16 Jan

Billy Mitchell Posted in ANA

The Dilemma of lab testing in rheumatology and chronic illness

What you’re looking at here are autoantibody results, diagnosis – lupus and Hashimoto’s Thyroiditis. Her symptom cluster? A smoldering process cruising along for decades, with interspersed crashes along the way. Vague… flu like symptoms, odd skin sensations, episodic chest pain, widespread pain. Geez… it could be anything! Her physical exam is unrevealing, her other laboratoryRead more about The Dilemma of lab testing in rheumatology and chronic illness[…]

04 Jul

Billy Mitchell Posted in rheumatoid arthritis

Eileen Laird and her story in making the decision to start medication for Rheumatoid Arthritis

Some of my own rambling here… An incredibly difficult decision made by those wrestling autoimmune disease is committing to medications. While some make the decision without hestitation, it is important to recognize and respect different neurotypes, philosophies, traditions and preferences. Additionally, the overwhelming amount of information we have at our fingertips with the internet, theRead more about Eileen Laird and her story in making the decision to start medication for Rheumatoid Arthritis[…]

20 Mar

Billy Mitchell Posted in Autoimmune

I have an autoimmune disease. When should I consider a medication?

How does one know if medication should be thrown into the mix? Life isn’t fair. Jack can smoke, drink, live off ding dongs, mocha chokas with extra yocas and dance across the finish line. Jane has a gluten free oreo once in a blue moon and will crawl across the finish line. Some fortunate soulsRead more about I have an autoimmune disease. When should I consider a medication?[…]

06 Mar

Billy Mitchell Posted in Fibromyalgia

Fibromyalgia is often merely a symptom!

Recall what fibromyalgia is… Otherwise referred sometimes referred simply as central sensitization. It is a very real condition, still thought to be fictitious by many practitioners out there. A condition of the central nervous system An analogy that I did not have the genius to create- “the volume dials in the brain for pain perceptionRead more about Fibromyalgia is often merely a symptom![…]

19 Dec

Billy Mitchell Posted in ankylosing spondylitis

Hyper-empathy hurts… is it in the way of your remission?

One of my observations so far as a clinician has been that many women on the autoimmune and hypermobility spectrum trend more towards hyper-empathy. What do we mean when we refer to the hyper-empath? The ability to express empathy occurs on a spectrum from low to high, the result of a number of different factors…Read more about Hyper-empathy hurts… is it in the way of your remission?[…]

01 Nov

Billy Mitchell Posted in ANA

What you need to know about positive ANA

Isn’t that the one that means lupus? The answer is yes and no. If you’re a patient who has long been tumbling down the rheumatology rabbit hole, you are likely already familiar the above answer. Rheumatology is heavy in the shades of grey. For the latest of you, prime yourself for the grey! ANAs areRead more about What you need to know about positive ANA[…]

21 Oct

Billy Mitchell Posted in Robust

Are you exercising this muscle?

Pearls from a wise man… Most Sundays, I have long conversations with my grandfather about all sorts of things. He was a clinical psychologist, a military man in his younger days and now mostly just a geek. He drops wisdom bombs the whole time. Something really neat I learned from him: Tucked away in ourRead more about Are you exercising this muscle?[…]

06 Sep

Billy Mitchell Posted in Psoriasis

Psoriatic Arthritis and Enthesopathy

You’re looking at a radiograph here of the right foot of a male diagnosed with psoriatic arthritis. Note the bone spur on the back of the heel, resultant from chronic inflammation of the achilles tendon enthesis. Psoriatic arthritis belongs to a family of diseases we called Spondyloarthopathy (SpA). Other diseases under the SpARead more about Psoriatic Arthritis and Enthesopathy[…]

31 Aug

Billy Mitchell Posted in Psoriasis

Essure Device and Arthritis

What you’re looking at here is an x-ray of a left foot in a peri menopausal woman with Psoriatic Arthritis (PsA). The joint I circled has a classic finding we call “pencil and cup deformity.” Her joint pain and swelling affects her wrist, an elbow, a few fingers and both feet in an asymmetrical fashion.Read more about Essure Device and Arthritis[…]

10 Aug

Billy Mitchell Posted in Robust

The concept of invisible illness

Just as oblivious as everyone else… Shortly after I finished my training, I met my very first patient with invisible illness in what then seemed to be the most unlikely of places. We climbed together at a bouldering gym for about an hour and had a neat conversation. She appeared healthy and fit, in factRead more about The concept of invisible illness[…]