I Saw It in the Mirror

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Omgrrrl left this comment on a recent post:

".......But I was wondering.
What was the MOMENT, the SYMPTOM that drove you over the edge and made you seek diagnosis? And what made you PURSUE diagnosis?"

What a great question. It's been awhile since I've thought back many years ago to the beginning of it all...

I've written about my path to diagnosis before, and it's probably a good time to resurrect a segment of that post:

Every Sjoggie has a different story to share, but here's how it all happened for me.
     In the fall of 2002, life slowly seemed to change for me, and I just couldn't put my finger exactly on what was going wrong. I had a job that I loved, my family was happy and well, and I felt as though I should have been living large and feeling fine, but overall, I felt lousy. Constantly. 
     Initially, I chalked my problems up to my age and my pudgy waistline. I began to be more careful with my diet and made an attempt to get more exercise, but in spite of my efforts, I felt as though I was becoming more unwell as the months went on.
     On an annual exam with my family doctor, I had brought along a lengthy laundry list of complaints, and bless her heart, Dr. H. pulled up a chair and reviewed each and every item on my list. My ears were constantly ringing, my eyes and mouth were dry, and my sense of smell had seemed to vanish. I was popping Tylenol and ibuprofen almost daily for aches and pains and the sensation that I was just on the edge of running a temperature. I had no energy to do anything but to go to work, then come home and collapse on the couch.
     And I was cranky as all get out.
     So she ordered lab work to screen for various problems and made a referral for me to see an ear-nose-and-throat doctor and an eye doctor.
     The ENT physician could find no structural problems that would cause a decreased sense of smell or tinnitus (ringing in the ears). My eye doctor noted that yes, indeed, my eyes were dry. She prescribed some eye drops. My labs showed that my thyroid not producing enough thyroid hormones, and I had an elevated sedimentation rate, which indicated some kind of inflammatory process.
     So I popped my Synthroid - replacement thyroid hormone - and tried every brand of eye drops that I could get my hands on for about six months. But in spite of continued discussions with Dr. H., I continued to feel as though I was slogging along through a giant bowl of jello, both physically and mentally. Routine tasks suddenly became difficult. I found myself checking and re-checking my work and second-guessing my decisions. My thought processes seemed to be slowed almost to a halt. I began to carry wads of kleenex in my pockets to mop my face since any small exertion left me sweating profusely and make up and mascara melted away. I knew these spells were not related to menopause since I had my ovaries and uterus removed several years previously and was already taking estrogen.
     I began a very expensive relationship with my dentist after multiple cavities began appearing in my teeth at my gum line. My dentist thought that my dry mouth may be causing the cavities, prescribed fluoride mouthwash and gave me the classic oral hygiene lecture. I also began to appreciate nitrous oxide during these uncomfortable appointments. (You can read more about my lucky shoes and nitrous oxide escapades here.)
     I was tired and miserable, and getting no answers. Then one day, my director of nursing took me aside. "So what's going on with your face, Julia?" she asked.
     Excuse me??
     "Have you noticed that well......you look as though you have the mumps? Here, look." She guided me to a nearby mirror.
     Whoa! No, I hadn't noticed that my face was swollen, especially right in front of my ears. But by then I was too tired to notice if my shoes were on the wrong feet. Or if my hair was purple. I didn't really care.
     "I want you to go home and get this checked out. Let me know what you find out - and feel better!"
     I dragged myself home and called Dr. H yet again. Later, I sat across from her in the exam room and cried. "I feel so awful. I know that this isn't the mumps since I had a whopper case as a kid. What is going on?"
     Dr. H. looked thoughtful. "I am going to have you seen by a rheumatologist. OK?"
     Why?
     "Because you might have an autoimmune disease called Sjogren's syndrome. Your enlarged parotid glands made me think of it. I'm not sure about this, but a rheumatologist will know what specific labs to draw and how to get a diagnosis."
     What the heck is show - show - whatever you said syndrome? Never heard of it.
     "Most people haven't. And I might be wrong, but let's check it out."
     At my rheumatology appointment, Dr. S. explained that I did indeed have the classic symptoms of Sjs: dry eyes, dry mouth, enlarged parotids, fatigue, achey joints, and brain fog. Further labs showed that I had elevated c-reative proteins, positive ANA, and positive SSA/ro autoantibodies, all of which indicated that I had joined the Sjoggie club. She prescribed plaquenil and prednisone and so it all began......

In answer to Omgrrrl's question, if I had to choose a particular time and place in which I made the realization that I was seriously ill and that this illness should be named and treated, it would be that moment that my director of nursing pointed out my swollen parotids and basically told me not to come back to work until I had it figured out.

I was bumbling along exhausted and hurting and brain-fogged, so it seemed to take another person's perspective and observations to bring everything more clearly into focus. Until Kathleen literally stood me in front of a mirror and pointed out my enlarged parotids, I had just been living minute, by hour, by day, trying to just barely hang onto the life that I was used to living. As I stood in front of that mirror, suddenly I knew. My face had changed. My body had changed. My life had changed. And with that realization, I knew that I simply HAD to find out why.

How about you?