The Little Big Victory

Monday, July 27, 2020

In life, there are so many different challenges, obstacles, and hoops that we all must maneuver through. They begin in childhood and don't stop until we are free from this world. Because the curveballs are so constant, we forget to take time out of our day to enjoy the small victories that come our way because we are so caught up on the next big thing in our lives and that is our only fixation. I am also guilty of having these long term goggles that keep me out of focus of the everyday positivity surrounding me. 

    My husband was diagnosed with an autoimmune disorder last year although he had been suffering from its symptoms for over eight years. Psoriasis attacks the skin and psoriatic arthritis attacks the joints. Over time, he began losing flexibility in his knees where he could not fully bend or put any weight on them. As a typical male, he chalked this pain in his joints up to osteoarthritis (old people joint pain) and the skin condition as something independent and annoying but not worth a visit to the doctor's office. Once we began talking and our relationship became more serious, I urged him to revisit his family physician to figure out exactly what was happening since the joint now progressed to his elbows and wrists and followed by neck pain after a bout of strep throat. 

    His family physician, gave him steroid injections in both his knees to relieve the joint inflammation after extracting out the fluid collected within and referred him to a well known orthopedic physician. Meanwhile, we focused on improving his diets and adding supplements. The orthopedic physician assessed the joint fluid and told my husband there was nothing wrong as far as his department was concerned. He stated there was some mild joint inflammation and that if the pain is worse he should continue using the temporary fix of steroid injections even though the joint pain continued to worsen to the point where he was unable to climb up and down stairs without difficulty. 

    I was very disappointed, frustrated and dissatisfied with hearing the dismissal of my husband's case without anywhere else left to go and my husband, he once again started taking it easy by throwing his hands up in the air and saying there was nothing else that could be done. I, however, was not finished yet. I asked him to return to the family physician and request a rheumatology workup of the joint fluid to check for any autoimmune reason behind the breakdown of his joints because I was already suspecting his skin condition to be due to psoriasis. 

    After a few more tests, my husband was diagnosed with psoriasis and psoriatic arthritis and finally referred to a rheumatologist. The initial medication for autoimmune-related to pain is to see if the pain can be managed with NSAIDs and that is what he was prescribed. However, if the pain continues despite daily NSAID use, then the doctors move on to specially targeted therapies that hold back the immune system from attacking the body. So despite pain medication, my husband was unable to perform many physical activities because of the difficulty in moving. It is also important to note that autoimmune conditions can cause fatigue and depression as well so when a family member or loved one is suffering, the others need to be understanding and supportive. Even if the afflicted person wants to exercise or be more active, their own body is mentally and physically holding them back.

    After marriage, I started going to the doctor's appointments with my husband so that he and the doctor would not miss anything via communication because my husband was not sure exactly how much information was or was not important. Eventually, he would be going to the meetings alone but we would still talk about what he should specifically discuss and what he should ask. We tried many supplements for joints such as collagen, omega fatty acids, chondroitin sulfate, multivitamins, and vitamin D but none provided any symptomatic relief. 

    The rheumatologist decided it was time to initiate disease-modifying anti-rheumatic agents starting with methotrexate. The medication provided relief and removed pressure from his joints enough that he initiated exercises and stretches into his routine. He would walk to and from work every day to maintain the acceptable level of physical activity required while being monitored with routine blood work. The only downside to his medication was the unknown risks of trying to conceive while he was on methotrexate even though we both were ready and trying to have a baby.

    Nevertheless, our other priorities were put aside because health comes before anything else. We discussed with the rheumatologist if there would be any other medication with fewer side effects that his insurance would cover through which we could continue to try and conceive. The rheumatologist agreed to switch my husband to a medication with fewer teratogenic side effects (side effects that could harm a growing fetus). While focusing on this, we failed to notice the steady improvement in my husband's condition until we went for a hike a few days ago and my husband did not complain once of knee pain. We both stood for a moment stunned, and held each other despite being sweaty and heated from the exertion, and celebrated our little but big victory. 


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