From Injury to Psoriatic Arthritis
This is part 4 of the narrative of my disease development from childhood, young adult and middle age. A list of my symptoms over that time frame and where I fit in the multigenerational family history of this disease.
The Injury
I was never a runner. It made my feet hurt. But at around age 50, I suddenly felt compelled to run for portions of my walks. I was running more and more each day and I was feeling so strong when we left for our ski trip.
But I also knew that I had never been good at snow sports. I didn’t grow up doing them and it had been an unfortunate 3 or 4 years since the last ski trip so I had to start from the beginning again. I preferred snowboarding over skiing so signed up for lessons, but group snowboard lessons are not for the middle-aged. The teacher randomly asks you to take one foot out and “walk” long distances. It was completely inappropriate for me, but I did not want to stand out, so I carried on. I didn’t know it at the time but all that “walking” was straining my ankle. The last straw was a fall on my tailbone that was significant enough to make it hard to get down the mountain but not so significant to seek medical help.
I made it through the rest of the trip just fine but about 2 weeks after we got home I started limping for no reason. My ankle was very swollen…and the testing began. First, we looked for broken ankle bones; there were none. Then we investigated the foot and found all kinds of tendon issues (see my Progression of Disease post) but nothing that explained the size of my ankle and the pain that was starting to move to other joints in my body. My tailbone, hips, and back had flares of significant pain. I had nerve studies, MRIs, physical therapy, acupuncture, and myofascial massage (which almost miraculously corrected some body alignment issues).
Menopause
About 6 months after my injury, my periods stopped suddenly. I began frantically trying to connect my symptoms to menopause. But there is a profound lack of medical science about the symptoms associated with menopause. Some women have back pain. Some women have numbness down one arm just like I did. But no doctor could speak to these experiences, how long they last, or whether there was something that could be done about them.
I spent the next year seeing doctors, searching for answers and managing the pain. In the process, I saw a rheumatologist (one of the worst doctors I have ever seen) that tested me for the HLA-B27 gene. She did nothing with that information and I didn’t know to ask more questions. In hindsight, I’ve decided it must have been because most of my blood inflammatory factors were within healthy ranges. But I also now know that is common for most patients with Psoriatic Arthritis.
The Diagnosis
The NEXT rheumatologist connected all the dots. SIBO (small intestine bacterial overgrowth), HLA-B27, all the tendon issues, the back, neck, hand, and foot pain and my red inflamed joints led her to diagnosis Psoriatic Arthritis. So, 2 years after I started seeking help I finally found a doctor that recognized my disease. Fighting the insurance companies to get on medication took another 6 months (another post to come on that). I have been on Humira for about 2 ½ years now and while there are times that I think it isn’t working, there is more evidence that it is working. When stopped for illness and surgery, the benefits of the drug are obvious. This year I had 2 foot surgeries and observed a phenomenon that I have yet to research. During recovery, it appears the body stops attacking itself and sends all its energy to heal the surgery site. I have been remarkably free of arthritis pain while recovering from my surgeries. I still have about 4 weeks left in this recovery and I know that as soon as my body heals, the distraction will be gone, and it will probably start attacking itself again!