Osteoarthritis - causes, symptoms, diagnosis, treatment & pathology
'College Joints:' Arthritis in Your Prime
Lauren Schwindt started college just months after being diagnosed with rheumatoid arthritis. Discover how she's succeeded, despite chronic pain.
By Dennis Thompson Jr., HealthDay News
Medically Reviewed by Niya Jones, MD, MPH
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The first semester of college can be a tough enough adjustment for any teen, but add in a life-changing diagnosis of rheumatoid arthritis, and concern over something as mundane as gaining the freshman 15 pales by comparison.
Lauren Schwindt had been a typical high school student, an active swimmer, and a dancer. In 2009 though, when she was a junior in high school, she began having intense knee pain that made it tough for her to complete certain dance moves or compete in different swim events.
"My knees would swell daily, and I had difficulty doing basic tasks like walking down the stairs," she recalled. "My hands were also painful and stiff."
Doctors and physical therapists initially thought the problem involved the cartilage in her knee. Then the middle joint of one of her fingers swelled so much that a doctor suspected cancer. An MRI showed that there was no tumor and no cartilage problem, but her symptoms continued to worsen.
In June 2011, when she was 17 and looking forward to college in the fall, blood work revealed the diagnosis: rheumatoid arthritis (RA).
Adjusting to RA in College
This kind of diagnosis can be incredibly tough for a young woman about to strike out on her own, said Tonya Palermo, PhD, a pediatric psychologist and professor in the department of anesthesiology and pain medicine at the University of Washington in Seattle. "For a young woman in college, it can become a real issue — being able to carry out a full work schedule and remain alert during the day," she said. "It requires being able to cope with your symptoms and remaining motivated."
When she got to Northern Arizona University, Schwindt arranged her first-semester schedule to improve her chances for success. "I made sure I didn't take classes too early in the morning," she said. "I was always tired when I woke up and needed time to prepare myself for the day. I would also schedule my classes pretty close together so I had a shorter day and could go home and rest afterwards."
She always kept the day after a methotrexate (Rheumatrex, Trexall) treatment, her initial RA medication, open because the drug's effects on her stamina were unpredictable. "Some days I was exhausted, others I'd be fine," she said.
Besides learning to live with the inflammatory condition and balance college demands, Schwindt had to educate faculty and staff who weren't accustomed to seeing a student with a disease that most often strikes women at an older age, usually between 25 and 50.
"I was the first student that campus health had seen with RA, who needed certain arrangements made," she said. "I had to have my injections shipped to the health building, and I had to check in with a doctor to sign for the shipment." She also needed regular blood work done and had to make arrangements for that as well.
RELATED: The CrossFitter With RA: Keri's Story
Schwindt found ways to self-manage her pain, which she still uses. She stretches a lot and takes warm baths, both to feel better and remain limber. "For me, the stiffness changes from day to day, and if I wake up one morning with a particularly painful joint, I try to continue on my day by periodically massaging it or wearing a brace," she said.
The real breakthrough was a change in medication, to the biologic infliximab (Remicade). "After I switched over to infusions, I had a 180-degree change," she said. "I no longer have to alter my schedule for this disease. The same goes for my social life and activities. I definitely enjoy being active, and I actually took a Pilates and kickboxing class."
Realizing a Dream
Schwindt also found the determination to follow her passion for fashion design and switched to a community college that offered the courses she needed. Once she completed her associate's degree, she returned to NAU, studying economics online to prepare for having her own clothing company one day and holding down a 40-hour-a-week job at a fashion retailer.
"I have taken a full course load every semester along with my job," she said. "It has been difficult and will take me a bit longer to attain my bachelor's, but I know that I will have no regrets and will be able to love my future career."
For other young people with rheumatoid arthritis, these strategies can help:
- Take charge of your medical care."As a student moving away for college, the first thing you want to do is to contact your campus health services to figure out your care and medical needs," Schwindt said.
- Know your limits.Don't be afraid to make your schedule fit your abilities. "It's just a matter of scheduling your classes smarter and making sure that you can realistically be attentive and ready for every class and activity," she said.
- Stay positive."Having negative emotions can make your pain worse and your sleep patterns worse," Dr. Palermo said.
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