My rheumatoid arthritis has gotten worse over time. My affected joints include those in my hands, my wrists, my elbows, mt shoulders, my jaw, my cervical spine, my ankles and my feet. My eyes as well as my ears are affected.

I no longer have flares. Flares are something that comes and goes. I am always inflamed, and I am always in pain. My lowest level of pain is three. I am usually at a pain level of five. And my pain level reaches a seven several times a week.

I am on Orencia. It is working. I would be at a pain level of seven all the time if it weren’t. There are few other choices. Some don’t work, some caused complications, some are contraindicated because of my three cancers. I can’t take NSAIDs either. I do take tramadol. Synovial tissue has opioid receptors. It helps.

I think I have just ticked over to another level of disability. Frustrating. I think of our club of rheumatoid arthritis sufferers. There are too many of us.

My sympathy goes to younger women with children to raise. Jobs. I was relieved when I retired. Those with RA suffer from depression. No wonder. Too much is expected of them.

Finally, the scientists have learned that RA can cause pain even when the inflammatory markers are normal. I could have told them that.