Pretty much every time I visit my rheumatologist, he tells me, “you look good. You’re in remission.”

Unfortunately, by the time I get to his office, I’ve usually been awaken for about three or four hours minimum and the worst of the “morning stiffness” is over.  My body has had time to adjust to itself. Sometimes I wonder if the pain stops or if I just adjust and don’t notice it as much…

So he says I’m in remission.  But when I think of remission, I think of cancer.  I think gone.  No more.

So you say I’m in remission.  But I wake up stiff.

So you say I’m in remission. But I don’t want to get up to walk to the bathroom because the pads of my feet are painfully swollen.

So you say I’m in remission.  But I swell up teaching a heated yoga class.

I want remission to mean gone.  Isn’t that what it means?  Guess not.  RA has different rules.

There’s a particular lifestyle associated with twenty-somethings. Binge drinking, nights of mischief and fashionably, attractive outfits (read: painful heels and clothes that don’t actually keep anyone warm) come to mind. Even though many people confine their overindulgences to their college years, the bar scene remains an important part of singlehood and twenty something social dynamics.

Unfortunately for us chronics, this lifestyle doesn’t actually do us any good. Truth be told, it’s probably not good for anyone, but we’re probably a little more aware of our own mortality… Invincibility goes with diagnosis.

Getting all dolled up to go out on the town with the girls is fun. Sure. Getting sloshed can also be fun. Trouble is there’s always a pay the price in pain.

For a chronic, a night out is a series of compromises and challenges. Before you’ve taken you’re first drink, you have to dress yourself. My roommates know my ritual—the number of times I change my clothes directly correlates to how I’m feeling in my skin. If my feet hurt, I’ll pick an outfit around my shoes (and probably change it half a dozen times in frustration). Depending on how peeved I am with my body, having to make a concession for my swollen toes could blow a whole night… High heels compound the pressure on the toes and balls of feet, so sore feet can feel really limiting for getting primped for an evening.

Aside from footwear, living in New England makes weather a consideration in preparation. As it gets colder, it becomes more of a problem (see my post on the snow).

Once you’re dressed appropriately and out the door, it’s time for a drink order.

Alcohol is no friend to me. In the elaborate dance of social interactions—nights out or business meetings—drinking is the lubricant that makes conversations happen with ease. But as a chronic, I have the tolerance of a gnat. One drink can be more than enough for an evening; with an already compromised liver, it doesn’t take much to get me to my tipsy, sweet spot. I’ve never been much of a drinker, but I’ve had to learn not to try to pace my friends’ refill orders.

The most challenging part of a night out is the next morning. Alcohol increases swelling. So the next morning can be a painful reminder of last night’s good time. I’d trade for a hangover an day of the week.

People say that your twenties are the best years of your life. Being chronic is a new set of premature challenges, but there can be balance.  How do you balance your disease and your social life?

It’s getting cold too quickly.  Weather.com tells me that there’s a chance of snow this weekend.  Aside from the annoyance that we longer have seasons (it’s October, where the heck is fall?), a long period of cold is really bad news for my joints.

Rhuematoid arthritis is a condition of heighten and chronic swelling in the joints.   And I’ve found that it’s particularly sensitive to cold and elevated humidity.   With my doctor, we had worked out a cocktail of drugs that had my condition pretty well managed through the warmer summer months.   I would wake up with the ability to use my fingers and toes, less swollen, less painful.  Cold weather, especially a wet cold, completely messes up that well working chemistry system.

I didn’t need a weather report to tell me it’s getting colder.  When I wake up, I’m swollen for longer.  I linger in bed because the balls of my feet hurt.  Even right now, I can’t close my hands into a full first.  Even if the swelling wasn’t painful, it’d still be causing lasting damage to my joints.

Damn the cold I say.   Every year I tell myself I’ll move somewhere warmer.  Eventually, and despite the things that keep me here, I think I’ll have to preserve my joints.