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23/Mar/2022

Written by Buffy Squires, with input from Mikayla O’Neill

Note: the names of the completion certificates vary across the country, e.g., VCE in Victoria and HSC in NSW. In this section, we refer to them all collectively as SSCE.

Wow! You’re heading into your final years of secondary school! Congratulations! It’s a really exciting time for you.

But perhaps you’ve heard from friends and others who’ve already gone through it, that it’s a lot of hard work. This may be making you a bit worried about how your body’s going to hold up. It’s ok to feel like this, but we’ve got plenty of tips and resources so that you can deal with the challenges and get on with your studies. And in doing so you can make your final years of secondary school as successful and enjoyable as possible.

Keep in mind that there are lots of different options for completing your SSCE. You may choose to do it over 3 years rather than 2 or do less subjects or an ungraded SSCE. It’s a matter of talking with your parents and your school and working out what works best for you.

All students should have the opportunity to sit their exams on as level a playing field as possible. This means that your arthritis or musculoskeletal condition shouldn’t put you at a disadvantage to your peers.

So, as exam time approaches, it’s important to remember that you may be eligible for special consideration. This could include extra time to do your exam, take breaks, use a keyboard instead of handwriting, access your medication, heat and cold packs and more. The process differs depending which state or territory you live in so check out the Curriculum and Assessment Authority links below for more information. Your school will help you with this, and they’ll lodge the application on your behalf.

Tip 1 – Start early

Special exam arrangements aren’t just for your final exams. If you live with a chronic condition (like arthritis), you can apply to have them in place right through your schooling to cover things like NAPLAN. But many students first apply for special exam arrangements as they approach their final school years.

Some students will be doing a final year subject in year 11, so if that’s you, you’ll want to start thinking about the process of applying for special consideration at the end of year 10. Speak with your rheumatologist about it, as they’ll have to write a letter supporting your need for special consideration. It might also be a good time to make an appointment with the hospital’s occupational therapist. They can do a writing assessment to see if you’d benefit from a laptop/keyboard and recommend other aids to help you. In the public hospital system, you might need to wait a few months, so again, start the process early!

Speak with the head of senior school or find out who is responsible for managing special exam arrangements in your school. Make sure they’re aware of your limitations and ask them for a list of anything they need you to provide.

Tip 2 – Have a support system in place

Make sure you have a support system in place at school. If you feel comfortable in doing so, it’s a great idea to talk openly with your teachers and the head of senior school so that they know your needs and limitations and are able to offer help around test or exam time. You may also want to have one particular teacher who’s your main “point of contact” so that, if you’re unwell or need to take time off school, you can deal with any issues through them.

After significant appointments it may be helpful to take into school a doctor’s letter or organise a quick meeting with teachers to keep them in the loop. You may also find that by keeping your teachers updated regularly, they’re better able to understand your condition. Then, when exam time comes around, you’ve already got that support system in place which makes it easier to organise the help you may need.

Tip 3 – Manage stress

Yes, it’s easier said than done, but if you put some plans in place and find some strategies that work for you, year 12 really doesn’t have to be that stressful. In a few years you’ll look back and wonder what all the fuss was about! Check out our A-Z pain guide (link https://msk.org.au/pain-guide/) and the pain section of our website (link https://msk.org.au/kids-pain) for tips on dealing with pain. Find things you enjoy that make you feel great. It might be something active like a walk with a friend or a game of soccer, or perhaps you enjoy meditation, music, gaming or colouring in. Whatever it is, have some options you know work for you, and use them as soon as you feel the stress starting to build.

Tip 4 – Check, and check again

Once you’ve got the paperwork in place, check with your school to see if there’s anything else they need from you. If you haven’t had confirmation to say your special consideration has been approved, don’t be afraid to ask them to follow it up. The creaky gate gets the oil!

Things may change as you get closer to exams. Perhaps you have a flare-up and find that you can’t sit for long periods. Keep the lines of communication open with your contact person at school and make sure they know what’s going on. They can always make later applications for amendments to your plan – for example, a stand-up/sit-down desk to help manage back pain.

Got any tips you’d like to share? We’d love to hear from you. Send them to buffy@msk.org.au

More to explore

State and territory resources


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13/Mar/2020

Having children, self-belief and acceptance

Written by Shirani Wright

Read part 1 of Shirani’s story.

Another thing that was very hard for me – and I’m sure turned out much better than the doctors thought – was having my children. I don’t think my rheumatologist was overly keen on the idea, but he knew me well enough, not to try and talk me about of it as he knew that nothing was going to stop me and nothing did!

I was advised that I had to come off my methotrexate for three months before we started trying to get pregnant. This is because it’s a category X drug for pregnancy and can cause serious birth defects, including spina bifida. This was a bit scary.

The doctors thought that, by coming off methotrexate, I might have a big flare-up and not be able to even get pregnant. I came off methotrexate and luckily for me, no flare-up. They also thought if I did get pregnant there were a lot of other possible complications that could have resulted in the baby being born early.

My doctors pretty much implied I was too sick to get pregnant and carry to full term. Well, you know what they could do with that idea!! Even if I had to sit in bed for nine months and not move, I was determined to have children and that’s what I did. I have two beautiful girls, Chloe and Jacinta. I’m not going to say it was always easy, but it was worth it. I feel extremely luckily to have my two healthy girls.

I’d like the all the parents of kids with arthritis, and children with arthritis, to know it’s possible to have children of your own if you want to, even if you do have arthritis.

Having arthritis does make looking after my girls difficult sometimes, but I wouldn’t have it any other way. I wasn’t about to let arthritis stop me from having children!!! It’s easier, now they are both at school. I’m also very lucky to have a very supportive husband who understands my health issues and does a lot with the children as well as working full time and supporting me emotionally.

I also get emotional support from my friends, and family, but I’ve found that the Young Women’s Arthritis Support Group has helped greatly, as everyone in the group knows what it’s like to be in pain, be on medication, have bad days and everything that goes along with having a chronic illness.

I believe having arthritis has made me a strong person mentally and that it has helped me develop a positive attitude towards life. It often hasn’t been easy but I’m not one to back down from a challenge. I sometimes wonder what I’d be like as a person if I didn’t have arthritis.

We all have our limitations whether we have a disability or not. There are those who might not be able to walk but they might be a terrific artist. People with a disability can have just as fulfilling a life as someone without one. We can do anything we set our mind to. It might just take a bit of extra work but we can do it.

If I can give any advice to children with arthritis I would say, we need to believe in ourselves. We need to accept that we have a disability and that we have limitations but we shouldn’t let our disability define who we are. We are more than our disability.

To leave you, I’ll finish with a thought. Never give up and always shoot for your dreams!


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12/Mar/2020

Growing up, school and working

Written by Shirani Wright

I wake up in the early morning to go to the toilet. I look at the time – 5.00am – early enough to take my tablets. I turn on the lamp and automatically reach over and take my prednisolone, plus eight other tablets so they have time to work before I need to get up and get my girls ready for school. I go back to sleep until my alarm goes off at 6.50am and then I start my day.

Taking medication is a part of my life as I have systemic juvenile idiopathic arthritis. I was three and a half when it all began.

It started when I got bronchitis. My condition worsened and I was in hospital for six weeks. No one knew what was wrong with me. The doctors thought I had pneumonia, and although I was on IV antibiotics I just wasn’t getting better.

I was transferred to The Royal Children’s Hospital, where I had a number of investigations on my lungs and they discovered that I had a massive amount of inflammation. With this discovery and further tests, I finally had a diagnosis – systemic juvenile idiopathic arthritis or SJIA, an autoimmune condition that has stayed with me to this day. Not many people know that lung involvement, like I had, can be a part of some types of arthritis. And for me, joint involvement happened a bit later.

Since I was diagnosed at 3, I don’t remember not having arthritis. I think maybe this has made it easier for me than other people I’ve met who got arthritis at an older age, who might have been used to a certain life. I don’t remember what it’s like not to be in pain or discomfort every day or not to regularly go to the doctors, have tests, and be in hospital. It’s all just a part of my life and I’ve accepted it.

My twin sister and I had tennis lessons for a while but I remember I couldn’t run fast enough. I also did gymnastics too, so as you can see I didn’t let my arthritis stop me! My sister played basketball with a school friend for a time, I didn’t because of my arthritis. I don’t remember being particularly upset by this. I used to go and watch her team play and sometimes score for them.

At school, my arthritis didn’t affect me that much. I pretty much always joined in with PE unless I was having a particularly bad day. Sometimes if we had to walk somewhere from school my mum would organise for me to get driven by one of the teachers and I could always take a friend. Sometimes I’d be late getting to school if I was waiting for my tablets to work.

I felt like I had a bit of support from Musculoskeletal Australia growing up but not as much as there is available now. The Arthritis Foundation of Victoria (as it was known back then) ran camps during the summer holidays as a way for young people with arthritis to get together, meet each other etc. On these camps, they offered workshops run by doctors, massages and free time. It also gave us the chance to meet other young people with arthritis.

Up until those camps, I think I had only met one other child with arthritis; that’s why I think MSK Kids is a really great idea. It gives kids and young people an opportunity to meet each other and support each other. It also gives their parents the same thing. I’m sure my parents would have liked to have known some parents of kids with arthritis.

One thing I didn’t like about having to take medication for my arthritis is that because I’ve taken prednisolone since I was 3 (and I’m still on it 41 years later) it has stunted my growth. So when I was 15 years old, I looked 10 or younger, and that really used to bug me! I remember once I was in a shop with my mum and the shop assistant said, “are you mum’s little helper” and I got really upset. As my mum said though, it’s not her fault she doesn’t know. Now that I’m an adult, being short doesn’t worry me really from a social point of view, it’s more on a practical side when I sometimes have trouble reaching things at the supermarket, or glasses on shelves etc.

I think one thing that got me through childhood with arthritis,(apart from my mum)
is a positive attitude. Because I have arthritis there are things I can’t do. However, I try to concentrate on what I can do rather than what I can’t. This isn’t always easy, but I try and take the attitude that there’s no use worrying about what I can’t do, as that won’t change the situation. I try not to get grumpy or sad about it as this doesn’t change anything. It just gets me down and isn’t much fun for the people around me.

It’s not always easy to accept my limitations but I try and think “well everyone, including healthy people, has limitations”. Not everyone can run a marathon but does that mean they’re not as good as someone who can? I would say NO. Those people who can’t do one thing might be able to do something that another person can’t do. A fish can’t walk, but they’re happy.

One limitation I have had to deal with because of my arthritis is that I’m not working.

I left school and went to university and then TAFE. I worked in several part-time jobs over 10 years. I had to change fields of jobs from Nanning to reception/admin work as nannying was too physical. I did try working full-time for a year and a half but ended up in hospital as I often became breathless (which happens a lot with my type of arthritis).

At that stage, my doctor said I needed to cut my hours back. I found this hard as up until then my arthritis had not really limited me in a big way. But the fact that I couldn’t work full time was a big thing. It made me feel like I was sick and not normal.

One of my friends didn’t understand this. She said it was good that I only had to work part-time. What she didn’t understand was that working part-time wasn’t a choice! I didn’t choose it, I had to do it for health reasons. After some time and thought, I accepted this change and continued with my life. I no longer do any paid work as my health isn’t up to it.

Read part 2 of Shirani’s story.


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22/Jan/2020

Written by Steve Edwards, MSc(Oxon), MSc(Edinb), BSc(Pod)

“A cortisone injection? You want to stick a needle in my sore foot?”

Your health care clinician has suggested you have a cortisone injection into your foot. As with any medical procedure, both of you are best advised to discuss the benefits and risks before proceeding. It helps to know what cortisone is, what it does, and why it’s been offered to you.

Cortisone is an anti-inflammatory medication that’s often used to treat musculoskeletal conditions. It’s a synthetic version of cortisol, a hormone that naturally occurs in your body. Injected into the affected area, cortisone can lower inflammation and pain, remove fluid, and thin scar tissue or adhesions. So if your clinician diagnoses a musculoskeletal condition affecting your foot or ankle – such as arthritis, bursitis, neuroma, or tendinitis – a cortisone injection is commonly raised as an effective treatment option.

Cortisone injections also contain a local anaesthetic. For certain conditions an injection can be painful, so the anaesthetic may be injected separately before the cortisone to block this pain.

The clinician may or may not use ultrasound technology to guide the injection. For pain relief in the foot or ankle, research finds no statistically-significant difference between procedures conducted with or without ultrasound. Interestingly, trials on cadavers injected with dyed cortisone show how it rapidly spreads from the injection-point to adjacent tissue, indicating that pinpoint accuracy is not key to effectiveness.

There are several types of cortisone. In most cases the clinician will administer a long-duration cortisone, taking effect within 1-3 weeks, with benefits lasting between 1-9 months, depending on the condition and its severity. There’s a clinical consensus that no more than 3 injections should be administered to the same body-part within a 12-month period, though there’s no research literature to clearly support this belief.

After the injection, you can quickly return to most activities. The clinician may recommend you avoid strenuous physical exertion such as gym workouts or running for a few days, so the cortisone isn’t displaced from the target tissue.

As for risk-factors, there’s been research into whether the injection may risk tearing tendons in the target area. There’s no recorded case of this in human trials, though it has occurred in trials on dogs and horses. There were cases of more general tissue damage recorded in early trials on American gridiron players, but various factors could have produced this result – the needle used, the amount of fluid injected, and the subjects receiving multiple injections within a short period.

No medical procedure has a 100-percent success rate, but a single cortisone injection administered by a trained clinician is both safe and effective in providing medium-term pain relief. Side effects are minimal, and the benefit to your musculoskeletal condition is potentially vast. And for some foot-specific conditions – such as a neuroma (pinched nerve), or plantar fasciitis (heel pain due to scar tissue) – a cortisone injection can often be a cure.

Our guest blogger

Steven Edwards is a trainee foot and ankle surgeon with the Australasian College of Podiatric Surgeons. He also teaches pharmacology and foot surgery to undergraduate podiatry students at La Trobe University.


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20/Jan/2020

How we discovered Sam had arthritis

My son Sam is now 18 years old. He was diagnosed with juvenile idiopathic arthritis (JIA) just after his 13th birthday.

Seeing your previously healthy and sport-loving son crawling down the hall just to get to the bathroom is heartbreaking. The impact on our whole family was enormous. You just can’t imagine the changes you suddenly have to make. One minute we were dealing with all the normal teenage activities and the next we had an occupational therapist talking to us about putting grab rails and mobility aids through our house. The whole future you envisage for your child changes in a split second.

Sam complained for a few weeks of sore knees but like most mum’s vying for that “Mum of the Year trophy” I pretty much ignored him, figuring it was too much sport or growing pains or something along those lines.

It was the Queen’s Birthday long weekend and he had a weekend off sport so I thought ok, this will give his knees a rest and a chance to settle down and everything will be fine. We went for a short walk as a family on the Sunday and after about ten minutes he said to me “Mum, I can’t walk anymore, my knees are killing me”. We headed home where he lay down on the couch and after an hour or so he got up and discovered that it wasn’t just his knees anymore, the pain had now spread to his ankles and hips.

The next morning I took him up to our GP who ran a range of blood tests and told me she wanted to see him again on the Friday but if it got worse before then, to take him to the ER. On Wednesday morning he woke up and the pain had also moved to his wrists, shoulders and elbows. We headed out to the Monash Hospital where we began what would be a long relationship with the wonderful paediatric rheumatology team there.

Sam was officially diagnosed with JIA two weeks later and started on methotrexate that day. His pain got worse and worse and he was admitted to the hospital for a week for further testing. After ruling out a lot of other nasties, he was eventually diagnosed as having pain amplification syndrome (PAS) also known as amplified musculoskeletal pain syndrome (AMPS).

To be honest, this floored me more than the diagnosis of JIA. I really felt that they didn’t know what he had, so they were just pulling something out of thin air! The PAS was harder to deal with in many ways than the JIA. With JIA I felt we had a well-trodden path to follow whilst with the PAS it felt very hit and miss.

We saw a pain specialist through Monash and Sam was put on a lot of different drugs with various success. Eventually we found some websites and read a lot of information on pain and educated ourselves about what pain is and the importance of movement. Sam did a lot of hydrotherapy and got moving and strengthening his body once again and slowly we began to see improvement.

Sam missed the majority of the second half of year 8 and a similar amount of year 9 before finally finding the right combination of medications that worked for him. The burden of the pain was enormous but missing out on school, playing sport and contact with his friends was even harder. The medication he was on also made him put on a lot of weight and some of the kids at school could be cruel.

I was no longer able to work as Sam needed my support at home for both his day to day care as well as his multiple appointments so I approached Musculoskeletal Australia about volunteering half a day per week. To be honest it also gave me a much needed break from the stresses of suddenly becoming a full time carer! I started working on the Help Line which not only gave me vital information about JIA but gave me access to a knowledgeable nurse as well as a number of other volunteers who could share their own stories with me.

Along with a great rheumatology team and the correct medications, Sam works hard on his fitness to ensure he remains well enough to do the things he wants to do. He also needs to pace himself which, like many teenagers, he does with varying degrees of success! Although he still has challenges that other teenagers just can’t imagine, he’s now studying full time at Uni, has a part time job and is able to participate fully in life – just as any 18 year old should be doing.

On a side note – I’m now working at MSK Australia 3 days a week running the MSK Kids program. It’s a program I love and am very passionate about. You can contact me about MSK Kids Tuesdays-Thursdays on 8531 8039 (1800 263 265) or buffy@msk.org.au


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02/Aug/2018

Gathering your all-star support team

Written by Amanda Sobey

Attempting to take control of your chronic condition can at times be a daunting and uncertain challenge. Ensuring you have a strong team around you to help tackle each milestone, step by step, can make it feel achievable.

So who might be in your personal support team?

Health professionals

Depending on your individual needs, your team may be made up of a variety of health professionals. These could include your GP, rheumatology nurse, specialist, pharmacist, physiotherapist, rehabilitation practitioner, occupational therapist, nutritionist or dietitian, physiotherapist, remedial massage therapist, acupuncturist, health coach, counsellor, podiatrist, or your exercise physiologist. Share your goals with your health practitioner up front to maximise the limited time in your appointments and so they can help you progress.

Your personal cheer squad

Surrounding yourself with people who lift you up and encourage you to take charge of your condition can be empowering.

Family and friends

Let them know how they can help you and keep them in the loop as you go along. Let them celebrate the small wins with you. Examples could be receiving positive results of reduced inflammation from your latest blood test, that you managed to walk around the block comfortably, or that you had a pain-free night’s sleep. They might be able to help you hang out that load of washing or put a home cooked meal in your fridge. They can provide a second pair of ears when you need to off-load, question information you’ve been given or accompany you to your next medical appointment. They can also be great companions for a belly laugh, keeping active and getting out of the house!

Peer support group contacts

Being able to connect with people who are going through the same challenges can mean the world. This might be through online social networks or contacts you’ve made at meetups. Group members will be at various stages of their conditions. Some will be newly diagnosed, others may be long-time chronic illness warriors. They’ll be happy to share their experiences and provide insight based on what has helped them.

Studying?

Consider letting your teacher or course convenor know about your condition, so that they can provide assistance if you need to ask for an extension, or are unable to attend a class. It’s also worth finding out about other support services available at the school or university you are studying with.

In the workplace

If you feel comfortable, let your employer or HR Manager know about your condition so that they can provide flexibility, if and when you need it. They’ll be appreciative of any information you can share with them about your condition, so they know how best to help.

On the road to wellness

With the right support around you, taking control of your chronic condition can feel even more possible. Keep your care team in the loop, share your highs and lows and be sure to celebrate each milestone on your wellness journey.

Our guest blogger

Amanda Sobey is a co-founder of Young Adults with Arthritis+ (YAWA+), an online peer support network for young adults in Australia aged 18-35 with arthritis and related chronic conditions. Amanda was diagnosed with rheumatoid arthritis at age 22 and is passionate about raising awareness and helping others on their wellness journey.

For more information please visit the following links:

Facebook: www.facebook.com/yawaplus
Twitter: www.twitter.com/yawaplus
Instagram: www.instagram.com/youngadultswitharthritisplus




Musculoskeletal Australia (or MSK) is the consumer organisation working with, and advocating on behalf of, people with arthritis, osteoporosis, back pain, gout and over 150 other musculoskeletal conditions.

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