“Is she going to live?” Knight asked her. “She has a child.”
“Look, it’s going to be OK,” the first year fellow in rheumatology told him. “I was here. I have this disease, and I was here and I got better.”
It’s not something Machua does often, sharing her lupus diagnosis with patients. Even though she will be making a presentation at a Living with Lupus Symposium at the university March 22, she is not sure whether she will talk about her disease and might stick with her talk on vaccines.
The disease has had a big effect on her medical career, though. Lupus is an autoimmune disease in which the body’s immune system attacks different tissues and organs, so it can have a wide range of symptoms and severity.
Machua was in her fourth year at Morehouse School of Medicine when she awoke one day with great pain in her joints. She attributed it to doing tae bo every morning, but then her joints started to swell. Later, Machua had trouble breathing, and doctors thought she had pneumonia and she ended up in the hospital with a breathing tube.
“It felt like I was drowning,” Machua said.
Knight’s daughter, Tami Harrison, can relate. She had a host of symptoms, starting with severe fatigue, that led to her getting fired from jobs.
“Everyone thought I was just lazy,” Harrison said. “Everybody kind of shunned me because I never wanted to do anything. I just didn’t have any energy to keep up with anything.”
She would get nosebleeds and had blood in her urine and was diagnosed with a sinus infection and a urinary tract infection. Then she started coughing up blood.
“I didn’t even know I was bleeding internally,” Harrison said. “I had no clue.”
Neither did the emergency rooms she ended up in. It wasn’t until she got to Georgia Regents that she was diagnosed with lupus.
“It is different for every patient, but then they are very nonspecific symptoms that overlap with many diseases,” Machua said. “It mimics a lot of other diseases. It’s a very significant diagnosis, so it is not the first thing people jump on.”
There are only two drugs specifically approved by the Food and Drug Administration for treating lupus, but physicians can draw on a host of other medications, such as steroids, to help treat symptoms. Harrison said she is feeling much better now, nearly three months after her diagnosis.
“I love not coughing” – and then looking for blood, she said.
The aim is to get Harrison into remission, Machua said.
“A state where the disease is not active – that’s our goal,” she said. “I consider myself to be in remission.”
It’s not that unusual for physicians who have a medical condition to specialize in that field, said Dr. Alyce Oliver, a rheumatologist at Georgia Regents who went into the field because she has rheumatoid arthritis. But does it make them better doctors?
“I would like to think so, that we can be more empathetic since we have been there and we often know the treatments, the pain that may be associated with the condition,” Oliver said. “On a more positive note, we also know that you can still go beyond the disease and excel in school and in a career if that’s what you want to do.”
It might play more into what physicians like to call “the art of medicine,” knowing how to treat patients beyond just the science, which is particularly important in rheumatology, Oliver said.
“We still have a lot to learn about autoimmune diseases,” she said. “Some of our treatments are still a work in progress. Definitely that is the art of it.”
Because the lupus struck just before Machua would be applying to residencies, it delayed her from getting into a residency for two years. During that time, her focus shifted from psychiatry to rheumatology.
“Then I decided, you know, maybe I can make a difference,” Machua said.