One of the most common things I hear in the lupus community is that it took a very long time to reach a diagnosis. Patients with lupus have very vague symptoms which can also mimic other diseases. If you’ve ever watched the show “House, M.D.”, you know lupus is almost always on the differential. We suffer through multiple tests and treatments searching for an answer. You would think as a doctor, someone with experience diagnosing patients, that I would have been able to interpret my own signs and symptoms. But, alas, I could not.
My symptoms began most likely a year or so before I was officially diagnosed. I say most likely, because I am not sure. The symptoms I had were mild and transient so I never paid much attention to them. Things didn’t start to become noticeable until my second year of residency. It had started out with knee pain. The pain was quite strong, but I was still able to walk if I wore a soft knee brace and popped a couple Aleves. I consulted with the orthopedic residents, and although they could feel a little crepitus (crackling), they couldn’t find anything specific. They said maybe I hurt myself at the gym, and we left it at that.
The next thing I started to notice was the pain in both my wrists. Being a physician, I was constantly writing or typing notes and orders, so I figured I had carpel tunnel syndrome. I bought a couple wrist braces, more NSAIDs and called it a day. I also was very fatigued, but doesn’t every resident feel that way? We run around all day, up and down stairs, pushing patient’s beds, working overnight and twenty-four hour shifts, and then coming home to study or work on power point presentations. I mean just writing about it makes me tired.
And then it was the hair loss, but I didn’t actually pick up on it. My landlady had hired a cleaning lady, and when the cleaning lady quit, she would come down and clean my basement apartment. She would get upset about the amount of hair on the floor and clogging the shower. But doesn’t stress cause your hair to fall out? And residency was definitely stressful.
Then things really started to spin out of control. On my vacation to California, I started to feel a lot more joint pain. It was in my knee, and my wrists, and now in my toes. I could hardly walk when we were sightseeing, holding back the tour groups we were in. I told myself I would get it checked out when I got back, but I knew I’d be too busy to.
A week after I got back, I started developing swelling in my face. I thought I was allergic to my boyfriend’s cat. I took Benadryl but it continued to get worse. I was too embarrassed to go to work looking like the Marshmallow Man. My vanity finally brought me to the doctor’s office.
My boyfriend took the day off and drove me to the office, since I could barely see through my puffy cheeks. The doctor took some urine and blood, and started me on prednisone for my “allergic reaction”. I didn’t know it then, but my life was about to change completely.