Interior, Doctor’s Office. Dr. House sits at his desk, bum leg propped up and cane twirling in one hand. The other holds a sheaf of papers, which he reads with a bored expression.
Well, it wasn’t lupus. Huh. Guess we’ll never know.
House shrugs and tosses aside the sheets of blood work results. Fade to black as episode ends forty-five minutes early. Roll credits.
I had my follow-up with the new doctor today. He had ordered blood work and x-rays to find the underlying cause of my persistent, systemic joint pain. Along with general panels on inflammation, they tested for the rheumatoid arthritis factor. I crammed the lab visits into one of my days off to get everything done. I had to wait a month, though, to get the results.
During that time, I read up on rheumatoid arthritis. As much as I hated the idea, it sounded like everything I had experienced over the past five months or so. So I figured out how I would cope.
I started doing regular stretching routines. I focused on improving my diet. I used apps to track my pain levels and stiffness. I took way more NSAID painkillers than I felt comfortable with or than my stomach could tolerate (on the doctor’s orders).
Today he told me I don’t have positive RA factor*. In fact, I don’t have any signs of inflammation in either my blood work or my x-rays. There is, as far as he’s concerned, nothing wrong with me.
I plan to dramatically cut my hair, in part because braiding it in the morning is getting to be too difficult for my fingers. I get foggy-headed from the pain while working, even with the painkillers. I got my old cane out in the hopes that it will help me walk more easily outside of work.
There’s nothing wrong with me.
I tried to press the doctor for answers. I didn’t have a lot of hope. After waiting almost an hour to see him, he had only been in the room for three minutes before ostentatiously checking his weirdly oversized wristwatch. He hadn’t even finished telling me the results of the tests at that point. Still, I asked.
What else could it be? What do I do now? Why is this happening?
He told me there were no more tests he would run. He had no answers as to what was wrong. Grudgingly, he said it could be wear and tear. (To disability levels within a few months? In someone who only just turned thirty? Doing a job that, while physically demanding, is not exactly digging ditches?)
Ultimately, his answer was that he didn’t know what was going on. It wasn’t the first thing he suspected, so he was done looking.
Like the most boring episode ever of House M.D., he gave up fifteen minutes in with a shrug.
So what did he suggest for managing my new mystery chronic pain condition? More pills, mostly. Keep taking the naproxen that upsets my stomach, then throw in some acetaminophen as well if I need it. See if hot or cold helps. Try tai chi.
(I did, at this point, explain that “staying active” is emphatically not a problem I am currently having. If anything, I’m trying to find ways to be less active. While I do stretches, I don’t bother to plan aerobic activity; I can safely count on work to provide periodic bouts of frantic scurrying to get my heart rate up.)
So that’s the big punchline. I’m out a bunch of money, I don’t have any answers, I’m not any better. Oh, and I have the unenviable task of being disappointed I wasn’t diagnosed with a horrible autoimmune disease. Nothing’s changed.
And I mean that in every way possible. I’m not going to stop what I’ve been doing. No matter what his tests show, I have swollen, stiff, painful joints. I live with chronic pain. It affects my ability to work, to play, to think. I’m going to have to find ways of coping with that. I’m going to do the work of living, even without medical help.
After the episode ends, we the patients have to live with our diagnosis. Or our lack of one.
[*NB: That being said, only 80% of people diagnosed with RA show a positive factor level. It is possible to be diagnosed based on other factors. Conversely, some people with positive factors either have no symptoms or have non-arthritis causes for the elevated levels.
Will this level change in a month or six? I don’t know. I suppose I could go back, if I keep getting worse, and demand another attempt at explanation. After yet another experience of being ignored and disappointed by a doctor, though, I’m not eager.]