A diagnosis of rheumatoid arthritis (RA)—a lifelong disease that causes chronic pain in the joints—might make anyone’s stomach drop. Diagnosed in his late twenties, fashion designer Michael Kuluva worried what having rheumatoid arthritis would mean for his career. RA can affect all the joints, but the hands and wrists—arguably a designer’s most important tools—often take the brunt of it.
“Everything I was trying to do in my day-to-day required me to use my hands,” says Kuluva, the creative director for LA-based fashion brand Tumbler & Tipsy. Each of his bold, colorful garments requires careful stitching, snipping, and measuring, so dealing with RA symptoms would demand some adjustments.
RA is an autoimmune disease in which the immune system mistakenly attacks the body’s joints, according to the Arthritis Foundation. This causes inflammation and swelling in the joints, which can cause serious pain and instability in the hands, wrists, elbows, knees, and ankles.
For Kuluva, RA flare-ups typically occur in his hands, knuckles, and wrists. “There’s nothing I can do about it besides put a heat pad or a massager on it,” says Kuluva with a nonchalant shrug. “During Fashion Week is one of the biggest times I get flare-ups and it’s because of the stress that I’m under.”
Stress can serve as a trigger for both the onset of RA and flare-ups of everyday symptoms, according to the Arthritis Foundation. A 2014 study in Annals of the Rheumatic Diseases found that patients’ daily stressors or worrying could actually predict severity of joint pain over the next month.
But Kuluva, who used his RA diagnosis to inspire a fashion collection at New York Fashion Week, didn’t let stress from his condition prevent him from pursuing his career goals. “I just have things that are put in place so that I’m not overworking myself,” says Kuluva.
To manage stress and prevent flare-ups of RA symptoms, Kuluva sticks to a purposeful and consistent routine. Here are some of his strategies.
He (tries to) exercise every day. Kuluva aims for 30 to 60 minutes of physical activity a day. “As much as I can, I try to do any yoga that is pretty tame,” says Kuluva. Exercise is a primary part of RA treatment as it can improve muscle strength and range of motion despite joint pain, according to the Arthritis Foundation.
He follows a strict diet. Kuluva aims to eat meals full of protein, fruits, and veggies. “I have a weakness for candy and chocolate,” he admits, “but I try to really limit it.” (Here’s an anti-inflammatory diet experts recommend for treating arthritis.)
He typically drinks only water. You won’t see a cappuccino or energy drink in his hands during the tiring hours preparing for Fashion Week. Staying hydrated may help fight inflammation and keep joints lubricated.
He gets emotional support from his pup. Kuluva’s dog, Cooper, helps with stress relief and staying active: “It’s great to have a dog, too, because I think that really helps you get out and move, even though you don’t want to in the morning,” says Kuluva. (Learn about more health benefits of having a pet here.)
He manages his stress. “When I do feel down, [I like] to do things that make me feel good,” says Kuluva, such as scouring the web for fashion inspo. This is especially important on days when he can’t get in his yoga. (Here are more stress relievers to try out.)
When it comes to living with RA, your tiny, everyday actions can make a big difference. “[There are] little things that you can do to just make yourself feel better when you know your body’s not that good,” says Kuluva. “Even just mentally, it’s so important.”