Nicky
Nicky has Behçet’s disease, a type of systemic vasculitis with symptoms including ulcers, swelling, rashes and fatigue. Nicky is grateful to the dentist who recognised that she needed specialist investigation and treatment.
When Nicky was diagnosed with Behçet’s disease, she says she just about danced out of the hospital. Although she understood it was reasonably serious and couldn’t be cured, she now knew that something could be done about the symptoms she had had for 30 years. She says it was only when the disease was brought under control that she realised quite how ill and miserable she had felt.
The symptoms included diabolica mouth ulcers which would go from a normal crop of around 10, to being all down her throat. This made it difficult to speak, eat, brush her teeth and swallow. Similarly, genital ulcers made it painful and uncomfortable to sit. Sores on her fingers meant at times she couldn’t hold a pencil and was embarrassed to shake hands. Alongside this came crippling tiredness and headaches, a particular challenge given the long hours and demands of working in the police and Special Branch.
Nicky is disappointed that a GP suggested mouthwash as a solution but is grateful to her dentist who asked for a specialist opinion. She says everything fell into place when the dental hospital referred her to an immunologist. Investigations included a pathergy test (skin pricks) and a biopsy. The immunologist diagnosed Behçet’s and, supported by a specialist Behçet’s centre, started Nicky on treatment.
Unfortunately, none of the standard immunosuppressants worked and, while steroids (prednisolone) helped, Nicky put on a lot of weight. Moving to infliximab, a biologic drug which suppresses the immune system, worked a treat Two years ago Nicky changed to another biologic drug, adalimumab, which she self-injects once a fortnight. This means that, instead of making the long journey to the immunology department at the hospital every six weeks for the infliximab infusion, her appointments are now every three months.
Nicky is pleased that the adalimumab is keeping her Behçet’s symptoms under control, along with a steroid cream as needed for genital ulcers. However, she knows from experience that stress can lead to a major flare. She feels that running her own business means she cannot afford to take time off work, so does what she can to reduce and manage her commitments.
Nicky can now enjoy again things her mouth ulcers used to make difficult, from eating citrus fruits to playing the oboe. She feels her future is relatively bright and is looking forward to doing more travelling once COVID-19 pandemic restrictions allow. She urges people not to feel they just have to put up with persistent ulcers. She would also like medical professionals to be more aware of what such symptoms might indicate.