Hi Bob,,,  I have RA and have had it since I was 38 years old.   I am
now,,,65.    I have not spent one day in a hospital for myself.   No foot,
knee, ankle, wrist procedures.   I owe all of what I can still do to my RD
but I have been taking very strong medicine to control my arthritis since I
was 45 or 20 years.   When a joint like a shoulder or knee gets out of
control with swelling and/or pain, he is there with a steroid shot or change
in how or how much I take in my medicine.   People that continue to use
joints when (with work or play) they need to be rested with medical
attention are their own worst enemy and it leads to joint operations and
loss of function.
   I had to retire 10 years two soon because I could no longer do my job as
well as it needed to be done.   That was 10 years of my four kids out on
their own and doing well.  In other words, 10 years of earning and saving or
buying for my wife and myself at over $80,000/year.    Maybe,,, just maybe
those 7 years that I simply ate Naprosyn to keep going,,,,had been spent
finding out which DMARD controls my RA the best,, I could of worked the 10
years or more.
    It is true that if you have used up your body with your job,,,, what
you have lost can not come back.  You and I are not teenagers anymore.   We
need to try to save what we have left and use it as best we can.
   A good RD can tell you what you can do or not do anymore and what you
can do to save what you have left.   If it is too late for some joints or
what have you, getting a procedure done could extend the use of the joint
without falling back on stainless steel or ceramics.
Good luck with it all and a person needs to have good insurance to deal with
the cost of today's medicines and doctor costs      but        like my
wife,,, she is worth it.
Harv