The good news is that you (and all your classmates) seem to be learning about the dark side of RA in med school.

If you are getting deformities, you need aggressive treatment. Have you found a good rheumatologist? This site is chock-full of nurses, many of whom will be happy to weigh in about working with sick people while on DMARDs and biologics.

If you're looking for a specialty, have you considered rheumatology? We need a few good ones.

I agree with altocief. Rheumatology would be a great specialty for you. We need more good ones that really understand what is going on with RA. There are so many different types of autoimmune diseases it would keep you busy just studying them for a long time.

I guess I might be lucky in the sense that my mother dies of complications with Lupus and she had RA as well. She refused treatment and died within 5 years. So the systemic effects of it were driven home to me before I was ever diagnosed with both diseases.

I am learning to live with the new me that shows up every day. For the most part I can coast along with the meds and then all of a sudden wake up to another nasty surprise of pain and swelling.

Don't let it get to you too much. Keep your focus on your goal of being a doctor. Work with your rheumatologist with that goal in mind. With the right meds you could lead an almost normal life for quite awhile. Goals help in that they give us something to aim for. Yours is being a doctor, mine is retiring to the Bahamas (with stateside visits to my Rheumy).

It's true...they don't tell us and they should. I knew because I lost a cousin to Ra and I've got organ involvement. First, find a good rheumy and get back on MTX. Then choose a biologic carefully. They really are the drugs that keep the inflammation down and can even put you into remission(I was for 3 years).

As for your chosen career...how about going into psych? Or be a rheumatologist...although that means doing an internal medicine residency first and that means germs! Really the only branches of medicine that don't involve berms on a regular basis are psych and pathology where the germs should be dead(maybe???) In Surgery, you get to wear masks and gloves to protect yourself as does ICU work so that is possible but when you are trying to protect yourself, that's hard. Any kind of counselling available to help you....career wise?

Anyhow, welcome and get back on your meds NOW!

gentle hugs.........Jen (RA since 1977)

Yes the lack of education between doctors & patients is a topic that hits the board. Very sad & just wrong.
Thankfully the disease did not stop your pursuit to become a doctor.
It's messed with my cognitive skills on to many days.
Be interesting to hear from another doctor (a good, up front dr) on the risks you are subjected to.
Wish you the best of luck. Hope you share what you've come to learn about this disease if & when the need arises. Lord knows Should be educated about what we face.
Blessings
Sammy

I'm 36, was diagnosed as a teen, saw a rheum that was awful and creepy in every possible way and was not offered any treatment beyond NSAIDS. Fortunately my RA was mild and very slow to progress. A long series of PCP's through out my 20's offered no advice, or referrals, didn't even want to talk about the RA, until I was 33 or 34 when my latest PCP said that I should be on anti-rheumatic drugs and have my organ function tested because I'd been on massive doses of NSAID's for over half my life. I vaguely mentioned that I was worried about taking drugs because my mother and grandmother had such bad side effects and her response was a sympathetic "Oh, yeah ... " and she dropped it. It wasn't until a year later, when I was in absolute agony that she started me on a DMARD. When I was horribly allergic to that, she referred me to a rheumatologist. Kudos to her for being the first doctor in a dozen to say anything at all about my RA. It does kind of suck that at the first sign of reservation on my part, she dropped it entirely without any cautionary advice. Regarding all the others, it's truly amazing how many doctors are checked-out but still on the job.

Food for thought, my current rheum suffers from a rheumatic condition. I think it makes a difference. I am taken seriously and I always receive prompt care.

Hi gdsonn2. Kudos to you! Managing medical school, your RA and a med student spouse.

I don't know first hand but I did witness many, many med students, residents and fellows in my time at the teaching hospital for whom I worked for 15 years. Long hours, passing your spouse like a ship in the night..... Just know there are those who are rooting you on all around you.

Whenever you need a place to vent....you know where to come. Find a DMARD to facilitate you non-hurting body awaiting you.

Soft hugs,

Vicky

Thank you everyone for your kindness. It's always pretty amazing how far a few kind words can go. I apologize for taking so long before replying, but have been up to my ears in studying . . . as usual.

Sammyo1 - oh the tales I have to tell about what we learn in med school about RA. The running "joke" for med students is that if you don't know what a patient has, it's probably diabetes. The joke came about because diabetes is taught in every single component of everything we learn - what makes me saddened is that the joke has now come to include RA (and Lupus). Different med schools go about teaching things differently - my school has a 1st year curriculum that is pretty generic (cell bio, genetics, physiology, micro, a little pharm, anatomy) and then 2nd year everything is broken down into systems (cardiovascular, renal, musckuloskeletal, dermatology, etc.) and the systems include a wide variety of information - everything ranging from pathophysiology to pharmacology and clinical presentation. What has really struck me, and my classmates, is that there are 3 conditions that, without fail, appear as either an actual disease for a system or a risk for a disease/complication in a system. Those 3 are diabetes, smoking, and RA. RA itself puts all of us at much, much higher risk for lung, cardiac, and kidney disease due to the life-long state of inflammation. There little was not a single system that we learned that did not mention RA in some form or fashion. Not one. To add insult to injury, the drugs that help stop the progress of RA and give relief of pain put us at risk for some pretty rare and serious complications of viral, bacterial, and fungal infections. By treating our RA, we become immunocompromised patients. RA patients on DMARDS, biologics, and long-term steroids, are placed in the same category as the elderly, babies, cancer patients on chemo, and HIV/AIDS patients. It's really a pretty sombering picture. I'm not saying all of this to scare anyone in any way what so ever, but I think everyone with RA has a right to know these things. I was never told them by my rheumatologist. I thought RA was just a condition of the joints. I was so very wrong. I think it's important to know these things so we can do all we can to prevent them, to protect ourselves, and to try and live as long and healthy of a life as possible. RA is manageable. Just with the right information and care.

Ok - I'll step down off my soapbox now :)

I was only diagnosed a couple of years ago but the two rheumatologists I saw more than once never mentioned any of the complications. In fact, before I started Enbrel, I was asking a ton of questions about the immune compromise stuff and was basically brushed off. (FYI, I had to stop both Enbrel and Humira due to raging upper respiratory infections at weeks 12 and 13). I've now found a new office, a new doctor, and am starting over after about 20 months living with it and trying to ignore it.

I've found I can't heal anything as well, from a minor cut or scratch to a tattoo. I don't know what long-term changes my immune system has experienced, but it's changing the way I live my life for sure. If it wasn't for sites like this and RA Warrior, I wouldn't have had any clue about my disease because no one sat me down and really explained it to me.

All I can say is thank goodness for the Internet.

My rheumatologist seems to expect me to be a well-informed patient. She advises me to read and learn as much as I can online and ask her when I have questions or need clarification and that approach does make sense given the scope of the disease and the limited time in the doctor's office. Maybe I'm giving them too much credit but I wonder if most rheumatologists assume that their patients are reasonably well-informed because we have access to so much information.