It’s my birthday.  Yes, there is going to be much celebrating.  Yes, there will be cake, and yoga, and Ethiopian food and all the other things I love (including my fabulously supportive fella D).

However, in the back of my mind, I’m always concerned about what comes next.  I was diagnosed a little over four years ago — timing I’ll never forget because the doc told me that I’d need to be on meds that I wouldn’t be allowed to consume alcohol on… Not something you want to hear right before your 21st birthday.

In any case, what I’m really concerned about are these future kids I want to have.  I told myself I’d have them early; I set this year in time as an initial and slightly unrealistic benchmark for myself… I always wanted to have kids early.  And the RA was another reason to do that–as I get older, I suspect it’ll get harder for me to chase them around, get up in the middle of the night to tend to them, etc.   That would be the case for anyone, but I know there’s a good chance I’ll be in pain.

Trouble is that you can’t force children, and I’m not in a place to have babies yet.  So this birthday serves as an odd reminder of my own impermanence and internal clock.  It’s been a happy day so far and I know it’s going to be a good celebration. But I have to acknowledge that this is the first birthday that I’ve actually cried about.  I am afraid to get older, afraid to miss things because of this stupid disease.

I’ve never felt that fear before.  When I was younger I used to relish the thought of getting older, being on my own, taking care of myself.  Now, painfully aware of my own internal tick tocking, I know I’m living a good life.  I know I have everything I could ask for in my life.

And still, tick, tock, tick, tock…

When I was in high school, I dated a boy we’ll call John here.  We talked of our goals and our future and we also shared our fears.  He admitted to me that he was afraid of getting old.   I remember at the time, I thought it was strange to fear aging.  I wanted to be older.  With age came so many things I wanted: freedom, responsibility, control and that all wisdom.

Yesterday I was walking around the city on swollen feet and I almost cried.  In a one block span, I passed an elderly man hobbling by on a walker, a woman with feet so fat and swollen that they couldn’t fit in her old people sneakers, and a hunchbacked man walking his old dog.  I was immediately terrified that I’m going to be in pain and deformed forever.

My doc always tells me my joints look good.  But it’s scary to think about loss of mobility and other physical abilities–when my grandmother finally passed she couldn’t hold anything in her hands.   If it hurts to walk now, what will it be like in ten years?  When I’m 40? What about 65?

I’m pretty comfort-conscious.  But I never want to bound to those hideous puffy shoes because I have a disease.  I don’t want to be making decisions based on physical limitations I might have.  Then again, what else can you do?