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The meds make you feel sick, but you’ve still got to take them, and the doctor visits feel endless. In th itmn for HealthCentral, I share tips for getting through the hard times with rheumatoid arthritis:

“WE DO IT silently and behind a smile. We do it with a grimace and a groan. We do it while sending up a small prayer to the gods for strength. And then we do it all over again. The ‘it’ in question is everything involved in living with rheumatoid arthritis (RA) that requires a deep breath and a wish for a hand to hold. It’s that first-ever blood test or self-injection of a new medication, showing up for a procedure you know will hurt, getting out of bed even though every joint is screaming, and taking step after step when your feet feel as if you’re walking on rocks. There are so many more of these moments than we let on and each takes courage of the kind we never imagined we’d need.

When you’re faced with a real need to summon every ounce of bravery you’ve got, it’s nice to know you’re not the first person to struggle with big RA challenges. Here are five examples of moments with RA when you’ll need a lot of courage, and some personal notes on how I’ve managed through these trials myself.

Being Willing to Take Medication that Makes You Feel Awful

We all hope to be that lucky person who has no side effects to the meds needed to treat RA (yes, those people really do exist), but for many, the meds come with their own set of issues—some mild, some truly debilitating. Willingly signing up for feeling like crap every week or two can feel insurmountable. My best tip is to focus on what the medication gives you. I’m a side effect magnet and have yet to find any medication that only works in the desired way without also dragging along a host of other interesting symptoms (why is there always so much gas?). But I still remember what my life was like before the meds and I don’t wish that on anyone. To me, suppressing my RA and having a life that is filled with love and joy makes it all worth it. Sleeping through the night, being an active participant in my family and friendships, and not having to fight so hard to get through the day are all part of my equation.”

Read more on how to tap into your courage when living with RA on HealthCentral.