Tag: symptoms

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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Tuesday, October 6th, 2009

Samantha’s Rheumatoid Arthritis Story

Samantha shares her story of rheumatoid arthritis.  She talks about how the disease changed her life and how she adapted to the changes that it brought her.  It is an honest story of what it can be like living with rheumatoid arthritis.  I could relate to her story on many levels.

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Wednesday, August 26th, 2009

Potassium Lacking in Rheumatoid Arthritis Patients.

potassium foodsAccording to a National Institutes of Health clinical trial, most patients with Rheumatoid Arthritis(RA) do not have high enough intake of potassium in their diet. Deficiencies in potassium  reduces cortisol, a hormone that is involved in immune function and inflammatory response and can result in many RA symptoms.

Potassium is an electrolyte that plays a role in muscle contraction and nerve transmission.  It is also involved in the storage of carbohydrates for muscles.  The relationship between Potassium and sodium and choride is important in maintaining the body’s ph balance. Many expert have recommended that the ratio between potassium and sodium should be 5  times more potassium than sodium.

How can you increase you intake of potassium? Well the best way to increase your potassium intake is in your diet. Food rich in potassium include, sweet potato, banana, potato, plums, prunes, orange juice and oranges, tomatoes, cantaloupe, peaches, spinach, almonds, and  molasses. Cooked foods can loose significant levels of potassium, so when possible choose raw fruits and vegtables. You can get potassium in a multi-vitamin suppliment as well, however the preferred method is in your diet.

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Friday, July 17th, 2009

Methotrexate for Rheumatoid Arthritis: Long Term Use Considered Safe

The results of a recent study published in the Annals of the Rheumatic Diseases indicate that the drug methotrexate (MTX) appears to be safe for long term treatment of rheumatoid arthritis.  This conclusion was based on data collected from 88 studies that involved patients treated with methotrexate for at least 2 years.mtx 001

Methotrexate is classified as a disease-modifying anti-rheumatic drug also known as a DMARD.  Methotrexate had been used to treat psoriasis and cancer prior to its approval by the U.S. Food & Drug Administration in 1988 to treat rheumatoid arthritis. It is also used to treat other autoimmune diseases including ankylosing spondylitis, psoriatic arthriis, lupus and vasculitis. It can take from 6 to 12 weeks to feel the full effect of this medication.  Taken once weekly via either 2.5 mg tablets or self injection,  methotrexate blocks certain enzymes that affects the production of folic acid which is necessary for growing cells. Therefore it is necessary to take folic acid suppliments while on methotrexate.

It is important to avoid drinking alcohol while using this medication because of the increased risk of liver damage.  Methotrexate can cause abnormal liver function so it is necessary to have blood work monitoring done every 8 weeks. The 88 studies concluded that 13% of people taking methotrexate experienced elevated liver enzymes however only 3.7% had to stop using the drug due to liver toxicity. Other side effects include nausea, vomiting ( may be based on the dosage), mouth sores, rash, diarrhea, blood count abnormalities,  persistent dry cough, unexplained shortness of breath, cirrhosis of the liver ( rarely), gradual hair loss, and sensitivity to sunlight.  Some over the counter and prescription medications may increase the toxicity of methotrexate so it is important to check with your doctor or pharmacist before taking any additional medication. Methotrexate can cause birth defects and can cause complications during pregnancy.  It should not be taken if you plan on starting a family.

Patients in the study experienced side effects but usually mild. Methotrexate rates of discontinuation were less than gold, sulfasalazine and penicillamine but more than plaquenil in this study.

Of the 88 studies only 2 assessed the relationship between methotrexate and cardiovascular disease. One study concluded that there was no increased risk of cardiovascular disease, the other suggested that there may be a reduced risk.  There was no increased risk of infections linked to methotrexate.

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Wednesday, April 8th, 2009

Allison Parker Runs the Boston Marathon to Support the Arthritis Foundation

Allison Parker is running the Boston Marathon on April 20, 2009 to raise funds for the Arthritis Foundation’s Joints in Motion campaign and to raise awareness about the disease.

Allison Parker

The Arthritis Foundation has provided almost $14 million in grants to more that 200 researchers to help find a cure or better treatments for arthritis.  For over 60 years the Arthritis Foundation’s commitment has resulted in major treatment advances for most arthritis diseases.  The Arthritis Foundation has provided scholarships, self help courses, a wide variety of free educational brochures, along with exercise classes and videos to help those dealing with arthritis diseases.  Their volunteers have served as advocates for over 46 million Americans suffering with arthritis and chronic joint symptoms to local and federal governments.

Alli trains for the Boston Marathon

Alli is running in memory of her grandfather Laurence Kearns who suffered from rheumatoid arthritis.  She has set a personal goal of raising $3,000.00.  To date she has raised $1465.00.  Time is running low for her to meet her goal. If you would like to help her raise money for this cause you can donate at Allison Parker’s Donation Page . All contributions are tax deductible.  I just made my donation.  Please remember, no donation is too small, every penny counts.

This is the 113th running  of the Boston Marathon, the world’s oldest annual marathon.   In 2008 nearly 22,000 runners completed the race. This will be Alli’s third Boston Marathon. If you would like to check out Alli’s training progress you can at www.allirunsboston.blogspot.com


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Monday, March 9th, 2009

How do you handle uncomfortable questions about Rheumatoid Arthritis?

Recently I was asked by a fellow parent at my son’s school, “What did you do to yourself?”  He was addressing my limp. I don’t limp every day.  It comes and goes depending on a myriad of variables.   Sometimes it’s my feet, or my knee, or my ankle, there is no telling which body part is going to  “act up” or when.  I have been asked this question so many times you would think that I would have a standard response, but I don’t. Sometimes I am so focused on trying to get where I need to be  in the least amount of pain that the question takes me by surprise. 

Many times I have taken the time to explain that I have rheumatoid arthritis and frequently the response is “Oh my grandmother (aunt, mother, father, grandfather, fill in your choice of family member)  has that.”  And what they are usually referring to is Osteoarthritis which is not the same.  In the beginning, when I was first diagnosed, I felt the need to clarify this to whomever was posing the question. This only served to frustrate me when most people just don’t get it and aren’t that interested in a medical discussion.

Sometime when I am in a hurry and really don’t feel like getting into an in depth discussion of my medical history, I will come back with a quick reply of “Oh that, I just twisted my ankle on the way out the door.”  People usually nod in understanding and go about their business.  I wonder afterward am I doing myself an disservice by dismissing the symptoms of this disease to avoid an uncomfortable discussion or the look of pity from some.

There have been times when  I have been asked to volunteer for some event or another that I physically would not be able to handle. When I explain that I can’t because I have RA and standing all day (or whatever the task is)  is not something I can physically do, I have been greeted with a look of doubt, as if to say, “Well,  you look fine to me…”.   

Unless I limp or try to give someone a thumbs up, my disease is invisible to the outside world. I don’t think of myself as disable, or courageous,  or a warrior battling the arthritis demon.  I try to take each day as it comes and handle as best I can the challenges that each day bring  just like everyone else with this disease.

 So the question remains; how do you handle the stares, the looks of concern, or just the questions? How do you deal with people who don’t understand?  Is there one easy answer?  I would love to hear how you respond to these issues.

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Sunday, March 1st, 2009

YouTube – Do I Have Rheumatoid Arthritis?

 

via YouTube – Do I Have Rheumatoid Arthritis?.

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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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