“I was engulfed with pain.”
Michael Kuluva, the creative director for Los Angeles-based fashion brand Tumbler & Tipsy, was carrying his books across the campus when it happened: “My back just gave out,” says Kuluva. “I had immense pain, and I just [fell] to the sidewalk.”
At age 28 and a freshman at the Fashion Institute of Design & Merchandising, Kuluva didn’t have an arthritis diagnosis on his mind that day. Many people associate arthritis with aging, but there are more than 100 subtypes of arthritis and they can affect people of any age. Symptoms can begin suddenly with no warning.
One such subtype is rheumatoid arthritis (RA), which is an autoimmune disease that affects more than 1.3 million Americans, according to the American College of Rheumatology. Unlike osteoarthritis—the “wear and tear” arthritis that mostly affects people over 50—RA is typically diagnosed between the ages of 30 and 50. As an autoimmune disease, RA occurs when the immune system starts attacking the joints, causing inflammation and pain. (Learn more about what rheumatoid arthritis is here.)
“I pretty much grabbed everything, crawled to my car, put everything in it, and drove to the hospital,” recalls Kuluva.
The first step to getting an RA diagnosis was ruling out other possibilities. Due to the extreme pain Kuluva was in, a urologist first checked for kidney stones. When those tests turned out negative, the urologist referred Kuluva to a rheumatologist.
Symptoms of different kinds of arthritis can be similar during the early stages, but a trained rheumatologist can detect subtle differences. Doctors use these exams to test for and diagnose RA:
A physical exam checks for tenderness, swelling, warmth, or pain in the joints.
Imaging tests like X-rays, MRIs, and CT scans can detect joint damage, such as swelling of the soft tissue.
Blood tests can find biomarkers and antibodies, which are proteins the immune system releases when it believes the body is under attack. Antibodies are a strong signal for RA and are present in 60 to 70 percent of patients at diagnosis.
“Things started lighting up really fast like a Christmas tree,” says Kuluva. “I was engulfed with pain. My knees [and] my elbows started to hurt more, and they were stabbing pains.” With Kuluva’s pain and his test results, doctors settled on a diagnosis: rheumatoid arthritis and possibly fibromyalgia.
But Kuluva, who recently used his RA to inspire a fashion collection for New York Fashion Week, managed to find a silver lining. “Yes, it’s horrible—we all know that. It’s not something that anybody wants,” says Kuluva. “But at the same time, you can’t let it get in the way of your dreams.”
Adjusting any new diagnosis can be challenging, emotionally and physically. Here’s Kuluva’s advice for newly diagnosed patients with RA.
Do I have arthritis? Atlanta, GA: Arthritis Foundation. (Accessed on February 13, 2018 at https://www.arthritis.org/about-arthritis/understanding-arthritis/do-i-have-arthritis.php.)
Heidari B. Rheumatoid arthritis: early diagnosis and treatment outcomes. Caspian J Intern Med. 2011 Winter;2(1):161-170.
Osteoarthritis. Atlanta, GA: Centers for Disease Control and Prevention, 2018. (Accessed on February 13, 2018 at https://www.cdc.gov/arthritis/basics/osteoarthritis.htm.)
Rheumatoid arthritis. Atlanta, GA: American College of Rheumatology. (Accessed on February 13, 2018 at https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Rheumatoid-Arthritis.)