Sally acknowledges that her decision to remain quiet with her employer could change if her condition worsened. “I feel very lucky,” she says. “It would be a totally different story if my RA was more severe.”
An expert says: According to Lumley, it’s understandable that Sally would opt to remain quiet about her condition, given that it’s manageable at this time, because it’s generally true that the stage and severity of your disease determines your decision to share.

“For a lot of people, when it hurts to shake hands or open a jar, they start to develop strategies to share their condition with people,” he says. “But when it’s only an internal experience, a lot of people choose not to talk about it.” 


Paramedic Fire Fighter Rick Williams remembers nearly 10 years ago when throbbing pain in his hands would regularly awaken him at 2 a.m. The pain sometimes meant he couldn’t do his job the way he once had. “On the fire grounds, I would often be the backup person instead of working the nozzle (of the hose),” recalls Williams, 50, of Silverton, Ore.

It grew increasingly difficult for him to administer shots to sick patients. Even recreational activities with his firefighting buddies were tough to do. “We play volleyball, and I couldn’t set the ball,” he says.

A self-described “tough guy,” Williams brushed the pain aside, electing to take an over-the-counter pain reliever until, at his wife Karen’s urging, he scheduled a doctor’s appointment.

“It probably took four or five months for me to decide to go to the doctor,” says the father of three and grandfather of six. “I thought, ‘I can work through this.’”

When he was diagnosed with RA, Williams was relieved to know what had been causing the pain, but still didn’t share the condition with his fire chief and fellow firefighters. He worried how it could affect his job status. “At that point I had at least 11 years until I could retire,” he says.

He found he was more open at his church, where he was no longer able to play guitar in one of the music groups. “People got to know about my RA because I was having to back off activities that I’ve always done,” he says.