Donna proves why arthritis is not the curse of old age

10:45am Wednesday 29th April 2009

By James Connell

TWENTY-one is a very tender age for a woman to be told that she has rheumatoid arthritis.

But Donna Saunders of Worcester is glad her diagnosis does at least expose one of the enduring myths that still clings to public perceptions of the disease – that it is exclusively the curse of old age.

It is a prejudice Mrs Saunders, now 34, still has to confront when she parks her car in a disabled bay only to weather the pointed stares and barbed comments, often from disgruntled disabled people who make a snap judgement that she looks too young and healthy to have a serious disability.

Mrs Saunders of Colin Road, Northwick, is only too happy to politely set them straight, although it would be easy to sympathise if she lost her patience.

Her rheumatoid arthritis is so debilitating that she struggles to lift either of her two children or hold them in her arms – she cannot bend her wrists at all and her whole body can be racked with pain.

“I have a disabled badge and I use it to park but sometimes I get looks and comments.

“They say, ‘Do you know this is disabled parking, my love?’ They pull up and say, ‘Have you got a badge?’ “They think I’m parking there and I shouldn’t be. They think I’m using a disabled bay like mother and baby parking because I have two children.”

She cannot bend either of her wrists because a pin has been inserted in each one to protect the joints, which became extremely painful and inflamed.

If she wants to hold one of her children – Harry, eight, and Frankie, three – she has to try to scoop her arms around them, one of the many physical coping strategies she has developed.

Harry always seemed to sense as a young child what caused his mother pain and would instinctively move in a way that avoided aggravating her symptoms, often holding onto her to take the strain off her arms.

Mrs Saunders is lucky enough to have a supportive husband, Mark, who is an IT consultant.

A range of medication helps her manage her condition – steroids reduce inflammation and taking risedronate sodium once a week treats her osteoporosis (a side effect of the steroids).

She has to inject herself in the thigh once a week with methotrexate, which inhibits the activity of the immune system, reducing inflammation, and Enbrel which slows down the progress of the disease.

Painkillers help her cope with day-to-day challenges but she also has to deal with extensive fatigue and has to take calcium tablets to try to build up her bone density.

Problems arise not only from the disease itself but the side-effects of the drugs she takes to manage it – the methotrexate makes her feel physically sick the day after her injection and can give her mouth ulcers and sores, forcing her to take folic acid tablets.

After 13 years of having two steroid tablets a day, she now suffers from osteoporosis, a condition which usually affects women after the menopause.

The condition reduces bone density and leads to an increased risk of broken bones.

A blood test at the age of just 17 revealed that Mrs Saunders may be prone to arthritis but it was the stress of moving into a new house which she believed triggered the disease which also affected her mother, Pam Adams.

The pain eventually became so intense that Mrs Saunders was forced her to take early retirement from the job she loved as a nursery nurse.

“My job was everything. I really enjoyed it but it could be a physical job. Sometimes I look back and think, ‘Was I too hasty?’ but my husband says it was too much for me. It was the right thing to do.

“The fatigue is also a big thing with rheumatoid arthritis – you don’t have the stamina that others have.

“The pain could be so bad that I could not get up the stairs, off the toilet or out of bed.”

The drugs manage these symptoms but for Mrs Saunders to conceive a child she had to come off all her medication, except the steroids, which meant a lot of her pain returned.

She provides advice to mums with arthritis who want a baby as part of her volunteer work for the National Rheumatoid Arthritis Society (NRAS) and does not pull her punches when describing to them what it is like to come off medication.

She said: “I say to them, ‘Look I don’t want to scare you but it’s hard’. You have to put yourself through hell to have a baby if you have rheumatoid arthritis. But being able to talk to someone who has some idea of what you are going through makes such a difference.”

There is also the frustration of seeing women her own age who are able to do more than her.

Mrs Saunders cannot attend exercise classes with her friend even though she would like to lose more weight – one of the sideeffects of steroids is weight gain.

But she has booked an induction at St John’s Sports Centre in St John’s, Worcester, and hopes she can work out a training regime that she can complete without causing discomfort.

She is now co-ordinator of the Worcester group of the National Rheumatoid Arthritis Society (NRAS), which offers advice, help, support and friendship to people with rheumatoid arthritis.

They have guest speakers and discuss issues such as claiming benefits or ways to exercise and also enjoy socialising together.

● The Worcester Rheumatoid Group next meets at Lyppard Grange Community Centre, Ankerage Green, Warndon Villages, on Monday, May 11, between 1pm and 3pm.

For more information, call the National Rheumatoid Arthritis Society (NRAS) on 0845 4583969 or visit rheumatoid.org.uk.

● Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints.

It can also cause inflammation of the tissue around the joints, as well as in other organs in the body.

Autoimmune diseases are illnesses that occur when the body’s tissues are mistakenly attacked by their own immune system. Patients with autoimmune diseases have antibodies in their blood that target their own body tissues, where they can be associated with inflammation.

Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease.

● Osteoporosis means parts of the bone become thin, which makes the bone more fragile and prone to breaking after a minor bump or fall.

Although fractures can occur in different parts of the body, the wrist, hip and spine are the most commonly affected areas.