As Erica Rimlinger tells it
I was walking to my college class when the top of my left foot began to throb in pain. When I took off my shoe to check, it looked like a bullet had appeared on my foot. Had I popped it? Did I drop something on it? The skin wasn’t red and I wasn’t bleeding. What was going on? It didn’t go away even after several days and the pain made walking difficult.
Over-the-counter painkillers had no effect. I went to my family doctor who gave me a steroid injection to combat the inflammation, which helped. And with that, I thought, the story of my mysterious pain ended.
Actually, the story was just beginning. Shortly after the foot swelling, raised, red, scaly patches appeared on the skin above my forehead. I visited a dermatologist who diagnosed me with plaque psoriasis. “Do you have insurance?” she asked me. It’s a good thing I did that. I started using tar shampoo, creams, medications and expensive injections. Only the injections helped, but never for long.
Meanwhile, the mysterious pain and inflammation returned. My left knee swelled, then my wrist, then my back and then my right elbow. It seemed to move through my body without reason or predictability. Has this stress wreaked havoc on my body? What was going on?
My doctors suspected my weight might be to blame, but I knew that wasn’t the problem. In fact, I had recently lost weight. I was diagnosed with insulin resistance and thyroid problems. Taking medication for these conditions reduced my weight and brought me out of the pre-diabetic range. But losing weight did not provide relief from my constant pain and swelling.
The pain could occur at any time in any joint in my body. The affected joint could only move as much as I could withstand the sharp pain that accompanied it. I wore braces on my wrists. The pain was exhausting and wore me down.
Visits to the doctor didn’t help. Being plus size meant making comments full of shame and guilt about my size. I left several doctor’s appointments upset by the advice: “Eat less, move more.” I knew in my heart there was more to it.
My protests went unheard until an appointment with a new doctor gave me a diagnosis that linked my plaque psoriasis to my joint pain. I had an autoimmune disease called psoriatic arthritis.
It was almost a relief to get the diagnosis. I knew it was a big deal and that I would be embarking on a treatment journey that would require some trial and error. One medication would work, then stop working and I would have to start over with a new plan. Sometimes I’ve been tempted to tell the doctors who promote weight loss that my symptoms have gone away by treating my autoimmune disease.
Even with insurance, the medication was expensive. Particularly expensive were injections for every plaque psoriasis flare-up, which only helped with skin problems, not joint pain. I participated in clinical trials because the drugs were free, and I received a scholarship to try cutting-edge treatments: a win-win.
I am currently taking an effective biologic and have been for three or four months, one of the longest treatment periods I have had success with. I keep my fingers crossed. Along the way, I found support through my online community. It helps to talk to people who know what you’re going through. It’s also nice to have a supportive partner who knows I’m strong, but who also knows that sometimes I need a good shout.
Psoriatic arthritis is lifelong and difficult to treat, but the hardest part of this journey was finding a doctor who saw me as a whole person and not just a number on a scale. Obesity is a complex disease and although it can cause health problems, it is certainly not the root cause of every health problem. And although obesity can be linked to psoriatic arthritis, my new doctor told me straight up: Your weight is not the cause.
I was lucky that repeated requests to lose weight didn’t stop me from going to the doctor when I needed it most. I spent a lifetime being told that my pain was due to the size of my body and realizing that I was the problem and that the pain was my own fault.
I advise women of all sizes to see a dermatologist sooner rather than later if they experience pain and plaque. Even if you think the symptoms aren’t a big deal, like I did at first, don’t just flinch. Have it checked. Any autoimmune disease is a difficult diagnosis, but new treatments are being developed every day, and hope is harder than psoriatic arthritis.
This educational resource was created with support from Merck and Takeda.
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