Trusting the Experts

Betsy Randolph has always been an active person; running, gardening, and working out at the gym. She is a lieutenant and former spokesperson for the Oklahoma Highway Patrol and served 12 years in the U.S. Army Reserves as a military police officer and drill sergeant. Being active, Betsy sometimes got injured; however, she noticed she wasn’t healing as quickly as she used to. She also noticed that her injuries seemed severe. “My ligaments, cartilage and tendons tore easy,” said Betsy. Between 1995 and 2011, Betsy underwent six knee surgeries, a hip surgery, two wrist, two elbow, and one finger surgery. “The injuries and subsequent surgeries were taking a toll on my body,” she said. “I couldn’t run or work out without pain any longer. And it was getting harder to do my job—which is sometimes very physical.” No one could pin point what exactly was wrong.

Betsy came to the Oklahoma Arthritis Center in July of 2011, after her finger reconstruction surgery. She wasn’t healing correctly. She developed a boutonniere deformity on her finger and was seeking answers. Years before she consulted with a different rheumatologist after hip surgery. She was very stiff from swelling in the joint to the point that one pant leg was always tight. She was miserable, but she received no answers and no treatment path. After explaining her concerns, Dr. Carson ran several tests and Betsy followed up with Cindy Hagan, PA-C. When Betsy received the diagnosis of Rheumatoid Arthritis (RA) she was shocked. “I was just flabbergasted,” she said. “This can’t be right.” She never suspected she had RA.

That same year, Betsy’s Great Aunt Pat died in New Mexico. Pat was in her 80’s and very crippled and debilitated with Rheumatoid Arthritis. Now Betsy had the same diagnosis. “I was terrified. My Aunt Pat’s hands were always gnarled up. She was crippled. It’s all I ever knew of her.” Betsy said she was in denial but admitted she was in slow motion in the mornings. She suffered from chronic fatigue, stiff, sore joints, and she wasn’t sleeping. “Arthritis was kicking my butt. It seemed like all my joints were hurting and I wasn’t pleasant to anyone, especially my family.”

Dr. Carson started Betsy on DMARDs (disease-modifying anti-rheumatic drugs). They tried Plaquenil, Methotrexate, Enbrel, Humira, Simponi Aria, and Xeljanz. Each drug presented with side effects which Betsy could not tolerate. “I knew I was going to be a difficult patient because of my allergic reactions to medication. And I have some serious trust issues, as well” she said. “I suppose it’s because of the work I do.” Dr. Carson convinced Betsy to try Remicade infusions.

In December of 2017, Betsy started having heavy, burning, lung pain. She felt like her lungs were on fire. Her throat burned and her eyes were red. She spent the weekend near a campfire and was sure that had something to do with her symptoms. Betsy went to see Dr. Carson again. He ordered a series of pulmonary tests including a lung and nasal biopsy. The tests concluded Betsy was suffering from chronic inflammation in her lungs. “RA has decided to attack your lungs,” said Dr. Carson. He encouraged her to try Remicade again.

“Honestly, I didn’t believe him,” said Betsy. “It made more sense to me that it (the burning lung pain) was from the Remicade infusion, the exposure to the fire, chemicals, or even bug spray. I was sure he was wrong.” Betsy went home and spent time researching her symptoms and treatment options on WebMD and the Mayo Clinic. So much so that, “My husband asked me how I was coming along with my medical degree,” she laughed.

Betsy Randolph with actor Tom Selleck.

Betsy’s research led her to believe that Rituxan was the answer. She returned to Dr. Carson’s office and insisting to try Rituxan. “Dr. Carson disagreed with me right away. He told me Remicade was a better choice and that Rituxan could cause trouble,” she said. She had no evidence of pulmonary nodules which Rituxan treats, but Betsy insisted. Dr. Carson allowed her to be active in her treatment decisions and she tried Rituxan. “It did nothing for me. While I was getting the infusion, my blood pressure dropped really low. Dr. Carson came right in and we stopped the infusion,” said Betsy. He reminded Betsy of the risks of Rituxan and encouraged Betsy to go back to the Remicade. “Trust me, Betsy. Just trust me,” said Dr. Carson.

Betsy finally relented and agreed to try Remicade again. Her husband still reminds her not to rely on her own medical degree. She agrees, “I plan to stick to law enforcement and leave medicine to the experts,” said Betsy. “I’ll be back for another Remicade infusion soon. I look back now and have so much more trust than before.”

She is relieved to be on a treatment path to slow the progression of her RA. With treatment, she hopes to work longer, ride motorcycles—alongside her husband, piddle in the garden, and enjoy her grandkids. Betsy also plans to pursue her writing career, her work can be found on her website http://betsyrandolph.com.

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