There have been some major changes and initiatives in the last few years in the management of rheumatoid arthritis. Some of these have been in a better understanding of the underlying mechanisms of inflammation and the development of new and effective drugs. Another very important area has been the opportunity for great patient and patient–carer involvement. Patient led organisations have become a vital and driving force to improve the level of government funding for care of patients with rheumatoid arthritis in an ever increasing and competitive arena of health care.

Rheumatoid arthritis is a complex condition and its effects vary considerably from patient to patient. It can last for decades, and best and possible therapies are continually changing. This book covers such an important aspect of the care of rheumatoid arthritis. It reflects the need for greater input from both patients and their carers. It is unique in that a highly trained occupational therapist offers her experience both as a patient and as a therapist in what to expect and how to cope with this condition. Patients, their relatives and carers, and therapists in training, will find this account very readable. It is illuminating, sensitive and reassuring. It comes at a most opportune time.

Consultant Rheumatologist

A long time ago, nearly 30 years, I visited my doctor. I had severe pain in my fingers, toes and wrists. The doctor gave me anti-inflammatory drugs but he gave me no indication at all of what was wrong. These attacks occurred three more times during the next ten years; each relapse happening when each of my three daughters was three months old. I was still not aware of why all this was happening and I still received anti-inflammatory medication and no explanation.

Ten years later I visited my doctor because I couldn’t understand why I had no movement in my wrist. I wanted to discover the reason for this and find out what I could do about it. I became more assertive and asked for an explanation for these attacks. Finally I was given a blood test and a referral to the consultant rheumatologist who consequently informed me that I had rheumatoid arthritis (RA). This was a devastating situation. I was 32 and I had three small children. I also had virtually no wrist movement and the joints in my fingers, toes and elbows were damaged. I was given a referral to the Occupational Therapy department. At that time I had not heard of Occupational Therapy but I decided to attend hoping that it might prove useful. I did not know then what a prominent part it would play in my life subsequently.

At the Occupational Therapy (OT) department I learnt all about my condition and how to look after my joints. I learnt exercises to improve my strength and to maintain the movements of my finger joints. I began to understand the importance of posture and how to problem solve. I was given equipment for the kitchen and I was able to discuss any problems that I had in my everyday life and find practical solutions to them. The OT department made an impression on me. I enjoyed the calmness and the time that I was given for discussion as well as the practical help that I received.

I wanted to find out more about the therapist’s role in other areas of disability and I wanted to find out how to qualify. Eventually I started work as an OT assistant and later on I trained to become a fully qualified Occupational Therapist. At the time that I commenced training I was 40 and I had had rheumatoid arthritis for 18 years. It was a positive outcome from a very negative situation. I write this book from the perspective of practitioner and patient in the hope that it will enable others to gain a more positive outlook.