blood levels of C-reactive protein in the blood. C-reactive protein signals inflammation and is high in RA and lupus patients when they are experiencing a flare. At the Harvard School of Public Health, researchers found that women who ate 16 or more strawberries per week were 14 percent more likely to have lower levels of this protein than non strawberry eaters.

It is important to note that strawberries are known to be heavily treated with pesticides. When in comes to strawberries it is organic or nothing for me.

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  • Jo-Ann Colburn: Kelly, I will email you the name and address of my...
  • kelly siesel: could you tell me the name of your Lyme dr? I have...
  • Jo-Ann Colburn: Unfortunately the Lyme tests are not that accurate...
  • Pam: Congratulations on feeling normal (even if was onl...
  • Lene: Wow! Just.... wow. So happy you've left RA behi...
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