How I Was Diagnosed
I’ve been active and in great health all of my life – I played sports through high school and college, went to all of my regular check-ups, and by the time I was married didn’t really have any medical issues other than seasonal allergies. I’ve never been skinny, but by keeping active and watching my diet I was able to move from "slightly overweight" to "normal weight" on the BMI scale a few years prior to getting pregnant.
I gained about 10 pounds just getting pregnant (due to a higher protein diet - yes I was one of those Moms-to-be who was very conscientious about what I ate) and another 60 pounds with the pregnancy. I gave birth to a perfectly happy and healthy 10 pound 7 ounce baby boy in 2006 - it was a scheduled c-section as they knew he was "big." At my six week follow-up visit with my OB, I was strongly encouraged (as I’m sure every postpartum mother is) to lose ALL of the baby weight. Additionally, it was suggested that losing the additional 10 pounds I gained getting pregnant would provide me with the best starting position to ensure that I didn’t develop gestational diabetes with any subsequent pregnancies. As such, I turned to Weight Watchers and grabbed my jogger to lose not only the 60 pregnancy pounds I had gained, but an additional 20 pounds.
Not having had an actual physical since I got married in 2001, I decided that I should get a full exam now that I had lost all of the pregnancy weight and was an active Mom. In March my husband and I both visited our PCP for an annual exam which included routine blood work. Although my cholesterol and iron counts were normal, the blood work came back with a high protein count which the doctor informed me in a follow-up call could mean hundreds of things. We waited six weeks thinking the results could be due to a viral infection and would clear up, and then I went back for another round of blood work. The second round also showed a high protein count, as did a third round six weeks later. As I wasn’t exhibiting any symptoms and appeared to be perfectly healthy, my PCP referred me to a rheumatologist who would be able to determine what, if anything, was causing the high protein count.I saw the rheumatologist at the end of June and she did a FULL exam including a physical (walking, bending, general movement) and asked me tons of questions. I said I had noticed a few things on her giant list of questions in the months leading up to my visit – fatigue, bruising, incessant thirst, dry eyes, and trouble sleeping through the night. I honestly thought these symptoms were just either Mom or nursing related types things that would eventually resolve themselves (I had just stopped nursing my son in May). The rheumatologist said it was tough to tease out whether or not these symptoms were related to being a new Mom as they are also symptoms of an autoimmune disease. As such, she ordered a more comprehensive round of blood work and had me schedule a follow-up visit a few weeks later to discuss the results.
My husband and I met with her in mid-July and learned that I do have an autoimmune disease. My blood work showed certain antibodies (SSA and SSB to be exact) that indicated I do indeed have a glandular autoimmune disease called Sjogren’s Syndrome. As this is typically not diagnosed until a woman reaches menopause (less that 15% of women are diagnosed prior to the age of 35 and women are 9 times more likely than men to have this), I’m VERY fortunate to find out so early – especially since the symptoms I have were not all that noticeable (not bothersome enough to mention to my PCP during my annual physical).
My rheumatologist explained that some people are, for whatever reason, predisposed to autoimmune diseases. This does not mean that they will actually DEVELOP the autoimmune disease. What causes someone to develop the autoimmune disease is an environmental trigger like a severe trauma. She elaborated by saying that an autoimmune disease develops when the body “sees” the inside of its cells due to the cells exploding from an infection or rupturing from a trauma (such as being hurt in a car accident). When the body “sees” the inside of its cells, it begins an autoimmune response protecting itself against what it considers to be a foreign substance. In Sjogren’s Syndrome, it sends white blood cells to the glands causing them to become inflamed and ultimately, restricting their functionality. My rheumatologist surmised that the autoimmune disease I was predisposed for having (Sjogren's) was triggered during the c-section delivery of my son. At this time, there isn’t enough information to understand whether developing autoimmune diseases is genetic, but supposedly most people aren’t predisposed to autoimmune diseases, and most of those who are predisposed never have the disease triggered.
I’m still learning a lot about Sjogren’s – especially the things I need to watch out for. Mainly, I need to watch my stress level, as emotional or physical stress will put the disease into overdrive. Besides the fatigue and having dry eyes and mouth, I’m at an increased risk for cavities, as well as kidney, liver, heart, and glandular diseases (including lymphoma) so I’m trying to become educated on how this is going to impact me long term. There’s no reversing the symptoms I have now, but there is a medication called Plaquenil I can take (for the rest of my life) to slow or even stop the progression of my current symptoms and the onset of others.