by Mark Rucker
“Hmmmmm….I wonder why my wrist hurts?” I thought.
I remember it just like it was yesterday. I woke up one morning last August and noticed that I had some pain in my wrist on my left hand. It was just a small area, on the back on my hand on the inside portion closest to my thumb. I thought about what I might have done the day before to make it hurt but dismissed it as a “mystery” pain and went on about my daily business.
The next day I noticed that the pain had moved to the middle of my wrist on the back of my hand. Again, I wondered about the cause but again simply dismissed it as one of the joys of being 46 years old. Then the next morning the pain had moved to the outside of my wrist on the pinky side of my hand. I was perplexed by what could have caused it but again didn’t give it a whole lot of thought. Over the next few days the pain spread to the underside of my wrist and slowly began working its way up my palm and into my fingers. Admittedly, I was a little concerned but like most men I know, I milked it for some sympathy from my wife, and decided that it wasn’t worthy of a doctor’s visit.
And then on Thursday, August 22, I woke up with pain in my right wrist. This pain started on the underside of my hand which was different from how it started in my left hand. Later that day, I met my wife for lunch in Frankfort and the pain had spread into the palm of my right hand. After lunch, I drove back to work in Georgetown. After work I had to drive to Shelbyville for a soccer match for my daughter and by then the pain had moved into my fingers. I stopped to get gas in my car and struggled to remove my gas cap and squeeze the handle on the pump. I knew something was definitely not right. At the game I couldn’t even clap my hands to cheer and on the drive home, I struggled to wrap my fingers around the steering wheel. By the time I got home I was exhausted and decided to go to bed. Unfortunately the pain in both hands was so intense that I wasn’t able to sleep. I got up, went downstairs, and decided to watch some TV to take my mind off of it. But the pain intensified and I noticed that I had several red areas on my hands and wrists that were hot to the touch. I also had some swelling. I convinced myself that I had contracted some rare blood disease and that my hands were now going to have to be amputated. I decided to wake my wife and head to the ER.
At the ER, the Doctor looked at my hands and asked me quite a few questions. My wife volunteered the fact that I am a social media addict and that in her opinion I had carpal tunnel. I admit that I do spend a lot of time on my phone using social media. And I use the computer non-stop at work as well and work had been very busy for some time leading up to this event. After a few minutes, the Doctor told me that he thought it was carpal tunnel and possibly a touch of RA.
“RA?”, I thought. “ME?” I think I even laughed out loud at the suggestion. I was only 46 years old. RA is something that only old people get. And I was not old. And I had no family history, so I thought there was no way that I had RA.
He prescribed some pain meds for me so I could get some sleep, as well as some prescription Tylenol. He also gave me wrist guards to wear to help keep my wrists steady. I was a little embarrassed to wear them to be honest, but I decided that it would be best to follow the Doctor’s (and my wife’s) orders.
For the next couple of weeks things seemed to be going okay with my hands. I took a break from social media, wore my stylish wrist guards, and took my meds. But then I noticed that I was starting to have some pain in the balls of my feet and in my toes. I had just volunteered at Ironman Louisville though and had spent about 14 hours on my feet so I chalked the pain up to that. But over time it wasn’t getting any better. In fact, it was getting worse.
In October my wife and I went to Cape San Blas, Florida with some friends for a much needed vacation. The pain meds that I was prescribed in the ER were long gone and the pain had returned to my wrists, hands and fingers, and was still in my feet and toes. It had also spread into my shoulders over the weeks after my ER visit. What should have been a very relaxing, enjoyable time at the beach turned into something of a nightmare. Doing simple tasks was extremely difficult. It was difficult to get dressed in the morning because of the pain in my hands. Walking up and down the stairs at the rental house was a tedious task because of the pain in my feet. Walking in the sand on the beach, which is one of my favorite things to do, only caused more pain. Sleeping was hit or miss at best. Fatigue was overtaking my body. And then, while still on vacation, I woke up one morning and could barely move my jaw. So now eating was even difficult. And being on vacation and not being able to eat very well was not much fun. I decided then that it was time to go to my Doctor.
When I returned from vacation I made an appointment immediately. I talked with her about my symptoms, how it all started, and how it had spread. I honestly was convinced that I had gout at this point. She examined my hands and feet and decided to do some lab work. A few days later I got a call that told me that everything looked good: there was no gout, blood sugar was fine, thyroid was fine, liver function was good, triglycerides and cholesterol were good. But there was one small potential issue. The indicator for RA came back positive. She told me that the test isn’t a definitive indicator for RA but rather of inflammation in the body. She told me that she needed to refer me to a Rheumatologist for further testing.
I was scheduled for the Rheumatologist for January 19. That was two months away. I really wasn’t sure how I was going to make it that long. Over November and December, the joint pain moved into my ankle, knees and hips and also into my neck. I was unable to sleep lying down anymore. Every night I would retire to my recliner because sleeping in an upright position was the only way that I could get enough relief to sleep for 2-3 hours at a time.
I know you’re probably asking “Why didn’t you ask your Doctor for pain meds?” Well that is a valid question. And I wanted to ask her. But I didn’t want to be that person who seeks out pain meds. To be honest, I hate taking medicine. And I hate going to the Doctor. So much so that in 2001 I actually broke my arm while rollerblading with my kids but didn’t go to the Doctor for two weeks. It’s just not something that I do. And so I decided to wait until I could see the Rheumatologist.
On January 19, I went to the Rheumatologist with my wife. She is such a trooper. And I was so thankful to have her by my side. I was nervous. And scared. I wanted an answer but was truly afraid of what the answer might be.
The Doctor was very nice and asked me a lot of questions about my symptoms and how everything had developed. He inspected my hands and feet and also ordered some very extensive bloodwork and X-Rays. As we spoke, he told me a little about RA and the different meds that they use to treat it. At this point I was thinking that he was wasting his breath because I didn’t have RA. But the more we talked, the more certain he seemed to be that it was RA. So I had the X-Rays done and then gave what seemed like a gallon of blood and that was that. I left still thinking that he was wrong and that there was a perfectly reasonable explanation for everything that was going on with me. I knew that I didn’t have RA.
And then I got the call.
“Mr. Rucker, this is the Doctor’s office calling you back with your test results. The good news is that the X-Rays show that there is no permanent damage to your joints.”
“Great,” I thought.
And then she continued, ‘but the bad news is that the tests did come back positive for RA.”
Honestly, I was stunned. Completely shell-shocked. I was only 46. I’d just spent over three years losing over 100 pounds. I was in the best shape of my adult life.
“I’m a freaking Ironman,” I thought to myself. How could this be happening to me?
I called my wife and shared the news with her. I think that we both already knew but we both had hoped for a different answer. I asked her to pick up my new meds for me on her way home. I was still struggling with the fact that I was going to be facing a lifetime of meds to fight this disease and I couldn’t bring myself to go to the pharmacy. It was almost as if by refusing to pick up my meds, I was refusing to accept the disease.
If only it were that easy.
So now I just started my fifth week of medication. I take a daily dose of Prednisone and I take a weekly dose of Methotrexate once a week. I had taken Prednisone before so I was aware of some of the potential issues with it but I didn’t know much about the Methotrexate. Unfortunately I decided to Google it. After reading just two or three posts about it from other people with RA I realized that it was best to not read any more. I mean, after all, my options were to (1) take the meds and deal with the effects, or (2) not take the meds and deal with the pain. I chose option 1.
As part of my plan of attack on this disease, I also decided to change my nutrition completely. This wasn’t something that my Doctor recommended but rather a decision that my wife and I made in an effort to cut out anything that might have an inflammatory effect on my system. I have cut dairy out of my diet completely. Now, I’m a big fan of lattes which of course contain milk so this has been very difficult. Fortunately, my wife convinced me to try Almond milk and I’m slowly adjusting to it. I make them at home now and use the Almond milk instead of dairy. I’ve also cut out alcohol. I love lattes but I love drinking a good beer even more. Unfortunately there is no substitute for that so it’s just something that I’m learning to deal with. I’ve also removed grains from my diet, at least for now. I know that gluten can cause inflammation for some people so I’m just testing it to see how my body responds. And I’ve also cut out all processed sugars. My diet now consists mostly of fruits and vegetables, lean meats, like chicken and fish, and nuts and seeds. But again, I have to say that my wife has been amazing through all of this. She’s searched for new recipes and has learned to make new, healthy foods that fit all of my new restrictions. And if there is a silver lining to all of this, it is that I’ve been losing additional weight which I know will make it easier on my joints. And I know that by eating healthier, I am making my body healthier.
So what does my future look like? Well I’m not sure. I know that for now I’ll be taking meds for some time and hoping that I can eventually get off the daily Prednisone. I hope that maybe someday that I’ll be able to get off all of my meds. I hope to get back into training soon. Because of the pain in multiple joints I’ve not been able to do much in terms of working out. But the meds do seem to be working and the joint pain has subsided tremendously. That gives me hope that soon I’ll be able to get back to swimming, cycling, and even running. I hope to be able to compete in either Ironman Louisville or Ironman Florida later this year. That will depend on how my body responds to the meds and also to the intense training. But I believe that having a goal is essential to overcoming any obstacle in life.
To me the battle against this disease is a lot like the battle that I waged against my weight. It’s not one that can be won overnight. It will take a lot of determination and dedication. There will be triumphs. And there will be setbacks. But I know that with the love and support of my wife, my family, and my friends, and with my faith, I CAN and WILL beat this disease.
Mark Rucker is a Lexington attorney, runner, and IronMan athlete.
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This article also appears on page 21 and 22 of the March print edition of the Hamburg Journal.