When I Sought Treatment for Pain, All the Doctors Saw Was My Size

As told to Erica Rimlinger

I was walking to my college class when the top of my left foot started to throb with pain. When I took off my shoe to investigate, it looked like a ball had appeared on the top of my foot. Had I banged it? Did I drop something on it? The skin wasn’t red and I wasn’t bleeding. What was going on? It didn’t go away after several days, and the pain made it hard to walk.

Over-the-counter pain meds had no effect. I went to my general practitioner, who gave me a steroid shot for the inflammation, which helped. And that, I thought, ended the story of my mysterious pain.

The story was actually just beginning. Shortly after the foot swelling, the skin above my forehead developed raised, red flaky patches. I visited a dermatologist who diagnosed me with plaque psoriasis. “Do you have insurance?” she asked me. It’s a good thing I did. I started using tar shampoo, creams, medications and expensive injections. Only the injections helped, but never for long.

Meanwhile, the mysterious pain and inflammation returned. It swelled my left knee, then my wrist, then my back, then my right elbow. It seemed to be moving through my body with no reason or predictability. Was this stress wreaking havoc on my body? What was going on?

My doctors suggested my weight might be to blame, but I knew that wasn’t the issue. In fact, I’d recently lost weight. I’d been diagnosed with insulin resistance and thyroid problems. Taking medication for those conditions reduced my weight and lowered me out of the pre-diabetic range. But weight loss provided no relief from my constant pain and swelling.

The pain could show up in any joint in my body at any time. The impacted joint could move only as far as I could withstand the stabbing pain that came with it. I wore braces on my wrists. The pain was exhausting and wore me down.

Doctor’s visits didn’t help. Being plus-sized meant fielding comments dripping with shame and guilt over my size. I left multiple doctor’s appointments exasperated with their advice: “Eat less. Move more.” I knew in my heart there was more to it.

My protests went unheard until, at an appointment with a new doctor, I was given a diagnosis that linked my plaque psoriasis and my joint pain. I had an autoimmune disease called psoriatic arthritis.

It was almost a relief to get the diagnosis. I knew it was a big deal, and that I’d be starting a treatment journey that required some trial and error. A medication would work, then stop working, and I’d have to start over with a new plan. At times I was tempted to tell the weight-loss-touting doctors that my symptoms had disappeared with treatment for my autoimmune disorder.

The medication was expensive, even with insurance. Injections under each plaque psoriasis flare-up were especially pricey, and these only helped the skin issues, not the joint pain. I joined clinical studies because the medications were free, and I was paid a stipend to try cutting edge treatments: win-win.

Currently, I’m on a biologic that’s working and has been working for three or four months, one of the longest times I’ve found success with a treatment. My fingers are crossed. Along the way, I’ve found support through my online community. It helps to talk to people who know what you’re going through. It’s also nice to have a supportive partner who knows I’m strong but also knows I sometimes need to have a good cry.

Psoriatic arthritis is lifelong and has been hard to treat, but the hardest part of this journey has been finding a doctor who saw me as a whole person, not just a number on a scale. Obesity is a complex disease, and, while it can cause health issues, it’s certainly not the root cause of every health issue. And, even though obesity can be correlated with psoriatic arthritis, my new doctor told me outright: Your weight did not cause this.

I was lucky the repeated message to lose weight didn’t stop me from going to the doctor when I needed it most. A lifetime of being told my pain was due to the size of my body reinforced to me that I was the problem and the pain was my own fault.

I tell women of all sizes to check in with a dermatologist sooner rather than later if you’re having pain and plaques. Even if you think the symptoms are no big deal, like I did at first, don’t just wince through it. Get it checked out. Any autoimmune disease is a tough diagnosis to get, but new treatments are being developed each day, and hope is tougher than psoriatic arthritis.

This educational resource was created with support from Merck and Takeda.

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