The office was located in South Philadelphia, a brownstone walk-up on Broad Street. It was a very old office with a television mounted on a swing-arm in a corner--perpetually tuned in to annoying talk shows. The staff was made up of South Philly types, their brogue and demeanor reminiscent of stereotypical neighborhood residents: tough, casual, and personal.

My initial exam took what seemed like a long time. He asked me a number of questions related to movement, comfort, lifestyle, etc. My hands had already started to twist into claw-like appendages--not resembling a useful hand. Making my hands flat was no longer possible. Everything still moved, but my grip and their appearance were altered greatly. He examined many places on my body and concluded that I had a high number of "hot spots" and that I should take a battery of tests before he would do anything. I can't remember if he prescribed something or not, but I do remember being disappointed with my first appointment. After the appointment, I went to a nearby lab and had seven or eight vials of blood drawn and gave a urine sample.

I think that I went back about a week later, where he read the results back to me. There were a number of elevated levels listed within the results, but it all seemed like a blur. There just wasn't any concrete proof that something was wrong. He ordered another round of tests, even looking for such far out stuff like Parvovirus. When the results of these tests came back, there was even more elevated results and it was clear to both of us that things were getting worse.

Around this time, I was having a terrible time walking during the day and I was literally crawling to the bathroom in the morning. I felt as though I had the body of an 80 year old man. I was losing a lot of weight, my joints and muscles were becoming atrophied. On the inside, I was panicking. I woke up one morning around 3:30 because the pain made it unbearable to sleep. I went to the bathroom, crawled into the spare bedroom, rolled onto the floor, and asked God for the name of the problem that had afflicted me. I didn't ask for relief, I just wanted to know what was wrong with me. Not knowing caused the most anxiety for me. I thought that it was probably very selfish to ask for the pain to go away. That was probably my weakest and loneliest moment.

Getting back to the doctor's office visits... Once we could both see that the results clearly showed my condition worsening, he started off with the standard steroid treatment (prednisone) and (mis)diagnosed me with fibromyalgia. Being diagnosed with fibromyalgia was not a good thing. There is no real definition of what fibromyalgia is--so it was a big question mark. He also prescribed very strong pain medication. I started taking the prednisone right away--only taking the pain relievers when the pain was unbearable. I had read too many accounts of people getting hooked on narcotic pain killers to fall into that trap.

When I first took Prednisone, I felt amazing, invigorated, and much more like my old self. I even felt good enough to get in a short jog. It was miraculous and my family rallied to my side--happy in my comeback after months of pain. It didn't last long though. After a few days, the effects were diminishing and I was rapidly going back--at what seemed an accelerated pace. I went back and forth with the doctor... He would up my meds, give me new stuff, and I would come back with less mobility and more deformity. After six months with this rheumatologist, he had changed his diagnosis from fibromyalgia to rheumatoid arthritis and put me on several old school drugs--methotrexate being one of them. The side effects of the old and newly prescribed drugs were pretty horrific. I had been on a pretty high dose of prednisone before he took me off of it when he changed my diagnosis. I had gained a terrible amount of weight and felt terrible when coming off the drug.

While being diagnosed with rheumatoid arthritis was a very definitive label to my anomaly, it was also a life-changing event. I scoured websites, support groups, printed matter, and talked with friends in the medical community about the disease. It all came down to a short phrase... "a chronic autoimmune disease with no cure." Okay, cool. So now I know. I will deal with it. Fuck it, I will win. Period. That was my mindset after seriously sitting down and thinking about the disease and the possibilities. This was the beginning of a long road to recovery and living with the disease.

There is something that I do want to say before closing this blog post. My family and the people at my job are probably the coolest people on the planet. My family is amazing. They have experienced everything that goes along with RA as if they had it themselves. My wife and son have been supportive and understanding of everything surrounding my affliction and have been instrumental in dealing with it from day one. My co-workers knew something was wrong and said nothing in order not to embarrass me. The management team at my office totally understood what was going on and offered me whatever was within their power to keep me working and accommodated. It was a struggle to get a grasp of this disease and it took a long time. The people at my work made making a living bearable, under sometimes unbearable circumstances. I am truly blessed with a loving family and great friends and co-workers. I will leave off now. I will cover the specifics of my meds, their impact on my health, and switching doctors in the next post.