how to handle this public situation....?

I need a fat pen to write also. Additionally, I am on immunosuppressants. Due to being immunosuppressed I actively avoid situations where germs could easily pass to me. A public pen is a perfect example of a germ magnet.

My fingers are visibly mishapen so it's easy to hold up one hand, smile, and say, "thanks for the offer (of the pen) but I need to use my special pen - arthritis." Most respond favorably.

Since you don't have visible problem, you can simply do as you do now. Or you can use those occasions to do a little public awareness teaching. A simple statement said with a smile might relieve the tension/feeling of self-consciousness. I tend to make jokes about things so I might say, "Arthritis is not just a baby boomer problem!" I bet you can think of something cute and disarming to say.

I guess I never gave it much thought...sometimes the person will put a pen on the counter but I just use my own more because I'm a germ o phobe! and on Enbrel and MTX , and I never even think to offer an explanation and the person never looks offended, they probably could care less that I don't use their pen

Hi, I would not worry what ppl think about carring a fat pen. I carry a fat pen and always used it. I don't care what ppl think it helps me.

I can understand what you are going through in a sense. My 22 year old daughter has had JRA since she was 13. A few years ago when she was on Enbrel and Methotrexate she got deathly ill with pneumonia and almost died. She hasn't been the same since as far as germs are concerned. She is extremely concerned about germs ALL the time. When we go somewhere she also brings her own pen and it is a fat one also. And as soon as she comes home she heads straight to the shower and will wash what she was wearing. If someone comes over she will wipe down the house after they leave. She does kind of go overboard and I worry about that but she is very stubborn but on the other hand I can understand; I have mixed emotions about it and have expressed them to her. Some germs are ok but of course we really don't want germs ; if that makes sense; especially her since her immune system is deprived.

Oh and as far as what the public or what the other people think about you and others having your own pen go......what does it really matter; after awhile it gets tiring having to explain and wondering why you have to explain yourself to others. I don't mean to sound mean or rude about it but more and more it seems people with disabilities (even arthritis) are questioned or looked at funny as if they don't have a disability because you can't see their pain as if everyone with a disability has to be always in a wheelchair or missing a limb if you get my gist. I hope that I am making sense.