How my rheumatoid arthritis has adapted to cope with me From experiencing RA through his mother’s diagnosis to seeing it through his general practice as a doctor, to his own eventual diagnosis. How one man was determined that his RA would have to work around his plans. During my childhood in the 1950s, my mother had severe rheumatoid arthritis. I remember very well the marked deformity of her joints, the wrist splints, the elbow crutches and the pain and suffering she endured. Then the main stay of treatment was large doses of aspirin. Every year or so she would be admitted to The Devonshire Royal Hospital in Buxton for many weeks to try and help her, the treatment being physiotherapy and wax treatments; she always came home improved but rapidly deteriorated again. At home, we had a galvanised mop bucket that was ⅔ full of wax, which was heated on the gas stove in the kitchen, and then, when at the required temperature, she immersed her painful joints. My brother and I used the wax to make candles, which one Christmas we proudly put on the tree, the resulting damage was reduced by my quick-thinking father who rushed outside with the burning tree! During my teen years, my mother’s arthritis worsened with markedly reduced mobility; the district nurses visited regularly to give injections of gold or ACTH (an early steroid no longer used). At the age of 17, I found myself attending an interview at Leeds Medical School as, by that time, I wished to train as a doctor. I explained at interview about my experiences with my mother, and this was well-received, and I was accepted. I certainly didn’t add that it was in equal measure due to watching Dr Finlay’s Casebook on a Sunday evening on our black and white TV! After training, I entered General Practice, where the treatment of rheumatoid arthritis changed very little over the next 35 years until I retired in 2011. We treated patients with different anti-inflammatory drugs similar to ibuprofen and aspirin and only referred to rheumatology when we couldn’t control the symptom of pain and deformity. Methotrexate and similar disease-modifying drugs were only used as a last resort when symptoms could not be controlled. 2 years ago, I noticed my grip was poor, and after a few months, I developed stiffness and swelling in the joints of hands and both knees. I realised it was rheumatoid arthritis and was started on methotrexate and hydroxychloroquine. Once the dose of long-acting steroid, which I was given at my first appointment, wore off at about 8 weeks, my symptoms worsened. The dose of methotrexate was increased and remission induced at 6 months. I do not allow my RA to affect what I do; it has to adapt to me, not the other way round. I continue all my usual activities of walking 50 plus miles a week, backpacking with camping equipment, and fell walking. My only worry at present is which tent and sleeping bag should I take on my Scottish trip next week 100 miles along the Southern Upland Way; should I take a large tent and sleeping bag heavier, but more comfortable, or take lighter less comfortable equipment? Ah, these problems!