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How can I prevent flare ups during my exams?

Hi, I need help managing my symptoms during examinations. I am currently trying to do my MBA. I can do assignments with no to mild problems. I generally only experience problems after writing for 2 hours straight in my hands (which is understandable) But always without fail, 20-30mins in, I will experience mild to severe pain in all parts of my body during the exam (swelling, stiffness and burning pain). I understand that stress plays a huge part in it but most of the time I don’t feel stressed. And if it is subconscious how can I prevent these symptoms. Please, I really need help (I have 2 examinations to 3 weeks).

  1. Hi shauzrad, Thank you for reaching out. Congrats on working toward your MBA! I hope others in our community reach out as well to share their personal experiences to share with you. Have you discussed your symptoms with your doctor? Take a look at your habits and routines before your exams. Do you eat different foods? Do you get less sleep? As you mentioned, are you more stressed than normal? You may consider being intentional with your diet and some relaxation techniques before your exams. In addition to speaking with your doctor, these articles may be helpful to you:
    Flare Triggers:
    Community Thoughts on Flares:
    Relaxation through yoga:
    I hope those are helpful. Please keep us posted on how you are doing. Wishing you some relief soon. Kelly, Team Member

    1. Thank you for responding Kelly. I am quite mindful of the food I eat, especially during exam time. I recently found out that I have a inflammatory responses to gluten, cow's milk, chicken eggs and green peas. I do tend to have unhealthy sleeping habits during that time (procrastination obviously). I may try meditation before the examination starts but yoga is still kinda out of my reach currently.

  2. I have two thoughts. First, could your RA doctor prescribe a week course of pred? Although I haven't done it myself, I know people who have proactively taken steroids when they know a stressful period (for example, travel or your exams) are coming up and that they are very likely to have a flare. The pred can keep you from having symptoms during the exams.

    My second thought is to ask how long the exams are. I know that if I sit completely still for more than 40 minutes, I'm in real pain. If your exams are 60-90 minutes, ask if you can have accommodations (which schools are legally required to provide)--ask for a quiet room and an extra 15 or 30 minutes. Then every time you finish a section (or an answer if the answers are essay), get up to walk around and stretch for 5 minutes.

    1. Hi Annalisa, thanks for answering. To your first thought: My doctor is very reserved when it comes to giving out steroids. He mainly only offers an injection that you take 2-3 days before travel or a stressful event, but that method does not help me at all. I have taken a form of steroids orally during the first couple of months of my diagnosis (I had gotten to a stage where walking was no longer an option). But I personally wish to stay away from steroids fearing their long term effects.
      Answering you second though: My exams are 3hours/180mins long and 2 days apart. I have taken measures like doing an electronic exam instead of paper and I am given extra time of 10mins. I am just concerned with the level of pain because it can sometimes be distracting and its hard to get back in the zone or (touch wood) I get brain fog.

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