Arthritis in your early 30s, exercise, weight, motivation.

[Methe]

My DH has, over the last 5 years or so developed arthritis. He initially had a type called palindromic arthritis which was intermittent and in different joints. It always resolved completely after a short period of time and left no residual problems. Over the last year or so though it has progressed to RA and has quite badly affected his right wrist. He is now on methotrexate. He is 32.


The reason I am posting is that he has stopped doing anything and does no exercise at all citing his wrist as the reason. As this is now RA it is unlikely to get any better. I don't know very much about arthritis but surely he should be using the joint? If he doesn't will it fuse completly?

Does anyone have any useful words of wisdom? I am not sure how to motivate him to stay fit, he appears to have given up completely and it worries me.

[rootypig]

I have osteoarthritis, not RA, so can't offer specific advice on the condition - but wanted to say that having that kind of diagnosis young (I was 19) can be deeply depressing and takes time to process. It's a grief, I think. Yes, your husband should stay active - regardless of the situation with his wrist, he needs to keep the rest of his body fit and strong. But it sounds as though you may need to offer emotional support for that to happen. Would he consider counselling?

[Methe]

I don't think he would tbh. I am quite crap at emotional support and have been trying to get better at it, but he's not a man who likes to be patronised though and whenever I mention it I sound like a patronising cow. I was hoping to arm myself with some facts about what he should or shouldn't be doing because at the moment I really don't know.

[MarcelineTheVampireQueen]

Hi, I have RA, am 32. Have had RA now about 28 years. The other poster is right about counselling, it could really help. I understand though that its not for everyone, I would suffer on before I would go to counselling. It isnt my thing.

But a diagnosis is a tough thing, and it can be almost like a death as such, he has to mourn the old life pre arthritis and go through those stages. He sounds like me, I dont like to be patronised either but here are my tips!!

1. The worst exercise he can do is none. He can continue any type of exercise but he needs to discuss it with the instructor/doctor in case it can be modified.
   
2. Physio is important to keep the joints active.
   
3. If he has weight to lose, lose it!
   
4. There is no such thing as an arthritis diet no matter what you see on the internet. However, some foods can trigger flares due to intolerance and some vitamins and minerals can help keep your body supple. There has only been one definitive proven study in the UK about this. You can find that n the arthritis.couk page I think.
   
5. The idea that arthritis is for old people and that his life is over is probably a big thing in his head right now. It really helps to know you are not alone. Peer support can be huge. It saved my life when I went through a terrible time after my son was born. I dont know where you are but in Ireland we run self management courses. I am sure they have the same in the Uk and US. In fact the one I run was developed in the US.
   
6. Get to now more about the condition, treatments and the best doctors in the area.
   
7. Remember that it is not a life sentence, just a different life.
   
8. Look after yourelf! The partners of people with arthritis go through it too.
   

You dont have to patronise him but at the same time he cannot act the victim. Arm him with the info and remind him that if he doesnt take care, he will cause joint damage. Medicine has come a long way since I was diagnosed. Steroids and pain killers were the order of the day when I was diagnosed. Now biologics and anti tnf 's mean that deformities will be wiped out. Thing are changing for young people with arthritis. You cant make him accept it, but you can show him the tools to help. Best of luck and feel free to pm with any questions!

[rootypig]

What has helped me is yoga. I originally started it for the physical benefit, but found myself processing and coming to terms with the new reality of my body - and the general pain of life. Eight years in, it's still painful - literally and metaphorically. But that's a good thing to confront. If he would consider it, I would recommend wholeheartedly (after consulting a doctor / physio about its suitability).

[Methe]

At the moment is is doing no exercise at all and is binging on food as he is down so is understandably putting on weight which is making him feel worse and so it goes on. I have suggested walking to the shops or round the block and got raised eyebrows - why walk when you have a car! He hates swimming which IMO woud be the best thing he could do. He used to go to the gym a lot but won't now as he won't use his wrist for anything and the runners are always busy. He doesn't play any sport and we don't really have time for him to be playing football or anything like that at the weekends as we both work. He doesn't do anything - no excersidse, no diy, no gardening and its obvious to me he needs to do something! I guess part of the reason I'm worried about his lack of physicality is having worked with elderly people with RA I know how absolutely disabling it can be. I know I said I am crap at empathy and I really, truly am - I just want to tell him to stop whining at get on with it! Which is awful, I know. It just feels like he has given in to it.



Should he be having physio? No-one has mentioned that to us. I will suggest Yoga. I quite fancy that myself!

[ouryve]

I have osteoarthritis in many joints, in my early 40s, due to hypermobility syndrome which was only recently diagnosed, after the damage was done.

It pisses me off, particularly when it hurts, but I know I have to pick myself up and get on with things, even if that means just doing the bare minimum on a bad day. If your DH is struggling with this, then, like others, I do suggest counselling. It might be worth finding out if it's possible for him to be referred to a pain clinic, as they do screen for depression related to his condition, since it can be a vicious circle.

The bingeing might be related to the drugs he is on, btw. Some of them are notorious for weight gain.

[rootypig]

Ok, but it doesn't need to be about empathy or become condescension. You want your partner to remain fit and healthy - that is totally understandable. Encourage him go to his GP - make him if you have to - go with him, and together with the doctor come up with a practical plan, because speaking brutally, if he's like this at 32, he is going to end up losing a lot of his physical capacity in the next decade or two. So in that sense I support a bit of tough love!

You both need to arm yourselves with knowledge - there's a wealth of information online. Have a look at the Arthritis Foundation.

Ask the GP for a pain management clinic referral, a physio referral (yes, physio is helpful, not least because physiotherapists are muscular/skeletal experts in a way doctors are not and will advise on exercise) and referral to a rheumatoid clinic to see a consultant to discuss drug therapy in the long term. Ask about nutrition too.

I would also explore complementary therapies - yoga is great and you could do it together, many people find acupuncture effective, diet is important. Exercise will not only keep his weight down and keep the rest of his body strong but will lift his mood.

All of this and, be a little gentle with him in any tender moments you find. Hard I know! The way he has seen himself until now, as a fit young person, is gone, and whether he knows it or not, he is grieving.

[bigfatfeet]

I am 36 and was diagnosed with RA last year (which I don't think technically counts as "early" 30s, but is probably close enough). Counselling really helped me come to come to terms with the diagnosis and in particular taught me some techniques to stop catastrophising about what the future might hold, concentrating instead on taking one day at a time.

I was prescribed methotrexate and it really helped in getting my pain and swelling under control (you don't say how long your husband has been on it, but it takes a good few months to kick in fully). Since then, I have been going to the gym regularly (having previously been a prolific exercise-dodger) and am probably fitter than I've been for years - if a joint is painful then I ease off it it but I can do (fast) walking, cycling and cross training without any problems.

There is a lot of other support he should be able to access via his rheumatology clinic - wrist splints, steroid injections - and a physio would be able to show him range of movement exercises which he could do at home to keep his joints moving.

I am single, but all I would say is that it is very difficult to come to terms with the fact that the person you thought you were and the future you thought you had has gone and uncertainty lies ahead, so please be gentle. It may be that the "tough love" approach will be needed in due course, particularly with regard to exercise, but a few months isn't going to make too much difference so give him a bit of time.

[MarcelineTheVampireQueen]

And sometimes I need a kick up the arse and to be told get on with it and stop whining. And I've got it 28 years! End of the day,you can't make him look after himself. It could be depression.

I caused myself a lot of irreparable joint damage burying my head in the sand after the birth of my child. He will do the same. Does he see a rheumatologist? If so he should have been referred for physio. And be seeing a clinical nurse if on mtx...[unless gp does his bloods]

[Methe]

Well he came in from work and took himself off to they gym without so much as a nudge!

He's been on the methotrexate for maybe 2 month and doesn't seem to have noticed any improvements at all. We went away a couple of weekends so and the warmth made a huge difference! Shame we're English eh.