The Big Sick film highlights writer’s real-life battle with adult-onset Still’s disease. The Big Sick film is based on the real-life courtship between Silicon Valley actor Kumail Nanjiani and his wife, writer Emily V. Gordon. In the movie, Zoe Kazan portrays Gordon onscreen, and Holly Hunter and Ray Romano play her parents.
The romantic dramedy portrays how the married co-writers dealt with the extremely rare form of arthritis that brought them together 10 years ago. Back then, Gordon was a therapist in Chicago and has been together with the then standup comedian Nanjiani. Gordon’s initial symptoms were similar to a cold. She thought she had a really bad cold or pneumonia. She fainted in the middle of getting an X-ray and was rushed to the emergency room.
Gordon was eventually diagnosed with adult-onset Still’s disease (AOSD), a rare form of arthritis that can shut down major organs if untreated. Adult Still’s disease is characterized by high fevers, inflammation of the joints, and a salmon-coloured rash on the skin. It can either be chronic or episodic (having flare-ups a few times a year). In children, this disease is known as systemic onset juvenile rheumatoid arthritis; when it occurs in people over age 15, it is known as adult Still's disease. In Gordon’s case, AOSD affected her lungs, causing water to accumulate in her lungs. As a result, she had trouble breathing.
Adult Still's disease affects men and women in approximately equal numbers. Though it can occur in adults of all ages, it tends to strike two age groups most commonly: those from age 15 - 25, and those from age 36 - 46. A fairly rare form of arthritis, adult Still's disease affects approximately 1 in 100,000 adults.
The cause of adult Still's disease remains unknown, although scientists think that it may be the result of an environmental trigger such as a prior viral or bacterial infection, ultraviolet light exposure, toxins, stress, among others. Because the disease only very rarely affects members of the same family, researchers are doubtful that there is a genetic connection.
Although the cause and ultimate cure of AOSD are still unknown, the disease is relatively manageable after diagnosis. Medications can help control mild symptoms and underlying disease. Other ways to manage the disease include exercise and maintaining a healthy diet and lifestyle. Gordon explains to The Hollywood Reporter: "I just have to practice self-care in the ways we all should be doing — get enough sleep, eat healthy and regularly, exercise and keep my stress and drinking down — but I have to be a little more diligent about it because if I slip on any of those, my immune system can act up. My parents call him my lion, and he really is. At times when I'm not great at self-care, he will force me to be good about it."
It is important to have open communications with your partner about your disease activity. Nanjiani explained about understanding his wife’s disease flare-ups: “When it first happened, [I felt] the guilt of, how could I not see this happening? She was with me, and she got so sick – how could I not know? Emily can be so stoic about it. She can be super sick and still have a great attitude. So part of the process for us has been Emily telling me, 'Hey, I feel something coming on,' and then me trying not to freak out for a little while."
According to Nanjiani, Gordon will be tackling house chores and trying on dresses two days after a flare-up. She’d laugh and say, "Let's try and own this, and have a good time if we can. It's time to relax, lie on the couch and watch movies. Let's eat cakes and shit."