Life

I had a painful foot after a night out in my 20s – I never suspected it could be arthritis

A Co Down former nursing home worker was used to hearing elderly people talk about their arthritis – but then she herself was diagnosed with the condition in her 20s

Joanne Weston who was diagnosed with rheumatoid arthritis at the age of 28. Picture by Hugh Russell
Joanne Weston who was diagnosed with rheumatoid arthritis at the age of 28. Picture by Hugh Russell Joanne Weston who was diagnosed with rheumatoid arthritis at the age of 28. Picture by Hugh Russell

WHEN Saintfield woman Joanne Weston worked in a nursing home for six years, she often heard the elderly residents complain of their aches and pains and arthritic joints. It was a condition she associated with old age and wear and tear, so when, at the age of 28, she was diagnosed with Seronegative rheumatoid arthritis, it came as a shock to the fit and healthy Joanne.

The post office employee, who also works part-time in Belfast's Empire bar, recalls waking up with a burning, painful foot after a night out with her friends. She immediately presumed she'd overdone it on the dancefloor but when the pain worsened as the morning went on, she made an appointment to see her GP.

“The ball of my foot was so sore and felt like it was on fire, almost as if I'd been walking on hot stones,” Joanne says. “When I'd been dancing and having a good time, I hadn't felt it. But the next day, my left foot was in agony. I hadn't a clue what I'd done. But I could barely walk.”

Her GP took blood tests and told her it looked like inflammation around the joints in her foot. Joanne, who is now 33, was sent home and told to elevate her foot and treat it with ice. When she got no relief from this treatment, she returned to the doctor's and was given anti-inflammatory medication to try and bring the swelling down. But this made no difference, and with the pain getting worse, she went back to the doctor yet again, fed up and frustrated with the situation.

“At that stage the doctor thought I might have gout and asked me if I ate a lot of meat but I'm vegetarian. I don't drink much alcohol either,” she says. “I was working in the old Hudson bar at the time and on my feet a lot, so I ended up having to come out of work. It wasn't so bad in the post office, because I was able to sit, but when I tried to walk, it still felt like my left foot was on fire. The pain was agonising. I was pretty fit and enjoyed playing netball and running, but I wasn't able to do either, which got me quite down.”

Joanne's parents offered to pay for her to go private and see a specialist at the Ulster Independent Clinic. Not knowing what was wrong, she opted to see an orthopaedic surgeon, who examined her as she walked to see if her hips were the issue. An MRI scan was suggested and she was sent home with an orthopaedic boot and crutches. This left her unable to drive and having to rely on lifts to and from work.

In the meantime, the inflammation and pain had spread to her right foot as well and an NHS appointment came through to see a rheumatologist. Fluid was drained from both her feet and Joanne was told she would need an MRI scan to determine the cause of the inflammation and burning pain. Joanne was admitted to Musgrave Park Hospital, where she remained for three days.

The MRI scan revealed that Joanne was suffering from Seronegative rheumatoid arthritis, a diagnosis of rheumatoid arthritis without the presence of certain antibodies in the patient's blood. Further scans, including a full skeletal one, showed the rheumatoid arthritis hadn't spread but was confined to her feet.

Joanne was told that what she had was an autoimmune condition which seemed to have been triggered by stress. At times when she is run down, it flares up and, due to a weakened immune system, a simple cold or the flu can knock her off her feet.

Drugs to reduce the swelling were so severe, her mouth broke out in ulcers so she was offered cortisone injections instead, which helped the pain.

“My feet look like they're clawed,” she says. “They're like the feet of a 70 or 80-year-old and there's nothing the doctors can do about that. But at least it hasn't spread, although I do get referred pain in my hips and back.”

While the investigations into her conditions were going on and Joanne was pretty much out of action, the situation had an affect on her mood. Having to give up her beloved sports, unable to power walk or dance, she couldn't understand why she had taken ill at such a young age.

“Even wearing high heels is a problem,” she says. “I do so at my own risk. I tend to wear flats all the time now, unless I'm going to a wedding and need to glam up. But I always bring a pair of flats with me.

“I did get quite depressed and kept thinking 'why has this happened to me?' I always thought arthritis was something only elderly people suffered from. It just seemed so unfair.”

These days, Joanne attends Musgrave every three months to undergo a review, which takes in her diet and lifestyle as well as looking at the medications and treatments she's receiving to see if they're helping.

She wears a special orthopaedics insole in her shoes, which restricts the types of footwear she can buy and if she does go out for a walk, she often finds she suffers afterwards. She still manages to work in both the post office and the Empire bar, where her bosses have been supportive, adapting her duties to facilitate her condition.

At times, when she's been in severe pain, she has to fall back on using crutches, which she doesn't like doing. As well as finding them tricky to use, Joanne says she feels self-conscious, especially given her age.

“I got the diagnosis in 2017, a year after this all started, so I'm content about that because at least now I know what it is,” she says. “The medication won't cure it but it will help to give me a better quality of life.

“My fiance Eamon has been a great support too but it has been a rough few years, I won't lie. I know I'll have this for life now but I'm determined not to let it beat me and for now, the weekly injections are keeping it at bay.

“Working in the home, I used to hear the residents talk about their aches and pains and how they suffered badly from arthritis so it's always had that stereotype for me. I never expected to get that diagnosis at 28 but it can even affect newborn babies.

“It is what it is. There's not much I can do to change it. I just have to keep going.”