Imagine being a seventeen-year-old girl. Suddenly you begin experiencing pain in your hands every morning. Your fingers are stiff and swollen; they look like little, fat sausages. When you walk across the room, it feels like sharp rocks under your feet. The constant pain puts a damper on your appetite and you begin to lose weight. Now imagine being told you have a crippling disease that will change your life.

Thirty-five years ago, I was that young girl. The disease was rheumatoid(RA). Constant pain and the loss of twenty pounds in three months told us I was experiencing more then “growing pains.” Even after an examination and several blood tests, my doctor wasn’t sure what was wrong. She suspected rheumatoid arthritis, but at that time, a diagnosis of RA was rare for someone my age. Our small town didn’t have a rheumatologist, a doctor who specialized in RA, so I was referred to a doctor in a nearby city. A week later, I was admitted to the hospital where further testing confirmed it. I had rheumatoid arthritis.

Doctors visits to monitor my pain, hospital stays to build up my appetite so I would gain weight, and therapy sessions began to take up much of my free time. My life had changed. I had a schedule to follow.

An inflammatory disease, rheumatoid arthritis alters the immune system, causing it to attack healthy cells in the body. Mainly, it strikes the joints, but other parts of the body could also become affected. Redness and swelling of the joints occur. There is also pain and stiffness, primarily in the morning. Sometimes, damage and bone loss occurs, eventually requiring surgery.
Early treatment can often slow or stop the progression of RA. Treatment varies with each person, but some basic steps are common. A regimen of medication to relieve pain and inflammation, over-the-counter or prescription starts immediately. When I was diagnosed, the treatment involved several doses of aspirin a day. The plethora of medications we have today was not available, and initial treatment wasn’t as aggressive.
I took up to fifteen aspirin tablets every day, five doses of three pills each. Keeping this schedule was a lesson in creativity. When I was in class, I learned to chew my pills with a piece of Dentyne gum. The teacher didn’t want me to “interrupt the class” by leaving the room to get a drink of water. To this day, Dentyne gum doesn’t taste right unless I chew an aspirin tablet with it.
Rest and relaxation is needed to help heal the injured tissue around the joints, Staying off the feet and resting for an hour relieves the pressure, which helps reduce swelling and pain. I had no problem with this part of the treatment. I was often tired anyway. Fatigue is a symptom of RA-lying down for an hour was easy. I would pass the time reading a book and daydreaming about faraway places.

Exercise is important in maintaining mobility and strength of the joints. How much and what type of exercise depends on the severity of the disease. Recommendations have changed over the years.
My doctor excused me from my physical education class, but I still had to exercise everyday. In the evening, I soaked in a warm bathtub for thirty minutes, before climbing up on our heavy, wooden, dining table. My mother would move all my joints through their full range of motion. The process wasn’t unpleasant; having my mother do it was. At seventeen, the last thing I wanted to do was spend time with my mom. I made up every excuse in the book to get out of it, but to no avail. The sessions continued everyday until I moved out a year later. At first, I tried to do them on my own, but eventually I stopped. I was busy living my life and didn’t want to take the time.
Living with the pain of arthritis and being a teenager can be emotionally chaotic. Along with the normal mood changes, constant pain can cause frustration, despair, anger, anxiety, and depression. I experienced them all, especially at night alone in bed. I remember beating my pillow with my fists crying, “Why me? What did I do?” Other times I declared, “It’s a mistake. I can’t have arthritis. That’s an old person’s disease.”
I used to have guilty feelings about not doing the exercises because my joint functions are severely limited. I blamed myself, sure that stopping the exercises caused the destruction. My rheumatologist assured me the RA was so severe it is probable the exercises wouldn’t have stopped the progression of the disease.
In many cases, with monitoring and proper treatment, patients experience remission of RA within a couple of years from its onset. A remission means the disease is not active; inflammation, swelling, and other symptoms are reduced or nonexistent. Despite all of my treatment, I didn’t go into remission for fifteen years.

The extreme treatment for rheumatoid arthritis is surgery to replace or fuse damaged and destroyed joints. A prosthetic—a metal and plastic “joint”—takes the place of the natural joint. Although I didn’t know it at the time, eventually all the major joints in my body would sustain enough damage to require this treatment.
In 1982, at twenty-six, I had my first joint replacement surgery. I had been experiencing a lot of pain in my knees when bending or walking. A visit with an orthopedic surgeon—a doctor who specializes in bone surgeries—discovered that the cartilage in the joints was destroyed and the bones were rubbing together. Cartilage is the material that cushions the moving parts of the joint.
Two surgeries, six months apart, gave me “new” knees. I still remember the first steps I took after the operations; I could walk without pain. I was delighted and amazed! Even telling me that in twenty years I would probably need the surgery again didn’t dampen my joy. I was young; twenty years was a long time.

To insure success of the operation, my doctor cautioned me about any activity that could jar the new joint; activities such as running or jumping were prohibited.

Working closely with my doctor, my pain is now under control, and I am in remission. I have limited movement, and need help with most of my everyday activities, but I look towards the future—a future filled with promise. There isn’t a cure for rheumatoid arthritis, yet, but controlling it is possible. Medications, pain management, and therapy procedures continue to evolve allowing patients to live more active, independent lives.

Created on: September 03, 2010