The current thinking is to get aggressive treatment with DMARDS [typically low dose Methotrexate and a biologic]. This will preclude damage from happening in the overwhelming majority of cases. With the appropriate medication drug-controlled remission is very likely. But do it early because once damage has been done, it's not reversible.

Don't be discouraged. Get the best rheumatologist you can find. Learn everything you can about the disease. Ask questions. Take the bull by the horn and accept the diagnosis and think positively.

Good luck.

Lynn

I'm so very sorry... I understand exactly how you feel. I was dxed 7 years ago this November and was devastated. I lost my career as a professional educator and prior to RA I hiked, biked, walked, and was very physically active. I felt like all of my dreams DIED and I actually had to grieve over the life that I lost. It took a couple of years, but I "rebuilt" my life from ground zero up. I took a part time job teaching at a community college instead of public school. I now do yoga and Qigong. I sew, play the ukulele, go to a book study, joined a writing group, joined a group that helps w/ my weight and nutrition focus (TOPS). I have to rest more, and do not travel as much and my life is very different than I thought it would be at age 55. But I take nsaid, dmard, and biologic and most days of life are very good.... even though I tire more easily and I had to really slow down.
Yes, it really sucks in the beginning.... and I was terrified. But life is good now... during a flare it still sucks. But I always get up. I do well until fall... but my rheumy always helps me pull out of it. Take care. Take hope. You will find that life can still be very good. xo Sun

RA hit me at age 44. I was working full time, I had my 4 kids in all kinds of ice sports, (hockey and figure skating) usually about 17 ice slots a week. I was very involved in my church, studying advanced flute, and exercising daily.

RA crept up on me slowly, but I gradually started eliminating things. To the point where that meant not shopping or cooking. Very bad times. I finally had to go on disability from work, and I never went back. Depression is very common, when you lose almost everything, and I was very depressed.

It took 7 years to get on a good med combo! It lasted 5 years. I lost 80 lbs, started a Master's degree. (I did graduate with distinction), took up cycling, stretches and weight lifting, and got back into helping at church, teaching and leading the music ministry.

After the good meds failed, I went on some less successful ones, but tried not to give up everything again, plus not get depressed. Things were pretty good until Feb. 2015, when Simponi just failed out of the blue. It was complicated by the fact that I had moved provinces, and my rheumatologist could not give me any new biologics till I was able to get on BC medical and pharmacare. Even my supplementary insurance would not approve a new biologic unless the province approved it first.

So, I lost everything again, and got depressed. But I knew what was happening, and I crept out of that depression hole. On reasonably good days, I exercised and played flute, I lost a lot of conditioning and flexibilty, but not totally.

So this is all to tell you, there are real ebbs and flows with this disease. Get on the best drug or combo of drugs you can. Once you start feeling better, you will come to a state called "acceptance" and not get depressed about either the disease or the limitations that remain. My feet are horribly damaged, I cannot walk any distance. That is when I have no flares, my feet are still not good. So I gave up speed walking, and took up cycling. Right now, cycling is still hard, mostly because of the further damage Rituxan did to my lungs, so I am taking up swimming. If that doesn't work something else.

So get on some good meds, and do not give up. Life is still incredibly worthwhile even if you are suffering from RA. In fact, I would say getting RA, as much as I hate what the disease has done for me, God used it for enormous good. He used it to help me mature, and to have compassion on the broken and suffering. I was working as a chaplain in long term care, until my meds collapsed again last year. But I still kept doing various things.

So do not give up. Allow yourself to grieve, we are all entitled to that. But do NOT wallow in it. And figure out what little things you can get back. I love Sunvalleygals post, and all she is doing since she rebuilt her life.

Perhaps we can get together one day and play ukelele one day! I used to teach it, and I have 4 lovely ukeleles.

I was diagnosed in my thirties. I was able to carry three pregnancies, rise three children, then go back to work when they were ll in school. I continued to knit and crochet driven do all my house-cleaning and keyboard. (I wrote two books and dozens of published articles).

Remission? I've been in total remission for 6+ years on Orencia and methotrexate (with a six month break when I had abad infection). I know someone who has had 15 years of remission on Remade and methotrexate.

You can definitely live a FULL and fruitful life with RA. You will have some bad days - even some bad months, but...on then the hand many of us live free of colds and flus!

What keep see going is knowing there are so many FAR WORSE diseases!

Getting diagnosed is scary, but it is far better to know what you are dealing with and that it is treatable and remissions ARE possible! get started don treatment as soon s possible!

I will echo what a lot of others have said. You need to get on a DMARD concoxtion ASAP & the typical format is to treat very aggressively up front. The way I look at it, is that they're trying to beat the crap out of the RA at an early stage.

I would say I'm a very typical example of someone who caught it early & was treated aggressively. But everyone is different! Keep that in mind. I was dx'd at 43, I'm 46 now & I'm completely off med's. My doc feels I'm in remission but in my own mind I'm looking at it as forever "temporary". Because unfortunately I don't want to bring the "doom & gloom" but this disease CAN go into remission forever, or for a month or a year or a few years, but it can & often times does come back, in the form of flares or even full blown again.

Try to keep active, if you can't right now due to the ailments then do what you can & wait for the med's to kick in & then get back into being active. Get on a good schedule, get your labwork done, go to your appointments, learn as much without being too overwhelmed!

Thanks for al the words of advice! The rheumatologist can't see me for another 2 months. A PA is avail at the end of November so I took that appointment just to get my foot in the door.

Marlene, why did you have to stop working? Were you not able get drugs after diagnosis that could put you in remission?

Why do some not go into remission? Or why do the drugs not work for some?

Do many people find they have to stop their careers? I fear the cost of medication without insurance. Isn't it very costly?

What about diets? Do you feel gluten free or vegan help put/keep you in remission?

Sorry for all the questions but appreciate the guidance and support!

No proof at all that gluten free diet helps anyone except those who truly are gluten-sensitive. [Too many people THINK they are.....but aren't.] However, a good diet is ALWAYS a good thing for overall health. But for RA, there is no proof of any diet or supplement that helps RA. You need a DMARD.

I never took a day off due to RA in the entire time I've had RA [since 1992]. Few people ever do. Remember, most of the people who visit this website are not yet in drug-controlled remission. Those [the overwhelming majority of those with RA] who are in remission are too busy living their lives to visit this website.

The sooner you get started on a DMARD the quicker you'll halt disease progression. This is very important, especially if your job requires physical activity.

The drugs don't work for a small percentage of RA patients. No one knows why. My guess is that they have a slightly different version of RA or another adjunct disease that precludes the drugs they take from working. Again.....this is a small percentage of people. Odds are you won't be in that group.

DMARDS: It depends on the drugs. Typically you're started at a lower level DMARD [e.g., MTX] which is very reasonably priced if you don't have insurance. The biologics are very expensive. Some insurance companies do cover them.

Do you have drug insurance where you work? This is Open Enrollment time, so you want to explore "specialty drugs" such as Humira, Enbrel, to name a couple. Make an appointment to talk with your company HR rep about this. How much does it cover?

The good news is that if you have insurance that covers part of the cost of a biologic, odds are that the pharmaceutical has a program where they'll pick up most of the balance.

But first things first. Sit down with the HR rep and get facts. Choose the plan that covers biologics and has a great network of doctors. I recommend a PPO plan with one of the top insurers. You only have another week or less to make your choices, so you'll want to investigate immediately.

Keep asking questions. This is the time for getting the facts. Lots of people here who can help answer questions.

Lynn

PS: I'm almost 70 and still run my own consulting firm.

One other question: is it normal to have pain in lots of joints. I have swelling and pain in wrists, fingers, elbows, knees, ankles and toes

Call the RA's office everyday and see if there's a cancellation so you can get in as early as possible. Diet, tried most, have good success at a nightshade (google it) free diet. You won't like it but it'll help you adjust to "missing" things that you once enjoyed. Oh, also diet like you have an active case of gout as well. Diet won't shut the disease off but might lessen the pain/swelling significantly. Best of luck!

Absolutely agree with nonightshades2 about calling the doctor's office daily. I'd try about 30 minutes after the office opens. People do cancel and if you're the next caller, more than likely they'll put you in that cancelation spot.

I tried to keep on working, but I was not diagnosed properly for 2 years, then untreated because I was sero-negative. It seems like the rheumatologists in those days in Vancouver, mostly knew nothing about sero-negative RA. I finally found a really old guy - in his late 60's who diagnosed me by symptoms, and wondered what was wrong with the young doctors. My rheumatologist told me he is still working - he must be in his 80s!

So I was really, really bad. I couldn't dress myself or walk after a while. Mthx helped a bit, and I was given NSAIDS. They took Celebrex off the market, and I thought I would die. So I saw my rheumatologist and he finally put me on a biologic. I got a lot of my life back, but I had a lot of feet and hand deformities by then. After 4 years of feeling good, I went back to my teacher's union and asked if I should come back to work, and they said no, because the meds could fail any day. About a month later, mthx failed, then I had my foot reconstructed which was a terrible fail.So that was the end of me trying to go back to work. I had disabilty, and it forced me to retire a year ago. So, end of my work life!

As to why drugs fail - sometimes they just never work. There are different families of RA, and different meds work for different families. Actemra never worked for me, and Xeljanz. Kineret with mthx was 100%. But then mthx failed, and I tried Sulfasalazine,and it worked not quite as well, but not too badly. But after 6 months I started needing Bendryl to get through the day. It took two months to realize I had become allergic to Sulfasalazine. That was because it took 2 hours to hit the intestines, it was enteric coated, so I could never figure out what I was allergic too.

Rituxan didn't work long enough. It is supposed to last 6 months to a year. Mine lasted 4 1/2 months, then the insurance company put me off another couple of months, so sometimes I was flared more than not flared. But it also did something to my lungs, so I stopped.

I am sure everyone here has a few stories and most differing a bit. But many people do find a drug that works right away, and they can work, so don't give up. I have ultra severe RA, apparently, so I am hard to treat. Most people are not even close to as bad as I am. Like I want to be so bad!

As for covering the drugs, I am Canadian and pretty much all my RA drugs are covered between my husband's work extended care, the provincial drug plan and the companies until the deductible is paid. All the provinces are like that. We are not covered for medical by work, but rather by the provincial plans, which costs nothing in most provinces, except BC where we pay $85 a month. American health care, Obamacare that has been a nightmare apparently is beyond my understanding. But many here might know a bit about negotiating medical costs and subsidies. Don't give up!

Diets do not work. There is no magic formula, although it is always good to eat well. I was an organic vegetarian, growing all my own veggies when I got RA. I had been for 37 years before I got RA. So eat well, but it is not a cure, for sure!

I think all the commercials for the RA drugs paint a bleak picture. It doesn't have to be like that! You're in pain now, but once you get on the drugs, you will most likely be feeling better very soon. You might have to adjust your life some, but maybe not. I am actually more active now after 10 years with RA than I was ever! I started playing soccer about a year ago, since i figured my legs & feet were good, so I should exercise them. I do yoga & have to adjust some of the hand/wrist poses, but so what! My yoga teacher says pain is not gain in her class.