Maggie (not her real name) was 40 when she came to see me, having suffered from rheumatoid arthritis for eight years.
She was in pain all the time unless she took her prescribed medications. Although they worked, she found the side-effects intolerable, especially the headache, tummy ache, dizziness and mouth ulcers.
So she oscillated between the pain and the side-effects, and she was very miserable. Many joints were sore at any one time, but the most disabling were the thumbs, the fingers and one hip.
Maggie worked as a landscape designer but was now unable to do much actual gardening. (She had been an organic gardener from the start, so had not had contact with herbicides; we could cross them off the list
