After consulting the ophthalmologists on the implications of HLA-B27, it was time for a formal diagnosis for the disease as a whole and not just the uveitis. We made an appointment at New York University Langone Medical Center Dept. of Rheumatology in Manhattan. Along with blood work, a full chest and spine x-ray and a urine sample, the doctor was quick to agree that the symptoms Dad had been seeing over time along with the HLA-B27+ marker were definitely attributed to one of the several diseases classified under the spondyloarthropathies. To test the advancement of the disease in the spine, he tested the range of his vertebrae (see: bend over and touch your toes!) to make sure there was still significant expansion (the ability for the vertebrae to separate from each other). Patients with advanced ankylosing spondylitis have vertebrae that fuse and therefore they cannot move apart from each other.
Thankfully, Dad is not a member of this category. All things considered, the state of Dad’s body is actually pretty darn good. X-Rays showed that there is only mild disc degeneration at C5-C6 vertebrae which is where he feels most of his pain. I am frankly thrilled that we caught it in time before it became more debilitating. I am ready for us to take charge of life and be able to eat and move and keep on showing up to gymnastics meets, soccer games, and for us to be able to cannonball into the pool in the summer and build snowmen in the winter.
To confirm the diagnosis and to hone in on whether Dad’s illness is specifically ankylosing spondylitis or IBD-related arthritis or something else in the spondyloarthropathy category, he will need to meet with a gastroenterologist and have a colonoscopy to see the state of his gut. Stay tuned! After that, the doctor will be comfortable prescribing a biologic called Humira to manage symptoms. However, because this medication is an immunosuppressant, we are going to take charge of symptoms primarily with diet first. This led us to discover The Low-FODMAP Diet, but more on that in the next post! We are so excited to share our meal planning into the future with you!
**We are so grateful to the staff at New York University Langone Medical Center Dept. of Rheumatology who were so intelligent, competent, and accommodating to us. WE want to give particular thanks to Dr. Samuels who listened to all of the explanations of symptoms and worked with us to achieve a diagnosis.