Rheumatoid arthritis is a chronic auto-immune disease, in which the immune system essentially attacks the body's joints, causing pain, swelling and joint damage over time. It's not known at this time what causes RA nor is there a cure. It affects more women than men. The progression of the disease is also different for each person, meaning what works for one individual may not work for someone else. There's also no set treatment plan, and sometimes that's a confusing and frustrating part of the treatment of this disease.

I was diagnosed with RA in 2000, following a year of mysterious come-and-go symptoms and missed work. After several visits to my family doctor, I was eventually referred to a rheumatologist, who made the diagnosis.

Rheumatoid arthritis can be difficult to diagnose. There are several blood tests that can aid in diagnosis, but not every person with RA tests positive for any of the tests that can confirm a diagnosis, particularly at the onset of the disease.

To aid in making a diagnosis, my rheumatologist needed from me very specific information about my symptoms; what parts of my body were affected, when the pain and stiffness started and how long it lasted, if it was preceded by anything else, such as a cold or flu, what I did that might make it better, or worse.

I was diagnosed in my early 40's, so my disease progression has been much slower than someone who may have been diagnosed in their 20's and I feel very fortunate. The earlier the disease starts, the more aggressive the disease can be and the longer time for severe joint damage.

So if you've recently been diagnosed with RA or have had the disease for some time, I hope the following things I've learned living with this disease can help you.

One of the primary things I've learned is to keep a diary of symptoms. Mine happens to be a Google document, since I spend most of my time on the computer, but anything that is easy for you to maintain will work.

BRAIN FOG: A common symptom of many RA sufferers is "brain fog." It's more than just forgetfulness. Difficult to describe to those who've never experienced it, the closest I've ever come is to envision your brain wrapped in a thick blanket. Not much gets in and not much gets out and what does just feels muffled. Whether caused by fatigue or the disease itself, it's frustrating.

You can cope with this by first acknowledging it exists. Don't try to tough it out or make the effort to "just try to remember." It strains your already taxed mind and body even more. Learn strategies to make it easier on yourself.

As an Administrative Assistant, people were always stopping me away from my desk with requests. I got in the habit of always carrying pen and paper...or more often I would ask they send me an email with the request. I have sent emails from work to home, home to work, left myself voice mails, invested in sticky notes by the score, put pen and paper in any place I might need it, including the car and my bedside table.

I have put my car keys in my brown bag lunch, so I would remember the lunch, because car keys were something I didn't forget--even though I still misplaced them--because I can't go anywhere without them. I set up as many bills as I could for online payment: I would literally forget the bill arrived, and forget to pay it; days just got away from me.

RECOGNIZE A FLARE UP: Rheumatoid arthritis sufferers usually have flare ups of the disease. These can last anywhere from days to months, followed by long periods of disease inactivity. Sometimes it's hard to recognize a flare up. Symptoms can start off like the flu, with joint and muscle pain, fever, loss of appetite and fatigue. But unlike the flu, the symptoms don't resolve in 24-48 hours, and may return over the course of several weeks. If you keep a journal or diary, you can track the symptoms, determining if you really did have the flu or if it is a flare up.

WORK AND RHEUMATOID ARTHRITIS: The year before I was diagnosed, I missed work with enough frequency because of the "flu" that my supervisor felt the need to talk about my attendance. It was only seeing it from her side, that I realized something was wrong, that people usually do not feel ill enough to stay home two days one week, and three days two weeks later, followed by more episodes of "flu" over several months. The symptoms felt like flu...aches, pains, fever, exhaustion...but put in context of RA, they made more sense.

Rheumatoid arthritis can have devastating effects on your work life, and attendance is one of the things first noticed. However, the Family and Medical Leave Act, which helps protect employees with serious health conditions, can help protect you in your job because of intermittent absences due to your disease. Your Human Resource department can provide forms that your primary physician fills out. Contact them as soon as you are diagnosed, before your attendance becomes an issue.

DEPRESSION: Living with chronic pain can sometimes lead to depression. And in the midst of treating RA, it's sometimes hard to distinguish between RA symptoms and those of depression. Tired all the time? Forgetful? Sleeping too much, or not sleeping well? Emotional? They sound like symptoms of both diseases.

My nurse practitioner was the first to recognize my depression. As she said, living with chronic pain can make anyone depressed. Left untreated, depression can sap your remaining energy and make treating your RA more frustrating. Don't be afraid to bring ALL your physical and mental symptoms to your physician. Let them help you.

FAMILY: Rheumatoid arthritis can take its toll on your family life as well. It's a confusing disease for those who do not suffer from it, or do not know how it progresses. It's baffling to see someone in pain and unable to function one day, but be up and seemingly well the next, only to have this cycle be repeated over the course of weeks or months. Particularly before the disease is diagnosed, and in the early stages before treatments start to take effect, it is vital to have good communication with your family, keeping them as much information about RA as possible. The Arthritis Foundation website (www.arthritis.org) has a wealth of excellent resources for both patient and family to help understand this disease.

ADAPT: Some things in your life may have to change as your disease progresses. You may be an ardent stair taker, but you might find you need an elevator for only one floor. Writing might be painful; I tend to type most things in my life, even notes at home. And to make that easier, I search for keyboards that have "soft" touch keys. Certain manufacturers seem to make keyboards that have keys that are easier to depress than others.

EXERCISE: Keeping up an exercise routine is vital to maintain muscle strength, which makes you feel better overall and helps support painful joints, along with helping maintain a healthy weight. There's a fine line that exists for those with RA of knowing when to exercise, and when to rest and take it easy. Finding a program that you can adapt to those times when you have a flare up is crucial. I walk, lift weights and use a weight machine when I'm not having pain; however, during a flare, sometimes walking becomes painful. I know through experience when to stop using weights, to take slower paced walks, and when to stop all together to let my body rest. It's a delicate dance RA sufferers learn to maintain strength and flexibility, which not contributing to further joint damage.

DIET: Diet plays a key role in managing any chronic disease, and rheumatoid arthritis in particular. Since the main action of RA is inflammation, diets low in sugar and saturated fats, basically no junk or fast food, can have a huge impact on reducing inflammation. Others have found reducing or eliminating foods from the nightshade family of plants such as potatoes, eggplants and tomatoes, can have a positive effect on their RA.

Increasing foods such as fruits and vegetables, particularly brightly pigmented fruits like blueberries, cherries or deep green vegetables like kale or spinach, can help reduce inflammation. Soy products also help some RA sufferers reduce the inflammation caused by the disease. Green tea is also added to many anti-inflammatory diets because of the large amounts of anti-oxidants it contains.

I hope this article has provided some insight and advice on coping with rheumatoid arthritis. I am not a medical professional, but someone who suffers from rheumatoid arthritis. Please consult with a medical professional if you feel you have symptoms of RA.