Do not ignore joint pains – Recognise early

Just as I was winding down my  consultation with a patient of mine known to have Rheumatoid arthritis and ensuring her everything was going well – she just smiled and asked “Dr , where were you 8 years ago?”

 

Not realizing the exact reason of her question I enquired why she was asking me the same.

 

She began her story by saying that ill fate had dawned on her 8 years back when she suddenly lost her husband who was a government employee and sole bread winner for the family. After his demise she was offered employment as a help in a government office to meet her needs and bring up her 2 children who were schooling then. There were significant  financial and social difficulties.

 

She said if this was not bad enough she started noticing that her mornings were getting difficult and her joints would seize up – she would take longer for all routine activities which also meant most days her kids left without their meals to school. She would notice improvement by mid day but found it difficult to carry files and do activities which required fine movements and grip.

 

Given the responsibilities towards her family, she just carried on – trying to put a brave face but felt so exhausted and tired with each passing day that tiny tasks at work were becoming a challenge. She remained silent about her problems at work so as not to give an impression that she was lazy – the job after all was precious to her.

 

Family did notice her difficulties but also reassured her that it may all be the stress she is facing due to recent events and will eventually pass. She did seek local medical attention but not regularly and tried pain killers or alternative treatments suggested by neighbours.

 

This went on for years and in last 2 years she came to a stage where she was becoming house bound – on long sickness leave and required her now grown up kids to look after her.

 

Her daughter now educated and working in a hospital gathered information and got her to our department to be evaluated. When I met her she was very frail, had low blood count requiring blood transfusion and had joints which were swollen and sore. She could hardly walk.

 

A diagnosis of Rheumatoid arthritis was made on clinical grounds and supported by special blood tests. Her treatment was initiated – In the last  6 months  of her treatment she is now well  describes herself as an energetic lady who finds it difficult to stay still – has resumed her work and is carrying her duties with such efficiency that is earning her praise and more so over she is now independent and has truly started enjoying her life with her children who have done well educationally.

 

She says she has lived her life to fullest in the last 6 months and is continuing to compensate what she has not lost in the last few years. Even more she has rightly identified patients like her in the neighbourhood and at work and directed them for the appropriate treatment. As I gathered my thoughts over her story I realized every patient of Rheumatoid arthritis has a journey – It can be difficult  and challenging course getting to the right diagnosis and specialist due to lack of awareness about the same.

 

The key highlights through the story are–

  1. Recognize the symptoms ( highlighted in bold )
  2. Seek early medical attention – timing is crucial
  3. Do not self medicate or follow practices which are not guided by specialists
  4. If you are a patient of RA then contribute to the society by raising awareness and helping others who need help and are lost just like our lady has done.

 

It has increased her confidence and she has earned respect in her vicinity. As to my answer to her question of where I was 8 years ago-

 

I smiled and said – “I was studying to be a Rheumatologist just so that I could witness this satisfaction on my patients face”. It is priceless.