Rheumatoid Arthritis Patient Shares Lessons Learned from Breaking Leg in a Fall

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Humpty Dumpty sat on a wall
Humpty Dumpty had a great fall
All the king’s horses and all the king’s men
Couldn’t put Humpty together again.
—Mother Goose

I feel like a female Humpty Dumpty. Recently I took a great fall, and now I am in the process of being put together again.

I was diagnosed with rheumatoid arthritis (RA) at age 25. For the past 38 years, I have fought my RA with medications ranging from 13 enteric-coated aspirin per day in 1978 to weekly etanercept injections since 2004. My body bears the scars of 13 orthopedic surgeries, including four total hip arthroplasties, fusions and synovectomies. RA may have contributed to my two cancer diagnoses, as well as my urticarial vasculitis, osteoporosis and a cerebrovascular accident (CVA) at age 31 followed by a miscarriage of my second daughter the same year.

I have fought my RA with a positive attitude supported by cutting-edge knowledge. Under the guidance of several excellent rheumatologists as well as physical and occupational therapists, I have worked to be the best wife, mother, grandmother and registered nurse possible. I thought I knew it all about RA and its effects on my body. I secretly hoped it would burn itself out. I was wrong! RA is not finished with me yet.

My disease continues to prove to me that RA patients have complex and interrelated needs that influence our health status in many ways. We, and those who care for us, need to keep this in mind.

RA Complicated by Osteoporosis

Post-op X-ray shows the repair of the author’s right femur fracture.

Any fall is detrimental, especially to an RA patient who also has osteoporosis. Having experienced compression fractures of my lumbar vertebrae at L2 and L4 in 2013, I successfully completed a full two years of daily teriparatide injections. I anxiously waited to have my post-treatment DXA scan done so we could determine how much my bone density had improved. To my dismay, my bone density could not be accurately measured.

I learned that there must be two consecutive lumbar vertebrae that have not been fractured to obtain a valid result. My lumbar spine did not qualify because both L2 and L4 showed old compression fractures. Also, both of my hips are prosthetic, and the bones of my left wrist have been too damaged by my RA to be measured. What a disappointment after giving myself 730 injections!

RA is not finished with me yet. My disease continues to prove to me that RA patients have complex & interrelated needs that influence our health status in many ways.

Post-op X-ray shows wire placed around the right femur near a hip prosthesis rod.