Tag: Rheumatoid Arthritis RA

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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Thursday, December 24th, 2009

Happy Holidays!

Merry Christmas

I wanted to take a minute to wish everyone a healthy, happy holiday.  I hope that everyone has the Merriest of Christmas’ and the Happiest of Hanukkah.  I plan on spending a quiet holiday with the people that mean the most to me in this world.

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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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Wednesday, October 21st, 2009

Finding A Rheumatologist That Is Right For You!

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Do you feel really comfortable with your current rheumatologist?  Are you able to discuss all of your questions and concerns with your rheumatologist? If the answer to these questions is no; you are not alone.  A surprising number of patients report that they fell rushed when they visit the doctor’s office and often leave without understanding what was discussed during the visit. It is important to be able to communicate with your physician at your visit.  Your health is at stake.

It is a good idea to make sure that before your next visit you are prepared.  If you have blood work that is due near the time of the appointment make sure it is done and the doctor has had the opportunity to look at the results before your appointment so that you can discuss the results while you are there.  Make a list of questions/concerns for the doctor.  Prioritize the list so that you cover the most important questions first.  If you do not completely understand the doctor’s response to your question, let them know.  Don’t be afraid to ask them to clarify something for you.  If the doctor wants follow up testing or changes  in medication, make sure you understand any side effects and/or  necessary information you may need ( ie. time of day to take meds or have test done, fasting, non fasting, etc…) before you leave the office. If you feel as though you did not have all your questions answered at the visit; don’t be afraid to call the office and ask for the doctor to call you back when he/she is free to answer your questions.

If you have done all this and still do not have your questions answered, your concerns addressed, or if you feel you are not being heard, and are rushed,  it may be time to find a new doctor!  My first rheumatologist was an extremely intelligent doctor, and a professor at an Ivy League University but we did not communicate well with each other.  After interviewing several other doctors I found a rheumatologist that is the right fit for me.  I am comfortable discussing all my issues with my physician and I always feel like her focus is on my wellness at all times.  My questions are always answered, I never feel rushed and I always feel that my health is of paramount importance to her.  It may take some time to find the right rheumatologist, but it is well worth the effort.

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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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Wednesday, September 16th, 2009

Power of Pomegranates for Rheumatoid Arthritis (RA)

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One of my favorite healthy snacks this time of year is the pomegranate.  The kids and I just love to pick at the little gems and eat the sweet, crunchy seeds just as nature made them.

Pomegranates are native to the mediterranean region and are a good source of vitamins A, C, E , folic acid and potassium. The name “pomegranate” in Latin is translated as seeded apple.  The polyphenols in pomegranate juice are antioxidants that can prevent and repair oxidative damage caused by free radicals.

In a recent study funded in part by the National Center for Complimentary and Alternative Medicine researchers from Case Western Reserve University studied the effect that the dietary supplement made from pomegranate extract called POMx had on an animal model of rheumatoid arthritis (RA) in mice.  The mice were treated before and after the arthritis was induced.  The mice that were treated with the POMx before the induced arthritis had significantly reduced incidence and severity of disease than the untreated mice.  In mice that were treated to exhibit arthritis symptoms before receiving the POMx, the effected joints showed less inflammation and less destruction of cartilage and bone that those that did not receive the POMx.Future studies will test the disease modifying effects of POMx on mice that have been treated to mimic the symptoms of RA.

Pomegranates are available in the market in the northern hemisphere from September to February.  In the southern hemisphere you can find them from March to May but the juice is available year round.

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