Onset of RA in the UK

Shortly after the new millennium began I set off to study abroad at the University of Oxford in England. I was a 22 year old college senior, and the world was my oyster. Nothing could hold me back. At least, that’s what I thought.

Before I left, I was talking about my upcoming trip with a British woman who had been living in the U.S. for a number of years, and she said, “Oh, in the winter in England I can just never get warm. The damp and cold sets into my bones, and my bones don’t feel warm again until I’m back in the States.” Looking back, her words almost seem like an unintentional curse, because man oh man, did I end up feeling England deep down in my bones.

It started the first week of my trip with pronounced swelling in my right wrist. I had had a ganglion cyst removed from that wrist five years earlier, so my initial thought was that the cyst was returning. However, as the semester went on, and more and more parts of my body started hurting, I realized there was something really wrong.

The program of study at Oxford was incredibly demanding, and I have never produced more writing in such a short time period as I was required to do there. I had to write one or two papers each of the twelve weeks I was there. Sitting in front of my early-model laptop for hours on end, the swelling in my right wrist soon expanded to my left and to all of my fingers. I had no idea what was happening, and purchased some ace bandages so I could wrap my wrists during my all-nighters.

I lived on the second floor of a large house shared by 27 students, and soon my ankles and knees began to protest each time I made the climb to my bedroom. When I happened to forget something, necessitating an extra trip up those stairs, I was crestfallen that I’d have to make a second ascent. Some of my housemates noticed my discomfort and would ask me what was the matter. I was at a complete loss as to why these seemingly random parts of my body were all hurting, and said as much. One of my new friends said, “Those are all joints.” It hadn’t even dawned on me that my fingers, wrists, knees, and ankles were all joints! Another friend said, “Do you think you have arthritis?” My response, which seems laughable now, as I have heard it from the mouths of so many others in the past 14 years, was, “Can young people get arthritis?”

She explained to me that there was such a thing as Juvenile Rheumatoid Arthritis. In retrospect, when I look back at the precursors of my RA that I had throughout my childhood, I wonder if I had mild JRA from about the age of eight years old. Yet, my time in Oxford was the first instance when I had so many joints affected simultaneously, so I had been in blissful ignorance that a disease called Juvenile Rheumatoid Arthritis even existed until that moment.

Luckily, I didn’t do much research at the time. I did see a doctor in England due to the extreme fatigue I was experiencing (I was sure it was some kind of virus), but I didn’t even mention my joints. I was already a foreigner, and exploring the possibility of a disease that was foreign to me while in a foreign land didn’t occur to me. So it wasn’t until I returned to the U.S. that I went to a general practitioner, who sent me to an orthopedist, who in turn referred me to a rheumatologist, who gave me my RA diagnosis. My British friend had certainly been correct about the way the cold and damp in England sets into your bones. However, unlike her, my return to the States did not bring my bones any of the comforting warmth it brought her.