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When Life Gives You Rheumatoid Arthritis: Turning Adversity into Opportunity

In October 2016, Nicole was diagnosed with rheumatoid arthritis after experiencing painful symptoms for several months. Despite having clues leading up to the diagnosis, it took three months to see a specialist and he struggled with chronic pain and deterioration in strength for the first two years. She has since learned to be mindful of mental health and prioritize self-care.

I can barely remember how it felt when the doctor confirmed that I had rheumatoid arthritis in October of 2016. It had been about a painful five or six months since symptoms had started to present. All I wanted to know is what could be done so that I could feel better and not be in so much pain.

It started with pain in the knees, which came and went. Then my jaw hurt, which made it hard to eat or talk, and my mother and I suspected that it was mumps. What happened between those first symptoms and eventually barely able to walk or even dress in about three months is a blur (was it even three months?). I was also going through a tough time work-wise, which could have been the trigger for the disease.

On hindsight, I had a few clues that led up to being diagnosed with rheumatoid arthritis. I had joined a yoga studio a couple of years before and one of the yoga teachers beckoned me over, asking me why I had not lost weight even though I had been attending classes for some time. He asked if I had any thyroid issues, to which I answered no, being quite bemused and not even sure what a thyroid was.

Around the same time, I realised that I was also suffering from anxiety, because I was always feeling nauseous when I went to work, so I saw a psychiatrist for this, but I tried to fix my sleep and also walked away from a toxic environment. Then, the year before symptoms started showing up, I did a full body checkup. During the review, the doctor asked if I experienced any joint pain or inflammation, which I again said no to and was quite confused till he said that it was just an indicator and it shouldn't be anything to worry about.

Nicole, French bulldog
Photo credit: Harriet Koh

It took three months to see the specialist as Singapore General Hospital, and the GP I was seeing could only put me on prednisolone and painkillers. Steroids were such a lifesaver at the time, as at least I was able to function in a new job, but I was and am still bad at taking my medications on time and would forget to take the calcium supplements, so it got to the point where I felt my teeth getting loose. Thank goodness the doctor switched me to methotrexate, but that brought its own set of problems.

For most of the first two years, I struggled to deal with the chronic pain from both inflammation of the joints as well as deterioration in strength, because I wasn't moving as much. I relied heavily on painkillers, though I tried to be very careful how and when I would use them. The methotrexate also caused a lot of hair fall, which made me very self-conscious (because I would leave lots of hair when I visited other people's places), as well as nauseous half the time. While I am currently off methotrexate, the thought of the little yellow pill which I had to handle with care makes my stomach turn.

The turning point was when my doctor switched me to Xeljanz, which was finally able to help me feel that the inflammation and most of the pain was gone. I still feel stiffness and my mobility is still limited, but at least I have less fatigue. One thing that has helped with my mobility is regular Traditional Chinese Medicine (TCM) meridian massage and fire cupping. I used to limp a lot because one of my ankles would be inflamed quite regularly, but after a few sessions, it has improved tremendously. It is a long-term therapy but it helps with my general health and it's great after a stressful week.

Over the four years that I have had rheumatoid arthritis, I have learned to keep only the people who care. I have been lucky to have had colleagues who understand and help where they can, like helping me to carry heavy items when we have to travel and more importantly, seeing the value I bring to the team than the amount of time I spend typing away at the desk. I have been lucky to have family and friends who worry more for me than I do for myself, making sure to keep me away from temptations that cause flares.

I have had to be more conscious about my mental health because I realise that inflammation and pain are directly correlated. I try to plan my work ahead and take time to do things that I like, such as crafts or most recently, attending a course on TCM. I have become more aware of the kind of situations I get into and make an effort to only do what I can so that I do not overstretch myself. I still get tired out for two or three days after an activity like spring cleaning (just a tiny part of my room).

Despite having to deal with chronic pain, it has not stopped me from travelling, which I love. I have had to make some adjustments, such as picking out the kind of clothes that I can wear easily because my mobility is limited, paying for check-in luggage and asking for help to put my bag in the overhead bin (though I try to avoid that, if I can, by placing it under the seat). I hope that travel will be able to resume soon so that I can continue to see the world.

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