"Why do your joints look like that? Are you an 80-year-old woman?"
For 27-year-old Tayla Greelish, questions like these are part of life with a chronic, incurable disease. Thirteen years after she was diagnosed with rheumatoid arthritis (RA), Greelish is now attempting to shift the stigma associated with the inflammatory disorder, particularly in young people.
"The hardest part is the lack of support for people my age," the Melbourne-based mum-to-be told Australian lifestyle network 9Honey. "Rheumatoid arthritis is this topic that no one discusses, because you don't think you need to know anything about arthritis until you're older."
Rheumatoid arthritis is an autoimmune and inflammatory disease characterised by the immune system mistakenly attacking healthy cells, causing inflammation or painful swelling in affected parts of the body. RA mainly targets the joints - usually many at once - but can also damage the skin, eyes, lungs, heart and blood vessels.
However, RA is typically - and mistakenly - believed to be an illness that affects the older population, a misconception that takes a significant toll on younger sufferers such as Greelish.
Speaking to 9Honey, the young woman explained she was diagnosed with RA when she was just 14. Despite aching knees, ankles and 'locking' wrists and elbows, doctors didn't take her joint complaints seriously - putting her pain down to netball injuries.
"I couldn't open my door to get out of my room in the mornings, I couldn't walk down the stairs of the house," she said.
With little support from the GP, Greelish's mum began to research her daughter's symptoms - a Google search that proved a pivotal moment in her ongoing, 13-year battle with the disease.
"It was actually my mum who, I guess, diagnosed me - we walked into the GP and she said, 'I've been Googling everything and the only thing that seems to make sense is juvenile rheumatoid arthritis'," Greelish recalled.
Her mother's perseverance paid off; at 14, Greelish was officially diagnosed with RA. But like many people, the then-teenager couldn't comprehend she was suffering with a condition commonly associated with those in their 40s and 50s.
Despite finding a specialist who helped her come to terms with her diagnosis, treatment plan and new way of life, Greelish struggled at school with fatigue, brain fog and consistent pain. Due to her weakened immune system, a common cold could also impact her for weeks.
But her physical struggles were only compounded by the fact she had no one in her life that could empathise with or understand her condition at such a young age.
As an adult, Greelish is still subjected to the intrusive, insensitive questioning she dealt with from her peers, such as, "Why do your joints look like that?"
Now pregnant with her first child, Greelish is struggling with the guilt that she may pass on the disorder to her baby. Pregnancy has also taken a physical toll, worsening her symptoms and limiting her medication and treatment options.
It's predicted one in six millennials will suffer from arthritis by 2040, with its prevalence expected to rise by 33 percent, according to researchers at Monash University's School of Public Health and Preventive Medicine.
Greelish told 9Honey that targeted services, such as specialised mental health assistance and support networks, remain virtually non-existent for young people suffering from RA. Education and awareness also remain low in the wider community, she claims - perpetuating ignorance and misconceptions from the likes of colleagues, employers, and even friends and family.
In New Zealand, rheumatoid arthritis affects between 1 and 2 percent of the population and is three times more common in women than men. There is no cure for rheumatoid arthritis, but a combination of treatments can help manage symptoms.
Although the condition can develop at any age, it most commonly arises between the ages of 25 and 50. Rarely, children under the age of 16 can develop a form of rheumatoid arthritis known as juvenile rheumatoid arthritis or Still's disease.
The disease is characterised by periods of remission (absence of symptoms) and "flare-ups". Sometimes there is an obvious cause for a flare-up but there is often no obvious trigger.
Symptoms of RA can include fatigue, joint pain, swollen, warm, or red joints, joint stiffness, muscle pain, mild fever, and loss of appetite or weight loss. As rheumatoid arthritis affects the lining of the joints, the painful swelling can eventually result in bone erosion and joint deformity.