By Jane Elliott
Health reporter, BBC News
Natalie had a lot of pain in her hip
Many students find balancing the demands of university a struggle but for Natalie Wright severe arthritis made completing her course harder than it is for most.
Natalie Wright recently got her dream job as an occupational therapist after three years hard studying.
But the 22-year-old, from Ellesmere Port, Cheshire, has severe arthritis and spent much of her student years in crippling pain.
Despite having had the condition, a rare form of the disease called juvenile idiopathic arthritis, since she was five, Natalie felt well enough to start her university course and her first year went as planned.
But as she started the second year she was in increasing levels of pain as her left hip started to ache.
"I missed so many days of university because I could not physically get up," she said.
"I was just so shattered all the time.
"I was on really strong painkillers to try and combat the pain and they made me feel even more drowsy.
"I literally lived two minutes away from university, but as my hip got worse I had to drive.
"I could not do a lot of the group work if it involved physical effort or walking, and I often asked tutors and classmates to let me know in advance what lecture room we were in so I could get a head start.
"Quite often I would go in to university and then have to go home to take painkillers and sleep.
"I started to drift away from friends because I could do so little with them, and I couldn't expect them to understand what was happening to me,'' she said.
Natalie found that her condition had deteriorated so badly that on one occasion she even needed her mobility scooter to get to the toilet - just minutes away.
"That was the last straw for me. I could not carry on the way I had been going. This was no way to be at university.
"I was not enjoying it and I could not go to lectures or do the work."
Natalie had always known she would one day need to have her hip joints replaced, because of the deterioration associated with her condition.
She knew it was time.
"I phoned my surgeon and told him I needed the operation. So they brought it forward and within a month I was having it done."
Natalie can now enjoy shoes with heels
One of Natalie's biggest worries was being put back a year and being separated from all her friends so she did a six week placement just eight weeks after her operation to keep her on track.
"Needless to say it was a struggle," she said.
"I was battling fatigue and facing issues of self image as I had to walk with sticks.
"Somehow the sticks made me feel more vulnerable and less capable than I normally felt on placement.
"I felt shadowed by them and by the association of being 'disabled'."
No sooner had Natalie had her left hip replaced than her right hip also began to fail.
She needed that replaced shortly after graduation.
Today Natalie is pain-free and managing to put the whole experience behind her.
"I am now working as an occupational therapist in Runcorn dealing mainly with joint replacement patients.
"I don't go round shouting about my joint replacement, but if I feel it is going to help the patient to know about my experience then I share it with them.''
Natalie graduated with her friends
"Now that both hips are done I am enjoying myself again.
"It is great I can go out and don't have to take a wheelchair with me.
"I don't have to worry about walking, and now I can properly work and enjoy starting my career.
"My hips are no longer the bane of my life - they don't trouble me at all now.''
"My life has completely changed from all the trouble and all the pain - it is such an amazing operation.
"My social life is improving all the time, I can dance the night away and I am slowly increasing the size of my heels!''
Mr Thomas Pollard, an specialist at the Nuffield orthopaedic centre in Oxford, said that Natalie's condition, was relatively rare with under 100 cases per million people, and he said only a small percentage of those went on to have joint replacements.
"Natalie's case is pretty unusual. We try to preserve joints wherever possible. It is very unfortunate at this age.
"Her new hips should last about 10-15 years. Most hip replacements last 15-20 years, although they tend to last less time if the recipient is younger and more active," he said.
A spokeswoman for the Arthritis Research Campaign said: "To have both hips replaced by the age of 22 is very unusual, but hopefully Natalie now has many pain-free years ahead of her."