“Your body was made for better things than Rheumatoid Arthritis.” So says the television ad for one of the many treatments for my disease. The woman in the ad wakes in a bright bedroom with crisp white bedding, looking perfectly coiffed (no bedhead). She proceeds to do all the things an upper middle class white woman should do: fold laundry, garden, take a walk with her family, chop perfect vegetables.

The ad isn’t selling a drug, it’s selling a lifestyle. And it pisses me off. Because even when my RA is under control, I don’t wake up in a pristine house or work in my manicured garden. Between the RA and my chronic hemiplegic migraines, I have pain every day, and maintaining my house takes a lot of energy that I don’t always have. There are usually dirty dishes in the sink waiting to be washed. The floor is strewn with toys more often than not, and there’s always a basket of laundry to fold. I love to cook, but sometimes dinner is peanut butter and jelly because that’s what I can handle making.

A lot of people with chronic illnesses have seen their incomes slip because of their diseases. Chronic conditions make it hard to work regular jobs, because disease flares are unpredictable and often require one to stay home and rest. Some people qualify for disability, but those checks are smaller than the ones they brought home when they were working. Other people, like me, are piecing together a living while we wait for a disability hearing. My conditions are stress-related, so if I work too much, I get sicker.

No medication is going to fix the myriad problems that come with chronic illness. For some people, a medication will keep them active and working. For others, it will take the edge off and make life just a little bit more possible. For many of us, it will be just one of several medications used to treat several conditions, including the depression that often comes with chronic illness.

Our lives are spent balancing medication benefits and side effects, managing stress, and trying to figure out how to live with and in spite of the diseases that are wrecking our bodies. We are professional patients, experts at visiting doctors and researching medications and alternative treatments. We worry about health insurance—difficult in the best of times, but ulcer-producing when Congress tries to make healthcare for many people disappear.

Not everyone who has chronic illness has the financial resources to live an upper middle class lifestyle. And no medication in the world will change that.