I can’t remember ever not being in pain but, I was four or five years old when I first woke up in such pain that I couldn’t open my hands. I would wake up to one of my parents massaging them so they could open through the pain and stiffness. Open. Close. Open Close. Sometimes biting my pillow because the pain was so great. This became my morning routine for years to come. The notion that this was abnormal never crossed our minds because there wasn’t quite the awareness for juvenile rheumatoid arthritis almost thirty years ago as there is now. But, yet we persisted with this morning routine because the longer time went on, the higher my pain tolerance grew.
“Focus on the ball. Stand with knees bent. Look forward at the fairway. Look back down at the ball. Loosen up those elbows. Common…loosen up those elbows. Why aren’t my elbows loosening up?”, I’d thought to myself before giving a ball hell on the golf course. It was around seven or eight years old when I realized the problem wasn’t just in my hands anymore. It also affected my layups in basketball and my throw in softball. I remember being a feisty little girl on the ball field, the basketball court and the golf course, well…that was more my zen. I loved playing sports but, we didn’t know why I had such pain and stiffness and I was often told “Common kid, push through!” or “Buck it up, shorty/Hoss!”, so I did. I became tough as hell with a pain tolerance like you wouldn’t believe but, it didn’t help my sports game because I was often benched for missed shots or throws that didn’t quite make it as far anymore because the pain and stiffness became worse as the seasons progressed. I took it on the chin and diverted my attention elsewhere and onto other things while still playing those sports but, only choosing one to focus on so as not to cause too much pain while doing other things that didn’t cause pain.
I grew up in a neighborhood made up entirely of boys and one other girl, not including my sister, who also loved to meet me in the yard for intense sessions of catch and playing “battery” as catcher while she practiced fast pitch. We broke a few windows and even my hand once. But, the boys…now they were a fun bunch. They introduced me to skateboarding, long-boarding and skiing. All of these things were wonderful because it allowed me to have some freedom under my belt while still staying active and there is nothing quite like feeling the ground underneath you zoom past you while enjoying beautiful scenery. It’s freeing and almost a spiritual experience in a way. It was also around this time I learned to play the drums and another neighborhood boy, Zach, also played the drums. It hurt my elbows and hands so bad but, on those days when I didn’t hurt as much, to feel that rhythm rip out of my hands and jam with Zach was as therapeutic as any medicine any doctor probably could have prescribed. My mom was a music and operatic voice teacher, so I grew up on everything from Bach to the Beatles. With that, music became my solace no matter how painful it was to play because music, or any art form for that matter, allows you to transform any pain (or any emotion), physical or emotional, into the most beautiful expression of love for others to hear and that all can relate to. At 29 years old, I’m still playing those drums and I think that’s important. I’m even teaching my sons.
“You’re too young for arthritis”, the orthopedist said as he examined my hands. I was 16 years old and I was finally at my wits end. “Why do my hands hurt so bad? They are starting to look crooked and I can’t even bend them for half the morning.”, I told the doctor. “I don’t know but, you are too young for arthritis. Sometimes people just have loose joints that make their hands look like that.” was the only explanation he could provide. I had been asked to play golf and softball for my high school and I had to turn them down because I had pain in my hands and elbows I couldn’t explain. So, I figured I better get my “issue” checked out. Again, I took the doc’s words on the chin, went back to school, told the teams I couldn’t join because “I just hurt, I don’t know why, I just hurt”. One friend said “You can play outfield.” I told her, “I’m not an outfielder and plus, doing all the drills are going to probably cause more pain and I don’t know why I hurt in the first place. Dr ****** said I am too young for arthritis but, it just makes no sense why my hands hurt and my fingers are going crooked at 16 years old!” We let it rest and we didn’t revisit it for another 8 years. I joined the Speech and Debate team instead and made it to State three times.
Eight years later, I was married with one son and when our second son, Tony, was born, it was a whirlwind of trauma for both my husband and I. He didn’t know if he was going to have to plan our newborn son’s funeral or if he was going to be able to hold his son for the first time with a smile on his face as he followed the ambulance from Butte to Missoula’s NICU. Tony was born with TTN (Transient Tachypnea of the Newborn), NRDS (Neonatal respiratory distress syndrome/surfactant deficiency), both of which led to pneumonia in the third day of his life. I had a fairly easy pregnancy despite a random spike in my thyroid levels which had my OB baffled but, nonetheless, it was uneventful, and we were to expect a healthy baby boy. When that did not happen, and he was whisked away, I figured my body was just rebelling in stress to the cesarean, not being able to breastfeed him right away (I wasn’t able to join him for four days due to having to heal from the c-section and a spinal headache that required a blood patch). But, as time went on, it became obvious that it wasn’t just “stress” it was something far more sinister. I couldn’t open my hands again, I could barely walk across a room, I couldn’t hold a coffee mug. I could barely bend my elbows or lift my arms. My knees were so full of fluid that they looked like softballs. The worst part was that I couldn’t hold my newborn baby. He was on oxygen for his issues once we got him home, so it was vital that I be able to pull his oxygen and carry him simultaneously. Not to mention, we had a 21-month year old on top of all this who still needed his Mommy because let’s face it, not only are toddlers not independent, they are incredibly mischievous.
This pain was debilitating. It was like seeing God face to face and when I finally mentioned it to my family doctor we started me on prednisone. When the swelling and pain went down with the burst of prednisone he called me right away and said “We need to get you into a rheumatologist! This must be autoimmune! Let’s run some labs first before we send you.” I remember crouching in a chair, scared, shaking and crying after getting off the phone. “Autoimmune!? What the f**k!? I’m 24!!”. My wonderful husband had just gotten home from work he sat beside me and I slid into his lap and said “I’m too young for this Chris! We just got out of the NICU with Tony and now this!?”. He is a very calm guy. He quietly said “We’ll get through it. There’s a lot of new meds out there that were never out there before so it’ll all be okay.” This was the beginning of a long, arduous, and sickly, five-year journey.
The first rheumatologist put me on a low dose of chemo. I remember being angry about that because he didn’t explain any side effects of it (which were frightening by the way), how it worked or the importance of medication itself. I thought to myself, “I don’t have cancer, I’m really confused by this”. Anyway, I took it and proceeded to get so sick I practically lived in the bathroom for almost the next month. I called his office and he said the vomiting was “totally normal” and gave me some advice for some OTC nausea remedies. The vomiting persisted to the point where I began to get weak and take naps in the bathroom which made taking care of a toddler and newborn difficult because I had to ask for help with them just to be on the medication. I told my primary care about this and he sent me to a new rheumatologist who discovered I was allergic to that drug.
When the new rheumatologist and I met, I was in terrible amounts of pain and my labs reflected it. Over the course of the next five years we would try 6 TNF inhibitors (tumor necrosis factor inhibitors) and 1 more kind of chemo at a low dose. That is 8 different kinds of medications that take twelve weeks each to reach “therapeutic” level for you to notice positive results. The side effects of TNF inhibitors are increase risk of infections, sinus infections, development of lymphoma, any demyelinating disease, cardiac arrest or blood disorders. Chemo obviously can cause hair loss, nausea and vomiting but, increase infections, liver irritation, high blood pressure and decrease blood count. If you are already sick with arthritis that causes you to have fevers, flu-like body aches and unfathomable fatigue, I’m telling you right now, being on those drugs are nothing short of trudging through hell. I am already prone to chronic sinusitis and being in a vicious cycle of flaring, prednisone, feeling okay for a couple weeks, getting a sinus infection, crashing again, having my arthritis flare because my immune system crashed again is not only frustrating but, physically, emotionally, spiritually and financially exhausting. You begin to feel little hope anymore.
Five years into that vicious cycle and all because of my arthritis, I had to have a joint repaired in my foot, my neck fused because I broke it as a result of a fall and the arthritis being so prevalent in my neck, and four sinus surgeries. The last sinus surgery was the most extensive because we figured out my arthritis had attacked my sinuses. I never knew that could happen but, when it comes to autoimmune arthritis, all is a fair playing field. I was sent out of town and recovered nicely for about a week and a half before I caught a wicked case of double pneumonia. I was incredibly grateful at that point I hadn’t started back on any of my TNF inhibitors because the blow from the immuno-suppressive effects of that could have made my pneumonia far worse than it was, and it was already terrible. I am prone to staph and the infection found in my sinuses during surgery was staph, so I was equally as grateful that I wasn’t on those meds while recovering from pneumonia.
Let’s backtrack to about two months before my fourth sinus surgery. That’s where the game changed….
For anyone who knows me well, knows that my 2018 has been nothing short of physically brutal. I joke that where Murphy’s Law is concerned, I am a good, law abiding citizen because anything that can go wrong with me, always does because my immune system is just crap. The Annie you know as of now, those who know me well, know it’s not the Annie that started out at the beginning of the year. It’s been a beautiful transformation from a lady who would take her trials with a smile but, anxious about what lie ahead to a lady who stands up straight, shoulders back, accepting the burdens of life with a glimmer of “bring it on” in her eye. It was between that transformation that I got angry. Which is interesting, it’s not in my nature to get angry, ask anyone who knows me. It’s hard to imagine, right? I got angry because of the vicious cycle of infection and arthritis pain.
It was a moment that happened out of the blue. My phone rang and it was my doctor. I was between the incredibly discouraging moment of finding out I needed a fourth sinus surgery and waiting for the operation and my arthritis was flaring something fierce. He simply called to check up and give me a few uplifting words and see how I was doing. He treated me when I was a small child for many infections and thyroid issues and then we became reacquainted this February and since then the man has saved my life a couple times and never gives up on me; He is a saint. So, after listening to my tear-filled rant he proceeded to tell me “Okay so, I have an idea and you can take it or leave it but, I think it may really help you.” He proceeded to talk to me about a bit of research he had done on CBD and knowing how skeptical I am on taking any medications he simply said “You do your research. I’ve done mine. Just hit me with any questions and we can chat about this later and see what you think, okay? Hope is on the horizon!” After our conversation I thought to myself “Hmm…okay. I need to read up on this.”
So, I did…
After discussing with my doctor about how much to start with, I started on a dose of about 25mg twice daily for about two weeks. After those two weeks I noticed an incredible calm over me. It was like someone pressed a reset button on me and I was at baseline, like where a human *should* be. My pain was less but not down to a place where I could do many of the things I wanted to do. I know I needed to persist, though. By week three I was able to pick up my ukulele and play with minimal to no pain. I also took out my camera for some beautiful dusk shots. Which as a photographer, you need healthy joints so to be able to capture those moments and those shots from that evening are nothing short of beautiful to this day. I took my sons out to teach them how to fly fish during this week as well because my pain wasn’t so great that I was able to. The memories from then will last a lifetime. Also, at week three I increased my dose to 40mg twice daily. Week four, I remember waking up one morning and it was raining out. I got out of bed, walked to the kitchen to grab my coffee and noticed I was holding it with one hand and then dropped some strong expletives to my husband because “It’s raining outside and I’m not in pain!! I can hold this coffee mug with one hand!”
I don’t think anybody, or anything could have brought me down that day. I had never felt so great. For the first time in twenty-nine years I woke up without pain. TWENTY-NINE YEARS! I remember hugging my husband and doing what resembled Michael Jackson’s moonwalk across the kitchen floor, coffee in hand, that morning. He was as equally elated. I contacted my doctor and told him my good news. We chatted later about how *truly* amazing it was. It was during this conversation I realized, and I think my doctor did too, that if CBD oil works on me and my complex case, it could work on anybody! Not only do I have autoimmune arthritis and the chronic joint pain and stiffness associated with it, I have nerve pain from previous injuries, chronic migraines and other types of headaches. I also struggle with anxiety that the CBD has helped tremendously as well.
As I said, this year hasn’t been a kind one in a physical sense previous to the point of being able to get my feet on the playing field and head in the game. I feel as though for a while, I was football that needed guarded with immense protection and the players on the field were my team of doctors. They’d get into position, tightly and safely cradling me under their arm between plays, sometimes tossing me to each other for decisions to be made and all the while, I have been kept safe. Sometimes, between plays they’d need to huddle up and implement forthcoming game plans with the understanding that the game may change therefore, we’d put further plans in place then and there. Teamwork. It has been teamwork at its finest. There came a time this year, about a month or two before my latest surgery that I decided, I had to make the conscious choice, to not be the football anymore, though. I wanted to take an active part on this playing field. That’s when my demeanor changed towards the entire “game” of my health.
It was when I was told by my doctor that I needed to meditate, and I was challenged with the question “What do you have to stress about?” when I expressed to him how frustrated I was with my arthritis flaring while waiting for my surgery. “Seriously. What do you have to stress about, Annie? You are being taken care of. You have people that love and support you. You’ve got this. You just have to get your head in the game. All this stress is really just a head game. You need to meditate and then this stress won’t seem like stress.” I thought long and hard about what he said. I went home and did some deep breathing, “I have stress but, stress doesn’t have me.” I kept repeating that mantra. I did this every morning to start each day. Pretty soon I started changing these meditations up from that mantra to things like “I have pain but, pain doesn’t have me”. When I made this life-changing decision to include these mantras in my morning meditations, I feel was able to get my head in the game as an active-participant with my health without having to fear the doctors themselves and be confident in the decisions we were making as a team knowing that no matter the outcome, I would be just fine. I’ve had some pretty bad experiences with doctors, so my fear of doctors was incredibly deep seated and doesn’t need to be elaborated on other than it is nothing short of a miracle that I can actually have a working, symbiotic relationship with everyone being a team player, respecting and accepting each other’s backgrounds, opinions, thoughts and personalities as valuable assets to working on my complex case. That is exceptional teamwork and is what every patient should strive for in their relationships with their medical care teams. This working relationship would soon lead to one of the most life-changing decisions we could have ever made in terms of my health.
“I am scared ****less to see one more rheumatologist and hear them tell me I have to be on these meds that cause all these scary side effects and that cause infection after infection when my immune system is already down. I feel pushed into doing so much I don’t want to do! Look at me right now, I’ve got another one!(referring to a sinus infection) I feel like I’m punching at the air. If the CBD is working, do I have to be on that crap that makes me sicker?”, I told my doctor as I sat in his office feeling defeated after I had just gotten over a bout of the stomach flu lasting 4 days and now presenting symptoms of another sinus infection. He explained to me all the long-term effects of the TNF-inhibitors and low doses of chemo I had been on and that in Europe, CBD is often prescribed as a standard treatment for many health issues. We discussed my fears and how I am too young to need to worry about having to worry about the long-term effects of these HEAVY DUTY drugs I was so used to pumping in my system. We covered the topic that most doctors of that magnitude are not going to support what regimen we have going. We talked about how the fact that if the CBD is working better than any other medicine I have tried in five years, and I tried 8 of them, why mess with a good thing? And lastly, how incredible my case was because with all my complexities. I thought to myself, “If the CBD would be effective for my severe an issue that has been around since childhood and shown obvious improvement, imagine what it can do for others?” Finally, an answer. I don’t HAVE to do something I don’t want to do that’s going to damage my body in the long run if what is working right now keeps working. Lord knows we have a lot of room to play with dosage.
Do you know what a relief it is to be given an out from trips to a doctor every 3 months where you nervously wait to be poked, prodded, asked question after question about how the pain is limiting your life and being told things such as “Well, if that hurts then don’t do that” but, not to be given a solution and felt like my only solution is to go along with the protocol of whatever my insurance will pay for according to my diagnosis. Then, after each appointment I would have to get a good bit of blood drawn which is never fun but, I have tiny veins, so I could always guarantee being a pin cushion by the time I walked out of there. At twenty-nine years old, those appointments began to become demeaning because I felt like not only was I not getting anywhere with my arthritis treatment in five years but, that I would walk out of there ever reminded of things I was no longer empowered to do because my arthritis and infections were getting worse. It sort of strips you of your identity in many ways; And it didn’t do it overnight, this entire situation robbed me of chunks of my life bit by bit.
I have many hobbies. I love to hike, golf, disc-golfing, am a photographer, a percussionist, I ski and snowboard, love to sketch and paint, I fly-fish, and cooking gourmet meals with my husband. Little by little these things were scratched off my list as things I could no longer do in the past five years. This year though, I have been able to add every single one back to my life except for skiing and snowboarding, simply because the runs haven’t open up yet. But, you better believe I have a season pass. Most importantly though, do you know the feeling of finally being able to pick up your child and hug them when you weren’t able to do that before and instead had to bend at the waist and give what anyone would likely call a half-hearted hug to their child? Do you know the feeling of finally being able to zip your child around the living room on your back while making silly noises when you weren’t able to give them piggy back rides before? Do you know the feeling of being able to get down on your knees and play dinosaurs, trucks, or lego with your child and be able to get up without a hand-up whereas you would have previously needed a hand as well as let out a sharp gasp from pain?
I’m not saying I don’t have pain. I am more mindful of where my pain sits now than ever before and what I am saying is that it is nowhere NEAR where it was. I still can have several bad days pop up out of nowhere and still call myself a human barometer. However, if I can go from being that child who bit her pillow in pain while trying to open her hands at five years old, you have hope with your chronic pain just as well as I did, no matter your age. We didn’t discover my arthritis until I was 24. We didn’t start me on the CBD until I was 29. Look at me now. There. Is. Hope. Utilize your best resources and use your voice. Do not ever let any doctor (or anyone for that matter) force you into any situation you don’t feel comfortable with. And if you can, surround yourself in a support system and care team that not only becomes your working teammates but, also your best cheer-squad. If you can, find a doctor who will be a champion for your health that you trust and can cover any ground with. It is life-changing when you decide to just walk through the doors that were already open to you. But, you have to make the decision, with courage, to do that. You have the power to change your situation. Be your best advocate but, most of all be a game-changer. You never know which spectators need your perspective, tenacity, strength, confidence, discipline, and your desire to be better than you were yesterday.