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Choices – real or perceived?

Choices – real or perceived?

The notion of real or perceived choices has peaked my interest lately.  What do I mean by that?  Well, simply put I have come to a place where I wonder how many choices are real and how many are actually predetermined but seem like they are in our control? And most importantly, does it matter?  Are there consequences when we feel choices are not ours to make?

When it comes to the choices I make with regard to managing RA, I like to think I have lots of choices, most of my own free will.  But when I really examine them, I do sometimes feel like they have to a large extent, been predetermined.

For instance, choosing a rheumatologist.  They are scarce and often we are directed to the closest one, regardless of whether that works for us or not.  So the reality is, we may think we have a choice, but the fact is, we are told who our physician will likely be.  Now, we can choose to drive some greater distances to see a different doctor but for many people this is simply not an option.  Does it matter?  It does to me.

With that in mind, I wanted to sort out how many choices are truly mine and how many are not?  I think this is a question worth asking, because for me, getting those answers made me feel much more in control of my destiny.  I happily found out that most of them are, at least in part, my choice.  They may be heavily influence by circumstances beyond my control, but that does not mean I have no choice. On the contrary, I will advocate for what I think is best for me in any given situation.

If you look at treatment for instance, you may think at first glance, that the choices you have are by no means real.  That, in fact, they are being made for you by a physician.  Well, the fact is, if you do your homework, you can learn to advocate for your choices, ensure your voice is heard, and by so doing, become a more active and informed chooser.  There are many, many treatment choices out there today.  The key is to not turn over your choice to someone else, unless of course you want to, in which case, you are good to go.

I determined that oftentimes our choices may not be 100% our own but that is fine as long as we still have some real input into the options.  That makes a choice real and not perceived and that is what I was hoping for when I started this inquiry.

I just did not want to find out that because I have a chronic and challenging disease with so many aspects that feel set in stone at times, my choices were not mine, not real.

What I have discovered is that if we want to have more real choices with regard to managing RA, then we must take responsibility by becoming informed, educated and invested.  The more you know the more you can choose.  It really is that simple.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • Connie Rifenburg
    4 years ago

    I believe I disagree with how you describe our ‘choices’.

    There are many more choices regarding RA than just the choice of treatment. If someone were to ask me whether or not I had choices in my life regarding my RA, I would list my meds as one of the minor ones. Is it just me, or don’t any of the other people with RA have daily choices that have been either reduced or completely removed due to your RA?

    My choices on where I can live. My choices on how I can travel and where I can travel. My choices to attend events – whether family or external – movies, plays, musicals, parks, etc. My choice as to what to wear or not wear. My choices on how to spend my money. My choices are so different from what they used to be prior to RA, that I feel like I am living someone else’s life at times.

    I am placed in the position of asking for help for at least 70% if not more of all those things listed above. And not just ‘help’, but having a reduced number of choices even when considering a choice. Does that make sense?

    I am a single person. I have been a single parent since age 20. I’m now 65. I have always been self sufficient, so maybe this is why I feel as though I have little or no control over my choices anymore. As a chronic disease takes over your body I believe your choices become less and less. Sometimes it’s only a “lessening” of choices for a while – maybe during a particularly bad flare. But as I age, I find those choices are becoming more and more difficult to accept and longer lasting when you add in the “normal” aging process to a chronic disease that is incurable.

    How do people face reality when reality seems so void of any new choices?

  • Nan Hart moderator author
    4 years ago

    Hi Connie: I really appreciate your reply and agree completely that the choices are many and control over them is challenging at best. I mentioned treatment as an example only not by any means the only or even most important one. You clearly have been through and continue to contend with the real and brutal effects of RA. I am in my 60’s as well and as we get older the choices can be limiting at best. Thank you so much for sharing your story. Nan

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