First Encounter with Rheumatoid Arthritis
Time seems elusive to me. I cannot seem to grasp it without context. I mention this because I have been trying to piece together the timeline of my encounter with rheumatoid arthritis (1, 2). There is an official date of diagnosis and an extended timeline of events leading up to the present. But looking back on all of the aches and pains I experienced before my first significant flare-up, I can confidently say there were indicators two years before my diagnosis by physicians. It feels so weird to write about this topic. I don't want to sound like I am complaining or want any kind of sympathy. Comparing my first significant flare-up to now, I have definitely come through to the other side of this malady. It has been a long road from not knowing to appropriate treatment and regained mobility. There were significant obstacles--after I was certain something was wrong with me--transitioning from afflicted to a more normal life. I feel that I should write these experiences and thoughts down for others, and a blog format is probably easiest for me.
Before RA, I was relatively healthy and enjoyed long-distance running in half-, full-, and ultra- marathons. I looked forward to solitude that came with the endeavor and was pretty disciplined when it came to training. I wouldn't let weather, sickness, or conflicting events impede my training schedule. Maybe it was being a former-Marine, but I was determined to get in my daily runs and enjoy the runner's high that came with the completion of my workouts. In 2006, I had finished an organized distance run in the spring and had started training for the Philadelphia autumn half- and full marathons. Somehow, in middle September, I had torn my anterior cruciate ligament (ACL) and meniscus while indoor climbing. I was in a bit of pain, but it wasn't horrible. Surgery was scheduled for the week after the half-marathon, so I taped up and braced my knee and ran it anyway. It was kind of a bone-headed thing to do, but I thought I could suck it up and cover the distance no matter the cost. Whatever damage happened during the race, the docs could fix in the operating room the next day. Leading up to the ACL tear, I had sporadic pains in my hips, feet, back, and knees. I had always thought this was due to over-training or worn out shoes. For a couple years, I would change my shoes frequently--every 300 miles. This seemed excessive to me, but I would do almost anything to have pain-free runs; even taking way too much Tylenol, an hour before my runs, in order to deal with the pain. When I tore my ACL, the orthopedic doctor was examining my knee and MRIs when I mentioned pain in my shoulder joints. He attributed this to damage from weight lifting. He gave me a shot of cortisone and we both thought the shoulder pain would go away. At this point, I thought that I was rapidly approaching middle age and that I should reevaluate my fitness regimen after the scheduled surgery.
The half-marathon, before my surgery, was to be my last distance run. I completed the distance, running only 10 minutes slower than the previous year. So I considered the event a success, all things considered. The next day was my surgery. It was an arthroscopic procedure at Jefferson Hospital in Philadelphia. The doctor repaired my torn ACL and meniscus while at the same time smoothing out the knee joint. After the surgery, I felt like crap and I was all doped up on pain killers. After a day or so, I was hobbling around on crutches and being a terrible burden to my family while we moved into a new home. We had purchased a house in Lansdowne, PA and moved in the weekend after the surgery. Here is where my memory starts to fail me a little. I started back to work, my leg healing nicely, and followed up with regular doctor's appointments for several weeks. It was around the middle of December when I felt as though I was having problems walking, taking the stairs, lifting things--any kind of movement in general. I was noticeably limping and it became so bad that I needed to take the stairs backwards, if that makes any sense. My orthopedic doctor didn't know what to make of the new symptoms, sending me back to my primary care physician for a referral with a rheumatologist.
Luckily, I was going on vacation from work and I would be able to deal with this on my own time. I was in pain before my appointment with a rheumatologist located in South Philadelphia, but nothing was like the full flare-up that hit me in the last week of December. The pain was all over and seemed to engulf my entire body whenever I made the slightest movement. My family was shocked and I was completely useless at this point. It was as though my joints were on fire and wrapped in broken glass. I found that I felt some relief as the day progressed and that a shower and tons of Advil would alter the severity of the pain. My mind was reeling and I scoured the internet for some kind of explanation for what was going on with me. After cursory searches, I came back with a number of amateur prognoses: gout, rheumatoid arthritis, Gulf War Syndrome, or fibromyalgia. Each of the maladies seemed cryptic and nebulous. My rheumatology appointment wasn't for another week and I endured the pain, hoping that the doctor would give me some kind of relief from the constant torment and allow me to be mobile again. Little did I know, successful treatment would only come after misdiagnosis, seemingly endless rounds of drug therapy, and a change in physicians.
This seems a good place to leave off. I do have a plan regarding this blog. The subsequent posts will deal with different areas of the linear timeline I have presented and other, less tangible, elements that surfaced during my experience with RA. I hope to update this blog on a weekly basis until my initial outline is complete. From there, I will post less in-depth updates related to RA and dealing with it. I know the timeline seems a bit muddled. Looking back on the experience, it all seems like some big blur. There were a number of people who helped me through this period and I fully intend to mention them as I continue to post. I used to think that I could handle anything on my own and come through without assistance. I still think that is my best way with dealing with crap that life throws at me, but it was really surprising to see how many people went out of their way to show support and helped me through this really dark period of my life. Thanks for reading my post.
