A Different Life with RA
by Andrea D'Angelo

Throughout life, people encounter changes that inevitably effect their entire lifestyles. When I discovered that I have Rheumatoid Arthritis, I knew my life would be significantly altered.

It's funny how people remember dates. The date that I will always remember is February 16, 2000. That was the day that I first began to notice the physical changes in the appearance of my body. My once long, slender fingers were red and swollen for no apparent reason. My feet and toes were significantly puffier than usual. These symptoms progressed in the weeks that followed. I began to grow cauliflower-like warts on the tips of my fingers. I felt chronically fatigued. I could barely walk due to the soreness of my body, particularly in my joints. If I sat down in a chair for a long period of time and attempted to stand up, my legs felt like they were still bent. If I stood up for a substantial amount of time and tried to sit down, my legs would be frozen solid and would be impossible to bend. It was a lose-lose situation. I experienced insomnia, as no position was comfortable enough to fall asleep at night. Yet when I eventually fell asleep, I dreaded waking up and feeling as if a Mack truck had hit my body.

I contacted my physician on several occasions; however, she was out on leave due to health problems of her own. Consequently, I was seen by a replacement doctor who insisted that nothing was wrong with me. He said I was most likely just a "stressed out, tired teen." It is probable that there was some truth to those elements, but I knew there was more. I was confident that it wasn't a state of depression leading to my physical deterioration. Rather, I felt that it was a depression that resulted from the lack of an accurate diagnosis. My frustrations only intensified my soreness. I had blood work taken to analyze my body systems and all levels were reported back within the normal ranges. Yet I still couldn't help but let my mind wander over the possibilities of having a rare chronic or even fatal disease.

In the months of ambiguity that followed, I became proactive by searching Web engines for symptoms similar to mine. After reading some of the literature and assessing the condition of my body, I reasoned that it was some type of disorder of the joints. Physicians had essentially dismissed my complaints, but with my advocacy, I was referred to a rheumatologist, which is a doctor specializing in rheumatic diseases such as that of the joints. It took months to get an appointment, but thankfully, April 28th eventually rolled around. Upon a physical examination and reevaluation the blood work taken months earlier, I was finally given a long-awaited diagnosis. I had Rheumatoid Arthritis.

Rheumatoid?? Arthritis?? What did all of this mean? Why me? How could it be...and at such a young age? Like many people, I thought that only "old people" were inflicted with arthritis. Boy, was I sure wrong. I learned that even babies and children could have a form of arthritis, called Juvenile Rheumatoid Arthritis. The rheumatologist told me that I was borderline Juvenile Rheumatoid Arthritis and adult Rheumatoid Arthritis because of my young age of 17. He told me that one out of every 100 persons has Rheumatoid Arthritis (RA), but over half are women. RA is commonly characterized by joint inflammation, joint stiffness following decreased activity, and weakness in muscles. With continuous inflammation, permanent joint deformity and disability can result. As with my case, the beginning stages attack joints of the hands and feet and usually then advance to the larger joints. RA is also a disease that affects the autoimmune system, which protects the body from bacteria and viruses. Therefore my warts appeared in response to a weak autoimmune system.

About 80% of the people with RA also have an elevated Rheumatoid Factor (RF) in their blood work, which displays the presence of arthritis. As it turns out, my blood work had indicated the possibility of RA by an increased RF. While a normal, non-arthritic person has an RF of zero to twenty; my RF was 265, which is considered severe arthritis. This was a huge red flag for possibility of RA, which had been simply overlooked by the interim physician. While I considered pursuing action against the doctor for the error, I decided to cut my losses and be grateful that I finally had an answer.

Although RA can be genetically linked, there is no known cause of the disease. With no cause, there can be no cure. However, early and aggressive treatment through proper exercise and non-inflammatory drugs is crucial to lessen joint damage and preserve function for sufferers of RA. Before I had RA, I was active in working out and exercising. I would go to the gym three to four times a week for weight training, spinning classes, and aerobic kickboxing. After learning that some of these high-impact activities were putting additional stress on my joints, I began to alter my exercise routines. While I still work out several times a week, I now walk on a treadmill, use an elliptical machine, and relax my body with yoga stretches. Although physical activity can be a struggle at times, there is a worthwhile payoff. Physical exercise actually works to decrease the stiffness in the joints and build muscles so that the joints have increased protection. In addition to exercise, I have found that massage therapy helps to decrease some of my arthritis pain. There is no replacement for the medication on which I am dependent, but there are alternative medicine remedies such as exercise and massage that supplement the health of my joints.

Having RA has also changed more than my physical state. Dealing with RA on a day to day basis has changed my personal attitude. Before RA, I made myself very stressed from having to do everything independently and perfectly. Although I am still somewhat of a perfectionist, I've learned that it's okay to just let things go undone once in awhile. I have also learned to accept help from others, including my family members. From having to help me dress, to holding my hand during surgery, to helping pay my doctor bills, to giving me injections; my family has been there to assist me and make me stronger every step of the way.

There was once an ignorant person who told me that I'd never "make it at college with my condition." Well, despite my limitations, I trudged through and completed four years at the State University of New York College at Geneseo in a four-year period. I know that this is an accomplishment for anyone, but my rheumatologist often reminds me that this is especially momentous for someone with RA. I made a multitude of friends at Geneseo and together we joined a national sorority, which even elected me as president. During my undergraduate work, I obtained a Bachelors Degree in Education and Dual Certification in Childhood and Special Education. My interest in Special Education stems from my own experiences with a physical disability. While one may never know the pain that I physically suffer on the inside due to my smiles and energy on the outside, there is always a part of me that struggles because of my disability. I only hope to send the message to others that they too can work to accomplish their goals, regardless of a mental, physical, social, or emotional disability they may face.

I have now been living with the disease for about five years. At the moment I am feeling stable, but my joints change from day to day. There are some days that I think I could climb Mt. Everest and other days where I sit in a bed of my own tears trying to remember what it felt like to wake up without pain. I believe in the concept of "mind over matter" and I try to tell myself that for every bad day I have, I will have 100 better days. It is frustrating that at times I suffer more from the side effects of the medications and from having an overall weakened immune system, rather than just the stiffness of my joints. I don't think that there is a flu that I haven't caught or an infection that I haven't attempted to fight off in the past few years. Like a typical young adult, I think about my future and the idea of being pregnant with the disease. I know that it will be a tough process, and I worry about the possibility of my child having RA someday. Yet when I think of it in optimistic terms, a child with RA would have no better model to help him or her than me.

Change is a frightening word for many people, and to me, arthritis is a synonym for change. However, I truly believe that as I age, I will continue to find inspiration in the diverse impact that Rheumatoid Arthritis has had on my life.