Dalia often refers to RA as an “unwelcome guest” — she has no choice but to care for her condition carefully or she will be wracked with pain and fatigue stuck flat on her back. It’s not easy; her life is littered with bad days when she is confined to bed and cannot accomplish even the simplest task.

Although most people with RA experience a gradual onset of the condition it snuck up on Dalia unexpectedly. “People always want to know — did I see it coming? Were there warning signs for years beforehand? Honestly no. I felt terrific was always in good health and physically fit ” Dalia shares. Even her earliest symptoms appeared benign at first.

“Shortly after my baby’s birth I had that sore all over feeling but most mothers can relate — giving birth can make you feel like that and I had been very busy setting up the nursery before he came home so I thought maybe I just overdid it. It wasn’t until I woke up that morning and really couldn’t move at all that I realized that something was seriously wrong with me.”

Despite the debilitating effects of RA (see sidebar) Dalia is a prime example of someone who truly lives with the condition. She refuses to see herself as a sick woman. Instead she’s just a regular mom at the PTA meetings and shul dinner. Only her family and friends know the burden she’s struggled with for the past decade. Dalia works full time and actively raises five talented children shuttling them to a host of extracurricular activities. A devoted wife and homemaker Dalia invites Shabbos guests creates homemade costumes for her daughter for Purim and tackles the arduous job of cleaning her home for Pesach.

A Range of Treatments

Medications for RA can alter the course of the disease and significantly improve the quality of life of many RA sufferers. Dalia’s disease is mostly controlled through steroids which reduce inflammation making her joints less stiff and painful. A drug called methotrexate also reduces pain and swelling and slows the progression of arthritis over time.

Dalia’s symptoms are sometimes so well-controlled by medication that she can go several days weeks or even months feeling “normal.” This lulls her into false hope that her RA has disappeared. But she has learned not to overexert herself even when she feels great. “When I go through a long period when everything is good I think I can do everything again ” she admits “but if I want my really great days to continue I have to be careful and not overdo it or I’ll end up in a flare-up again.”

Despite their substantial benefits medications for RA are not without downsides. Dalia must be monitored closely by her long-time RA doctor (a rheumatologist) due to the side effects of her plethora of meds. For instance methotrexate is associated with a range of side effects including abdominal pain nausea dizziness and fever and can cause birth defects and even fetal death when taken by pregnant women. (That’s why pregnant women those who can become pregnant or those who are breastfeeding must not take methotrexate.)

Other lifestyle modifications may also enhance the quality of life of people with RA. Under her doctor’s supervision Dalia has implemented a variety of treatments for RA including nontraditional and natural remedies. She once tried a food elimination diet intended to reduce inflammation. With this regimen she was allowed only a handful of foods to start and slowly incorporated more monitoring for symptoms. “We saw no results at all ” reflects Dalia “so now I am on a normal calorie-reduction diet trying to lose a few pounds. The less weight on my joints the better I feel.”

Weight loss is commonly recommended for people with RA who carry even a small amount of excess weight. There’s more at stake than mere appearances — extra weight can exacerbate joint pain in the knees and ankles. But the limitations of the condition make it more difficult to lose weight. For example because of stiff or deformed fingers and hands many people with RA have trouble preparing healthy foods and they are forced to rely on less-healthy convenience items or fast food.

Exercise is another key component of the weight loss equation helping overweight individuals burn more calories. Physical activity offers additional advantages to people with RA helping them retain muscle strength flexibility and range of motion through the course of their illness. Yet it is obviously more challenging for people with RA to get regular exercise. Imagine not being able to go for a brisk walk because RA has damaged the cartilage in your knees and that working out too rigorously could land you in bed for days. 

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