In honor of Arthritis Awareness Month, I would like to introduce you to Mischelle Jackson. Mischelle is living with RA, Diabetes, Ankylosising Spondylarthropathy, Psoriatic Arthritis and Sjogren's Syndrome. Mischelle is an RN. She has taught me a lot of things over the course of our friendship. Some of those things came from her medical background. Others came from her experience living with AI diseases.

Q How were you diagnosed with RA?

A. I had a total abdominal hysterectomy in March of 2009. A few months post surgery, I woke up with my left jaw locked. I’ve never had TMJ; however, that is what my doctor suspected and referred me to my dentist who agreed. I woke up every morning with the right jaw locked. I was only able to open my mouth a few inches. This only lasted for a month, and as quickly as it came on, it left. I knew something was wrong when I woke up one morning shortly after the jaw pain had disappeared, to find my left hand was locked.

I saw my PCP and told him about it, and he examined my hand. Since I was 42 years old, he said it could just be osteoarthritis. He examined my right hand and there was no swelling, redness, or pain. Because the hands were not symmetrical, he dismissed a possible diagnosis of Rheumatoid Arthritis. Blood was drawn and a few days later my PCP told me my tests were negative for the Rheumatoid Factor.

I was working as a RN on oncology unit at the time. A fellow nurse, who had been diagnosed with sero-negative RA , told me that her RA was not symmetrical and she did not test positive for the RA Factor either. She urged me get further medical treatment by seeing a rheumatologist.  So, basically I was diagnosed by a nursing colleague who had the same disease.

I would say my diagnosis was delayed because the doctor did not think my symptoms were typical of what he had been taught about rheumatoid arthritis. I was diagnosed with sero negative rheumatoid arthritis is November 2009; however, I did not feel comfortable with this physician. I a second opinion from an award winning, reputable rheumatologist. In January of 2010 this physician expanded the diagnosis: sero negative rheumatoid arthritis that is atypical in presentation, undifferentiated spondylarthropathy to the lower spine which is a precursor to ankylosising spondylarthropathy, psoriatic arthritis, and sjogren’s syndrome. During the next few months of treatment, I was also diagnosed with fibromyalgia secondary to chronic pain associated with RA.

Q. How did you learn that your diabetes was Type 1.5, and how does that affect your treatment for RA?

A.  My disease process progressed to moderate to severe in just three years. In retrospect, my endocrinologist and rheumatologist agreed that my diagnosis of Type II diabetes in March 2000 was erroneous, as evidenced by failure to respond to any of the oral hyperglycemic medications over a 5 year period, and failure to respond to injectable insulins and hyperglycemic medication combinations over the next 3 years. In 2009 I was placed on an insulin pump which continually infuses insulin to help work like a pancreas. By 2011 I wasn’t producing insulin on my own.