The problems of Sjogren's syndrome are so diverse that they often go unrecognized as having any relation to each other. A patient may, as I did, go to an ophthalmologist for an explanation of blurred vision, a dermatologist about dry and irritated skin, a urologist about recurring infections, and an internist about the aching and swollen joints of arthritis. Dentists and dental technicians constantly admonish her about the build-up of plaque and excessive cavities which seems to go on constantly in spite of ardent brushing and flossing. No one, least of all the patient, sees any correlation among all these ailments, and more often than not, the patient ignores or suppresses some symptoms for fear of being considered a hypochondriac. Although I had always, as long as I can remember, had an aversion to crackers and other dry foods such as the gritty corn bread that is so essential to Southern menus, I never gave it a thought as a medical problem, until the very moment when my doctor asked that deceptively simple question.
Different patients report different symptoms as the first sign of trouble.
In my case the first recognizable sign of trouble was swollen and aching elbows and wrists. I remember very well how it started. I had transplanted a whole hedge of shrubs from an abandoned home down the street to my own yard, digging each one up, lifting it into the trunk of my car and reversing the chore at my home. The next day, a Saturday, we went out with friends on their boat. They were enthusiastic water-skiers and urged us to try the sport.