Photo Credit: Courtesy of Gin Bell
It started with a slight swelling in her knee and toe, but one morning, Gin Bell, 67, an attorney specializing in public policy in Washington, D.C., woke up with such excruciating pain and stiffness in her jaw, shoulders, wrists, hands, knees and feet that she could barely get out of bed. She was only 54 and had a busy couple of days ahead watching her 18-month-old grandson. “That morning, the baby cried out, and I went to him but I could barely move. The pain was just awful, but I had to take care of him,” she recalls. As soon as her grandson went home, Bell went to the doctor and was diagnosed with rheumatoid arthritis (RA), a chronic disease characterized by swelling of the synovium, or lining of the joints. RA causes severe pain and loss of function, and ultimately can lead to long-term joint damage.
“The first thing I did when I was diagnosed was ask all of my friends if they knew anyone else who had rheumatoid arthritis, and I spoke to all of those people,” says Bell. At first Bell tried to control her RA with diet and nondrug treatments such as water therapy. But before long, she says, “I realized I could not get the pain under control without medication.” Bell’s doctor prescribed hydroxychloroquine (Plaquenil) and sulfasalazine (Azulfidine), two medications known as disease-modifying antirheumatic drugs (DMARDs). Both can slow the progression of rheumatoid arthritis and help prevent permanent damage to the joints. Some research shows that using the two drugs together may be more effective than either one alone.
Gradually the medications kicked in, the pain lessened and Bell regained function in her joints. “It took about three months before I felt like I had returned to my old life,” says Bell. “When you’re in pain, just getting up and down from a chair or carrying your groceries become really difficult.” After Bell began to feel better, she looked again to other patients for suggestions on how to handle the disease. “I asked my rheumatologist to put me in touch with a patient who was in remission. I talked to him and started doing what he was doing, including keeping a daily diary of my pain level, what I ate, my activities and my medication.”
Bell’s RA flares over the 14 years since her diagnosis have been minor, with one exception: After twisting her knee during a golf swing last spring, it swelled up and her orthopedist injected it with a medication that was supposed to cushion the joint and lessen the pain. The treatment backfired, sending her into a full-blown flare that left her with serious cartilage deterioration. Three weeks after adding a third drug, methotrexate, to her regimen, Bell began to feel better, but the damage caused by the flare led to knee replacement surgery. The procedure went well and she is recovering nicely.
Bell credits her active lifestyle with helping her to maintain function in her joints and stay strong overall. Right after she was diagnosed, she worked with a physical therapist who specialized in arthritis. “Even when I could only lift one-pound weights, I was doing something to keep my body moving,” she says. Over the years, she has continued to exercise as much as possible. When she’s feeling good, Bell walks regularly, participates in water therapy classes, does tai chi and works out with weights. Her active life has not only helped her to maintain muscle mass and mobility, but it’s also kept her at a healthy weight—important because being overweight strains the joints, interferes with the body’s response to treatments and lowers the likelihood of remission.
Partners in Health
Bell knows that if she has another flare, or if one of the medications she takes regularly stops being effective, there are others she can try. As an active volunteer for the Arthritis Foundation, she keeps on top of new developments in rheumatoid arthritis research, and maintains ongoing conversations with other RA patients as well with her doctor. “I am very involved in my treatment,” says Bell. “We go over all of my options together and discuss what would be best for me. It’s really important to stay informed.”
Rheumatoid arthritis is an autoimmune disease, and immune system problems run in Bell’s family. “My hope for my future is simply to lead a normal life, to enjoy my grandchildren, travel with my husband and not be impaired by my condition. But my ultimate goal, and the reason I’m so involved in the Arthritis Foundation, is to help find a cure so that my children and grandchildren never have to experience this disease.”