An important part of managing well with RA, whether it is at work, life in general or in relationships, is to get your disease is treated. Once your RA is suppressed, issues of fatigue and pain will diminish, allowing you to relegate the disease to muttering in the background. I'm glad to hear that you're starting on meth today - it usually takes about 6-8 weeks to really kick in and while you wait for that to happen, you may want to talk to your doctor about bridging the gap with e.g., prednisone and an anti-inflammatory like Celebrex. It is quite likely that you won't have "horrible" side effects - I have heard of people who have managed well for years on methotrexate without any major side effects. Personally, I took it for several years and had a bit of woozyness and fatigue for a few days following the dose, as well as some stomach upset, which I managed by eating a bland diet for a few days. Some people experience hair loss, but my hair just got more curly - which I considered a benefit! - and that's stuck around even after I switched to another medication. I wrote a post last year about managing medication side effects and you might find that helpful. You can also check out our area for people who are newly diagnosed for articles and tips on how to live with RA.

About the horrible statistics about RA. They are not necessarily true anymore. The statistics are based on the old treatment, before the Biologics (Enbrel, Humira, Remicade) which are medications that have completely changed the prognosis of the disease. Because they are so new, we simply don't know what the future will hold, but it is quite likely that it is a much brighter picture than it used to be. These days, methotrexate is on the lower rungs of the ladder of treatment for RA and although it may work very well for you for a long time, there are other options that very likely could keep you living a relatively normal life for decades. But - and I warn you, I'm about to get opinionated - even if you lose your ability to work full-time (and by the way, you may want to read one of my recent posts on working with this disease), does that mean you have no more value as a person and a partner?

We are more than our jobs, more than our ability, more than our disease. To say that it wouldn't be fair of you to "hold back" your partner due to your illness ignores all the other things she loves about you. The fact that you have RA, are in pain and are tired doesn't negate all the other wonderful things about you and doesn't mean that you don't bring anything to the relationship. Every relationship develops its own rhythm and distribution of responsibilities - so your partner may be the one who does the more physical chores around the house and you're the one who deals with e.g., paying the bills. There are relationships out there with two perfectly healthy people who find the same distribution of responsibility, based on what they enjoy and what they're good at.

Considering not marrying your beloved to "save her" from a life of drudgery and caregiving - because that's what you're afraid of, isn't it? - is treating her as if she is not an adult who knows her own mind. Don't take this the wrong way - I completely understand your thinking, have in fact been there myself and after a lot of thinking, I realized that I was making decisions for another person. A person who loved me just the way I am and had no problem taking on the physical baggage, just as we all take on each other's baggage and quirks when we enter into a relationship. In the end, I decided to respect that person's intelligence and free will and allowed myself to be loved. Another reason you may be hesitating could be because you're afraid she'll leave you if it gets worse. And it's a valid concern, however, statistics show that women are much better at coping with a partner's chronic illness than men are, so you're ahead of the game there! There are many reasons why a marriage might split up down the road, most of which have nothing to do with illness.

Once your RA is suppressed, the roller coaster of sick and well will even out, but you'll still likely have some days that are not exceptional. You learn to live with the unpredictability, you learn about pain management and living within your limits in such a way that you don't tire yourself out, needing days to heal, but can keep going, perhaps doing a little bit less every day, but able to live your life most days. It's trial and error, it's about paying attention and having patience while you figure it out. Last year, I did an interview with M.E.A. MacNeil, author of The First Year with Rheumatoid Arthritis, which is a terrific book that can help you get a handle on all the different aspects of life with RA and I highly recommend it. I would also recommend that you and your partner consider counseling. Adjusting to chronic illness can be difficult, both for the person who has the illness and for their partner and having a therapist or counselor guide you through that process can help you develop coping skills for the rest of your life, talk out the issues and fears around your illness, as well as give you a closer bond.

Living with RA is not for the faint of heart and in many ways it gives you as much as it takes. It gives you strength and the knowledge that you can do anything, it gives you compassion and the ability to adapt to change. Those all skills that you can use in making your relationship stronger.

As long as you keep talking with each other, keep working at the relationship like everyone else does, RA is just another thing that needs to be handled. RA is part of what you are, but it isn't who you are. Your partner loves who you are. Take the leap. Trust her, trust yourself and have faith in the future. Because the future will be there no matter what you do and what it'll look like is completely up to you.

(sorry for the length... got a bit carried away)