Speaker 1: My entire foot.
Speaker 2: Around the joints of my toes, they were like red
Speaker 2: and inflamed and swollen.
Speaker 3: She reminded me of my grandmother when she lived with us,
Speaker 3: and she was ninety and had a walker. But then
Speaker 3: I look at her and it's like, you're not my grandma.
Speaker 3: You know, you should be dancing down the street as
Speaker 3: it used to be.
Speaker 4: There are no tests to make the diagnosis, and where's
Speaker 4: it headed. A lot of the time, we also have
Speaker 4: no definitive idea, and that's incredibly unsettling.
Speaker 2: I physically took my toe and tried to bend it,
Speaker 2: and I could not do it.
Speaker 5: How terrifying would it be to fight an unknown enemy,
Speaker 5: one you didn't recognize and didn't see coming. What if
Speaker 5: that enemy was coming from within a disease that even
Speaker 5: doctors couldn't identify. Nearly half of all Americans suffer from
Speaker 5: some chronic illness, and many struggle for an accurate diagnosis.
Speaker 5: These are their stories. A Lauren bred Pacheco, and this
Speaker 5: is symptomatic. As a formally trained dancer, Lauren's biggest strength
Speaker 5: has always been finding connection through movement. Dance was a
Speaker 5: place for seeking calm and creativity as well as a
Speaker 5: way to push herself physically and mentally. Now a mother
Speaker 5: of two sons, Lauren may not dance as much as
Speaker 5: she used to, but she's found ways to apply that
Speaker 5: same passion to all aspects of her life as a wife, mother,
Speaker 5: and business owner.
Speaker 2: I'm a dancer, a former dancer. I love dancing. I
Speaker 2: don't do it professionally anymore, but it is something that
Speaker 2: I will always have in my heart. I am a mom.
Speaker 2: I'm a family oriented person. My favorite thing to do
Speaker 2: on the weekends is watch my son play baseball and
Speaker 2: basketball and do active things with my kids.
Speaker 1: I'm extremely active.
Speaker 5: And you're a boy mom, so that's a good thing. Yes.
Speaker 1: Yes. My thing is fitness and nutrition. I run a business.
Speaker 2: I'm a full time fitness and nutrition coach and we
Speaker 2: help clients all over the United States and Canada.
Speaker 5: Being the dance was such a driving force for most
Speaker 5: of her life, it seems only fitting that she met
Speaker 5: her now husband, Matt while country line dancing.
Speaker 3: She's very outgoing, very helpful. She loves to help others
Speaker 3: when she can, so leave it to me to meet
Speaker 3: the line dance instructor at the time, and I'm the
Speaker 3: guy with the two left feet that can't soon to
Speaker 3: figure it out, but very good at it. And then
Speaker 3: there's the fitness side of it, where she's always been
Speaker 3: into eating rite and trying to improve herself on a
Speaker 3: personal level.
Speaker 2: I mean, I eat, sleep, and breathe dance. You know,
Speaker 2: I'd close my eyes at night and do dance routines
Speaker 2: in my head.
Speaker 3: And at the beginning of a relationship, she was very
Speaker 3: big in the dance industry. She had a lot of
Speaker 3: choreographing and she also did a lot of performing. She
Speaker 3: was in a bunch of different dance backgrounds. Ballroom to
Speaker 3: hip hop is where she started, and she loved it.
Speaker 2: It just gave me a place to go when I
Speaker 2: needed it. I'm an only child. I didn't have people
Speaker 2: to play with, so it just gave me something to
Speaker 2: be able to be my sounding board.
Speaker 1: So it became a lot to me.
Speaker 5: Dance was more than just an outlet for Lauren. It
Speaker 5: was a way of life. She cherished the feeling of
Speaker 5: freedom and expression that dance provided her. But you know,
Speaker 5: an insidious illness would soon begin to erode the ability
Speaker 5: she had for the things she loved most. So take
Speaker 5: me back to the first time you remember seeing symptoms,
Speaker 5: physical symptoms, that anything was a mess, and I think
Speaker 5: it was skin correct.
Speaker 2: Yes, I was young when I started having skin rashes.
Speaker 2: It was before high school that I started noticing these
Speaker 2: patches of skin. And I mean I remember scratching them
Speaker 2: until they would bleed. They were so itchy and uncomfortable.
Speaker 2: They were my elbows, my shins, my ankles. So it's
Speaker 2: not like it was on my face or anything like
Speaker 2: that that would really make me super self conscious about it.
Speaker 2: But it still didn't look pretty right. So that's when
Speaker 2: I went to a dermatologist, and the dermatologist diagnosed me
Speaker 2: with what they called at that point, dermatitis. They just said,
Speaker 2: here's Cortizon cream. This is what we can give you.
Speaker 2: But getting through high school, through college, even through getting married,
Speaker 2: I always had patches somewhere. They were always a part
Speaker 2: of me.
Speaker 5: Even as Lauren continued to excel at dance at increasingly
Speaker 5: advanced levels, her skin patches became unrelenting. Having the dermatitis
Speaker 5: diagnosis didn't seem to matter much because none of the
Speaker 5: topical treatments provided any real relief. As Lauren pursued her
Speaker 5: dreams of becoming a professional dancer, she simply pushed her
Speaker 5: symptoms aside, where they remained unresolved into her college years.
Speaker 5: So what happens when you got to college? How do
Speaker 5: your symptoms morph? How do they evolve?
Speaker 2: You know, I went to college in a very rural area.
Speaker 2: I was at Western Illinois University. It was cornfields, and
Speaker 2: you know, my environment changed.
Speaker 1: I have bad allergies.
Speaker 2: Those were definitely affected with moving into a different area,
Speaker 2: different seasons, and my my skin did actually get worse
Speaker 2: when I got to college.
Speaker 5: Her husband, Matt, remembers noticing the inflamed areas of skin
Speaker 5: near her ankles.
Speaker 3: She started seeing like skin issues. I used to give
Speaker 3: her a hard time. I'm like, stop touching that, stop scratching,
Speaker 3: and she's like I'm not, and I'm like, oh, it
Speaker 3: looks like you are.
Speaker 2: I did also start having issues where I couldn't do
Speaker 2: the things that I like to do as much anymore.
Speaker 2: So I started to feel like some stiffness in my legs,
Speaker 2: in my feet, the bottoms of my feet would hurt
Speaker 2: when i'd go run. I was dancing in college, and
Speaker 2: so there were times where I would just have to
Speaker 2: take a break from practice because I just my body
Speaker 2: didn't feel good.
Speaker 5: A college level competitive dancer starting to see her body
Speaker 5: wear down has to be a little unsettling.
Speaker 2: Yeah, So we would practice multiple times a week. This
Speaker 2: might be popping up for me, you know, once a month,
Speaker 2: where it wasn't at that point in time affecting my
Speaker 2: day to day or week to week. But it was
Speaker 2: a pattern that maybe as an eighteen year old, nineteen
Speaker 2: year old college girl, I just wasn't quite aware of
Speaker 2: the frequency of which it was happening, in the patterns
Speaker 2: that I was getting quote unquote worse.
Speaker 5: That's so insidious too, because it's so easy to say,
Speaker 5: I'm away from home for the first time, I'm eating
Speaker 5: different foods, I'm partying a little bit more than I
Speaker 5: could with parental supervision.
Speaker 1: Correct.
Speaker 2: I had no idea that anything else was really brewing
Speaker 2: or anything else was going on for me. The younger
Speaker 2: I was, the less I was really in tune with,
Speaker 2: you know, like, oh, I'm fine. You know, that's like
Speaker 2: what a teenager says, right, I'm fine, it'll go away,
Speaker 2: I'll be better tomorrow.
Speaker 1: And that's kind of where I went with it.
Speaker 5: The stiffening muscles and sensitive skin continued to linger, draining
Speaker 5: Lauren of the strength that used to be so readily
Speaker 5: available to her. She used to have no problem getting
Speaker 5: up the energy to juggle studying and dancing, but now
Speaker 5: everything was beginning to feel more and more like a chore.
Speaker 2: It's like if you have a really bad head cold
Speaker 2: and you just feel completely bogged down by it.
Speaker 1: It was this fatigue that just wouldn't go away.
Speaker 2: I came home from college at one point and got
Speaker 2: cat scans of my sinuses to see and yeah, my
Speaker 2: sinuses were extremely inflamed. They told me that it was
Speaker 2: I had the option of getting sinus surgery, or I
Speaker 2: could get put on different allergy medication or use nasal
Speaker 2: sprays like that was the extent of what they thought.
Speaker 5: And that must have been difficult psychologically for you too,
Speaker 5: because you've already said that dance in particular, was this outlet,
Speaker 5: this escape, and now it's getting more difficult to really
Speaker 5: enjoy that outlet and escape.
Speaker 2: Yes, But I think also with that athlete mentality, my
Speaker 2: heart was you need to push harder, you need to
Speaker 2: try harder, you need to show up, you need to
Speaker 2: do the things. You need to keep working. So it
Speaker 2: wasn't even like, oh, I'm not really enjoying it.
Speaker 1: Anymore. It's that addiction.
Speaker 2: It's at hunger where you want to get better, you
Speaker 2: want to keep working harder, And that's where all of
Speaker 2: my energy was focused on, which sometimes meant ignoring the
Speaker 2: things that I probably shouldn't have ignored at that time.
Speaker 5: During her last year of college, Lauren ended up contracting
Speaker 5: MRSA and a serious staff infection, which required multiple procedures
Speaker 5: to clear out of her system. This health setback forced
Speaker 5: Lauren to stop dancing and to move back home to
Speaker 5: properly recuperate. This abrupt transition from a vibrant dance field
Speaker 5: routine to a more sedentary lifestyle took its toll on
Speaker 5: her body, but after she'd recovered, she was determined to
Speaker 5: get back into a fitness routine. And what better workout
Speaker 5: partner than her future husband.
Speaker 2: I said to him, my foot feels funny moving through
Speaker 2: these workouts. He says, maybe you should take a step back,
Speaker 2: and I'm like no, I'm like, I'm really getting results.
Speaker 1: I can work through it.
Speaker 2: And there comes my elite athlete mentality, right, I can
Speaker 2: work through it.
Speaker 1: I can work through it.
Speaker 5: What did you initially attribute to that to? I mean,
Speaker 5: were you ever on point? Did you do ballet. Were
Speaker 5: you thinking that it was just like a leftover injury.
Speaker 5: I figured that it was just too much wear and tear.
Speaker 5: I'd rest for a few days, A month would go
Speaker 5: by and it would come back. A month or two
Speaker 5: would go by and it would come back. But I
Speaker 5: always knew that if it came back, I'm like, that's
Speaker 5: my warning sign that I just need to take a
Speaker 5: few days off and I'll be fine in no time.
Speaker 5: So I did let that go for years. Lauren and
Speaker 5: Matt married and soon after started their own family, welcoming
Speaker 5: two beautiful sons, but the journey through pregnancy and childbirth
Speaker 5: two times over exasperated Lauren's symptoms. With her focus on
Speaker 5: all the ups and downs of being a new parent,
Speaker 5: she continued to push her pain aside, not realizing a
Speaker 5: larger picture was starting to take shape. It wasn't until
Speaker 5: the signs became obviously beyond the postpartum norm that Lauren
Speaker 5: and Matt knew they had to take action.
Speaker 2: Finally, it got to a point where I was doing
Speaker 2: laundry and like He's like, you are limping to the
Speaker 2: laundry machine, Like there is no.
Speaker 1: Way that you are actually okay.
Speaker 3: She starts limping, and it's like it's just weird. All
Speaker 3: of a sudden, you're in your mid twenties and then
Speaker 3: you start limping and you're like, what's going on here?
Speaker 3: Did you twist your ankle? Did you do anything? And
Speaker 3: it just kept seeing a trend of like different body
Speaker 3: aches and pains, and sometimes it switched from one side
Speaker 3: of her body to the other. It was really hard
Speaker 3: to understand.
Speaker 2: My entire foot around the joints of my toes they
Speaker 2: were like red and inflamed and swollen, and he's like,
Speaker 2: you need to put your feet up. Something is not right,
Speaker 2: And I thought, well, maybe I hurt myself. Normally, when
Speaker 2: you hurt yourself, you could like pinpoint the time where you,
Speaker 2: you know, broke your foot or broke a toe.
Speaker 3: We weren't sure what it was. We just thought maybe
Speaker 3: it was after having a child. Certain things happened to
Speaker 3: you that I don't know, either change or take a
Speaker 3: long time to go back to the way they were.
Speaker 2: We had kids, and right around the time I had
Speaker 2: my second son, I was still avidly working out and training,
Speaker 2: and I got to a point where I could not
Speaker 2: do a lunge because my toes would not flex that
Speaker 2: was where I was, and I got to a point
Speaker 2: where I physically took my toe.
Speaker 1: And tried to bend it, and I could not do it.
Speaker 5: So it was like it was a fused, solid bone
Speaker 5: as opposed to small bones that move in conjunction with
Speaker 5: one another.
Speaker 1: Correct.
Speaker 2: It was like imagine something like completely rusted and you
Speaker 2: trying to move it like there was no give there.
Speaker 1: It was stuck.
Speaker 5: You must have felt so betrayed by your own body.
Speaker 1: Broken, completely broken.
Speaker 5: Until now her body had been her instrument, her outlet,
Speaker 5: her means of expression, but that was being quickly ripped
Speaker 5: away from her by these unexplained symptoms. Balancing the demands
Speaker 5: of her two greatest loves, dance and family, became an
Speaker 5: ongoing struggle.
Speaker 3: I mean, Lauren's always been really good at pushing through
Speaker 3: and fighting for what she wants. It definitely gotten a
Speaker 3: way of her day to day activities, and like there's
Speaker 3: certain things like we didn't go to the zoo with
Speaker 3: the kids or go to certain things that you're going
Speaker 3: to have to be on your feet a lot, because
Speaker 3: she knew she wouldn't be able to handle it or
Speaker 3: she'd be paying for it for days afterwards.
Speaker 1: So I left my dance career. It was an impossible
Speaker 1: choice for me to make.
Speaker 2: I think, you know, to be a professional dancer takes
Speaker 2: an extreme amount of work and perseverance and dedication and
Speaker 2: sacrifice to get to that level, which is where I
Speaker 2: was at.
Speaker 1: It was like crashing into a brick wall.
Speaker 5: Lauren explained, dances almost her happy place, a safe place
Speaker 5: where she could just lose herself. What was it like
Speaker 5: to see her mobility challenged, to go from forget about dancing,
Speaker 5: not being able to walk? What was that like to witness?
Speaker 3: It was hard to watch. She struggled with it a lot,
Speaker 3: just because she had so much creativity that didn't feel
Speaker 3: like work, because she loved what she was doing. Was
Speaker 3: hard to see. You know, she had multiple occasions where
Speaker 3: she would get down on herself because she just couldn't
Speaker 3: do it, and she couldn't understand why.
Speaker 1: You have all of this momentum driving you forward.
Speaker 2: You're like, you're driven to get to where you're going,
Speaker 2: and then you come to this halting stop and you
Speaker 2: can only push through it so much before it just
Speaker 2: starts to break you down. Than if you know, boys
Speaker 2: when they're toddlers, you are doing nothing but trying to
Speaker 2: chase them down as soon as they get they get
Speaker 2: move in. It is just a constant hustle and it
Speaker 2: was tough. It was really tough. So I had nothing
Speaker 2: other to say than I can't play with my kid
Speaker 2: on the playground, but I can show up to work
Speaker 2: and dance with my dance partner. There's something that didn't
Speaker 2: seem right to me about that picture, and I had
Speaker 2: to at that point give or take something.
Speaker 1: And it was always going to be family over everything.
Speaker 5: Despite setting dance aside, Lauren didn't lose her passion for
Speaker 5: improving lives through fitness. She redirected that enthusiasm into a
Speaker 5: career in personal training, providing empowerment in a much less
Speaker 5: taxing way. But with the tightness in her feet worsening
Speaker 5: and none of her at home treatments working, she decided
Speaker 5: to go to a pediatrist in search of more effective solutions.
Speaker 1: I thought I broke my toe.
Speaker 2: It was on one foot specifically at that point, and
Speaker 2: I said to my husband, I said, something's wrong. I
Speaker 2: don't remember breaking my foot, but it is bad to
Speaker 2: the point where I cannot move.
Speaker 1: We went into the pediatrist. I got X rays.
Speaker 2: He's like, well, your to's not broken, but you're not
Speaker 2: even thirty years old, and we're seeing like advanced arthritis
Speaker 2: patterns in your joints. So that was kind of the
Speaker 2: first time. I was like, what do you mean I
Speaker 2: have arthritis in my feet?
Speaker 3: And we're like, well, she was a dancer, so I
Speaker 3: guess that could be possibility. That also puts another curveball
Speaker 3: in the situation of like, when we're looking at her feet,
Speaker 3: is this like a byproduct of all the years of
Speaker 3: dance or is this something new?
Speaker 5: Wow, I'm trying to wrap my head around that. So
Speaker 5: you are a young mother, very active, very health oriented,
Speaker 5: and suddenly you're in a position where you're losing mobility
Speaker 5: entirely of one foot.
Speaker 1: Correct.
Speaker 2: What was going through my head was he's wrong, Like,
Speaker 2: there's no way I eat healthy, I am active, I exercise,
Speaker 2: I do all the things that you're supposed to do,
Speaker 2: and I'm only twenty six. There's just no way that
Speaker 2: it's a possibility that I have arthritis.
Speaker 5: While the arthritis diagnosis didn't sit well with Lauren, it
Speaker 5: would lead to another clue. The pediatrist was examining her
Speaker 5: feet and noticed the rough skin patches on her ankles
Speaker 5: and knees. Though Lauren had been previously diagnosed with dermatitis,
Speaker 5: this looked different.
Speaker 2: He said, I highly recommend that you go to you
Speaker 2: back to your dermatologists and ask them to buyopsy these
Speaker 2: skin patches to see if it is psoriasis. And he said,
Speaker 2: and if it is, your next visit is going to
Speaker 2: be to a rheumatologist. So the dermatologist they did find
Speaker 2: that it is psoriasis.
Speaker 5: That must have been for both of you, like, who
Speaker 5: cares about the psariasis? Right, We've got bigger fish to fry.
Speaker 3: Yes, the skin issues were definitely not on like the
Speaker 3: top of the list to deal with her appearance of
Speaker 3: her skin and the different spots that she has were
Speaker 3: a drop in the bucket compared to like the joint
Speaker 3: pain and the discomfort that she had on daily basis.
Speaker 5: In the moment, it was difficult to decipher, but Lauren's
Speaker 5: symptomatic picture was coming into focus. So at that point
Speaker 5: you must have been so frustrated, what's happening now in
Speaker 5: terms of your physical symptoms?
Speaker 2: In my physical symptoms, I was beyond frustrated. I was
Speaker 2: at that point where this was happening much more frequently,
Speaker 2: where I could not walk. I was an excruciating pain
Speaker 2: waking up in the middle of the night, even like
Speaker 2: laying in bed if your feet are covered and like
Speaker 2: the foot of your bed tucked in, and even that
Speaker 2: pressure of trying to bend my toes if I was
Speaker 2: laying on my back would wake me up with throbbing
Speaker 2: pain in the middle of the night.
Speaker 5: What would you say was the psychological impact?
Speaker 3: It was scary as almost scarier than the injury. The
Speaker 3: physical limitations that she had that we watched all the time,
Speaker 3: But like when you see someone mentally like slowly being
Speaker 3: broken down, it's a hard thing now to watch and
Speaker 3: wonder where's this going? You must have also helpless, Yeah,
Speaker 3: it's difficult.
Speaker 5: You mentioned at one point she was even on crutches
Speaker 5: without answers, what do you think was kind of rock
Speaker 5: bottom in terms of her symptoms.
Speaker 3: Be honest, like when she did have to actually use
Speaker 3: crutches and couldn't even get inside from outside without taking
Speaker 3: five minutes, reminding me of my grandmother when she lived
Speaker 3: with us and she was ninety and had a walker,
Speaker 3: and it was just a very snail type pace to
Speaker 3: get it anywhere. But then you know, you look at
Speaker 3: her and it's like you're not my grandma. You know,
Speaker 3: you should be dancing down the street as it used
Speaker 3: to be, but it's just difficult to see it happen.
Speaker 5: It was all so difficult and frustrating fighting the unknown.
Speaker 5: Lauren's progressing physical limitations were increasingly interfering with her personal
Speaker 5: and professional life.
Speaker 2: I figured, well, if my pediatrist was right about the psoriasis,
Speaker 2: then it's definitely worth at least taking a look into
Speaker 2: the roomatologist, mostly because looking back at the patterns, looking
Speaker 2: back at the history, this pattern had been going on for,
Speaker 2: like I said, years and years and years.
Speaker 5: Knowing Lauren's family had a history of autoimmune conditions, the
Speaker 5: doctor ran every blood tests they could in hopes of
Speaker 5: finding a clue as to what was causing Lauren so
Speaker 5: much pain, but nothing came back conclusive enough to narrow
Speaker 5: down the root cause.
Speaker 2: So here I was not being able to sleep, not
Speaker 2: being able to do anything, and I looked at this
Speaker 2: roomatologist and I'm like, what can you do for me?
Speaker 2: We tried an oral immunosuppress at first, and that was
Speaker 2: really tough for me.
Speaker 1: It did not work.
Speaker 2: It made me feel sick and also gave me pretty
Speaker 2: significant depression.
Speaker 5: Matt, did you have fears that something much worse was
Speaker 5: going on?
Speaker 3: We did when we got deeper into it, like what
Speaker 3: could this be? Is this like a lifelong thing? Then
Speaker 3: you start looking into all these possibilities, and you know
Speaker 3: scary when you start looking up stuff on the internet
Speaker 3: because you normally don't find anything good.
Speaker 5: Lauren felt everything was slipping away from her, her family,
Speaker 5: her passion, herself, all because this unexplained disease was overwhelming
Speaker 5: her system and she had yet to find a doctor
Speaker 5: who could see the bigger picture. Do you remember just
Speaker 5: feeling so desperate that you didn't think you could handle.
Speaker 1: It one hundred percent?
Speaker 2: I remember it was with that rheumatologist that I went
Speaker 2: in there in tears, on crutches, unable to live my
Speaker 2: life the way that I wanted to live at that
Speaker 2: point was twenty six, twenty seven years old, and I
Speaker 2: was not getting answers.
Speaker 5: We'll be right back with Symptomatic, a medical mystery podcast.
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Speaker 5: Now back to Symptomatic a medical mystery podcast. Lauren was
Speaker 5: at the end of her rope. She was no longer
Speaker 5: able to dance or play with her two young sons
Speaker 5: in the way she had always imagined. Movements and stretches
Speaker 5: which had once been part of her normal warm up
Speaker 5: routine were now far out of her reach. Her feet
Speaker 5: and lower legs were stiffening, to the point where she
Speaker 5: had to use crutches to walk. How would you describe
Speaker 5: that kind of pain to someone.
Speaker 2: I always say it's like a throbbing pain in the feet.
Speaker 2: A lot of times it like I'd get out of
Speaker 2: bed and I would feel like I was walking on bruises.
Speaker 2: The stiffness is similar to like if you've broken or
Speaker 2: sprained like a finger, and you're trying to move it. It's
Speaker 2: almost like when you're bending something that is not supposed
Speaker 2: to go that way.
Speaker 3: What made her pursue more answers even harder after she
Speaker 3: kind of got like a generic answer was that she
Speaker 3: got put back in crutches, because, like I said, it
Speaker 3: would come and go and wave. Some days would be okay,
Speaker 3: or a week would be okay, and then all of
Speaker 3: a sudden, for no reason, it would get terrible again.
Speaker 3: She wouldn't be able to walk. She wanted answers, she
Speaker 3: desperately needed them, and the doctor told me there was
Speaker 3: nothing I could do other than wait for it to pass.
Speaker 5: Lauren needed a practitioner who would be her partner in
Speaker 5: this battle to help her break out of the pattern,
Speaker 5: listen to her story, and recommend new methods to help
Speaker 5: find the cause of her symptoms.
Speaker 2: So I do remember like a cry out that I
Speaker 2: put on Facebook and just said, I need a rheumatologist
Speaker 2: that could help me. Can anybody give me a recommendation?
Speaker 2: And it was a neighbor of mine who recommended me
Speaker 2: to doctor Aaron Arnold, who I mean has taken the
Speaker 2: best best care of me. I'm so happy to have
Speaker 2: been introduced to her.
Speaker 5: What was so different about doctor Arnold's approach.
Speaker 2: She was willing to listen, she felt for me. She
Speaker 2: also was to me way more thorough than the other
Speaker 2: rooumatologists that I was saying before. She was looking at
Speaker 2: different types of blood work she put in for work
Speaker 2: they call a vectors screening, which is a more in
Speaker 2: depth evaluation of your inflammation.
Speaker 1: And my vectress tests came back off.
Speaker 2: The charts to the point where she's like, I don't
Speaker 2: even know how you drove yourself here, which was so
Speaker 2: validating to me because I'm like everyone else thinks I'm
Speaker 2: crazy because the typical inflammation markers that most people look
Speaker 2: at are not worth shattering. They're not alarming, They're maybe
Speaker 2: a little bit on the high side of what they
Speaker 2: call normal.
Speaker 5: Doctor Arnold is a Chicago based doctor who is inspired
Speaker 5: to become a rheumatologist after seeing her father's passion for
Speaker 5: the field, the allure for the detective work involved, and
Speaker 5: the impact the long term relationships can have on her patients.
Speaker 5: Cemented this as her specialty.
Speaker 4: I will tell you that as special as Lauren is,
Speaker 4: her really her story is not so unusual or unique.
Speaker 4: So if I think about my engagement with her, it's
Speaker 4: a similar engagement I've had with a lot of my patients,
Speaker 4: many of them women, though, because I do think it's
Speaker 4: still as hard for women who are in pain to
Speaker 4: really be heard, even by other female doctors.
Speaker 1: Right.
Speaker 4: So when I remember meeting her, part of the impression
Speaker 4: I got when I first met with her was the
Speaker 4: I don't know if trauma is the right word, but
Speaker 4: the energy that she had was because I think she
Speaker 4: wasn't being heard.
Speaker 2: Doctor Arnold made me feel like I was not crazy,
Speaker 2: but she also made me feel like there are so
Speaker 2: many options, and she also made me feel like we
Speaker 2: were not going to stop trying until we could find
Speaker 2: an option that.
Speaker 5: Worked, an approach that would ultimately lead to some answers
Speaker 5: in Lauren's medical mystery.
Speaker 4: So one of the first things we wanted to try
Speaker 4: to differentiate was is this an inflammatory disease that was
Speaker 4: causing her pain? And our suspicion was very high because
Speaker 4: she's young.
Speaker 5: What were the possible diagnoses running through your mind when
Speaker 5: you started seeing Lauren.
Speaker 4: So sometimes you can see with people, for example, with
Speaker 4: severe endocrne disorders, where maybe they have like hyperparathyroidism, which
Speaker 4: is a hormone that the glands sit near the thyroid,
Speaker 4: but if the levels get really high, they can actively
Speaker 4: go to break down the bone and that can cause pain.
Speaker 4: So that would have been one of.
Speaker 1: The things we would look for.
Speaker 4: Her history wasn't significant for something like a cancer, but
Speaker 4: we look for evidence of that and some of the
Speaker 4: standard blood tests that we draw, right, so those would
Speaker 4: be other things that would be ruling out. We'd be
Speaker 4: making sure that she didn't have some type of a
Speaker 4: systemic infection that could be causing her symptoms.
Speaker 2: I had no idea that one thing was linked to
Speaker 2: another thing, which was linked to the other thing. Who
Speaker 2: would have thought that my sinuses had anything to do
Speaker 2: with the excruciating foot pain that I was experiencing, you know,
Speaker 2: years later, and that is something that I was never
Speaker 2: able to link together. So, you know, looking at that,
Speaker 2: looking at my history, looking at all of my symptoms.
Speaker 2: Even though my genetic marker was negative, she said, not
Speaker 2: everybody who has this condition has a genetic marker for it.
Speaker 2: So sometimes it's almost just as important or even more
Speaker 2: important to look at the symptoms and to be able
Speaker 2: to really evaluate the progression of how things have moved along.
Speaker 2: And she diagnosed me with siatic arthritis.
Speaker 5: Wow, and you're twenty eight years old at this point,
Speaker 5: twenty eight years old. So Matt, take me to the diagnosis.
Speaker 5: You know, when you first heard those two words soriatic arthritis.
Speaker 3: Part of it was a relief because we had a
Speaker 3: diagnosis and there's treatment. But the other side of it
Speaker 3: is like, this is not technically curable, like entirely, there's
Speaker 3: no like magic medication that you take and it's like
Speaker 3: just gone, in a week, you're done, You're all better now.
Speaker 5: So you did mention that you had to confirm that
Speaker 5: there was inflammation, But in terms of a gold standard
Speaker 5: for soriatic arthritis, is there a specific test that you use.
Speaker 4: In fact, there are no tests to make the diagnosis
Speaker 4: of soriatic arthritis. So our blood tests are helpful when
Speaker 4: they're helpful, but most of the time it's really history
Speaker 4: and physical exam and response to interventions, and this is
Speaker 4: where that long term relationship really starts to develop, and
Speaker 4: seeing people over time and how things change. But there
Speaker 4: is not a single blood test to make the diagnosis
Speaker 4: of soriatic earthritis. Well, often if we're lucky enough see
Speaker 4: something like psoriasis or a history of psiasis, we'll see
Speaker 4: targeted joints that will typically think about in either distal psoriasis,
Speaker 4: like specific distributions in the hands, for example, are larger joints.
Speaker 1: So it is always.
Speaker 4: Easier to make a diagnosis of soriatic arthritis when patients
Speaker 4: have psoriasis. But there is a large enough number of
Speaker 4: patients who don't develop psoriasis before their arthritis, but actually
Speaker 4: after their arthritis.
Speaker 5: The symptoms that have been shrugged off throughout Lauren's life
Speaker 5: were actually little clues all adding up to give doctor
Speaker 5: Arnold the full picture of what had been plaguing Lauren
Speaker 5: for fifteen years, soriatic arthritis. It sounds like the symptoms
Speaker 5: can really run the gamut. That said, are there a
Speaker 5: list of most common symptoms if you.
Speaker 4: Were to google soriatic earthrtis? I think that for sure,
Speaker 4: people would talk about swelling in stiffness in specific joints
Speaker 4: in the hands rather than the knuckle joint. People would
Speaker 4: talk about mostly skin psoriasis in association with siatic earthritis.
Speaker 4: People would talk about morning stiffness that's greater than thirty minutes.
Speaker 4: So if you're not twenty five anymore, when you get
Speaker 4: out of bed in the morning, you might feel a
Speaker 4: little bit stiff. As you make your way to the bathroom,
Speaker 4: you notice that you loosen up. People with sooriatic arthritis,
Speaker 4: that's just ongoing. It could be for hours.
Speaker 5: What are some common misconceptions that people have about arthritis.
Speaker 4: I think it's really important for people to understand that
Speaker 4: there are like hundreds of kinds of arthritis. We simplify things, right,
Speaker 4: but there are all different kinds of arthritis, and so
Speaker 4: I think the misconception is that this is not just
Speaker 4: an illness that affects your joints. So I'm going to
Speaker 4: generalize the thing that is a rheumatologist I worry the
Speaker 4: most about when I meet patients with inflammatory arthritis are
Speaker 4: actually not their joints. I worry about their heart I
Speaker 4: worry about their risk of cancer, because we know that
Speaker 4: patients with inflammatory disease that is uncontrolled have a higher
Speaker 4: incidence of heart attacks, especially true in our sooriatic arthritis patients,
Speaker 4: and higher incidents of some lymphomas and cancers. And so
Speaker 4: I think the misconception is, oh, that it's just my joint.
Speaker 4: But when I say to people, the likelihood of your
Speaker 4: rheumatoid arthritis have left untreated causing a heart attack is high,
Speaker 4: and that what killed patients with rheumatoid arthritis and soriatic arthritis.
Speaker 1: Is heart disease.
Speaker 5: What did that diagnosis mean for you?
Speaker 2: It meant a lot of things. It was validating to
Speaker 2: know that I wasn't crazy, that something was really wrong,
Speaker 2: and so there was a piece of me that felt
Speaker 2: relief that at least now we know what it is
Speaker 2: and now.
Speaker 1: We can hopefully treat it.
Speaker 2: It was scary for me also really hard because I
Speaker 2: knew a lot was going to have to change my lifestyle.
Speaker 2: I was scared was I ever going to be able
Speaker 2: to go dance again or exercise again?
Speaker 1: What was working out going to look like for me?
Speaker 2: I was in a full time coach where running on
Speaker 2: the treadmill was part of my job, and.
Speaker 1: I didn't know that I was going to be able
Speaker 1: to do that again.
Speaker 3: It gave her a direction of like where to like
Speaker 3: research so she can figure out how she wants to
Speaker 3: pursue moving forward, and I mean, you get some hope.
Speaker 3: She's good at finding the good and things been like, Okay,
Speaker 3: here's a new adventure or new project to try and
Speaker 3: work towards and you know, make things better.
Speaker 5: It just occurred to me that really you do almost
Speaker 5: need to embrace the mindset of an athlete with these
Speaker 5: chronic illnesses, because it's a marathon, it's not a race.
Speaker 4: And you have to focus on the things that you
Speaker 4: can have control over, right, And I think it's instinctual
Speaker 4: for all of us to number one, know what caused this,
Speaker 4: which often we have no idea, and where's it headed,
Speaker 4: what's the prognosis which a lot of the time we
Speaker 4: also have no definitive idea, right, and that's incredibly unsettling.
Speaker 4: So you have to then be able to give over
Speaker 4: some of that wanting to control the outcome, to kind
Speaker 4: of just go for the ride right, to jump forward,
Speaker 4: and to let's just keep moving forward, is what I
Speaker 4: say to patients.
Speaker 2: In some ways, I feel like it's given me the
Speaker 2: gift of being more in tune with my body because
Speaker 2: for so long I ignored so many things. It has
Speaker 2: allowed me to identify triggers and things that trigger these
Speaker 2: episodes and inflammation. I can't say that I'm flare up free,
Speaker 2: I can't say that I'm in remission, but I can
Speaker 2: tell you that I can understand that my body can
Speaker 2: only tolerate so much exercise.
Speaker 5: As Matt lovingly described her, Lauren is the eternal optimist.
Speaker 5: Despite having to give up dance and accept the physical
Speaker 5: limitations that can accompany her flare ups, Lauren remains dedicated
Speaker 5: to moving forward and motivating others. What are you most
Speaker 5: proud of your wife for?
Speaker 3: I'd say I'm just most proud for her resilience and
Speaker 3: trying to like not let her condition take over. She
Speaker 3: always is trying to better herself physically and mentally. She's
Speaker 3: always pushing to find the brighter side of things and
Speaker 3: not let anything get her down. So it's just nice
Speaker 3: to see pushes me too.
Speaker 2: All that passion, all of the love I had for dance,
Speaker 2: I mean, it's all still there, but I have been
Speaker 2: able to redirect that passion and fire to help others
Speaker 2: that are like myself that are going through dealing with inflammation,
Speaker 2: weight loss, resistance, feeling exhausted or fatigued, and all of
Speaker 2: those things. And so I took the majority of that
Speaker 2: energy and really put it into studying and understanding inflammation
Speaker 2: at another level, so I could help others work through
Speaker 2: exactly what I work through and understand their bodies the
Speaker 2: way that I'm able to understand mine.
Speaker 5: I love that it's the same kind of imparting of empowerment.
Speaker 5: It's just knowledge.
Speaker 2: Now exactly, and a knowledge that I so personally can
Speaker 2: relate to, right, because I know those feelings of frustration,
Speaker 2: and I know those feelings of you know, when you're
Speaker 2: just you're feeling defeated, when you're dealing with something along
Speaker 2: the lines of battling, whether it's sooriatic arthritis or another
Speaker 2: inflammatory condition, right, And I want to help others be
Speaker 2: able to beat it the same way that I was.
Speaker 2: And once you start to identify and understand what your
Speaker 2: body needs. What your body responds to is a life
Speaker 2: that is waiting to be lived by you.
Speaker 5: To find out more on soriatic arthritis, you can check
Speaker 5: out the Arthritis Foundation's website at Arthritis dot org.
Speaker 2: My name is Lauren shol I pushed through pain for
Speaker 2: fifteen years before being diagnosed with sooriatic arthritis at the
Speaker 2: age of twenty eight.
Speaker 5: Since this is the final episode of Symptomatic Season two,
Speaker 5: we want to say a huge thank you to all
Speaker 5: of our listeners. We truly value the opportunity to bring
Speaker 5: these episodes to life. We'll be back soon with more.
Speaker 5: Until then, if there's a story you want to hear
Speaker 5: us cover, you can get in touch with us by
Speaker 5: emailing Symptomatic at iHeartMedia dot com. And please don't forget
Speaker 5: to rate and review Symptomatic wherever you get your podcasts.
Speaker 5: Until next time, we hope you stay well. Symptomatic a
Speaker 5: medical mystery podcast is a production of Ruby Studio from iHeartMedia.
Speaker 5: Our show is hosted by me Lauren breg Pacheco. Executive
Speaker 5: producers are Matt Romano and myself. Our ep of post
Speaker 5: production is James Foster. Our producers are Sierra Kaiser and
Speaker 5: John Irwin and this episode was researched by Diana Davis.
Speaker 8: What are real people with storyatic arthritis saying about cocentics?
Speaker 3: I had to do something cocentics. I moved better because
Speaker 3: of concentics.
Speaker 8: Cocentic sec ukenyumab is for adults with active storiatic arthritis
Speaker 8: and is given as a one hundred and fifty milligram dose.
Speaker 8: Don't use if you're allergic to cocentics. Before starting, get
Speaker 8: checked for TB serious allergic reactions, severe skin reactions that
Speaker 8: look like eczema, and an increased risk of infections. Some
Speaker 8: fatal have occurred. Cocentics may lower ability to fight infections,
Speaker 8: so tell your doctor if you have an infection or
Speaker 8: symptoms like fevers, sweats, chills, muscleleggs, or cough, how to
Speaker 8: vaccine or plan to or if ibed symptoms develop or worsen.
Speaker 8: Learn more at cocentics dot com or one eight four
Speaker 8: four cocentics. Don't wait. Ask your doctor about cocentics