This Is 40
I recently hit the big 4-0. While many people are living more vibrant elder years than was once common, thanks to advancements in medicine, the “over the hill” theme for turning 40 has developed for a reason. For the average American, 40 years is still about half a lifetime. It’s also around the midpoint for most careers, depending on when one entered the workforce. For women, it’s a time of rapidly decreasing fertility. And for many people, the forties represent the early stages of physical decline.
A time of reflection
Recognizing all of this, the milestone of turning 40 has been a time of reflection for me. I’ve been thinking about where I am in my career, I’ve compared the expectations I had for my middle-aged life when I was young with the reality of where I am now, and I’ve thought a lot about what I hope to achieve in my next decade. It’s been a time of taking stock and setting goals.
It has also been a time of noting the physical reminders of my age. While my laugh lines (I will never call them “crow’s feet”) have been developing for years, since turning 40 I’ve looked a little longer in the mirror and realized that some lines on my face and body are now permanent fixtures, rather than momentarily appearing in certain expressions. Feeling like insult added to injury, my gynecologist sent me to my first mammogram (why couldn’t my first mammogram be at age 39 or 41?). And at my last visit to the ophthalmologist, required due to the risk the Plaquenil I’m on poses to one’s eyes, I was informed that I have the beginnings of a cataract. Yes, I have indeed hit middle age.
There are some physical downsides to being 40. However, while at this age many people begin to experience daily aches and pains for the first time in their lives, I am no stranger to the constant presence of pain in my body. Diagnosed with rheumatoid arthritis/rheumatoid disease (RA/RD) at the age of 22 after having symptoms for years, it’s been decades since I took physical vitality and health for granted.
I have good days and bad, but the unpredictability of the bad days is always a little caveat in the back of my brain. When I’m invited to do something physical (go for a bike ride or a hike) my response is along the lines of, “That sounds like so much fun. I definitely want to, but I will have to see how I’m feeling that day. Can we have a plan B in case my body isn’t up for it?” While many 40-year-olds are just starting to wrap their brains around the possibility of not being able to do everything they want to do, I’m well accustomed to it.
One could see that as sad, that my 20s and 30s had too much in common with middle age. While there are times that I do grieve the “might have beens” associated with having a painful, chronic condition, for the most part I am grateful for all that my body is able to do in my 40s in spite of contending with this challenging disease.
When I was a college student going through the diagnostic process to find what was causing my severe symptoms, an orthopedic surgeon said he thought I had Reiter’s syndrome. This is a form of reactive arthritis in which symptoms are triggered by an infection and then go away within a year. When he gave me that (mis)diagnosis, I felt crushed. “I’m going to have to feel this bad for a whole year?!” Now I look back and I shake my head with compassion and a smile at that naïve college girl who had no concept of time because she hadn’t lived long enough to develop one.
I’ve now done that year that seemed so insurmountable 18 times. My symptoms haven’t been as severe each day of these 18 years as they were before I started treatment for the disease, but hundreds of them have been. Yes, at the age of 40 I have already experienced hundreds upon hundreds of horribly painful days. And I’ve survived them and they have not broken me. I continue to live my life, develop new goals, make new friends, and try new experiences in spite of the inherent setbacks that RA/RD routinely causes.
In this way, making it to 40 and having lived longer with this disease than without it, my milestone birthday feels like a major accomplishment. In those years, I have learned so much. While I remain a constant work in progress, I’ve learned to self-advocate, to listen to my body and honor its needs, and to be kind to myself and feel less guilty. Reflecting on what I have gone through and where I am now, I am so much stronger than that college senior ever could have imagined.
When was your last flare?