Hey James,
Darned good question! I guess I don't know if there is a "pat" answer for these people. I think it depends alot on the person asking the question and how it was meant.
While most of my symptoms do not effect my outward appearance, other than a grimace or just looking totally worn out from fighting it, I still get questions or statements posed to me that do strike a nerve.
I try to just let them roll off and keep going. I have tried explaining what AS is and how it effects me. This is usually met with the glazed over stare of a deer in the headlights and alot of head bobbing. How do you explain AS in a short sentece that a person without a medical background can understand? Anymore I guess it just depends on the person and what was said.
The ones that strike the biggest nerve with me right now are the ones that see me doing something, and then question how I can do that but can't go to work for 6 months... That really felt good coming from my dad. Yeah he is my dad, but he also is one of those people that engages their mouth before their brain kicks in. In this instance he didn't see that the little job I was doing that would normally take me a few hours had turned into a 4 day marathon. 4 days of doing a little piece here and then taking another trip to Vicodan-land. Waking up and doing another little dab there and float off to the world of Oxy. No that part never even entered his head.
In this case I was on my last nerve anyway, so I just looked him straight in the eye and told him just how much I appreciated his support, and that I really needed that kind of help at that moment. I told him that the last time I checked I couldn't work my regular job while I was on these meds. And a busy fire appartus shop is not the place to fly off on pain meds. And besides we don't get nap time at the shop..

Let alone the dreaded random drug testing..

Yeah I can see that dipstick turning all the colors of the rainbow.
Keep Kickin'AS
Chris