When you have rheumatoid arthritis, much of your time is spent thinking about things most people don't think about.

Things like turning a doorknob, peeling a potato, searching for keys in your pocket and innumerable other tasks. These are major chores for someone with inflamed, painful joints, said Susan Klinker of Rancho Bernardo. Klinker has had rheumatoid arthritis since 1991.

Joints are sore in the morning, and you'd like to remain in bed. But even there, you're not free from pain, Klinker said, because pulling up the covers hurts your swollen hands.

As a volunteer at the San Diego chapter of the Arthritis Foundation, Klinker works with companies to make them understand what it's like for employees with arthritis. She simulates the effects by having people walk with rocks in their shoes, and taping their hands and telling them to take a dime out of a bowl or deal cards.

Before falling ill, Klinker was a professional organist at a Chicago church.

"I was getting ready to play a piano/organ duet with a friend for Easter Sunday when I saw my hands were swelling up. It looked so weird and it hurt, so I called my doctor and made an appointment," she said.

It's an allergy, she was told by the doctor, and a series of other doctors. They didn't perform any tests or even listen to her symptoms, she said.

More than six months went by before Klinker found a doctor who correctly diagnosed her disease. But in those days before the new drugs, there wasn't much help she could get.

"I had knuckles that looked like walnuts. I couldn't make a fist. I couldn't hold a pencil," Klinker said. She had to give up her organist career.

Things took a turn for the better after Klinker and her husband moved to San Diego, about seven years ago. In 2001 she was put on Remicade.

"This was a miracle drug," she recalled. "It was wonderful. My knuckle swelling went down."

About six months later, she had an anaphylactic reaction, a life-threatening allergic response. Klinker was moved to other drugs, many of which didn't work well -- or eventually caused other severe allergic reactions.

"I did drugs like plaqinel, prednisone, Relenza, methotrexate, Vioxx -- I've been through all of them," she said.

Klinker said most of her symptoms are now under control with Rituxan, which she's been taking for about 18 months. That's longer than her success with Remicade, but not as long yet as with Humira, a three-year period of relief.

All told, the various kinds of arthritis affect about one-third of the population, according to the U.S. Centers for Disease Control and Prevention.

"And guess what? The baby boomers are aging and it's going to be more prevalent," Klinker said.

Contact staff writer Bradley J. Fikes at (760) 739-6641 or bfikes@nctimes.com.