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Healthy is Wealthy

My Psoriatic Arthritis Diagnosis Started With a Fall

It started with a fall. On solid pavement. Yes, ouch indeed.

I was crossing the street on my way to work as I had done for years. I knew this crosswalk well, despite its odd construction. For some reason, the pedestrian median on the crosswalk had angled concrete on the outside edges of the crossing, so one of my feet was on flat concrete while the other was on an angle.

I lost my footing, and, I cringe even writing this, I fell and both of my knees simultaneously smacked the ground. My hands were scratched as they rubbed against the pavement, and they were red and throbbing with pain. My knees, shockingly, seemed fine, despite their taking the brunt of the hit. 

Thankfully, nothing seemed broken. I was able to walk, but something just wasn’t quite right. The next few weeks involved severe pain and swelling in my knees that got worse. I felt fluid in my right knee. It was visible to others as well, and I hobbled a little when walking. I kept taking anti-inflammatory medications, which seemed to help a bit, but deep down I knew something was wrong.

I remember being in the synagogue for the High Holy Days and having to elevate my knee on another chair just to get some sense of comfort, yet it was not very helpful. I prayed for the pain to go to away so as to avoid seeing a doctor. After all, I’m young and healthy. The only health issue I had was these relatively large crusty psoriasis patches on my shin and arm. That was just flaky skin, right? Shouldn’t a small fall be something I could heal from if I didn’t break anything? 

After pushing it off long enough, I decided I needed to see a medical professional. But, like most young people, once I made that decision, I needed to see someone urgently. Not next week. Rather, today or tomorrow.

So, instead of going off a friend’s recommendation or waiting a longer period of time to see someone highly rated, I found a local orthopedist in the area at an hour that fit well with my work schedule and saw him the next day. I didn’t love the reviews I had read online but dismissed them, convincing myself that as long as I took the first step to actually SEE someone about the pain, it was better than nothing.

I was not impressed with the doctor’s rushed bedside manner. He asked me repeatedly to jump up and down on my foot. I was in pain, and depending on the diagnosis, this could potentially have been harmful to my condition. I regretted making the first appointment I was able to find within a 1-mile radius. I was an adult, but when it came to my health, I was acting like a child, and was disappointed in my poor judgment. 

The doctor told me to take over-the-counter painkillers. They did not help. He then, in a follow-up, suggested it was time to get an MRI, which would require approval from my health insurance company. It took many phone calls, but eventually, and coincidentally, when I had the insurance company on the phone, the representative shockingly informed me that at that very moment, my doctor’s office was also on the phone with them and she was able to conference all three of us on the call.

It was at this moment that things began to get very weird. The insurance company representative asked the doctor’s office to confirm that I had been prescribed opioids, as that was apparently a prerequisite to get the MRI approval. The doctor’s office confirmed as such.

I spoke up, as this was patently untrue and I had only taken over-the-counter medications. But the secretary spoke over me and told me, “Mr. Goldstein, we are getting you the authorization. Hang up and I’ll call you back.”

This experience left a very sour taste in my mouth. Did I want the MRI? Of course, but obtaining it in an unethical way bothered me very much, and I knew this was the end of the relationship between the doctor and myself. The MRI was approved, and in my next blog entry, I’ll tell you the initial diagnosis!

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