Pneumonia in July 2010 totally out of the blue had not been sick, actually was never really ill my entire life and had never had pneumonia. I hadn't had antibiotics for 15yrs at least and no over the counter drugs in my system. The out of the blue pneumonia was fast developing and hard and I was on two very strong oral antibiotics and going into the doctors office for rocephin injections and nebulizer treatments and when all was said and done after a month of heavy hitting antibiotics my immune system was out of control and has never recovered. My RA would be classified as Reactive Arthritis only it isn't behaving as Reactive A and going away as it should so I am classified as sero-negative RA and have some bone erosion that happened in the first year of my disease. So I don't fit any patterns and treatment has been a challenge. Currently on Orencia but it is no longer working and waiting for Rituxan to be set up. Another long process of hurry up and wait.

I honestly believe I had RA most of my life (lots of childhood symptoms that were never reported or acted on). I had seen a PCP about 2 yrs before my DX with RA, who said he thought that I probably had RA then as my sed rate was elevated rbc's were low & I had some symptoms, but we didn't pursue the DX. (I totally refused to even think about me having RA after seeing my mom struggle with it for yrs!).
So back to what triggered mine---My husband and I had gone on a Fall camping trip, there was a storm and the power went out, we were in a camper, and I got extremely COLD that night. At first daylight we packed up and headed for home. After all the unpacking etc, I layed down for nap and when I woke up I had so much pain (all joints) that I really thought I was gonna die! Luckily I got in with my doc who ran bloodwork ect, the RF was + and the sed rate was elevated, all the right symptoms, so he treated me and gave me referral to rheumatologist. The rheumy concurred with DX, and so my RA journey began. Let me add also that I had been running a low grade fever daily for months before and during all this. So in my case maybe being that cold counted as physical trauma/stress or maybe a virus (the long term fever), I'm not sure.
And yes, maybe you're on to something ? It's all very complicated to be sure.

I went thru the process of elimination.
I had been having problems for years....getting sick way too often-pneumonia twice last year, joint/bone/muscle pain, numbness/tingling, limbs going to sleep, mixing up words-losing words, EXTREME fatigue episodes with flu like symptoms 1-2 times a year with severe residual effects lasting for months. The cold hurt my bones/muscles/joints but the heat just knocks me down to the ground!

I decided to find out what was wrong. The episodes were getting more severe and was taking longer to recover - sometimes I felt like there was no recovery.

I knew I had thyroid problems - my ob/gyn had been prescribing meds for several years. My sister works for an Endocrinologist. So I went to see him. Turns out I had Hashimotos along with being Hypothyroid....changed med from Levothyroxine to Synthroid name brand and all was better. My endo doctor didn't think the bone/muscle/joint and extreme fatigue episodes was from thyroid. So I decided to find a Rheumatologist.

I faxed a letter to a Rheumy with my symptoms...they called and made me an appt. Dr. Rheumy thought he could help with "some" of my symptoms. And he was right. Blood works shows RA. Meds have helped. But he thinks I have something else going on.

I believe I've had some low-lying autoimmune tendencies all my life and that stress brings it to the fore. When my first child (special needs) started kindergarden, I got shingles in my eye and was left with a contained autoimmune disorder in my eye. It's been over a decade and I still use drops to maintain. When we had to choose a college for the same child last spring, the pain all started the very month we visited schools and made a decision. I was diagnosed with RA in mid-July. So far I'm responding well to Plaquenil.

I'm a pretty laid-back person for the most part, but clearly there is some stress that pushes my autoimmune buttons. And pre-menopause isn't helping calm the waters at all!

The trigger for me was menopause. Hormones can change your immune system. About a year before everything stopped I would get sore joints. I thought I was pulling muscles. They would get red and hot to the touch. They would only last a day then be gone. I took Ibuprophen and it calmed it down. How i got diagnosed was my right calf got very swollen. My pcp thought I had a blood clot in my calf. I went for an ultrasound and all they found was much fluid around my knee that was causing my calf to swell. He sent me to an orthapedic surgeon to have it drained and a cortisone shot. Then he had me go to a Rheumatologist. They did the blood work and it showed all the RA factors. The first couple of years I would not take any of the meds. My Advil was keeping it under control. Then it got worse and I started meds like Plaqinal, Sulfa, Arava and MTX. None of those meds agreed with me. Then I started Enbrel and it was like my RA was gone over night. I have been on it for about 3 years off and on now.

Probably most of my life if I piece everything together. Was a sick kid with multiple bouts of pneumonia & tonsillitis every year. Always picked up every illness that was around me. Had weak joint & hip problems as a kid. Mother was forever taking me to a chiropractor.Had migraines for over 20yrs. In my early 20s drs thought I had Epstein Barr and just gave up testing & dx'd me with chronic fatigue. A few years after that came alopecia with 2 recurrences since. Sacroiliitis during and after my pregnancy. Pre-eclampsia during that same pregnancy. Heart attack during delivery. A car accident in 2009 really set the symptoms off. Strange pains & swelling. Diagnosed in 2010.

51% Ok, so here's another theory....for you.

Infectious mononucleosis is a common infection that results in fever, sore throat, and cervical lymphadenopathy accompanied by a lymphocytosis.

Etiology

The causative agent of infectious mononucleosis is "Epstein-Barr virus" (known as EBV or human herpes virus 4 [HHV-4]).

EBV initiates B lymphocyte proliferation (plasma cells) and immortalization (memory B lymphocyte) without the role of T-helper cells. EBV is a B-cell mitogen that can cause many B lymphocytes to become antibody-producing plasma cells.http://www.atsu.edu/faculty/chamber...

So based on this 5 minute read I did I wonder if rituxin or bynlysta, both selective b cell inhibitors, would be effective for you personally since your original trigger virus set off a b cell reaction and specifically did not include t cells, which orencia would target.


Anyway, that's becoming my take on this....hopefullly I can experiment with the bio one day and test my theory out.

After almost 3 years now, and so much time researching and thinking about the cause for me, it come down to one thing - stress. I was never a stressful person, but back about 4 years ago there was a slight change in my job which brought myself a lot of stress. There was a schedule implemented with a daily deadline was impossible to meet. I didn't realize it at the time, but it makes perfect sense now when looking back.

I think Mono too... in my 20's.

My labs showed an antibody for mono but I cant remember ever having it. Dr said I must've been exposed or it wouldn't be there. My white cell count was through the roof that's what started the testing. But they gave up in frustration. Infectious disease Dr who said there's 1000s of unknown viruses and he couldn't test for all of them. This was yrs ago though. Hopefully they've made progress since.

Geez, it took awhile to add my comment. Homer, my dog, decided that right now was the time for cuddles and kisses and climbed into my lap. He was very persistent about it and when I tried to push him off...........he wrapped both paws around my neck, hanging on tight and head nudging me when I tried to get him off. Awwww, sweet little dog, right? Not so much. He's a 60 pound mutt-aka: wanta be Chihuahua.
So instead of typing a reply, I ended up wrestling with him. He won. 15 minutes later, I'm back.

I think mine started in my 30's. I was an avid runner and lifted weights 3x a week. I was in great shape but I started aching badly after each workout. After months of making excuses, I saw a doctor. He did x-rays and ton of blood work, all negative. He told me way back then that he still believed it was some type of arthritis.

Fast forward a few years and I had a new doctor. She said it was fibromyalgia and treated me for that with no success.

After several more years of steadily worsening aches and pains and fatigue and on and off fever..........I was finally diagnosed with RA. It was a long, steady but slow, progression for me. No big Ah-Ha! moment to look back on.

This is a fascinating discussion.

Here's my theory about my trigger: In April 2012 I had a total knee replacement surgery on the right knee. The pain was not well managed. It took me several months before I felt like I was turning a corner and healing. My body was really traumatized by the surgery. If you want to see the surgery, search for TKA on YouTube. Fall of 2012 I noticed a problem in my left wrist that I attributed to overuse. Spring of 2013 I was preparing for my last professional keynote speech at a conference in Canada. Stress. Three days after returning home in June, I could barely move.

I think the knee surgery was an incredible trauma and threw my body into a tailspin. Eventually my immune system cranked itself way up and never came down.

i don't know. i wasn't a sick kid. in middle and high school, i developed asthma and had a couple of bouts of asthmatic bronchitis and pneumonia. when i started smoking, i'd get bronchitis at least once a year every year. in my 20s, i had a few sinus infections, my yearly fight with bronchitis, a couple of ear infections. at 24 and 25, six months apart, i was in two bad car accidents and had a total of 6 herniated disks, both lower and upper, as well as two cases of whiplash and a concussion that we hypothesize has affected my brain function.

at 27, i developed a RIDICULOUS ear infection that caused very high fevers and extreme pain. i believe my eardrum ruptured; i was bleeding from my ear but by the time i was finally referred to an ENT, he said he didn't see anything. i was in bed with little to no hearing in my left ear for almost six weeks. i was on more oral antibiotics and aural antibiotic drops than i can remember. my hearing came back; tests showed it was normal but i am still convinced i have hearing loss in that ear. at 29 i had a pretty nasty case of H1N1/swine flu.

fast forward to age 32. i developed serious pain in my abdomen that turned out to be a gallbladder issue. i had tons of tiny stones and a bunch of sludge. i was dx'd in august and put off the surgery because i was terrified until november. the biggest thing i'd had done before then was a simple wisdom tooth extraction. november '12 i had a laparoscopic cholecystectomy that went well. january '13 i had endometrial ablation, again the procedure went well and i healed well.

also, from august 2011 to a couple of months ago, i have been tattooed regularly. like every couple of weeks. and my tattoos have all healed well (except for one; we think that was a reaction to the ink). my point in adding that is that my immune system was always able to heal my tattoos and my piercings. i had a moderately large tattoo done august 2013 that seemed to heal a little slow, but it was a large piece for me. i figured that was the issue. at first i thought the procedures done in nov/jan so close together pissed my body off; but i had been healing tattoos normally after those procedures - my immune system was reacting normally. i started noticing pain march '13, so the timing would be right - i just don't understand how my body could have healed all that other crap 'normally' but be triggered by the two procedures.

Interesting discussion. I've thought about this often. I've always been pretty healthy. Started having pain in my hands and feet over a year ago-maybe 2-3. Chalked it up to getting old. Then in June, I took a big hit to my left knee (darn cute little kid running out of the waves!) Within a month, both knees were so swollen and painful that I could barely walk. Diagnosed in August and started treatment at the end of the month. Starting to think that things were getting better and...fell. Hurt my wrist and back downhill. Finally feeling better now, but think humira has a lot to do with that!

For my mother it was stress from the death of my brother at age 16.

Me, well I first got symptoms right after nasty divorce.... It was obviously interleukin 6 since Minocin was an effective treatment, and that's what it inhibits. Took me ten years to discover root cause of symptoms which happened to be food allergies. One strong positive was to barley, and I've learned that most processed wheat products contain barley flour. So everyday for all those years I was consuming a product that raised my interleukin 6 levels and caused my RA inflammation.

Now with the results of allergy tests, I can try and avoid most of my triggers.... and stay in true natural remission for as long as I can!

It's been a long 12 years of discovery!