Why Doctors Kept Dismissing My Joint Pain — And How I Got Diagnosed With Psoriatic Arthritis at 26

Can you get arthritis in your 20s? The answer is yes — and Ayda's story proves it.

In this powerful episode of THRIVING WITH ARTHRITIS, Dr. Diana Girnita sits down with Ayda, who was diagnosed with psoriatic arthritis at age 26 after months of severe joint pain, swollen fingers, and dismissive medical encounters. If you're a young adult experiencing unexplained joint pain, fatigue, or skin symptoms — this episode was made for you.

Ayda opens up about the moment she knew something was deeply wrong, the frustration of being told "you're too young for arthritis," and the long road to finally receiving a proper diagnosis. 

Together, she and Dr. Girnita unpack what psoriatic arthritis really looks like in young adults, why it's so often missed, and what you can do right now to advocate for yourself.

In this episode, you'll learn:

• What the early warning signs of psoriatic arthritis look like in your 20s and 30s
• Why blood tests alone can't diagnose autoimmune arthritis — and what a clinical exam actually reveals
• How to talk to your doctor when you feel dismissed or unheard
• The truth about biologic medications, injections, and long-term side effects
• Whether telemedicine or telehealth can effectively assess joint disease (spoiler: yes)
• How diet, lifestyle, and anti-inflammatory habits can reduce flares
• What happened when Ayda finally started the right treatment — and got her life back

This episode is essential listening for anyone navigating a new autoimmune diagnosis, struggling with chronic joint pain, psoriasis or wondering whether their symptoms could be more than just stress or overuse.

Whether you've been recently diagnosed with psoriatic arthritis, rheumatoid arthritis, or are still searching for answers — you are not alone, and help is available.

Subscribe for upcoming episodes on living well with arthritis and autoimmune disease. 

💬 Leave a comment — have you experienced dismissal from doctors? Share your story below. 

Transcript

Diana Girnita:
Where you notice that there is something wrong. My knee was ballooning and was tingling and had all this really severe intense pain. When you deal with autoimmune diseases, those are complex diseases, not something that you see immediately. Yeah, there's no cure. It's just you're going to have to take some sort of medicine for periods of time. What scared you the most? I was like, I don't really want to be on a medicine every day for the rest of my life. I did the classic Google search and she found you and your YouTube channel. I appreciate that kind of approach. With your experience and your expertise showing you just my hands and my feet and my knees, you explain everything so detailed. Your story, in many ways, unique, but it will resonate with a lot of people.

Most people think that arthritis happens only to your grandmother, a stiff knee here, a sore joint there, just an inevitable march of time. But what happens when you are in your 20s climbing a career ladder? When you are planning for your future, a family, kids, and your body starts turning against you. When the pain is real and you know that, but the doctors will say that you're too young for this when inflammation is stealing your mornings and you are told that it's probably stress or is just in your head. Today, I'm sitting with Aida. She is a very dear patient of mine who not only that she lived this nightmare, but found her way out of it. And what she's going to share with you. You might be familiar with that, but listen to this episode of Thriving with Arthritis because you're going to learn a lot from her challenges and how she went from being dismissed and disabled to reclaiming her life. Aida, welcome to the show, Thriving with Arthritis. Thank you so much, Dr. G. I'm excited to be here. I want to say that I am really happy that you accepted my invitation because your story is in many ways unique, but it will resonate with a lot of people. Before we dig into the story, can you tell us a little bit about you? Yeah, of course. So I'm Ida as Dr. G mentioned. I'm 28 and I'm living here in San Francisco. And about two years ago, I was diagnosed with psoriatic arthritis after having psoriasis basically my whole life since I was three. Not in a really bad state. I had a couple patches of that dry skin that everyone loves, nose, on my neck and on my elbows. But it didn't progress until a couple years ago when I started to notice some joint pain. But other than that, that's my quick little intro.

But when did you start something is wrong with your body? You're used to those patches of psoriasis, but there must be a point in your journey where you notice that there is something wrong. Yes. So about a couple of years ago in the summer, one of my friends was visiting. And if you've ever visited San Francisco, we're known for the many hills and walking everywhere in the city. And I noticed that after a day of walking up and down all those hills, my knee started to tingle and was giving some pretty just intense sharp pains, but the tingling was what kind of made me a little nervous because with psoriasis, some joint pain and achy joints is pretty common, but it goes away. But the tingling made me a little nervous. And so I remember calling my mom and freaking out. as anyone probably would, and I actually took myself to the ER because it was a feeling I'd never experienced before. And as most autoimmune disease patients might know, a lot of times your blood work actually comes back pretty normal. And so after spending countless hours at the ER, I'll never forget this nurse came back into my room and had to discharge me because nothing on paper was wrong, but clearly something was wrong because my knee was ballooning and was tingling and had all this really severe intense pain. And I remember she gave me the advice of, know, when you walk out of here, you really have to be your own like accountability partner and like keep advocating for yourself because while nothing on paper, your blood work is coming back normal, this isn't normal. And so she gave me that advice and I'll always thank her for kind of giving me that little push that I needed because ever since then, the pain started to progress past my knee and into my hands and into my toes, mostly on my right side. But then in a matter of months, it progressed pretty severely and I had no explanation as to why. So at some point you probably went to see a doctor. How long after that year visit, you went to see your family physician or did you go directly to a rheumatologist? What happened? So I did the classic Google search, which you probably should never do, but I was a little under the weather this week. I did the classic Google search and I remember just looking up every single type of thing possible. But one of them was psoriatic arthritis and I was like, why psoriasis and this feels like arthritis. So what are the odds? It's that. And I remember being in San Francisco. I don't have all of my physicians here. I'm originally from Southern California and I didn't have a rheumatologist. And so I Googled and tried to find any rheumatologist in my primary, had written a letter of recommendation and sent all of my blood work. because you have to go through a referral process to go to any of these clinics. And I remember finding one maybe months later. It's a lengthy process. And it's also one where everyone has a very urgent case to see a rheumatologist, but when you go through that referral process, it does take months. And I remember walking into the appointment and I laid on the table and showed her my joints, like my hands and my toes, my knees. And in span of five minutes, she's like, yep, it's psoriatic arthritis. And now, very quickly, we went into like medicine choices and all the different meds that we could take. I also want to note that for months I'd been going to an acupuncture studio, I'd been seeing a nutritionist. I really wanted to holistically solve this. before kind of falling into just taking a medicine because a lot of these medicines are, as you're told, everyday for the rest of your life. And at the time I was 26 and I was like, I don't really want to be on a medicine everyday for the rest of my life. So no, she didn't tell me what it meant or even if it was confirmed. I remember asking like, Is there a way to know? And she's like, it's a clinical diagnosis. Like I'm diagnosing that. But in my head, I'm like, well, who are you? And why are you, why do you know this right off the bat? Not saying that she didn't have a great medical like biography and history, but in my head being 26 and like now having that be told that that's my diagnosis, I'm like, are you sure? Like, is there multiple tests I can take to double check that? Because I don't know if I really want this to be my diagnosis. I thought it. But now that you're telling me it, it's a little scary. But I remember she sat me down and told me about all the drugs on the market. And if you've ever looked at any of the side effects of those drugs, they're not very friendly. They're not appealing. They're not something at 26 and I was single and I was going and I'm going to an office every day, like I don't really want to focus on some of those side effects because it's so debilitating to my everyday life. When you were Googling the signs of the disease, what scared you the most? That's a good question. I think the weight of this being a forever thing is what scared me the most. You know, when you're younger, you're like, don't crack your knuckles or else you'll get arthritis. But not until you're in your like sixties, like sixties or seventies, maybe fifties. But to be diagnosed with a form of arthritis at 26, you're like, like I'm a very active person. I grew up competing in a few sports my entire life and I live a very active lifestyle and The idea that my joints are just slowly debilitating and getting worse and worse was very scary because in my head I'm like, at 50 then what am I going to do? And so I think that was probably my biggest fear and that there's just no, there's no medicine that's meant, I mean, there's some drugs on the market that are meant for this now, but again- There is no cure. Yeah, there's no cure. It's just- You're going to have to take some sort of medicine for periods of time to just do the things that you normally would do on any given day. And when you start thinking about medication and the option of medication was presented to you in your first appointment, you went home and you started to Google. What did you discover? What scared you about medication? all of them have really gross descriptions of bowel movements. not to be gross, but in my eyes I'm like, my goodness, am I gonna have no control over my body taking these drugs? Like every day for the first 30 days, I remember it was just side effect after side effect that I'm reading. And then if that doesn't work, then there's injection options, which I'm actually on now, but I'm really afraid of needles and the idea of self-injecting was something that I really didn't wanna do. And then you start reading more and there are all these drugs that you see on commercials when you're watching TV and you're like, I'm gonna be one of those people. I'm going to be a commercial drug. So those are probably my initial Google thoughts. I'm like, okay. crazy side effects, options are limited and it's broadcasted on cable commercials every day. And did you follow with the rheumatologist? How often did you see the rheumatologist? After she gave me a few brochures, I went with a drug that actually wasn't really intended for PSA. And after I think it was through a portal or maybe one other visit, we agreed to start with that one drug and never saw her again. And that's pretty much my experience, which is very different from our experience together. Why did you decide to change? You know, I'm curious. Most people, would, you know, follow the traditional medicine. They will wait for months to see the rheumatologist. Were you able to get in contact with her, kind of share what your fears were? Did you ask questions? Yes. I mean, you know me and you know my mom. We are question heavy. We always want to make sure that we're doing... educated, I would say. We're educated. and you want to make a decision based on information that is reliable. And I appreciate that kind of approach. I mean, it's my body. I want to make sure I'm taking the right thing for me. I understand what I'm taking because I do have a very sensitive body, as you know. If there's a side effect listed, I will probably experience it. And if there isn't a side effect listed, I will probably discover a new side effect. That's kind of been my experience, but with her, my first rheumatologist, I didn't want to continue because I didn't feel... very heard and I didn't think that she understood the gravity that I was 26 and being told, you know, some pretty crazy side effects and also being told some things about my future fertility options. And I'm not thinking about kids at the moment, but eventually I'd love to have children and to be sitting in a room, which most doctors' offices aren't the most inviting. But to be sitting in a room and just being told about this, you know, inkling of a diagnosis that I thought that was confirmed, and then told all these crazy drug side effects and, you know, this is my life, I don't think that I remember I started tearing up in the office and I called my mom after and I started crying because I just was, I didn't feel protected. And maybe that's not her job, but when you kind of tell someone something crazy, like that, that's going to affect a lot of their life, you would maybe like take a step back and make sure that they're feeling okay with the weight of the news. And so, you know, that already really turned me off from our relationship, but I also knew that I was in extreme pain and I needed something. And so I continued the relationship to receive the, you know, prior authorization to receive the medicine. And then I got an email that her practice was turning into a concierge service and, you know, all these concierge services require like a membership fee. And that's when I was like, why would I pay, you know, this amount of money when I don't feel like I have a really strong relationship? I'd rather spend that money to someone who's actually going to listen and acknowledge some of the fears and pains I have versus just being the person to prescribe me, you know, the drug. At that point, I was feeling a little bit better and I was like, maybe I could do without this medicine. I only took it for like two months and then lo and behold, it came back because it doesn't go away. And it came back kind of worse. And then that's how we found you, which all credit to my mom. She's the most educated and will search anything and everything all the time. And she found you and your YouTube channel. And so. That is how we found you and got connected. And I feel very heard and acknowledged and accepted when we talk. And we talk pretty frequently. William was actually the one who contacted our practice just for people to understand. And she asked a lot of questions. I will tell you that I would probably do the same for my daughter and for any of my kids. because I feel like doesn't matter how old you are, I'm still gonna be your mom and she's still gonna be your mom and she cares about you and you know, like you're telling me about compassion. I think that should be part of our, you know, package as physicians. We cannot take compassion out of the picture, especially when we are dealing with people that... And we are dealing with diagnosis, like you were saying, this is a diagnosis for life. It's not something that like an infection you treat it, it's going to go away. You have to give patients a perspective. have to make them understand. have to make them feel heard and you have to answer their questions. And I'm all for that. And for many years I'm practicing this way and I will always practice this way. I am a strong believer, like you're saying, that the patients, when they come to you, maybe you are not their therapist, but you are there to answer their questions and to show them that it doesn't matter what chronic disease they have because psoriatic arthritis and rheumatoid arthritis. And arthritis in general, it's a chronic disease. And by treating patients, you just have to be there to be their coach. And sometimes you're close to them that they do consider you like a family member. Now, what was different for you when you had the first appointment with us? I know that we were seeing you through telemedicine and that's a new option for patients. You were in San Francisco, I'm down in Irvine, California. you know, there is this barrier or imaginary barrier that you cannot get care through telemedicine. How was your first appointment compared to your appointment in person? I think the big thing that I had hesitations about was obviously this is about my joints and you're supposed to see and touch and feel my joints. But with your experience and your expertise showing you just my hands and my feet and my knees, like, I thought I was going a little crazy. I'm like taking pictures of my hands. I'm like, my hands were not this size. like, my rings that I've had for my entire life don't fit on my fingers anymore. am I going crazy? And for you to immediately justify how I was feeling and you explain everything so detailed, which for people like my mom and I, because obviously my mom joined those first initial appointments because she's amazing and is always, like you said, she's always my mom and is always going to be involved. You know, we had a lot of questions and we're like, okay, we know this is the diagnosis, but now what? And you explained everything so comfortably and I felt so acknowledged and so heard. And that was what gave me a breath of relief because at that point when I had met you, I was pretty defeated. I was feeling like, this is it. I'm going to wake up every morning and my hand is never going to be able to close. And I'm going to just have this morning stiffness and it's going to take me like 45 minutes to really wake up all my joints to even like walk to work. so I was really feeling defeated and, the comfort that you gave and, just the, like, like you were saying, educated, like you were giving us all those details. in medical terms that were easy for my mom and I to digest and understand, to really like grasp the situation. So I think that was the big difference and you're like, okay, how can you really tell over video? But when your joints are that big and they're that swollen, I think you can tell over video camera. Absolutely. You can tell. And experience will give you the confidence to diagnose a patient. And as I told you, and I tell others, if I I'm not confident about something. I'm going to be sincere about it. I'm not going to lie. I'm going to tell you, let's follow it. Send me the pictures. Come to see me in person. I will always be sincere if I don't know something. And, you know, I also say to my patients, we are not gods and I'm not god. So at some point I might be wrong, but come back, let's reevaluate. Let's follow you because that's When you deal with autoimmune diseases, those are complex diseases, are not something that you see immediately. The symptoms might change with the season. The symptoms might change with your eating patterns. So we're going to talk about that because I feel like it's important for people to understand it's not all about treatment. It's about the package. It's about your lifestyle, how you incorporate certain things into your lifestyle to help your body. and help your immune system to recover or to fight better, you know, because sometimes they think about that. Now you had a complicated, a little bit complicated story and you had to go from lifestyle changes that we're going to talk about to treatment. And you had some resistance there and that resistance comes from the internet, from Dr. Google. And from previous experience or the relationship that you started with the other rheumatologist, when you started the treatment, what happened? How did that change your life? Yeah, that's a good question. So lifestyle changes for any autoimmune disease is very, very important. I think what people don't understand, maybe don't understand, and maybe this adds a little bit of clarity is You know, it is something that you can't cure, but there are things that you can do in your everyday life to make it more manageable or easier. And a while ago back in college when kind of this was still maybe starting to brew, I remember I read this book called Healing Psoriasis by John O. Pagano. I don't know if I'm pronouncing his name correctly, but it's a book that really talks about all the different foods that you can eat that will fuel you to be better, but also make your inflammation worse. We all have some sort of inflammation in our body, but alcohol is a big trigger. The nightshade food groups are big triggers. And I remember back when it was just patches, I was seeing this nutritionist and we did an elimination diet and I stopped eating mushrooms for 30 days because they're part of the nightshade groups. And the patches I've had on my body since I was three years old just disappeared. I've done... cortisone shots, I've done ointments, steroids, like every type of treatment that you could think of for a skin patch of psoriasis or like eczema. And what cleared it was not eating mushrooms for 30 days. And that's when it really like hit me that the things that I'm eating and drinking and the type of activity I'm doing on my body really affects the internal inflammation that I have. And for someone who has a lot of inflammation with psoriasis, I have to be a little bit more aware of it. But that's also really difficult because I was in my teenage years in college and in my early and now late 20s and being told, you know, don't drink this and don't eat that and, you know, sleep is really important and stress is a big trigger as well for autoimmune diseases and inflammation. And you're like, I feel like I'm in the most stressful years of my life. I'm like, graduating college, I'm starting new jobs. Granted, everyone has stress at every point in their lives and these are just topical stresses. you know, in my life, that's, that was what stressing me and, and being told, don't stress about it because you're going to have a flare up and you're like, that's easier said than done. but it's one of those things where, you know, you don't realize how much more effort you have to put into your everyday kind of activity in life. And You know, like we keep talking about my mom and she's always like, well, text me and be like, are you like, watch your stress levels or like watch your sugar, like things like that, because they trigger and they make me more inflamed. And so it's a learning process. It's definitely, you know, for other people, mushrooms might be great, but for me, they affect me. And so it's... It's very much constantly like an elimination process of figuring out, okay, how do I feel in a couple of days after I have, you know, this type of drink? Is it going to make my joints feel a little more achy? If so, scratch it from the diet and kind of let it go. And that's where I've been in the like holistic side of this and the food side. Aida, if you don't mind, what was the treatment that you were willing to try? when we started your journey. So we started with Cosentix. And I do want to call out that that is one of those, I don't know the official term, but it's an injection medicine. And I was very, very terrified. But Dr. G here is not just someone who explains things very well, but she's a very good partner. And I think I've sent like 100 messages in our app and our portal. because I was so nervous starting this. But I did see pretty instant relief. It is a little terrifying for someone like me to do the injections. I did have some family members help me with that because that was a little scary. But I saw some pretty instant relief. I felt instantly better. We started with Cosentix and it is one of the injection. Medicines that I was a little scared to try just because I'm afraid of of needles But I did instantly feel Relief it's taken a process though. I think one of the first things you told me is you know I have to wait it out three to five months to really see how this is going to affect my body and I think I'm on month six now but those first months up until pretty much this last month like were pretty difficult because, you know, I got the relief in the joints, but then we go back to the side effects and I had some other side effects and we discovered a few new side effects for me specifically. it was definitely a trust the process type situation. So, you know, I got the relief in my joints, my fingers started to go back to their normal size, my toes went back to their normal size. But, you know, there's other types of pains that come with it and trying to figure out is this going to be something that is forever? Like month two, I started to thin out my hair and I started to lose some of my hair and I have a lot, which I'm, knock on wood, very grateful for, but that was a situation where, you know, I messaged you probably every other day, like freaking out, like, is this going to be permanent? Am I going to have damage to my hair? I remember calling my mom and it was one of those where again, trust the process. My body's adjusting to a pretty, you know, heavy medicine. I'm not taking this or I wasn't taking it before and now I am and my body's adjusting. And so with that came a lot of different changes, but the immediate relief that I felt in my joints was worth it. to go through a little bit of that mental gymnastics because all of a sudden I could wake up and like close my hand in a full fist. And that was something that for probably a year I wasn't able to do. I would like kind of stop around here. And so, yeah. I actually wanted to ask you, what are you able to do today that you are not able to do before starting the treatment? That is a good question. I tend to push through. my limits being a competitive athlete my entire life. I was like, I'm not going to let this stop my life, this diagnosis, it's like, it's not going to affect me. So it's not that I stopped myself from doing too many things because I didn't want to let myself kind of fall into not doing things, which probably made my joint progress a little bit worse at times, but it's the, it's the comfortability that I can wake up and actually feel like myself in my own body versus in the past I woke up and I had to like sit there and kind of like slowly try to close my hands and like open them and move my knee and my toes and that morning stiffness was probably the worst feeling that I had. So now I do everything that I used to do but with ease. I can type at work and not have to wear a compression glove. I can walk to work and not feel like I have to take a couple breaks to really roll out my ankle. I would say those are the big changes. Probably should have stopped doing them at the time when my joints were at its most inflamed, but I pushed through because I really didn't want this to be something that stopped me from doing the things that I would do every day. Now there are many months that you are on treatment and you feel better, but what would you say to someone that was newly diagnosed with psoriatic arthritis or another type of autoimmune disease? Nearly diagnosed, I would say to continue advocating for yourself because you are the only person that knows how you feel on a day-to-day basis. I think, you know, at any age, it's a little terrifying to go through. you know, changes in your body that you're going to start working through with a new drug and a new treatment plan with, you know, different nutrition and exercise. But I think if you continue advocating for yourself, continue, you know, telling Dr. G or whoever your rheumatologist is how you're feeling, write it down. You know, some months your medicine might have one side effect and then the next you might have another. It's like document everything because that's how you're going to tell yourself that It's working or that it's not working. It's a, it's a trial and error process. You know, I'm on co-centics now, but I might not be on co-centics in a few months. I might switch to something else that might be better for me at that moment. and tell a few people that you trust what you're going through. I think I tend to do things on my own and, and fight through things alone, but having, you know, small community of people that you can tell, know, hey, I'm not really gonna be drinking today because I'm having a bit of a flare up or, you know, can we not do this strenuous activity because, you know, I'm feeling a little stressed with my joints. Like, everyone's gonna understand and the people that don't should probably not be in your community because this is something that you're going through and having that support with friends, significant others. You know, that was a really big... That was really big for me. So it's probably my advice. Always advocate for yourself. Aida, thank you very much for sharing your story with the people that are listening, Thriving with Arthritis podcast. And thank you very much for your words of encouragement. I am too. You've been the best, Dr. G. Your team is awesome. I send way too many messages and they're always answered. And so I appreciate not only the help, but the partnership because We're finally seeing progress and that's a win. It means so much for people that are right at the beginning or they are in the middle of a diagnosis, but they still don't have the answers or they still don't have that communication with the doctor and they need to continue to work on the progress of their disease. As always, I want to thank everybody that listened to the show. And if you have comments, if you have suggestions, please leave them in the bottom of this show. Give us a review of the show and always think about the fact that there is another way to solve your problems. There is hope. Doesn't matter where you are in your journey with arthritis.