One of the hardest things to deal with, after leaving a rheumatologist’s office with a new diagnosis, is the ignorant comments from friends. Our society lives with the delusion that given any aches and pains, a trip to the doctor will result in a diagnosis and a prescription to make everything right again. Wouldn’t it be nice if that were how life really worked?
With a new diagnosis, wanting a listening ear and a little sympathy while we try to get our bearings and figure out what happened to our life, it’s distressing to be dismissed with a shrug and insensitivity:
- Oh, I have that, too, in my little finger
- Aren’t you too young for that?
- Just take a Motrin
Recalling those days, I try to be supportive when I meet others facing similar challenges. I was surprised then, a few weeks ago, by one man’s response.
After shaking hands, I thanked him for not squeezing too hard. His wife (standing beside him) said, “Well, he has arthritis.” Guessing that he’s about my age – maybe a bit younger – I asked, “Oh? What kind?” and was informed that he has polyarticular arthritis. Thinking to lend a little support, I mentioned that I understand, since I have RA. He snapped, “Well, mine’s worse! It’s in every joint.”
I was taken aback. The online community is extremely supportive of one another, so it was shocking to think I was offering understanding/commiseration and have it thrown back in my face, and also have my circumstances belittled.
Inside I was seething. How dare he! What kind of idiot automatically assumes his condition is worse than someone else’s? How could he remember a long word like “polyarticular” yet not know enough about it to realize what a jerk he was being? If I were ten years old again, I’d have shouted back at him, “Oh, yeah? Well that’s not even a real diagnosis! What ICD-9 code is your rheumatologist using?” Fortunately, I’m only ten in my head, so I kept my mouth closed and walked away.
Later I started second-guessing myself. Maybe I’d forgotten what polyarticular arthritis is; maybe I was confusing it with something else. I looked it up. Polyarticular arthritis means inflammation of more than four joints. It’s a symptom, like “sore throat” or “abdominal pain.” The trick is to figure out the cause, and the differential diagnosis for “inflammation of more than four joints” is a long list of possibilities. It includes things like parvovirus, Epstein-Barr virus, hepatitis B, HIV, gonorrhea, chlamydia, salmonella, lyme disease, multiple myeloma, plus a host of autoimmune diseases such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, scleroderma, Sjogren’s syndrome, and lupus. It was just what I remembered: the symptom is inflammation in many joints; the diagnosis says which disease is responsible.* Obviously, treatment will vary depending on which disease is causing the inflammation.
I feel sorry for the man. Imagine going through life competing to have the worst disease. I didn’t know it was a contest.
If it were a contest, it’s one I’d be happy to lose.
*If the doctor can’t figure out which disease is causing the symptoms, unspecified polyarthropathy or polyarthritis is a possible diagnosis (ICD9 code 716.5 ).