Cycling nearly killed me, but it’s still an important part of my life Julian was diagnosed with RA in 2009. In 2012 he suffered a head injury as a result of a cycling accident, which his wife was told he probably wouldn’t survive. This didn’t put him off the sport, and he now competes as a Para-cyclist and recommends cycling to others with RA By way of introduction, I am Julian Earl, and I was diagnosed with rheumatoid arthritis in the spring of 2009. In 2008 it was thought to be a post-viral reactive arthritis, but it did not improve as expected, so the diagnosis was amended to being seronegative RA. I qualified as a veterinary surgeon in 1981 and worked in Lancashire for eight years before moving to Lincolnshire in 1989. The development of swollen hands and wrists in 2008, made my work rather difficult but not impossible, although fine control of my fingers proved awkward. I just about managed with work, but I described it like working with two sprained wrists! Outside of work, and ultimately the reason I am writing this article, I was a keen cyclist, have been since my student days. I started competing the year after leaving university. It is fair to say and that it has been an obsession. Initially, my RA made cycling rather tough because I was severely anaemic, and even 500 metres was a major challenge. However, within two to three weeks of starting an anti-TNF in combination with methotrexate, the anaemia had improved, and I could ride once again. In fact, I was better so quickly that I have described adalimumab as my “silver bullet”! Very soon, I started preparing for racing again and progressed well. Despite some on-going discomfort in my hands and wrists, by the spring of 2012, I was able to complete ten cycling events, so-called “sportives” of one hundred miles or more, around the country. Two weeks later at a race, near Alford in Lincolnshire, everything literally came to an abrupt halt! I crashed into a big bunch of eighty riders, and my head struck a kerbstone outside a farm entrance. Just a few more yards and I would have landed on grass and mud! I was sent under a flashing blue-light to the specialist neurological unit at Hull Royal Infirmary. There, my wife, Annika, who had been called away from her leaving-do as a District Nurse, was informed that I probably would not survive! My wonderful consultant Neurosurgeon, Gerry O’Reilly, sat next to the bed and after asking how I felt etc.? He then asked me, “What am I like as a person? What do I want to do in the future?” All I could say was my honest answer, “I do not give up easily!” “All I want to do is get back on my bike!” To his great credit, Gerry replied, “It is useful if my patients are stubborn. If you want to get back on your bike, then I’ll get you there!” He did not say, “Don’t be daft; you cannot even stand up on your own right now!” I was discharged at the start of 2013, and because my sense of balance was severely damaged, I could not stand unaided, and the physiotherapists sprang into action. I joked that they were my dance-instructors! “Stand on your right leg for thirty seconds; now the left leg. Step to the right, now to the left, now two steps backwards, now forwards, and so on… I’m sure you get the picture? Nevertheless, I persisted, and some friends from my club took me out riding. On the 8th September 2013, I completed a sportive of 55 miles around Lincoln and three weeks later finished another one of 100 miles. My RA was now back under control, thank goodness thanks to the adalimumab. I received a club-trophy for the most outstanding performance by a member of the club in 2013! My consultant neurosurgeon, Gerry, was as pleased as I was with my trophy! No other trophy will ever mean as much to me as that one did, showing what my club-mates thought of my recuperation and my refusal to give up or give in. During my convalescence, Annika had an inspired idea. As a vet, I had given a talk around Lincolnshire forty or fifty times in the 1990s, so Annika suggested writing it down to try and get it published. In short, I did this, and it was published by Quiller Publishing in July 2016. The book is entitled “Cows In Trees” and is so-called because I was indeed once called to a cow stuck up a tree. People often ask how did it get there? My standard-answer is that in Lancashire where it happened, there is a special breed, that builds nests in trees. Or else it was parachuting and got stuck in a tree on the way down. Not sure why no-one believes me. In the mean-time, due to my head injury, I now compete as a Para-cyclist, and this is just as challenging a competition as I ever competed in. British Cycling deserves huge credit for supporting this branch of the sport. I believe cycling is good for a someone living with RA because, apart from crashing, (which I don’t recommend) it is impact-free on the joints and helps control weight and particularly improves my sense of well-being. I recommend cycling to you all! I hope that this brief story of my life with RA shows that there is indeed still life to be enjoyed after diagnosis of this potentially debilitating disease. I have commented several times that I might get older, but as long as I ride, I will not BE old! Much credit is due to so many people: Firstly, my wife Annika for her love, care and support above and beyond the call of duty, Gerry O’Reilly, neurosurgeon at Hull. My friends and family who have provided great support in recent years, Also, of course, thanks to the many medical staff for whom I hope I have not been too great a burden in recent years! I am now retired from work due to my injuries but not because of rheumatoid disease. My life now revolves around my wife, my family and my sport. This year in June, I achieved fifth place in the National Para-cycling championship, something that I could never have dreamt of when lying in hospital for several months during 2012 to 2013! Cycling has enriched my life like no other sport could do. Some things you never get over, you just have to get through. I would highly recommend cycling to anyone with rheumatoid arthritis but suggest you skip the crashing bit!