Rheumatoid arthritis patient grateful for being able to get her life back

MANILA, Philippines -  Sister Ma. Charisma Roslin found her calling early on in life when she joined the Servants of the Holy Eucharist. Here, she was able to fulfill her dream of both being close to God and serving the community.

Unlike other orders that spend majority of their days in quiet study and prayer, the sisters of Servants of the Holy Eucharist are also dedicated to their calling of ministering to prisons in various areas.

They commit themselves to the development of a correctional community among prisoners, their families, and the support community to help them experience the transforming presence of Christ in their lives and their relationships.

For Sister Roslin, being program director for restorative justice in Novaliches, it meant daily trips to the precincts and holding cells under her care, helping others, organizing volunteers, and supervising workshops, medicine drives, and feeding programs, among many others.

But six years ago, Sister Roslin felt a pain she had never experienced before. Her left wrist and her knees suddenly began to hurt. In the beginning she thought that perhaps she was just tired and needed to rest. But as the days went on, the pain intensified. What started off as a dull ache in her wrists and knees, it began to throb and consistently radiate pain. It wasn’t long before those body parts also began to swell.

“At first, I tried to just overcome the pain and not think about,” said Sister Roslin. “I thought perhaps I just needed some rest. But as time progressed, the pain became unbearable. Simple things became difficult for me. When we would walk to our community centers, I would suddenly lag behind. I had a hard time lifting heavy objects, and even writing on a blackboard. It was even hard for me to sweep floors in the convent. My wrists and knees hurt so much.”

She added: “I began to get severely depressed. And then, as if that was not bad enough, my knees began to inflame. They looked like tomatoes with water inside.”

Sister Roslin, who was always pleasant and a hard worker, began to change and this was noticed by her fellow sisters.

Sister Zenaida Cabrera, mother superior of the Sisters of the Holy Eucharist, shared: “Sister Roslin changed quite drastically when the pain began to intrude on her daily activities. She was irritable, depressed, and had difficulty fulfilling her duties, which she had done with relative ease and joy before.”

It was at that point that Sister Roslin decided to see a doctor. She consulted Dr. Rosario Baes, a rheumatologist at the Far Eastern University. It was then that she was officially diagnosed with rheumatoid arthritis (RA). 

The diagnosis came as a shock to her. She had mistakenly thought that arthritis is a disease that only affected the elderly. She never thought that it could happen to someone in her early forties. Once the diagnosis had been made, via several consultations and comprehensive tests, she began to work with Baes to find a suitable course of treatment that would prevent disease progression and help her alleviate the pain.

Search for best treatment

Sister Roslin tried several medications in the search for the treatment best suited for her. Many of them offered a little relief, but it was usually short-lived. Baes decided to try her on the new biologic drug, tocilizumab.

Tocilizumab is an intravenous therapy developed by Roche that specifically targets an inflammatory protein called Interleukin-6 (IL-6). This protein is said to be responsible for the inflammation and damage of joints in RA.

“When I was prescribed with this new medication, I was optimistic it could help me. I was praying for the pain to be relieved so I could get back to my daily routine and my duties in the ministry,” Sister Roslin recalled.

The initial infusions of tocilizumab granted Sister Roslin some respite by allowing her to sleep a bit more through the night and to begin minimal tasks like her sweeping duties in the convent and even some of her teaching duties.

But it did not alleviate the pain completely. However during her third and fourth infusions, she began to feel a change and her life slowly began to return to what it was like before her diagnosis.

“We noticed a great change in Sister Roslin when she was on the medication,” Sister Cabrera said. “Prior to her treatment I used to see her tossing and turning in bed from pain. From being happy and helpful, she became moody and irritable. Now, she is getting back to her old self again. She is more pleasant and is enjoying her ministry duties as she did before.”

“The medication changed everything,” Sister Roslin said. “Before taking it, I felt so helpless and depressed. I kept thinking I could never go back to my normal life and the pain was just going to be constant. Now, I am able to do the things I was worried I would not be able to do again.”

Tocilizumab helped Sister Roslin address and alleviate her pain. It also helped her achieve the best possible treatment rheumatoid arthritis patients can hope for — remission.

Since studies have shown that the disease is incurable, RA patients strive to successfully manage the pain and stop the disease’s progression. This is important because the disease is more than just the pain that the patient’s feel. If left untreated, RA will progress and could lead to irreversible joint damage.

In many cases, patients with RA are more likely to retire from the workforce or unable to do their daily tasks. The inability to do many regular activities has a tremendous impact on the patient’s life, resulting in problems with income, mood swings, and depression leading to compromises in the quality of life.

This need not be the case. With proper treatment and medication, RA can be sent into remission and life can go back to normal. In some cases, tocilizumab can even be taken alone without the support of other medications such as steroids and pain relievers like in Sister Roslin’s case.

“I was very happy to be able to stop taking prednisone,” Sister Roslin related. “While it was effective, it used to make me fully swell up. My entire face would get very large. I didn’t even look like myself.”

While Sister Roslin’s treatment is still continuing, and more maintenance infusions will still have to be given, the positive outcome of her treatment is already undeniable.

Rheumatoid arthritis can be a painful and even debilitating experience for many patients, but it does not have to be the end of normal life. With proper treatment and medication, pain may not only be alleviated, but RA can also be sent into remission.

While the occasional flare-up will still occur, life is otherwise back to normal for Sister Roslin. She is grateful to be able to fulfill her vocational calling once again through advances in technology and medication as shown by tocilizumab.

Today, she is back attending to the community and doing her missionary work. She is back to fulfilling her life’s mission of serving others.