The symptoms you should never ignore

By Suzanne Scholsberg

Four months into a solo bike tour of Australia, Susie Stephens' knees, hips and ankles had become so stiff and swollen that she could barely stand up to get in and out of her tent. For weeks she had attributed her symptoms to overtraining; after all, she'd been cycling eight to 10 hours a day. By the time she came home, she couldn't straighten her elbows. Her fingers had swollen up as if they were broken. "In five months," says Stephens, 35, a nonprofit consultant in Winthrop, Wash., "I went from being very athletic to not being able to turn on the shower by myself."

A physical therapist prescribed stretching and strengthening exercises, but the pain worsened. It wasn't until two months later that a doctor stunned Stephens with a definitive diagnosis: rheumatoid arthritis, a progressive disease in which the body's immune cells attack the membranes surrounding the joints.

Stephens is lucky. She began treatment before the disease permanently damaged her joints -- and lucky, she says, that her pain was severe enough to demand medical attention. "Otherwise, I might have played the stoic forever," says Stephens, whose symptoms are now under control with twice-weekly injections of a cutting-edge drug called Enbrel (which interrupts the physiological process that damages the joint lining). "When you're young and athletic, you don't think anything serious could be wrong with you."

That's a common -- and understandable -- attitude, physicians say. "People think they ate something wrong or they have a virus or they're exercising too hard," says rheumatologist Scott Baumgartner, M.D., an assistant clinical professor of medicine at the University of Washington in Spokane. That's why it's crucial for women to recognize their symptoms because many chronic conditions (rheumatoid arthritis, lupus and thyroid disease) are not emphasized in medical school, and thus physicians may not put all your symptoms together. You are your own best advocate. So if any of the symptoms on the following pages are familiar to you, contact your doctor immediately (and bring this article with you).