Oh Right, I Have Arthritis

On the first day, I thought my cheek was sore. I tried to retrace the activities of the day before. Had one of the kids inadvertently bopped me in the face with a toy, or had I somehow bumped my cheekbone on something? The next day, as the ache intensified, it occurred to me that my nighttime teeth grinding may have ramped up, overpowering the mouth guard I wear while sleeping. I began palpating my cheek to check for soreness, just as my dentist does, and found that yes, the muscles were indeed quite sore. However, it wasn’t until the third day, as the dull ache ramped up to a sharp jab of pain as I bit down on a slice of apple, that it finally dawned on me: It’s my jaw. I pressed my fingers over my jaw joint, and sure enough, this was far more sensitive than the muscle pain in my cheek. And I thought, “Oh, right, I have arthritis.”

That may seem strange coming from a person who has been diagnosed with Rheumatoid Arthritis for 14 years, who has tried at least 16 medications for the condition, including pills, injections, and infusions, and who currently self-administers weekly injections of Orencia. Of course I never forget that I have the condition, but I still have these moments due to the pervasive nature of this disease. RA can affect any joint in the human body, and as we have well over 300, that covers a lot of ground (not to mention that RA can also affect organs, muscles, tendons, and ligaments). When one of my “frequent offenders” acts up, such as my hips, wrists, fingers, knees, toes, shoulders or sacroiliac joints, I immediately recognize the pain as RA. However, when the pain rears up in a place that has previously been unaffected, my arthritis isn’t always my prime suspect.

Interestingly, the same thing happens with fatigue, even though I experience it frequently and have experienced it intermittently throughout my adulthood. I am fully aware that fatigue itself is a symptom of RA, yet, when it comes to my fatigue, I often overlook the obvious cause. Most days I assume that my fatigue is solely due to being a working mother of young children, with countless responsibilities to juggle. However, when I ask myself upon pouring a fourth cup of coffee, “Why am I so tired?” the truth sometimes surfaces: I am a busy, working mother of young children who also has RA, a disease which can cause incapacitating fatigue even for those who may get more sleep than I do or who may have to-do lists shorter than mine.

When I take a step back, this series of denials of my RA makes sense. Most therapists agree that denial is the first step of the process of coping with loss, and that the final stage is acceptance. Discovering that I had RA was certainly a loss; my diagnosis was the death of an adulthood I had unconsciously envisioned for myself, one without a chronic health condition. While on the whole I feel that I accepted this loss long ago, when I find myself thinking, “Oh yeah, it must be my arthritis,” I realize that I’m back in denial, and that the process of coping with this loss is never complete, because it’s not a single loss. Rheumatoid Arthritis is so pervasive and encompassing that it causes an ongoing series of mini losses. This jaw pain is its own mini loss: it is the loss of a pain-free joint. Therefore, it makes sense that even though I’ve come so far in dealing with my RA, there will be days when I feel like I’m right back at square one.

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