Disclaimer: This piece has been entered in the Patients Have Power Writing Contest run by Clara Health designed to raise awareness about clinical trials. I am passionate about this cause and hope it will help raise much needed awareness about the power of breakthrough research.
Twenty-one summers ago I had just graduated from high school when I received the diagnosis that changed my life forever: Rheumatoid Arthritis (RA). Sitting in the exam room on a chair next to my mother, tears fell down my face and panic rose in my chest as I heard the doctor give me the crushing news. In total shock, I couldn’t believe what I was hearing. No. No, I can’t have that. I’m too young! Images of twisted, misshapen, and mangled fingers filled my mind. Then the thought that the excruciating pain I had been feeling in my own hands and feet over the past several months would never go away terrified me. How can I live with this forever? I’m only 18.
Twenty years before that sunny yet devastating day in July 1997, my grandmother, Nana, was beginning her own journey of a body and life attacked by chronic inflammation. This forced journey, with its daily assault of swelling and unspeakable pain, was one that I, too, endured, except only as a close observer. As a small child I grew up knowing that she had very bad arthritis (I didn’t understand what Rheumatoid Arthritis was until years later), and seeing her life become increasingly disabled often confused and scared me.
Nana and I were close, as I was to all of my grandparents, although I probably spent the most time with her and my grandfather, Papa. I was in their house all the time, and I often sat in the small, orangey-peach kitchen watching Nana cook, which is something she loved to do. And it’s something that became increasingly difficult for her as RA continued to ravage her body, especially her tiny, slender hands that were always whipping up her signature meatballs or veal cutlets or any other delicious Italian dish. The kitchen was her happy place, as was her spot behind her old, black Singer sewing machine in the basement. She had a strong talent for both cooking and sewing, and they brought much joy to her life, yet RA mercilessly stole both of these things from her.
To say that Nana and I are strongly linked would be an understatement. I am her granddaughter, of course, and I have her feisty Italian blood coursing through my own veins. I have her dark hair and eyes. I have her long straight nose, her 5’4″ frame, and her thick unruly hair. And I have her hands. Not only are they small like hers, but they hold her pain, too. That day in the doctor’s office when I was told that I have RA, I immediately panicked that my hands and feet would become quickly disfigured like my grandmother’s. The thought that this could very well happen, and while still a teenager, compared to Nana being in her 60s when getting the disease, was almost more than I could bear. I cried. A lot. I cried for my own pain and fear and grief, and I cried for Nana. I finally began to understand her suffering.
Nana passed away in March 2003 from stomach cancer at the age of 82. I didn’t get to say goodbye to her in person, but sobbing from a phone booth on a desolate street in Cork, Ireland, late at night. I was studying abroad there for a semester and I wasn’t able to get back home to Minnesota in time to see her before she died. She deteriorated quickly, which surprised us all. That night I wanted so much to be with her in that hospital room, with my parents and sister and family members surrounding her bed, but I could only tell her I love her and say goodbye from that little phone booth. Even though she could no longer speak by this point (this also happened quickly), I know she heard and understood me. Clutching the phone in this surreal moment, an ocean away from her, I told her how much I loved her. I know she knew this, she always knew it, but I also hoped that she knew how much I admired her strength and passion for life despite living with such pain. Struggling with RA myself since my diagnosis, I don’t think I ever really articulated that to her. I wish I would have.
I also wish that the cutting-edge drugs and treatments that were beginning to become available to RA patients in 2003 had been around much earlier. Right before I left for Ireland, I began taking my first biologic medication, twice-weekly injections of Enbrel, because the other RA medications I had tried since my diagnosis weren’t doing much to stop the relentless progression of the disease. By age 20 I already had a severely damaged right wrist, with its cartilage and bone eaten and eroded away from RA inflammation. What was next to become permanently damaged? And when? Not knowing what else to do, my rheumatologist put me on Enbrel, and luckily it seemed to work. My fears of collapsed knuckles and grotesquely bent fingers like Nana’s began to subside, as did the mental image I had of being confined to a wheelchair before age 30, or 25, even. What a relief! Something was working. Really working, finally. Thank God for these “miracle drugs!”
Eight biologics and 15 years later, I have understood from years of personal experience, successes, and failures regarding these drugs that sadly they are not a miracle or a cure. Biologic medications have amazingly transformed the lives of many RA patients, enabling people to live much healthier and more active lives than they might have if not for the drugs. This is wonderful and I’m so thankful that these medications exist. What would my life look like now if not for the biologics? I shudder to think of it. But something I do think about a lot is this: What would Nana’s life have looked like if these medications had been available to her?
When my grandmother first began to have RA pain and swelling in the late 1970s, there weren’t that many options available, and I think she tried them all. Her body was constantly on fire and attacking itself: her hands, her feet, her wrists, her knees, and even her skin. Nana not only suffered greatly from RA for many years, but from severe psoriasis as well. If I could jump into a time machine and bring her some biologic drugs to help ease her misery, I would do it in a heartbeat. Unfortunately, this is reality and the reality is that these highly effective drugs were researched, developed, and made available to patients too late to help her.
The love I have for my grandmother, the love I have for my RA friends and everyone who suffers from the debilitating pain of RA, and the love and compassion I try hard to find for myself—this is why I am a passionate supporter of scientific and medical research, drug development, and clinical trials. Our lives are at stake and a cure is needed for these life-ruining diseases yesterday. The only way that people will get their lives back, that a cure will be found, is if new medications are developed and made accessible to patients. Clinical trials are a crucial part of all of this; we need them and we badly need more people to participate in them.
Even though living with RA often makes me feel frustrated and helpless, I believe that fighting against this disease isn’t a helpless or hopeless battle. Patients have power! We have the power to bring about awareness and even change just by sharing our stories. When you consider supporting medical research and clinical trials, I hope you will remember Nana’s story–and mine.