Hoping for a new blog post? Don't worry, I've got you COVID.

You'd have to have been living under a rock for the last month to not be aware of what is going on in the world at the moment. The bad news is, you're probably bored of being stuck* at home. The good news is, I've come out of blog retirement to provide you with at least 5 minutes of reading material and tell you about what this means for me.

*safe. You're safe at home.

I fall into a 'high risk' category
This is because I take certain medications (immunosuppresants) which weaken my immune system. If I become infected with the virus I am at higher risk of becoming more unwell from it than the average fit and healthy 32 (yes, I'm 32 now...) year old.

My job role has changed
I'm still an A&E doctor, but I can't see patients face-to-face at the moment, even the ones who come to hospital with a non-COVID19 related problem. There are constantly patients in the department who have confirmed or suspected COVID19, and even those that don't have symptoms right now could still be carrying it. Therefore I am currently reviewing patients with confirmed or suspected COVID19 remotely via a video consultation platform, as well as doing various administrative tasks to free up others who can still see patients. Whilst I know that this is the right thing to do, I can't help but feel a mixture of emotions about it -

I'm hugely frustrated that I'm not able to do my job - doctors, in fact all healthcare professionals for that matter, have an intrisic need to help people and not being able to do that because of something completely out of my control is incredibly difficult to accept.

I feel immense sadness that I am not able to see my colleagues - my friends - and comfort them when they are having a particularly tough day. The things we, as A&E department staff, often have to deal with means that we know how to keep spirits up (tip top bants, basically) and I really miss being part of the team.

I feel guilty for having an excuse to keep myself safe whilst my colleagues are putting themselves at risk day after day.

I'm super anxious that I'm going to get sick anyway and I will have stayed away for nothing.

People check on me a lot
Mostly my mother. But also lots of others, even some who I haven't spoken to in a long time. I guess that's the thing; when you talk openly about your medical condition everyone knows when you fall into one of the government's 'at risk' groups!

I have free time
Well, approximately 4 minutes of it between 'homeschooling' my children (iPads count as homeschooling, right?), tidying the house 17 times per day and going to work. Which luckily for you means that not only have I had time to make myself feel guilty for neglecting this blog for so long, I have also found time to write it.

When I turn my back on my kids for 5 seconds...

I will have to put up with pain for longer
I've been having problems with my shoulder for 3 and a half years now; for a long time it was assumed that it was 'just' a frozen shoulder, but no steroid injections, medication changes or physiotherapy made any difference. A couple of months ago I finally had an MRI and I'm sure you don't have to be a doctor to recognize that 'erosive arthropathy of the glenohumeral joint with complete loss of articular cartilage' does not sound like good news...

Normal shoulder x-ray

My shoulder x-ray

No one wants to have their shoulder replaced at 32.
Also, no one wants you to have your shoulder replaced at 32.
It's major surgery, a replacement joint only lasts 10-15 years and younger patients have a higher likelihood of early failure and the need for further, more complex revision surgery. Recovery can take up to 3 months and in the short term I won't be allowed to lift anything heavier than a pen. I'll be reliant on others to do absolutely everything for me (although I'm practicing wiping my bum with my right hand so don't worry, I won't be asking you for help with that) and I'll be hugely restricted in what I can wear for a while (my surgeon suggested ponchos...if that's not the biggest travesty of this whole saga then I don't know what is).

Obviously I do have a choice as to whether to go ahead or not...except I don't, really. My quality of life has gone downhill significantly - I don't sleep well due to pain, I struggle to lift anything heavier than a kettle (a concept which my children fail to understand), and even brushing my hair can be difficult. I have reduced sensation down one side of my arm and hand due to nerve impingement and my grip strength is reduced because some of my muscles are torn, meaning I drop things frequently.

So it was an easy decision, really. That didn't stop me crying like a baby though because a) I cry a lot (even once during an episode of  'Homes Under the Hammer') and b) it's not fair that I have to make decisions like this at 32 years old.

Anyway, I received this news 3 days before lockdown so, thanks to this stupid virus, I have to wait indefinitely to have the operation. When that day comes I will no doubt have a lot to blog about and a lot of time to do it in. And don't worry, even if I can't hold my phone, I can always do a vlog whilst wearing a poncho.

Is that why your face is so round?

Recently Isla and I celebrated mummy-daughter hip week, which essentially involves a two-yearly fake hip review for mummy and an ultrasound scan for daughter. I'm pretty sure it'll be the 'hip' new craze soon. Ugh, sorry.

As you may remember from two years ago, every two years I pay a visit to the surgeon who performed my hip replacement operation. It's now been six years since that life changing op, and due to my age and my active lifestyle even the cleverest of surgeons can't predict how long it will be before I need it replacing again. Pretty much everything about this appointment, whether it be my emotions on the day or the radiographer's 'Aren't you a bit young for that?' reaction to learning that I have had my hip replaced*, was exactly the same as two years ago so to save my arthritic hands the trouble of typing it all again, have a read of this instead. Most importantly though, like two years ago, I STILL HAVE TWO GOOD HIPS.

*I'm pretty sure she was the same radiographer that x-rayed my hip two years ago, asked me the same question two years ago, and looked confused two years ago.

When Isla was born she was found to have a slightly clicky right hip. Despite knowing that, although children can develop arthritis at a very young age, they are not born with it, my boyfriend and I couldn't help but exchange a slightly worried glance/awkward laugh at each other when we were told this. I wouldn't wish my disease on my worst enemy, let alone my own child, but I have to live with the knowledge that Isla (and any other children I may go on to have) is more likely to develop rheumatoid arthritis because of me. Despite being a rational doctor and semi-rational human being I know that every time she complains of the slightest pain in any of her joints at the back of my mind I will be panicking that this is the start of juvenile onset arthritis. This disease has taken away any chance I had of being a rational mother.

Clicky hips at birth are actually pretty common though, and more often than not nothing to worry about. Just to be sure though Isla had to have an ultrasound scan at 12 weeks old, which was absolutely fine. The consultant who performed the scan however was ABSOLUTELY NOT FINE. Our conversation went something like this:

Him: "Is there any history of hip problems at birth in your family?"
Me: "No, but I have rheumatoid arthritis and I had my hip replaced when I was 20."
Him: Are you on steroids?"
Me: "Unfortunately, yes."
Him: "Is that why your face is so round?"

I have several issues with this.
1. Why would you think it's OK to ask a girl why her face is 'so round'?
2. Why would you think it's OK to ask someone on steroids why their face is 'so round'?
3. Why would you think it's OK to ask ANYONE why their face is 'so round'?
4. IT WASN'T EVEN MY BLOODY APPOINTMENT.

But, seeing as he so kindly brought it up, now seems like as good a time as any to talk a little bit about steroids. I've mentioned them several times before, but never really gone into great detail about them. I have a bit of a love-hate relationship with steroids. I love them because they reduce inflammation, ease pain, and essentially help me to function in every day life. I hate them because...well, I believe this stunning diagram found in many a medical text book summarises it better than I ever could:

The steroid I take is called Prednisolone, which suppresses the immune system and in doing so reduces inflammation. If you take Prednisolone for long periods of time like I have you become particularly prone to infections because your immune system is weak. These infections may also be much more severe than they usually would be, so I have to be careful to avoid exposure to infections such as chicken pox and measles. I am also eligible for the seasonal flu jab along with the elderly.

As you can see from the incredibly attractive diagram above, the side effects don't end there. In fact, the NHS website lists 77 potential side effects of Prednisolone in total. Mood swings and changes are common, which means one minute I can be happy and the next sad, and I can be extremely short-tempered. My boyfriend would argue that I'm pretty short-tempered anyway, however I'm willing to blame this entirely on my medication and not on my flawed personality. He won't argue with this because I'm short-tempered due to my medication.

Although I wouldn't go as far as saying I have an 'obesity' problem as the diagram suggests, I currently weigh more than I did when I was pregnant. I WAS CARRYING AN EXTRA PERSON FOR CRYING OUT LOUD and yet still not as heavy as I am now. This is in part due to water retention and partly because steroids also increase your appetite, so I am always hungry. Prednisolone also tends to cause your face to begin to resemble the moon or, to give it the medical term, 'moon facies'. So in answer to your question Dr Insensitive, yes that is why my face is 'so round' and I'd like to take this opportunity to thank you for making me feel even more self-conscious about it than I already do.

As we learnt a couple years ago long term steroid use has also left me with osteoporosis, which means my bones are thinner than they should be and are more prone to fractures. I'm also currently covered in bruises, and I have two tiny cuts on my leg that have taken over a month to heal.

That all said, Prednisolone is doing a great job at keeping me going at the moment until the time comes to start the new wonder drug. I have already had the mandatory chest x-ray and blood tests, so now it's just a case of waiting for the call. In the meantime I'm off to find some doughnuts.

Dr Catherine Bull MBChB

A man went to his doctor complaining of aches and pains all over his body. 
"Doctor, my whole body hurts," he moaned. 
The doctor asked him to show him exactly where the pain was.
The man touched his shoulder - "Ouch."
The man touched his knee - "Ouch."
The man touched his nose - "Ouch."

"You've got a broken finger."

My boyfriend told me this joke a few days ago. It's relevant for two reasons:
1. My index finger currently resembles a sausage.
2. I'm now an actual doctor.

This blog post is a few weeks overdue actually, because my graduation ceremony was back in July. For once though it's not because I'm completely rubbish at finding time to blog. I've opened this page several times over the last few weeks, but it's been really difficult to put my feelings from that day into words. I have passed some of the time by searching for pictures of sausage fingers online. I didn't find any, but I did find this:

I have a sausage finger AND I graduated.

It appears that I have sunk to new lows in the name of procrastination. 

The truth is I don't think I'll ever be able to put into words how I felt that day, because there are no words in existence that would do it justice. My only solution is to describe to you my journey over the last eight years and let you imagine for yourself. I realise that this involves a bit of effort on your part, but I did just provide you with a picture of a sausage wearing a mortar board so I think it's only fair.

It's fair to say that most, if not all, people doubted whether I'd ever be able to make it as a doctor. It's not that people thought I wasn't capable but, let's face it, how many doctors do you know that have RA? Medicine is hard enough without all the pain, immobility, fatigue, and hospital stays that the disease brings. Careers advisors at college strongly advised me to consider another degree. Medical students on my course gossipped behind my back asking each other, "How is she going to be a doctor if she's got RA?" Even my parents, though they didn't admit it to me until recently and have always supported me, were horrified when I first told them I wanted to be a doctor. But, as regular readers of this blog will know, I'm not one to shy away from a challenge. And a challenge it definitely was...

May 2005 I become ill just at the time I am about to sit my AS level exams. 

August 2005 I don't get the grades I need to apply for medicine. 

October 2005 I apply anyway. I don't get in.

October 2006 I reapply for medicine and take a gap year to resit my exams. 

March 2007 I get accepted to the University of Leeds. 

April 2007 I get told by my rheumatologist that I need my hip replaced. The operation is scheduled for the first day of university. I cancel it. 

September 2007 I hobble around for a term, sleep for around 15 hours a day, don't make it to many lectures, with the end result being I fail my first exam. 

December 2007 I finally get a new hip. 

March 2008 I am allowed back to university at last, having missed most of the second term and two more exams. 

July 2008 Whilst everyone else is enjoying their summer holidays, I spend mine sitting every single first year exam in the space of one week. I pass. 

January 2009 My first of many gastritis-related hospital stays and my first of many endoscopies. 

January 2010 Another gastritis-related hospital stay. Another endoscopy. 

May 2010 The tonsillitis I have developed gets out of hand as my immune system cannot cope. I end up in hospital for a week following a collapse in A&E. 

July 2010 I fail an exam, mainly due to being ill (again) but also in part due to my poor knowledge of the female anatomy ("Considering you're a woman, Cat, you have surprisingly poor knowledge of the anatomy of the female genitalia." - Dr Pat McConnell, Anatomy Lecturer, University of Leeds). I am told I have to resit third year.

March 2011 The treatment I am on suddenly stops working, I visit my GP so many times in one week that I'm surprised they don't take out a restraining order against me. I miss several weeks of placement through illness. 

January 2012 Another hospital stay and another endoscopy means I miss my psychiatry placement and have to rearrange it for the summer holidays. 

September 2012 I am admitted to hospital after the ear infection I have developed gets out of hand because apparently my immune system doesn't do ear infections. 

November 2012 Hospital stay, endoscopy, yada yada. 

May 2013 I PASS MY EXAMS. 

July 2013 I am finally able to put two fingers up to every single person who ever told me I wouldn't be able to become a doctor and, most importantly, to RA. 

Six months of news

Yes, I'm still here. I know, it's been a while. For some reason, I was actually given work to do. At university. What IS that? What have six years of medicine taught me? That I should have chosen a normal degree.

Right. It's really hard to know where to start when you haven't written a blog post for SIX WHOLE MONTHS. If I had had the chance to tell you about what's been happening in my life I would have probably told you about the time I went to see Girls Aloud at the O2 in London with my friend, Sophie, and her mum, Tricia, and how my arms ached for days afterwards from all the clapping and arm waving, and how they left out one of my favourite songs, probably because Sarah Harding would have sounded a bit like this:  

I would have also probably told you about the amazing holiday my boyfriend and I recently went on, and how my hip set off the metal detectors at Gatwick Airport, and how the security officer oh so originally questioned whether I was too young to have had a hip replaced, and how it didn't set off the metal detectors at Chania Airport and I obviously therefore assumed we were going to die.

I would have also blogged around the time of year when I'm usually panicking, realizing I've got a marathon to run in a couple of months, and at least starting to consider putting on a pair of trainers. You would have heard that this year, however, was different and that I spent most of my evenings sat on the sofa, eating family-sized portions of banoffee pie out of the packet, with no intention of even getting up to find my trainers let alone putting them on. Once I even found myself watching Eastenders WEARING THE SAME CARDIGAN AS JEAN. I really need to start running again. 

When I first realized I wouldn't be able to run the London Marathon this year I was gutted. Regular readers of this blog will know how much the London Marathon means to me, and the thought that I wouldn't be a part of it this year was even more painful than the run itself. But instead I got to be part of it in a different way - as a spectator cheering the thousands of incredible people running for important causes, including two very special people running on behalf of myself and Arthritis Research UK. 

I've always found running the London Marathon to be emotional, but this year brought a whole new meaning to the word as I proudly cheered on my boyfriend, James, and one of my best friends, Alex, along the 26 mile course. Oh and by the way, they also happened to raise over £3000 between them for arthritis research in the process. 

...What else? At some point I probably would have felt the need to update you on my health. Part of the reason I haven't updated my blog in so long is because there hasn't really been a lot to talk about. This is a good thing for two reasons; one, because you haven't had to lose ten minutes of your life every couple of weeks reading about arthritis and two, because it basically means I haven't had much pain to grumble about. As a result I've even been able to stop taking medication for a while. 

And I would have at some point told you that I'm up the duff. I really hope you didn't just have to go and look that phrase up on Urban Dictionary like my friend Diviya. 

On that awful day in 2002 when I was diagnosed the freedom to have a baby whenever I so wish was taken away from me, possibly even forever. Some of the medications used to treat the disease are toxic to an unborn child, whilst the effects on a foetus of others are currently unknown. So I was told that if I ever want to get pregnant I would have to be medication free for at least six months before even trying to conceive. And then not take any medication whilst I am pregnant. And then still not take any medication whilst I am breastfeeding. Oh and somehow stay pain free so that I can actually function and, most importantly, hold my baby. For several years this simply has never been an option, because I have been too ill to stop taking medication for six days let alone six months. So when the chance arose I jumped at it...and I couldn't be happier.

Finally I would have told you about a great blog I have found written by someone else with arthritis who isn't 40 years older than me and who actually makes me laugh as opposed to making me want to eat my body weight in banoffee pie like so many other arthritis blogs do. I think you should read it.

http://arthritisactually.wordpress.com/

See?

You didn't really miss much.

And I've now finished what will hopefully turn out to be my last ever exams, so yay, we all win. 

Day 202: It's a good job I like hospitals

It's a good job I actually like hospitals because over the last couple of days I've barely spent any time anywhere else. 

Yesterday I went to see the surgeon who performed my hip replacement four years ago. As I've mentioned before I find myself playing a bit of a waiting game now. For the average person who has a ceramic hip replacement like mine it is expected to last up to 10 years before it needs replacing again. However the average person who has a ceramic hip replacement is about 70, not 20 like I was. They're not as active as someone in their 20s, they're not training to be a doctor, and they almost certainly aren't running marathons or climbing mountains. So noone can really predict how long it's going to be before it will need replacing again. I keep expecting my hip to need replacing again any day now. I guess I hope that if I expect it to happen then it won't come as such a shock when the inevitable does eventually happen and therefore it won't leave me as devastated as I was five years ago. But the truth is being told you need a hip replacement is always going to be devastating no matter how expected it is. 

So as you can probably imagine I was pretty nervous walking into that clinic yesterday. Memories of five years ago came screaming back as I walked past a man limping out of a consultation room sobbing his heart out. So I had an xray (along with standard "you're a bit young to have had a hip replacement aren't you?" reaction from the radiographer) and headed over to hear my fate. And guess what... 

I STILL HAVE TWO GOOD HIPS. 

What's more my surgeon assures me that they will stay that way for a long time yet, as long as I take good care of them that is. It's a good job I'm not running any marathons any time soon then isn't it...oh wait... Anyway I was so happy I genuinely skipped out of the clinic that day, you know, BECAUSE I CAN. 

Following a five hour coach journey up the M1 and about as many hours sleep I found myself making my way, yet again, to what has pretty much become my second home up here in Leeds:

Yep, today I spent the day on ward 8 at Chapel Allerton Hospital having another joint juice infusion, and today my poor friend Isla had the misfortune of having to keep me company for seven hours. I use the word 'misfortune' because a ward full of people, most of whom are at least twice my age, having seven hour infusions is not exactly the most exciting place in the world. And Isla kindly agrees to keep me company and what do I do? I fall asleep don't I. On the plus side though I can finally add successfully navigating a drip stand into a toilet cubicle to my extensive list of talents. All the staff on the ward are lovely, however my fave nurse is Debby and I'm pretty sure I'm secretly her fave too. She hates having her photo taken but next time I have promised her I WILL get a picture of her for my blog...even if I have to resort to chasing her round the ward whilst still attached to my drip. 

The only thing putting a downer on the last couple of days is my stomach. Not being able to eat properly has made me so depressed I wore the same outfit twice this week. For the first time ever I didn't mind being weighed in hospital today because the weight is literally just dropping off. This evening I thought I'd celebrate the last couple of days by treating myself to a McDonalds. I bought so much food that even the fatties on the table next to me were giving me judgmental looks. But could I eat it? Could I fuck. One bite of my burger and a handful of chips later I was in too much pain to battle on. First Nandos, now Maccy Ds - gastritis you are seriously taking the piss now. 

So as you can see RA has pretty much taken over my week so far, but for once I don't care because I HAVE TWO GOOD HIPS.

Love,

Cat x

Day 182: Happy New Year

To say 2011 has been a bit of a roller-coaster would probably be the biggest understatement since someone said that RA hurts.

2011 has been the year in which yet another treatment has failed leaving me barely able to walk, with irreversibly damaged hands and, at one point, in the A&E department of Leeds General Infirmary sobbing my heart out and begging for someone to help me - yep, RA strips you of your dignity as well as your independence and nope, nobody could do anything  to help. However 2011 has also been the year which saw me celebrate my 24th birthday pain free for the first time in over nine years thanks to my shiny new treatment. 

I shall leave you, and 2011, with a quick run down of the highlights:

- Yet another treatment failed. And I'm pretty sure I broke some sort of record with 4 GP, 1 out of hours, and 1 A&E visit in the space of a week. 

- Despite not being able to walk six weeks earlier, I completed London Marathon number three (with a little help from my brother and a swig of cider at mile 16). 

- I passed my exams. 

- I started new treatment.

- I saw Take That live.

- I rode a bike for the first time in nine years. 

- I started an amazing new job.

- I got a tattoo: the co-ordinates of the summit of Mount Kilimanjaro - my biggest achievement to date - on my damaged wrist. It reminds me of what I can achieve despite the pain.

- I went to Wigan to learn about hips. And to talk about mine. 

- I celebrated my 24th birthday pain free. 

- I said 'shit' in front of some posh peeps... and talked about joints (of course) at the ARUK 75th anniversary Lantern Opera. 

- I started bone treatment. 

- I talked some more about joints at the ARUK All Staff Day in Loughborough. 

- I talked about joints some more. 

- And last but not least, I went another whole year without letting my bitch of a disease defeat me. 

...I have a pretty good feeling about 2012. 

Happy New Year! 

Love,

Cat x

Day 167: Hip hip hooray

Today my hip is four years old. Can I get a "hip hip, hooray"?!

Yep, this time four years ago I was on the operating table, and at this point the registrar discovered what he later went on to describe to me as 'one of the worst hips he has ever seen'. Well, I've never been one to do things by half. To be honest, the competitor in me was a little disappointed that it wasn't the worst he'd ever seen.

My ceramic hip looks something like this.

I've said it before and I'll say it again: I am one bloody lucky girl to have had this surgery. Had it not been for the operation not only would I be in a world of pain right now but I would have inevitably ended up wheelchair bound and would not have achieved any of the things I've managed to achieve in the last four years. 

Before I arrived on the ward the day before my surgery, the staff on the ward genuinely thought there had been a typo on their patient list - i.e. that my date of birth was actually 1937 and not 1987... because no 20 year old could possibly be needing a hip replacement, right? I am actually rolling my eyes as I write this. If nursing staff don't realise that young people can get rheumatoid arthritis then it's no bloody wonder that the rest of the population don't realise it either. 

During my stay in hospital I made friends with two ladies named Vivian and Joan. I think their names give you a hint as to their age bracket but, age aside, we all bonded over our hip replacements and passing each other in the night with our zimmer frames on the way to and from the toilet. Joan in particular provided me with a lot of entertainment whilst I was on the ward... possibly not always intentionally:

Vivian: "I've had what you've had." (meaning a hip replacement, obviously)

Joan: "Constipation?"

With four years up now I have found myself starting to play a bit of a waiting game. For the average person who has a ceramic hip replacement like mine it is expected to last up to 10 years before it needs replacing again. However the average person who has a ceramic hip replacement is about 70, not 20 like I was. They're not as active as someone in their 20s, they're not training to be a doctor, and they almost certainly aren't running marathons or climbing mountains. So noone can really predict how long it's going to be before it will need replacing again. Maybe I'll be lucky and it'll last a whole 10 years, or maybe I'll need it done again next year. Either way, I'm extremely lucky that whenever the time comes, the surgery will be there to change my life all over again.

One more time now, HIP HIP, HOORAY.

Love,

Cat x

Day 105: That's my actual personality

You lucky folks are in for a treat... not one, but TWO whole blog posts in the same day. I know it's hard, but try to contain your excitement. 

Being an arthritis warrior is not exactly the dream job I hoped for as I was growing up. Air hostess, yes. Policewoman, yes. Ambassador for 'my nan's got that' disease, not quite. But now, I wouldn't change it for the world. I realise this might seem like a bit of a crazy thing to say. Being in pain everyday sucks, yes, but believe it or not after ten years I've actually more or less got used to it. And I get to turn my shitty situation into something positive: as an ambassador for two amazing charities I get the opportunity to share my story and spread the word that actually, I'm not 'too young for that', and help to ensure other unlucky ones get diagnosed quicker than I was. Being an arthritis warrior has lead me to be one of the busiest people on the planet, as I shall hereby demonstrate with the rundown of my week. 

Getting RA led me to study medicine. I saw the amazing work that my doctors, nurses, and physiotherapists did to get me to be well and to walk again that I decided I wanted to help others, too. Besides, I spent so much time in hospitals that I thought, well I might as well bloody work here too. So here I am, Cat who was quite happy with her career in retail, training to be a doctor. It's hard. It's tiring. It takes up most of my time. But it's totally worth it. 

So I have spent a lot of my week on placement. But in between colposcopy clinics and hysterectomies I have also managed to find time to celebrate my 24th birthday. By Saturday morning the situation in my mouth had finally started to calm down, and I had just five ulcers left, albeit still very painful and very determined to cling on. By Sunday morning they had disappeared. Not a trace. Nada. Now I'm not saying it was the alcohol that I consumed on Saturday night that cured me of my week-long-plight, but, well, I'm pretty convinced it was the alcohol that cured me of my week-long-plight. But whatever it was, THEY'RE GONE, and I'm finally back on solid foods again. I will not be so much as looking at a yoghurt for a very long time. I had an amazing birthday, complete with surprise party organised by my BFF and quality time spent with mama Bull. The best present however came on my actual birthday when I woke up to find... NO PAIN. Yep, you heard me right. For the first time in ten years I woke up PAIN FREE. I know, I couldn't believe it either. I did some weird and wonderful hand movements just to make sure, but nope, nothing. Best. Day. Ever. Thank you Rituximab, and thank you steroid injections. Not going to lie, there were some tears shed on Monday morning; I have dreamed that this day would come for ten years but never thought it would actually happen. So now the next game I shall be playing is 'guess how long this is going to last for'. Feel free to play along too. 

Yesterday I met up for dinner with Sam, my friend and fellow RA sufferer/arthritis warrior. Remember me saying I was finally going to do something about the whole arthritis-education-thing? Well Sam and I are working on a campaign to whack this problem over the head once and for all. That's all I'm saying... for now. 

And finally, today my awareness raising took me on a road trip to... Wigan. I am taking part in a BBC1 documentary about medical breakthroughs talking about my hip replacement and how it has changed my life (don't set your Sky+ to record just yet, it's to be shown in the Spring). And change my life it has; had it not been for that surgery I would be in a wheelchair right now and I would not be training to be a doctor. Anyway, this hospital in Wigan was the location of the first ever hip replacement and, without giving too much away, I had the pleasure of meeting the guy who was trained by the guy who pioneered that first ever surgery, and got to see various artifacts involved in the process. The science geek in me had a ball. The RA sufferer in me had a reality check. When, at 19-years-old, I was told my hip was damaged beyond repair, I took it for granted that I could have it replaced, no questions asked, hip hip hooray. But had it not been for this pioneering surgery, my life would be a hell of a lot shitter right now. Sir John Charnley, you're a bloody legend. 

The legend himself, Sir John Charnley.

The guy who was trained by the legend guy was lovely, ridiculously clever, and clearly passionate about all things hip. However, he said something which sadly reminded me of how patients feelings are way too often low on some doctors' list of priorities. So there we are, in between takes, casually talking about me having arthritis (what else?). He asks me if I'm on steroids, to which I reply that I am. And that's when he says this:

"Yes, I can tell just by looking at you. People taking steroids have a certain look. And personality, too." 

I could have burst into tears there and then. One of the few good things about RA is that it's not something you can generally see. If I didn't tell people, nobody would be able to tell I have it. Or so I thought. Apparently my face gives me away. Steroids unfortunately make you gain weight, particularly around the face. I am very self-conscious when it comes to my face weight as there's nothing I can do about it - I've been forced into taking medication by a bitch of a disease that has no cure and I can't stop taking them anytime soon. So basically, for all intent and purposes, he as good as told me I have a fat face. Way to make me even more self-conscious. And as for the personality part, well apparently people who take steroids become very restless and hyper. THAT'S MY ACTUAL PERSONALITY. So in one big fat sentence, he's managed to slag off my face AND my personality. Now I'm sure he's an absolutely bloody brilliant surgeon and a lovely person, but for God's sake, Prof, have a bit more consideration for my feelings next time. And that goes to all doctors actually. I'm a human being as well as a disease, remember that. 

Love,

Cat x