Dear Family: It's Not the Turkey That's Making Me Tired

by Casey Nilsson Patient Advocate

Dear Family,

I am tired and it's not because of all the turkey I ate at my parents’ annual Thanksgiving pre-game lunch. Nor is it the fatigue of a woman wrangling a husband, toddler, new house, full-time job, friends, and two love-starved cats.

It’s what’s going on inside of my body, way out of view, that exhausts me. That makes me want to wrap up in my comforter by 8. That makes it difficult to follow even the most stimulating of conversations without zoning out.

I want to hear how Sophia’s doing at Fordham and how your neighbor potty-trained her kid in a weekend, but I’d space out if my house were on fire these days.

Here’s the thing: My body’s at war with itself. Forget brokering a truce; I’m lying on the battlefield and I’m being trampled. Some days, I can look up at the sky and marvel in its beauty despite my battle wounds. Other days, it’s more difficult.

In 2016, I was diagnosed with psoriatic arthritis. It’s a fun combination of psoriasis, which my mom also has, and arthritis. Unlike carpal tunnel syndrome, I didn’t get it from sitting at a computer all day (although that doesn’t exactly help things). About 30 percent of people who have psoriasis develop arthritis.

My skin is under attack. My joints are under attack. My body’s causing all sorts of trouble, self-sabotaging with abandon. My immune system, which I didn’t think about until I had to, is in action all the time.

Think of it like this: If you have the flu, your body is working nonstop to fight the invading virus. (Note to self: must get flu shot.) You’re exhausted, not just because of the runny nose and sore throat, but because your body is doing its job.

Just like it would attack a virus or bacteria, my immune system attacks my joints and my skin. It’s always working, always fighting the inflammation that causes the symptoms. So on top of the psoriasis lesions and the joint pain in my hands and feet – and, let’s not forget, the nagging anxiety that either could take a steep turn for the worse at any time – I’m war-weary. For people living with autoimmune diseases, fatigue is a major issue.

I’d like it to stop. There are effective, expensive medications out there that could help. My disease hasn’t progressed to a place where I need them just yet. Plus, when my willpower is strong, I’m working on ways to tame my body’s inflammatory response with diet and exercise. (Pass the turkey and squash and leafy greens; hold the dinner rolls and mashed potatoes. Let’s take a walk to the pond after dinner.)

But even with a picture-perfect diet and decreased joint pain, I’m pooped.

One more thing: Autoimmunity can cluster in families, and if I have an autoimmune disease, you might too. That’s not meant to scare you. I hope you don’t join the club. But if you do, or if you’re already here and I didn’t know it, then we’ll be stronger, more informed, and tired — so very tired — together.

Now pass the cranberry sauce. No, the one from the can.

Love, Casey

Casey Nilsson
Meet Our Writer
Casey Nilsson

Casey Nilsson, an award-winning journalist and magazine editor based in Rhode Island, writes about autoimmune disease for HealthCentral. Casey is a 2018 Association of Health Care Journalists fellow, and her reporting on unfair labor conditions for people with disabilities was a finalist for the City and Regional Magazine Association Awards. Diagnosed with psoriatic arthritis in 2016, Casey enjoys digging into rheumatologic news, research and trends.