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Discovering Polyarthritis

CHERYL GERBER PHOTOGRAPH

A chef with polyarthritis
“It all started with a sharp pain in my right knee during dinner last August. I woke up the next morning and both my knees were swollen and throbbing,” says Jezz Jones, the chef and proprietor of Jezz’s Catering Service (858-2158). He stayed home that Friday, washing down extra strength Tylenols and rubbing his knees with BenGay. By the weekend his wrists and ankles had entered the fray. Excruciating muscle spasms added to his misery.

“By Sunday I hurt so much that I couldn’t get out of bed or even unscrew a water bottle. My wife called the doctor first thing Monday morning, but there was no way I could get to his office on my own. She called 9-1-1, and an ambulance took me to the emergency room.”

His physicians ordered a battery of diagnostic tests, a spinal tap, potent pain medications and intravenous fluids. Tests for rheumatoid arthritis, lupus, gout, fibromyalgia and septic joint infection were all negative.

“Three days later they threw up their hands and said I needed a rheumatologist. They called Dr. Joe Biundo. He stuck a needle in my right knee, drained off fluid and injected cortisone. He said it was polyarthritis. My knee felt better right away, but all my other joints still hurt, and I still couldn’t walk.

“They transferred me to the rehab floor so I could get physical therapy, walk again, and build up my strength. On the day they moved me to the ninth floor, I could see blood in my IV line, and it didn’t feel right. They said it was OK, but the nurse the next day didn’t like the way it looked. She changed the IV. The next morning my fever was 103 degrees. I ended up with a staph infection in my bloodstream from that IV line.

“Then they called Dr. Diane Failla. She is an infectious disease physician, and she saved my life. The staph infection had infected my heart valve – endocarditis. She ordered IV antibiotics. I ended up being in the hospital 22 days and then went home to finish seven weeks of antibiotics. Now, I feel fine.”

Polyarthritis
Jones had a constellation of symptoms and findings consistent with acute inflammatory polyarthritis, a syndrome and not a specific disease. Classic findings are pain, swelling and warmness in five or more joints all at the same time. A long list of specific diseases can cause this sort of inflammation. The joints involved along with onset duration, age, sex, medical history, associated signs and symptoms such as fever or rash and a physical examination help formulate a differential diagnosis.

Various diseases, bacteria and viruses can trigger the immune system to make havoc-causing autoantibodies. The symmetric involvement of Jones’ knees, ankles and wrists in the absence of positive tests for rheumatoid arthritis and lupus suggested a reactive arthritis. Most likely he had some sort of asymptomatic bacterial or viral infection a few weeks before the onset of his joint pains. Most of the time full recovery ensues, but other immune related complications months to years later are not uncommon.

Hospital acquired infections
Persons in less than perfect health are prime targets for bacterial infections. These days it takes a serious illness or major disability to rate more than an overnight hospital stay. The fashionably attired hospital patient has at least an IV line dangling out of one arm. Other accessories include Foley catheters, venous and arterial pressure monitors, nasogastric tubes, oxygen delivery devices and various tubes to drain unwanted body fluids collections.

Acid suppressing drugs like Nexium and Prilosec neutralize the bacteria killing properties of stomach acid. Overuse of antibiotics wipe out the good bacterial soldiers allowing their rogue cousins, like Staphylococcus aureus, to gain footholds. Steroids like prednisone, essential and miraculous drugs that can reverse abnormal inflammatory processes, also fuel infections by diminishing normal immune responses.

Outcome
“At the time I got sick, I weighed over 300 pounds,” he says. “When I first went to rehab, I couldn’t stand up by myself. It took two aides, two physical therapists, and a nurse just to get me out of bed. Then the fever came, and they diagnosed endocarditis. That really set me back.

“The first two weeks I was sick, I lost 40 pounds. Now I feel great, but I have gained back 42 pounds. My joint pains are gone, just like Dr. Biundo said they would be. I wouldn’t wish polyarthritis on anyone,” says Jones. “but at least I feel almost as strong as before I got sick, and I’m working for myself.”

 

New Orleans food legend Jezz Jones
Jezz Jones grew up in a matriarch-centered home on Euterpe Street with his grandmother and a great aunt. He owes both his name and his love for cooking to Ida May McCottric, his maternal grandmother. “My real name is Jezerel Jones. My grandmother named me after Jezreel, a city in the old testament, but she spelled it wrong. Someone called me Jezz after I got out of the military, and it stuck.

“I started helping my grandmother cook to get out of pushing the lawnmower. By the time I was 15, I could cook a full Thanksgiving dinner. After high school, I joined the army, became a professional chef and learned bulk cooking.”

After seven years in the army, Jones returned to New Orleans, plying his culinary skills around town until a call from Dorignac’s in October 1995. At that time Dorignac’s had two kitchens; one was up front with a small cafeteria line and the main production kitchen was in the back. First informally and then officially, its moniker became Jezz’s Kitchen
at Dorignac’s. Jones left Dorignac’s in 2014, and currently provides onsite catering. He and his wife Marilyn are longtime Gentilly residents.

 

 

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