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It’s your sister’s wedding and she’s asked you to be matron of honor. Or it’s your son’s birthday. Or maybe you’ve been tapped to give a major presentation for your boss’s boss. You’ve been preparing for weeks, you’ve seen to every detail—you are ready. And today—of all days—you wake up feeling as if you’ve been hit by a train. Forget about canceling…people are counting on you. Here are a few hints to get you going and help you make it through the day…

For weeks—months, even—you’ve been planning for today, rushing around like mad to make sure that every goes off without a hitch. You’ve been so busy, in fact, that you might not have even noticed any symptoms…and if you’re like most of us, you silently congratulated yourself on your luck.

Guess whose luck just ran out?

Sometime during the night, the arthritis fairy came and replaced all of your joints with broken glass. You’re so stiff and tired that it will take a crane to pull you out of bed. And then you remember… “Oh no! Not today!”

First of all, calm down. Stress will tighten already-tight muscles and will increase your pain. The secret to dealing with this day is to take a deep breath, relax and think…before you move.

It May Not be Bad as You Think

Not all pain and stiffness is RA-related. Even healthy people can fall asleep in awkward positions; insomnia and stress can also cause temporary stiffness. To better evaluate your situation, you should:

* Medicate immediately.
The earlier you take your normal daily dose, the sooner you’ll feel results.

* Head straight for the shower.
Take a long, hot shower and don’t skimp on the power spray. If standing is a problem, sit on the side of the tub or take a bath. Take your time and make sure the water can reach or cover aching joints and muscles.

* Get moving—slowly and carefully.
Lay your clothes out. Start a pot of coffee. Wake the others. And, as you are moving about the house, monitor your body for “danger” signals. Try to gauge what you can and can’t get away with today.

It’s a Flare, Alright

After a half an hour or so, you should have a better idea what type of flare you’re dealing with. Hopefully, the above preparations will bring the pain down to a dull roar. If not, don’t panic—extreme stress will bring on “fight or flight” syndrome, all those nasty hormones that tighten your body, increase your pain and suppress your immune system. The key to getting through this day is to approach everything calmly, slowly and carefully. If you still have time before leaving the house, you can:

* Call your doctor.

If there is time (and if it’s appropriate), he or she might be able to increase the dosage of one or more of your medications.

* Reach for the fire and the ice.
Alternate using heat and ice packs: preferably thirty minutes of heat for the stiffness, fifteen minutes of ice for inflammation. If you’re running out of time, try alternating 10-5.

* Dress as comfortably as possible.
Dress appropriately for the situation, but avoid clothes that cling, tug or bind, such as tight waistbands/neckbands, girdles, panty hose (try thigh highs or knee highs if you can), narrow shoes or anything else that will increase your discomfort.

* Eat a healthy breakfast.
A bad flare may decrease your appetite, but it’s still important to eat. Eating a healthy breakfast provides you with energy to combat the inevitable fatigue that comes with a flare. There’s no need to eat like a lumberjack: something as simple as a boiled egg, a piece of whole-wheat toast and a glass of milk will provide you protein, complex carbohydrates, calcium, vitamin E, B and D. Add a half-cup of blueberries or an 8-ounce glass of juice, and you’ll have vitamin C, as well.

* Squeeze in some exercise.
Ironically, exercise sometimes helps us the most when it hurts the most. Limit yourself to five-minute sets of gentle stretches or range-of-motion exercises recommended by your doctor or physical therapist.

* Reach out and get touched by someone.
A quick massage can reduce stiffness, pain and give you a better outlook on things. If there is time, ask your spouse, partner, roommate or even your kids for a five-minute rubdown.

* Gadgets, gizmos and orthotics.
Remember all those assistive devices cluttering up your drawer? Well, now is the time to use them. Zipper-pulls, car door openers, long-handled shoehorns, canes, splints—these are the tools that can ease your day. (Splints can also serve a dual purpose by inhibiting bone-crushing hand-shakers from making like John Wayne…a common—almost comical dilemma—for Americans with RA). Pack’em up before you head out the door.

Okay, I’m here…Now what?

Congratulations! Believe it or not, the hardest part is over. Now that you’re here, concentrate on balancing rest with responsibilities…but try to focus on the day, not the RA.

* Delegate…
No one is indispensable…do not suffer in silence. While it’s not necessary to make an announcement, telling the people who can help you—family, friends, coworkers—will make the day go smoother for everybody.

* …but still participate.
Don’t sideline yourself completely. Ask your mother if she will button the 92 pearl seed buttons on your sister’s wedding gown while you get her veil ready. Get your husband to organize the sack races at your son’s birthday while you help blindfold kids for pin-the-tail-on-the-donkey. Participating—even in a small way—will distract you from your pain. And being helpful improves your self-esteem, staves off depression and helps the time pass more quickly.

* Be a Zen Master.
Approach every responsibility or chore with great deliberation. Use the larger muscles to take the stress off of smaller

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