What is it like to have Rheumatoid Arthritis?

14/12/07: By Dr Louise Warburton

I am a doctor and have suffered from rheumatoid arthritis for 4 years. When I was first diagnosed, I was working in a two doctor practice as a ¾ time partner, with some out of hours responsibility.

I had had symptoms for at least two years before diagnosis, but when I was told that I definitely had RA, I was devastated. I knew from working in rheumatology clinics what the disease could do to me.

I didn’t take any time off work. I told my GP partner what was wrong with me; he was shocked and initially supportive. However, as time progressed, he became much less interested in the problems I was having and it was clear that he feared that my illness would have a negative effect on the practice.

It is difficult for work colleagues to be continually supportive when your illness directly affects them and can possibly increase their workload.

I have always been conscientious and attempted to continue working at the same level as before. My main difficulties were with extreme fatigue. This could not be ignored and often I would have to lie down for half an hour at lunchtime. My feet and ankles continually hurt.

My levels of concentration were affected. I am sure that my intellectual capacity was affected on bad days as I could not remember where I had put things, or information which I had recently read. However, I strove to give my patients the best possible care, often at the expense of my own health. My GP partner became exasperated with me and continually criticised the number of minor mistakes I made.

It would have helped me enormously to work less at this stage in my illness. I didn’t want to be off sick, as I knew that once off work it would be difficult to return. I would have found it easier working half-days. However, my work in the practice had to be done by someone and I had to pay for any locums, so I invariably worked when I shouldn’t have.

Late starts in the morning would have helped as well. The morning stiffness meant that it took me an hour or two to get going in the morning and this seemed to affect my mental functioning as well. When I felt bad with stiffness and pain, I wasn’t mentally capable of undertaking the more demanding aspects of my job.

Fortunately now I am feeling better but I still have days when I wake up with extreme fatigue and stiffness. Colleagues find it difficult to understand this very variable nature of my illness (even some rheumatologists!).

I don’t wish to give up work and have striven extremely hard to stay at work, even through the break up of my GP partnership and the stress of finding new employment. For me, the mental exertions of work and caring for patients provide me with huge rewards and a reason to keep going.

I now have a number of part-time jobs. I am most comfortable working with people who understand my condition and, within the demands of the job, will give me a bit of leeway. For example, by seeing some patients for me if I feel tired or ill, or making allowances for me when I have a ‘senior moment’!

Part of my own occupational therapy is to stay at work and feel that I am making a useful contribution to society. Having something else to think about, takes my mind off my aches and pains.

On behalf of all those out there with rheumatoid arthritis, I make a plea to allow us to stay at work and contribute to society. This will mean a certain amount of flexibility on the part of employers and an understanding of the very variable nature of RA. Some days we can function at 150%, but other days we are better staying at home and resting. I know that this is a ‘big ask’ in today’s modern society, but we continue to achieve amazing things; just look at Ailsa!