Things were looking bright, but for me personally there were clouds gathering on the horizon. It did not happen all at once. During the early spring of 1988 while on an east coast trip I noticed some dry skin patches on my arm. I did not think much of it, I had been prone to dry skin patches over the years, they were small, appeared in winter, and were gone by mid-summer.
I noticed these patches were a little larger than before, so I decided to see my doctor when I returned to California. My doctor gave me some steroid cream, which caused the patches to go away, but they soon returned. When I got back from an OEM sales trip in March of 1988 I went to the doctor again. He suggested I go to a dermatologist since the patches returned. I was very busy, we were in the process of selling our new 16 bit Microchannel adapter line which began shipping the fall of 1987, and the low cost CD ROM was just making its debut on PC’s and they needed SCSI interfaces, our 8 bit line fit them nicely. I was also working with Greg on preparing the business plan for Venture Capital. I was working 70-80 hours a week. I asked my assistant Mary Gierke to find a doctor close by, she found a dermatologist in Tustin. I went to see him and he told me he could “fix” the problem, he gave me an injection (which I later found out was cortisone) and some prednisone pills. He said that would fix the problem, which was “some kind of dermatitis”.
In fact it did make the spots go away. However three or four weeks after I finished the prednisone the patches came back, now more of them, bigger and redder than ever. I went back to his office and he gave me another shot, and more prednisone. He said “that should fix it”, and it did go away in just a couple of days.
It was now mid-May and I was done with the prednisone, and the patches came back with a vengeance. I decided to find a new dermatologist. I went to one, and he said “I don’t know what you have”, another wanted to give me more prednisone and cortisone cream. I began to research skin conditions, and guessed I had psoriasis. I found that a top doctor in that field taught at UCI, Dr. Gerald Weinstein, but I could not get an appointment for six weeks. I made an appointment for June and decided to wait.
Just a week later was Memorial Day weekend, 1988. I was pushing my younger son Jonathan around in his Little Tikes car on the sidewalk when I got an excruciating pain in my left knee. I hobbled into the house, and within an hour my knee was swollen to double its normal size. By now I suspected I had a serious problem, and suspected the prednisone treatments were masking psoriasis and psoriatic arthritis. Patty took me to the emergency room at Mission Hospital. The OR Doctor said I had a serious case of arthritis, and I need to have it treated quickly to avoid joint damage. He called in Dr. William Shiel, a rheumatologist.
My first impression of Dr. Shiel was a guy with a very big thick needle! He aspirated (removed fluid from) the knee and gave me a shot of cortisone in the knee joint. We talked, he agreed with my assessment that it was probably arthritis, and that the heavy steroid treatments just masked the problem and the rebound from them made it worse. He knew Dr. Weinstein as he instructed at UCI also. Weinstein had pioneered the use of methotrexate for psoriasis, and now it was also used as a treatment for arthritis. Dr. Shiel started some tests, and he would coordinate with Dr. Weinstein on my diagnosis. He told me to go home, stay off the leg a couple of days, and stay at home until the following Wednesday when he would see me at his office.
When I got home I was exhausted, it began to sink in that I would not be able to keep up the pace at Future Domain. In fact, I was wondering if I could even manage the company anymore. I called Mary on Monday and explained the situation; I decided to put Al Pease, one of the founding members of the company, and now Vice President of Engineering in charge.
I saw Dr. Shiel on Wednesday and he confirmed the diagnosis on Psoriatic Arthritis, he talked to Dr. Weinstein, who concurred and would confirm at my appointment with him the following week. Dr. Shiel drained more fluid, but said he would not give me additional cortisone; instead he started me on a powerful NSAID and methotrexate. At Dr. Weinstein the next week we would add PUVA light treatment to the mix to treat the skin flare. Within a few days psoriasis patches covered over half my body. It was pretty clear that for the next six months I would not be doing any traveling or company business, except for working with Greg Presson and completing our effort to raise venture capital for the company.