This was a very sad week for me. I learned that my amazing rheumatologist, Dr. Asha Shrestha, is moving.
I saw her a couple of days ago for the last time. As she injected my severely inflamed finger joints with cortisone, we talked about life as if we’d never see each other again — because unless the stars align, we won’t.
“I’m so sad,” I said.
“I can’t believe you are leaving!”
Dr. Asha (the name she goes by because her last name is hard to pronounce) explained to me that her husband had a new job, so they had to move. We’ve always related as mothers and professionals, so our conversation included her stress about having to sell her house quickly and the additional pressure involved with moving a family.
I have mentioned Dr. Asha frequently in my blog and in this column. She’s a truly special specialist.
I will never forget my first visit with her. My fingers were insanely painful from dactylitis, a symptom caused by severe inflammation, and one of them looked like a sausage. The rheumatologist I saw three months prior had been no help. The pain I experienced when someone shook my hand would cause me to cry out. Fortunately, I learned about a new rheumatology practice in my city, and after they reviewed my most recent hand X-rays, they quickly got me in for an appointment.
When Dr. Asha reached to shake my hand, I shuddered, put it behind my back, and told her, “I can’t shake your hand, it hurts too much.”
We proceeded to go over my entire medical history. She examined me, and after looking at my back scar from scoliosis surgery, commented, “Dawn, even though your back surgery was planned, that was a huge trauma to your body.” We then continued to discuss the correlation between physical and emotional trauma and autoimmune disease.
I left the office that day with orders to go for bloodwork. But before she left the examination room, Dr. Asha turned to me and said: “Dawn, give me your hand.” She gently held it, shook it, and said, “I will never shake your hand harder than this. I know what kind of pain you are in. You can trust me to never hurt you.”
None of my previous healthcare providers had shown me that kind of care and understanding of my pain levels.
I left her office and went straight to the lab to have the bloodwork completed: 12 vials full. Her phone call with the results shocked me.
“Dawn, your bloodwork shows your level of pain and inflammation. People often don’t realize pain can be correlated in autoimmune disease with bloodwork, but it indeed can be. You are also HLA-B27 positive, which makes you even more prone to autoimmune disease.”
As a result of that initial bloodwork, I had three more autoimmune diseases added to my already complicated patient profile: psoriatic arthritis, seronegative spondyloarthropathy, and ankylosing spondylitis. I already had a diagnosis of Hashimoto’s thyroiditis. My diagnosis of Lambert-Eaton myasthenic syndrome (LEMS) would be added six months later by my neurologist.
For the first time in over 15 years of seeing several rheumatologists, I felt validated that I hadn’t caused what my body was doing to me. My pain levels were real, and my symptoms were no longer lumped under my fibromyalgia diagnosis.
Since then, Dr. Asha has worked tirelessly with my neurologist to make sure my treatment plans line up across the board. I’m a complicated patient. Other than meloxicam and cortisone injections, I have no other options to keep my psoriatic arthritis from destroying my joints. When I started the first line of treatment, hydroxychloroquine, it aggravated my later-diagnosed LEMS symptoms.
The biologics used to treat psoriatic arthritis also aggravate demyelinating conditions, possibly worsening neuromuscular symptoms. Thankfully, my immunoglobulin treatments help to minimize the risk to my internal organs posed by my psoriatic arthritis.
Dr. Asha’s communication style, whether with patients or other providers when coordinating treatment plans, has had me singing her praises since she gently shook my hand. I have sent everyone within driving distance to see her when they have expressed frustration with their own rheumatologist experience.
So now, I’m making the same recommendation for my readers who live within driving distance of Mount Kisco, New York. Dr. Asha Shrestha starts at CareMount Medical at the end of this month. If you have other autoimmune diseases with your LEMS diagnosis, she is the most compassionate and knowledgeable rheumatologist you will ever see.
Please tell her I sent you and that I miss her.
Note: Lambert-Eaton News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Lambert-Eaton News or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to Lambert-Eaton myasthenia.
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