Recovery From Rheumatoid Arthritis

Monday, January 9, 2017

Surgeries, advanced treatments free patient from wheelchair

Nancy Clark was 34 when her health — and her life — changed inexplicably. For months she’d been experiencing worsening stiffness in her limbs that limited her movement and left her feeling sore and tired.

“I didn’t really know what was wrong with me,” Clark remembers. “I didn’t know why my body was doing what it was doing, and I was getting worse so rapidly. It was quite scary.”

Eventually doctors near Clark’s home in Indiana diagnosed her with rheumatoid arthritis, a painful chronic disease that causes inflammation of the joints. If untreated, it can lead to devastating deformities and immobility.

Despite trying various treatments and performing multiple joint replacement surgeries, her hometown medical team was unable to slow the progression of her disease. Clark found herself confined to a wheelchair.

“I felt like my life was on pause,” she says. “I had three young children, and I knew that there was more I wanted out of life than just taking care of my medical problems.

“I didn’t know what the future held for me. All I could see was that I was going to be in a wheelchair and that I would be limited in everything that I could do. I used to just hope that I could stick around long enough to raise my kids.”

Looking to Rush for answers

In 1995, after Clark had been fighting her illness for seven years, she made an appointment at Rush University Medical Center, hoping to find a treatment that would slow the progress of the disease. Though Rush was a greater distance from her home, Clark felt it was worth the drive.

“I knew the reputation of Rush, so I sought a rheumatologist there,” she says. “I found the best orthopedic surgeons to provide the joint replacements necessary to keep my mobility. My physician team also was able to offer me new and more progressive medical options so that I could really get my rheumatoid arthritis under control.”

That care has kept Clark returning to Rush for 21 years, during which she’s regained her mobility and established a deep bond with her care team.

One of the first doctors Clark encountered was Mark Cohen, MD, an orthopedic surgeon who specializes in disorders and problems in the hands, wrists, forearms and elbows.

Clark has been Cohen’s patient ever since, and they now they regularly exchange pictures of their families and stories about them.

Cohen stresses, though, that he is only one of a team of physicians who helped Clark overcome her illness and regain control of her life. “We try our best to identify and to integrate the doctors that have the best experience and (expertise) for a certain patient,” he says. “By collaborating with our colleagues, we can give the patient the best care within each area of medicine.”

Doctors seek, respect patient and family’s input

Clark and her family are included as integral members of her care team. “When I go to Rush to see one of my many doctors, I feel like they listen to my concerns,” Clark says.

“They tell me medically what their ideas are for treatment, but they know that I know my body best of all. I feel like they have a lot of respect for my input. They have really worked together with me and for me.”

That’s an opinion shared by Clark’s daughter, Megan. “The team at Rush has always been very respectful of my role as the daughter and caregiver of my mom. They’ve always kept me in the loop, and they’ve been incredible to work with.”

Surgeries replace joints, restore movement

Due to her illness, Clark has undergone a dozen surgical procedures at Rush over the years. “I’ve had many major joint repairs and replacements,” she says.

“I’ve had both my elbows replaced. I’ve had two hip revisions (to repair the original replacement hips), a knee replacement revision, fusions of my right ankle and the hind foot of my left foot, and a cervical fusion. I’ve never been afraid to go into surgery at Rush, because I always end up with excellent results,” she adds.

She also had an emergency middle-of-the-night surgery after she accidentally fell, fracturing her pelvis and dislocating her hip. An ambulance brought Clark to Rush at 10 p.m., and Brett Levine, MD, an orthopedic surgeon who specializes in hip and knee replacements, operated as soon as she was stable, working until past two in the morning.

“I received a nice, solid hip replacement and a plate in my pelvis so that I could get up and get going again,” Clark says. Levine also took time after the operation to talk with Megan about how the surgery had gone. “It was excellent care,” she says.

Cutting-edge therapy brings arthritis symptoms under control

In addition, Clark has benefited from the cutting-edge therapies available at Rush. “We have revolutionary treatments now for the treatment of rheumatoid arthritis that have helped her live a much more comfortable life,” says Sarah Everakes, MD, Clark’s rheumatologist.

Among those advanced treatments is biologic therapy, the use of medically engineered proteins. Biologics target a component of the human immune system that malfunctions in cases of rheumatoid arthritis, bringing the condition under control.

“We’ve only had these treatments for the past 15 years or so,” Everakes says. “Nancy has a lot of issues with her joints because she developed her disease before these treatments were available, but now that she receives appropriate medical management, her pain, fatigue and stiffness are much better controlled.”

Clark returns to Rush every eight weeks for specialized rheumatology treatment in the Medical Center’s infusion center, and sees Everakes in her clinic every four to six months.

‘Rush has really given me my life back’

Thanks to her care at Rush, Clark is able to live a full life. “Rush has really given me my life back,” she says. “I’ve been so fortunate because now I can get around so much better, pain free.

“I’m able to watch my kids grow up and see them continue with their lives. I’ve been able to travel and complete my career (as a school counselor), and now I enjoy my grandchildren and my friends.

“I have such confidence in maintaining my health, and I’m still pursuing all the things that I have yet to accomplish.”

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