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My wife (31 yo) also has RA. If your wife's hands are on the small side look at a Kahr MK9. It's light, small, doesn't kick near as much as the P9. My wife loves hers and it really slicks up after about 200 rounds of break in. My P9 on the other hand is not so fun to shoot as it kicks like a 3 legged ninja. Both fit the bill for carry and concealability though.

As for the RA diagnosis...my wife has been steady for a few years. I hope you have a good rheumatologist. It hurts to watch them in pain. I can only imagine what she goes through and still acts like a trooper.

Check into Remicade if your insurance will cover it. Has been a game changer in our house.