Diagnosed with arthritis in your 30s
BBC TV news and radio presenter Julian Worricker wonders if his reactions to arthritic pain might sometimes give studio guests the wrong impression.
I wonder to this day what the Chancellor, George Osborne thought when his handshake caused me to wince. Maybe he is living under the illusion that he is stronger than he thinks, in which case I might have done him a favour.
He had come in to the News Channel studio to be interviewed on a day when I was having a bad outbreak of arthritis. Any movement in my right hand or wrist was extremely painful.
In my job, you have to do quite a lot of glad-handing. I have to welcome guests into the studio and make them feel comfortable, even if I know I am about to ask them some searching questions. That means a friendly smile and a polite indication as to where I would like them to sit. In addition, of course, it means a warm shake of the hand. These are all gestures which most of us take for granted, and do not have to plan for unless, like me, you have to deal with the pain of arthritis.
I have had the condition for more than 15 years in its present form. In my teens and early 20s I had the skin condition psoriasis. The red, scaly patches associated with it were mainly on my knees, elbows and scalp. It runs in my family so it was not an enormous surprise when I got it too.
When joint pain followed several years later, I was told that in roughly a fifth of cases of people with psoriasis, arthritis can develop later in life. According to the NHS website, both conditions are thought to occur because of the immune system mistakenly attacking healthy tissue, but it is not clear why some people with psoriasis develop psoriatic arthritis and others do not.
Stupid little everyday tasks became an issue. These, I stress, are not life-changing, nor am I in any way overlooking the fact that many people with arthritis have it far worse than I do, but when you've been used to getting dressed, cleaning your teeth and combing your hair without giving it a second thought it's not great when that trio of morning essentials suddenly hurts.
On bad nights, I would struggle to sleep due to pins and needles. I could wear a splint if I chose to but I resisted it if at all possible because it was as uncomfortable as the condition I was trying to alleviate.
The condition quickly developed as a problem affecting my wrists, hands and fingers. It gave me near constant pain - dull some days, sharp on others. My fingers would change shape too, sometimes over the course of only a few days.
These visible signs helped, in a way, because they were evidence of a condition and not me just talking about pain. To put it crudely, if something is hurting, then people want to be able to see physical signs that it's hurting.
For years, I had played golf (very badly) but now could no longer grip the club because it either hurt too much or my fingers simply could not wrap themselves around the shaft properly. Yes, I now had an excuse for some eye-wateringly bad scores, but it was an excuse I could have done without.
More troubling was the piano. I have played since I was five, reached a pretty good standard in my teens, and was genuinely anxious that I might not be able to play it any more. On bad days, it was painful to use my little finger - the striking of a loud bass note is not supposed to be accompanied by the kind of wince I displayed to George Osborne.
However, recently things have improved, and I am virtually pain-free.
I remember the conversation with my specialist vividly. "How do you feel about self-injecting?" he asked. I have never had a problem with needles, so I tried to reply with casual confidence. He promised I would be given a quick lesson. I don't use a bare needle, I have a plastic pen-type gadget which I hold against a fatty piece of skin, and then press a button. A drug called Humira then goes into my system.
- Common condition causing pain and inflammation in joints; affects about 10m people in the UK, of all ages
- Two most common types - osteoarthritis, which can be caused by injury or other joint-related conditions, and affects the cartilage lining of the joints; rheumatoid arthritis which occurs when the body's immune system targets affected joints, which leads to pain and swelling
- Another, less common type is psoriatic arthritis which between one and two in every five people with the skin condition psoriasis will develop
- The pain, swelling and stiffness associated with psoriatic arthritis can affect any joint in the body, but often affects the hands, feet, knees, neck, spine and elbows
- Symptoms vary depending on the type of arthritis, but include joint pain, tenderness and stiffness, inflammation in and around the joints, restricted movement of the joints, weakness and muscle wasting
- No cure for arthritis but treatments can slow down the condition including painkillers, anti-inflammatory drugs, and in severe cases, surgery
- More information from Arthritis Research UK and Arthritis Care
I should stress that, a) I am not a doctor, b) Humira does not, I am told, work for everyone and c) it can have side effects. I still combine the fortnightly injections with a very small dose of methotrexate which helps with inflammation, taken in tablet form, and that combination means I need to have regular blood tests to make sure my liver is not being adversely affected. My immune system is slightly less robust as a result of Humira, so that needs watching, and I have had cellulitis - a troublesome infection.
On a day-to-day basis now though I barely suffer arthritic pain any more. I can get washed and dressed without having to think about awkward hand and wrist movements, I can play a loud chord on the piano and risk only upsetting the neighbours, and I can even take on a round of golf, still with eye-wateringly high scores, obviously, but no longer with a medical excuse for them.
So the next time the chancellor pops in to a TV or radio studio and I am there to greet him, I can promise him a relaxed and grimace-free hello. Viewers and listeners may choose to wince, depending on their political persuasions, but for me it will be an enjoyably painless encounter.