English
As Erica Rimlinger tells it
I was on my way to a lecture at university when I felt a throbbing pain in my left foot. When I took off my shoe to check, it looked like a ball had formed on my foot. Did I hit him with something? Did something happen to you? The skin was not red and did not bleed. What happened? My foot healed after a few days and by then the pain was affecting my ability to walk.
Over-the-counter painkillers had no effect. I had a consultation with a GP who gave me a corticosteroid injection which helped with the inflammation. And I thought that was the end of the story of this mysterious pain.
In reality, the story had just begun. Shortly after my foot began to swell, scaly, red, raised welts appeared on my forehead. I had a consultation with a dermatologist who diagnosed me with plaque psoriasis. “Do you have insurance?” he asked me. Luckily I had it. I started using tar shampoo, creams, medications and expensive injections. Only injections were useful, but never for long.
Meanwhile the pain and the mysterious swelling appeared again. My left knee was swollen, then my wrist, then my back and then my right elbow. It seemed to move through my body with no apparent reason or predictable pattern. Was it stress that was causing this chaos in my body? What happened?
My doctors suspected my weight might be the cause, but I knew that wasn’t the problem. In fact, he had recently lost weight. I was diagnosed with insulin resistance and thyroid problems. Taking medication for these conditions reduced my weight and put me out of the pre-diabetic range. But the weight loss didn’t relieve my constant pain and inflammation.
The pain could manifest at any time in any joint in my body. The affected joint could be moved as long as I could tolerate the sharp pain caused by the movement. I wore braces on my wrists. The pain was exhausting and left me exhausted.
Medical consultations were not helpful. Because I’m a large size, I had to deal with comments that made me feel ashamed and guilty about my size. I left several doctor’s appointments upset by her advice: “Eat less. Do more physical activity.” Deep in my heart, I knew there was something more to it all.
No one listened to my protests until I met with a new doctor and received a diagnosis that linked my plaque psoriasis to my joint pain. He had an autoimmune disease called psoriatic arthropathy.
It was almost a relief to receive this diagnosis. I knew it was something important and that I was embarking on a treatment that required a little empirical experimentation. The medication started working, then stopped working and I had to start over with a new plan. Sometimes I wanted to tell the doctors who were preaching that I should lose weight that my symptoms had gone away by treating an autoimmune disease I had.
Despite insurance coverage, medications were expensive. The injections given for every plaque psoriasis outbreak were particularly expensive and only useful for skin problems, not joint pain. I took part in clinical trials because the drugs were free and I received a grant to test cutting-edge treatments – a double benefit.
I’m currently taking a biopharmaceutical that works and has been one of the longest treatment successes for three or four months. I keep my fingers crossed. Throughout this process, I received support from my virtual community. It’s helpful to talk to people who know what you’re experiencing. It’s also nice to have a supportive partner who knows I’m strong, but also knows that sometimes I just need to cry.
Psoriatic arthropathy is a lifelong condition and treating it has been difficult, but the hardest part of this process has been finding a doctor who sees me as a person and not just what a scale says. Obesity is a complex disease and although it can cause medical problems, it is certainly not the cause of all medical problems. And although obesity may be linked to psoriatic arthropathy, my new doctor told me bluntly: Your weight is not the cause of it.
I’m lucky that the constant weight loss news didn’t stop me from going to this doctor when I needed it most. Throughout my life, people told me that my pain was due to my size, which reinforced the idea that I was the problem and that my pain was my fault.
I advise women of all sizes to see a dermatologist as soon as possible if they experience pain and plaque. Even if you think the symptoms aren’t a serious problem, as I initially did, you shouldn’t ignore them. Let them evaluate. It is difficult to get a diagnosis for an autoimmune disease, but new treatments are being developed every day and hope prevails when it comes to psoriatic arthropathy.
This resource was created with support from Merck and Takeda.
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