Hands-On Triumph: How Surgery Kept This Professor Teaching

Chara's hands don’t look like they used to. Her fingers curve slightly and the thumb joints protrude, giving her hands a unique appearance. But what matters to Chara is that her hands function the way they should—especially for a college professor who relies on her hands to type, write and teach.

Not so long ago, everyday tasks like typing on a keyboard and writing with a pen were almost out of reach for Chara. She has rheumatoid arthritis, a chronic autoimmune disease that affects the joints. Over time, rheumatoid arthritis had transformed how Chara’s hands look and function, making everyday tasks difficult and painful. As a professor and writer, her work requires her hands as much as her mind.

Rheumatoid arthritis was not Chara’s first serious diagnosis.

In her early twenties, she was living in New York when she went to a routine dermatology appointment. There, her dermatologist noticed red spots on Chara’s toes. A blood test confirmed the presence of an antibody often linked to autoimmune diseases. After being referred to an autoimmune specialist, Chara learned she had lupus.

“It was a fluke, which is not the case for many people with lupus,” says Chara. “People are often misdiagnosed and spend years not knowing what's wrong with them. I was just 23 and fortunate to have an amazing doctor.”

Lupus is a chronic autoimmune disease where the immune system turns on the body and attacks healthy tissues and organs. Symptoms include inflammation, pain and swelling. There is no cure for lupus, so managing the disease and preventing complications is a lifelong commitment. 

In 1993, Chara and her husband moved to Austin, Texas for her husband’s job. Shortly after, she began a PhD program in curriculum and instruction at the University of Texas, focusing on the history of education. By 1994, she had completed her first year of doctoral studies and welcomed a son.

While teaching at a high school in Austin, Chara began to experience the early signs of rheumatoid arthritis. The pain in Chara’s hands grew noticeable even to her students, who watched her struggle with everyday tasks like signing hall passes.

Like lupus, rheumatoid arthritis is an autoimmune disease in which the immune system attacks the body. The inflammatory response happens in the lining of the joints, but it can also affect the heart, eyes and lungs.

Over the next few years, Chara’s condition worsened. She gave up running, and simple tasks like buttoning a shirt became frustrating. But she didn’t let the setbacks stop her. She and her husband adopted a daughter from China. Around the same time, she took a teaching position at Baylor University in Waco, making the nearly two-hour drive from Austin to pursue her passion. 

When her family moved to the Atlanta area in 2006, Chara took a teaching position at Georgia State University. By then, Chara had done extensive research on autoimmune diseases. She was well-versed in the latest studies and treatments and advocated for her care with the help of specialists.

Her former doctor in New York referred her to Jonathan Waltuck, MD, a rheumatologist at Emory Healthcare and an associate professor at Emory University School of Medicine. The two doctors were close; Dr. Watluck trained under Chara’s former doctor in New York.

Dr. Waltuck and the Emory Rheumatology team have a strong focus and expertise in treating rheumatoid arthritis and lupus. Several researchers are involved in lupus research and clinical trials. 

“Chara’s case is unique among patients with rheumatoid arthritis,” says Dr. Waltuck. Her medical condition is especially complex, he says, because she has both rheumatoid arthritis and lupus.

A combination of immunosuppressive medications helps control the symptoms of her conditions, including pain and swelling, with minimal side effects. “But the characteristic deformities in her hands reflect the classic progression of rheumatoid arthritis,” says Dr. Waltuck.

Dr. Waltuck recalls his early years in rheumatology in the early 1990s, when only a handful of medications were available to manage the disease. Back then, these options often fell short. It was common to see people with rheumatoid arthritis become disabled within 10 years.

"We used to say that 50% of people with rheumatoid arthritis would become disabled within a decade," he remembers.

Today, thanks to powerful medications given to people earlier in their disease, outcomes have significantly improved. Although a small percentage of people find their conditions are resistant to treatment—about 5% now compared to 50% in the past, according to Dr. Waltuck—the outlook is more hopeful. Most people can lead active, productive lives. 

Managing rheumatoid arthritis often involves a partnership between rheumatologists and other specialists, such as orthopedic specialists. Because joint issues from rheumatoid arthritis usually progress gradually rather than requiring emergency care, rheumatologists can refer patients to orthopedic surgeons.

This teamwork goes both ways. Sometimes, a patient will see an orthopedist first for a joint problem. But they may learn it’s part of a broader inflammatory condition that requires rheumatologic care. These referral relationships at Emory Healthcare allow both specialties to address each patient’s needs from all angles, helping manage the systemic and joint-specific challenges of rheumatoid arthritis. 

Chara has undergone five surgeries since her first surgery in 2019. In winter 2024, she had the sixth and final hand surgery to replace two joints in her thumb and fuse the joints in her pinky.

Her recovery from each surgery is a lengthy process that includes physical therapy. But the challenges are worth it. Maintaining the use of her hands, especially her ability to type, was the primary motivation for undergoing extensive surgical procedures and enduring recovery.

“Her outcome is excellent, and that's partly due to the surgeries but also to her dedication to rehab. She's done a marvelous job,” says Dr. Wagner.

The work is worth it for Chara. “I'm still writing, and I'm still teaching!” she says.

About Emory Rheumatology and Orthopaedics

Visit Emory Rheumatology to learn more about rheumatology services or call 404-778-4366. For orthopaedic services, visit Emory’s Department of Orthopaedics or call 404-778-7777.

Whether you are suffering from joint pain, experiencing a sports injury or need a second surgical opinion, our orthopaedic specialists can provide tailored treatment options to get you back to feeling your best. Schedule your appointment online or call 404-778-3350.