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in Health &middot August 19, 2016

Common Spoonie Conversational Issues + How To Respond

If you have a chronic illness and you talk about it with anyone – even just your immediate family or your partner – you have probably run up against some … interesting … conversations. When you’ve first been diagnosed, the people you talk to might unintentionally say some really hurtful things because they don’t understand your health situation, and that can be true also for when someone learns of your health situation for the first time. And it’ll probably be even worse if your disease or condition is something that most people don’t know much about (or at least that the person you’re talking to doesn’t know anything about it or doesn’t know someone with a chronic illness in general). Basically, there are a lot of situations in which someone can say hurtful things to someone with chronic illness.

Last year, I asked my social media followers with chronic illnesses what they wished people didn’t say to them. And, well, there was a LOT. (BTW – Don’t say these things to us!) So since you’ll most likely be in a conversation where something like that comes up, let’s talk about what you can do or say in response.

Common Spoonie Conversational Issues & How To Respond

Most comments can fall into 3 categories, although there are many varieties.

1. The “You’re lucky” comments – Examples include, “You’re lucky you get to park in the handicapped spot!” “I wish I got an extension on my paper like you did.” and “You just want special treatment.” The vast majority of these comments are made because the person either speaks before they think or because they don’t understand the health issue in question. But the last example I gave is usually said because, once again, they don’t understand. Of course, that doesn’t make things any easier. Especially since they tend to really, truly, honestly mean it. So how do you respond? You can say something like, “Well, I don’t really want special treatment for my chronic illness,” or “I’d rather not need an extension or to park in the handicapped spot.”

2. The “You’re exaggerating” comments – Examples include, “What’s even wrong with you anyway?” “Everyone gets arthritis. It’s not a big deal.” or “Why do you always cancel plans?” They can come from a couple different places. One, they’re not aware of the vastness of health problems and the effects they have, including the seriousness of the symptoms and what living with them entails. Two, they can be (quite frankly) selfish and think that your actions reflect your relationship with them or that you cancel plans because you don’t want to spend time with them.

If you don’t want to deal with the energy (physical and emotional) that comes with a detailed response, you can brush them off with, “You should Google [your health condition here] before making an assumptions.” If you do want to respond, you can talk about the real statistics and information about your illness. For example, I’ll say, “Actually, there are over 100 diseases that fall under the umbrella of arthritis, and most of them are autoimmune diseases. Plus, rheumatoid arthritis can lead to organ damage and even death.”

Common Spoonie Conversational Issues & How To Respond

3. The “I know better than you and your doctors” comments – Examples include, “My cousin’s neighbor’s uncle tried [insert random treatment here]. You should try it!” or “If you just change your diet, you’ll be cured.” These comments almost always come from the place of someone trying to help; however, I would argue that sometimes it comes from the belief that you couldn’t possibly have researched your own condition enough or that your medical team couldn’t possibly know better than them, even if that belief is subconscious. This is so completely and totally annoying – and most people I talked to last year for that post agree with me. Don’t you think that we’ve looked up possible cures or treatments for our conditions? Don’t you think that our doctors know more about our conditions than you do?

The only time I want to hear possible treatments (especially the random holistic ones) are if I ask for them, and usually that’s from other patients. Nine times out of ten, my response is generally to smile and change the conversation as soon as humanly possible. The people who suggest these treatments really do think that they’re helping, which is probably the worst part. If you do want to respond to them, you can be polite and say something like, “I know that you’re trying to help, but please leave this to me and my doctors. It makes me uncomfortable when someone without a medical degree tries to give me medical advice, especially when I haven’t asked for it.” If you just want them to leave you alone and stop giving you medical advise, you can say, “Please stop giving me medical advice. I haven’t asked for it and I hate when people who don’t know the full scope of my medical history and don’t have medical degrees give me advice.”

As a whole, there’s a lot that goes into communicating with other people about your health issues. What I wish could happen more than anything else is that people thought before they spoke or researched things before talking to us. If someone thinks that someone with arthritis is making a bigger deal about their disease than is needed, they should research arthritis before saying something like that. Why is that so hard?

How do you generally respond to these types of comments?

Kate Mitchell

Kate Mitchell is a blogger, chronic illness patient, and advocate who helps people understand chronic illness and helps chronic illness patients live their best lives.

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I don’t know the exact date of my RA diagnosis, bu I don’t know the exact date of my RA diagnosis, but this is from right around then in July 2010. ⁣
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When I was diagnosed, I had been having symptoms for 9 years. ⁣
- 9 years of foot pain (partially from tarsal coalition)⁣
- Arthritic damage in said food⁣
- Carpal tunnel off and on for several years⁣
- And more⁣
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I was finally diagnosed because I woke up one morning and was unable to open my jaw more than 8 mm. It turned out that I had horrible arthritic damage to my TMJs, which got me off the waiting list at MGH rheumatology. I left that appointment with an autoimmune arthritis diagnosis. ⁣
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The fact that July is not only my diagnosis anniversary but also Juvenile Arthritis Awareness Month has always seemed right. I may not have been diagnosed with JA, but given the amount of arthritis I had along with my many years of symptoms, it's generally accepted that I had it. ⁣
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This year marks 16 years since diagnosis and this fall marks 25 years since my symptoms started. It's pretty weird that so much time has already passed!⁣
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⬛⁣⁣⁣⁣⁣⁣⁣⁣⁣
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I’m Kate, a chronic illness patient and advocate sharing what my life is like with 10+ chronic illnesses. Follow me for more and check out my blog at katethealmostgreat.com⁣⁣.⁣
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ID: Kate at 19 at Fenway Park for a Red Sox game. ⁣
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#RheumatoidArthritis #AutoimmuneDisease #Arthritis #JuvenileArthritis #JRA
Dos and don'ts for when someone in your life is di Dos and don'ts for when someone in your life is diagnosed with autoimmune arthritis! What are some that you would add?⁣
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I’m Kate, a chronic illness patient and advocate sharing what my life is like with 10+ chronic illnesses. Follow me for more and check out my blog at katethealmostgreat.com⁣⁣.⁣
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ID: "So someone you know was diagnosed with Autoimmune Arthritis". Under the Do column (indicated with a green checkmark) is:⁣
"As how they feel about it⁣
Offer specific ways to help⁣
Treat them normally⁣
Ask follow-up questions⁣
Wear a mask around them when sick."⁣
Under the don't don't column (indicated with an x in a red circle) is:⁣
"Say “At least it’s not xyz!”⁣
Say that and not follow through⁣
Assume nothing about their lives has changed⁣
Conflate autoimmune arthritis with osteoarthritis⁣
Pass your cold to an immunosuppressed person".⁣
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#AutoimmuneDisease #RheumatoidArthritis #PsoriaticArthritis #AnkylosingSpondylitis #JuvenileArthritis
Weekj 26 of 2026 Weekly Scenes of a summer week Weekj 26 of 2026 Weekly 

Scenes of a summer week in Maine! So glad I work from home, which means I can work from my real home (Maine, if that wasn’t clear)

1️⃣ Lots of Harley time
2️⃣ Working from home means saving my PTO for fun things!
3️⃣ Lots of duck families (📸 my dad)
4️⃣ What a lot of my days look like - Harley and my current project (needlepoint). And, yes, I’m still in a cast.
5️⃣ Learned how to play Mahjong, which my parents love
6️⃣ Lake views on the 4th

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I’m Kate, a chronic illness patient and advocate sharing what my life is like with 10+ chronic illnesses. Follow me for more and check out my blog at katethealmostgreat.com⁣⁣.⁣⁣⁣⁣

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IDs:
1️⃣ Harley the golden retriever on a deck as seen through some plants
2️⃣ Kate takes a selfie
3️⃣ A duck with little ducklings following on a lake
4️⃣ Harley coming up to Kate. Her legs are out on an ottoman, 1 foot in a walking cast, and an in-progress needlepoint project
5️⃣ Looking down at a Mahjong table with the game set up
6️⃣ A kayak on the shore of a lake 

#MaineTheWay #MaineSummer #Needlepoint #MaineLife
Living with chronic pain is really hard. You’re wi Living with chronic pain is really hard. You’re winning every day you’re still here.⁣
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I’m Kate, a chronic illness patient and advocate sharing what my life is like with 10+ chronic illnesses. Follow me for more and check out my blog at katethealmostgreat.com⁣⁣.⁣
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ID: The background image is a lake at sunset. Text reads what's above the first square and also "katethealmostgreat".⁣
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#ChronicIllness #ChronicPain #RheumatoidArthritis #Fibromyalgia #Endometriosis
I've been spending a fair amount of time at my foo I've been spending a fair amount of time at my foot surgeon's office this year, and boy has it been messing with my head. ⁣
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I spent a lot of time from 2001-2010 dealing with my left foot. Long story short, it took until this foot surgeon saw me in 2010 after fixing this foot for me to be diagnosed with rheumatoid arthritis. But I spent those 9 years going from doctor to doctor, having surgery after surgery, trying to figure out what was causing my pain and to fix it. ⁣
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Was it the tarsal coalition? Did I have another chronic health issue? Etc. ⁣
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I spent from age 10 to 19 unsure what exactly was wrong with me and in huge amounts of pain. We thought we figured it out, and then something else happened. ⁣
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We know exactly what is wrong with this foot this time around: in 2024, I got 3 stress fractures, and no one put me in a boot. They almost fully healed before breaking in 2025, and then the same thing happened in 2026. ⁣
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This is a different part of the foot than I used to deal with, but any problems with my feet and especially my left foot messes with me. While this doctor eventually fixed the problems and even got me diagnosed with RA, every time I go back to his office, I have to fight not to become 17 again. ⁣
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PTSD is a bitch.⁣
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(PS - if you want to know why I'm going back to this guy when it messes with me, it's because I don't trust anyone else to fix my foot.)⁣
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I’m Kate, a chronic illness patient and advocate sharing what my life is like with 10+ chronic illnesses. Follow me for more and check out my blog at katethealmostgreat.com⁣⁣.⁣
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⁣⁣⬛⁣⁣ ⁣
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ID: Kate takes a selfie in a doctor's office. ⁣
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#PTSDAwareness #ChronicallyIll #TarsalCoalition #RheumatoidArthritis #Osteoporosis
Week 25 of #2026Weekly Happy to be in Maine for Week 25 of #2026Weekly 

Happy to be in Maine for a few weeks! I didn’t get up to a lot, so another week of very few pictures

1️⃣ IVIG 
2️⃣ Lots of beautiful birds have been coming to my mom’s bird feeder!

⬛⁣⁣⁣⁣⁣⁣⁣⁣⁣⁣

I’m Kate, a chronic illness patient and advocate sharing what my life is like with 10+ chronic illnesses. Follow me for more and check out my blog at katethealmostgreat.com⁣⁣.⁣⁣⁣⁣

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IDs: 
1️⃣ Looking at Kate’s lap. Tubes are coming out from under her shirt and there’s a Kindle
2️⃣ Birds arriving at a bird feeder as seen through a window

#ChronicallyIll #InvisibleIllness #ChronicPain #IVIG
What do you have to do every day for your chronic What do you have to do every day for your chronic illnesses? ⁣
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For context, I have rheumatoid arthritis, fibromyalgia, endometriosis, POTS, heart disease, osteoporosis, and more. ⁣
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⬛⁣⁣⁣⁣⁣⁣⁣⁣⁣
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I’m Kate, a chronic illness patient and advocate sharing what my life is like with 10+ chronic illnesses. Follow me for more and check out my blog at katethealmostgreat.com⁣⁣.⁣
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ID: ⁣
Things I Do Every Day for My Chronic Illnesses⁣
Take pills at least 4 times a day⁣
Don’t eat gluten, dairy, corn, soy, or eggs⁣
Sleep 7+ hours a night⁣
Consume 80-100 grams of protein, 120 mg of calcium, 5-10 grams of sodium⁣
Wear a mask whenever I leave the house⁣
Do pilates 4+ days a week⁣
Work from home⁣
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#ChronicallyIll #InvisibleIllness #RheumatoidArthritis #Fibromyalgia
Filmed this back in April (hence the sweater) but Filmed this back in April (hence the sweater) but it applies to whenever I have appointments! 

Video: Kate talks to the camera while holding a purse. She holds up individual items mentioned in the video before putting them in the bag. There are captions. 

#ChronicallyIll #RheumatoidArthritis #Osteoporosis #ChronicPain
There are a lot of medical advancements that I'm g There are a lot of medical advancements that I'm grateful for, but one of them is the ability to do IVIG at home. ⁣
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I'm on IVIG - or, in my case, subcutaneous immunoglobulin replacement therapy - because I have to kill the better part of my immune system. There are, in fact, some parts of my immune system that don't attack me, which is why we add them back in. This helps reduce my chance of serious infection and also made my rheumatologist feel comfortable enough to increase my Rituxan dose. ⁣
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This is a weekly treatment that I do, but it's so much better that I can do it at home than going into the hospital. It takes around 2.5 hours from taking my pre-meds to tossing my needles into a Sharps container. While it's another thing that I have to do, because I do it at home, I don't have to risk exposure to infections at the hospital or deal with Boston traffic, which would add another hour to the process. ⁣
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I can finish my treatment and then go about my day, which I'm very grateful for.⁣
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⬛⁣⁣⁣⁣⁣⁣⁣⁣⁣
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I’m Kate, a chronic illness patient and advocate sharing what my life is like with 10+ chronic illnesses. Follow me for more and check out my blog at katethealmostgreat.com⁣⁣.⁣
⁣
⁣⁣⬛⁣⁣⁣
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ID: A Kindle on Kate's legs. There are tubes for an infusion coming out of her shirt.⁣
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#IVIG #ChronicallyIll #RheumatoidArthritis #Autoimmune #AutoimmuneDisease
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