At the age of about 18 months our daughter started limping in the morning and had swelling on her knee.
This is her story of getting a diagnosis and her ongoing fight against Juvenile Rhematoid Arthritis(JRA).
Click here to read her full story
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Sore Stiff knees in the morning At about the age of 18 months she started limping in the morning and had swelling on her left knee. We went to multiple doctors and she ended up being sedated so that fluid could be drawn off her knee to test for infection. The test was negative and eventually we were sent to a Rheumatologist who confirmed that she had JRA. The only joint affected at this time was her left knee.
First Medications They started her on naproxen which is an liquid medication that she takes twice daily. That seemed to control the pain and swelling for a while. After about a year and half of being on that medication, other joints started becoming affected. Both knees, both ankles, a toe and a few fingers were now stiff and swollen and causing her discomfort.
Procedure at UW Children's Hospital She had a lot of swelling in her left knee again and they ended up having to put her under and go in and drain fluid off of her knee and inject a high-power steroid locally into the joint. She was such a trooper, the only time that she cried was when we told her it was time to go home, she wanted to stay!. The steroid helped things almost immediately. She was also started on another oral medication, Plaquenil that smelled and tasted horrible...even with bubble gum flavor....only taken once daily though :-)
Methotrexate At her next follow up appointment, her joints hadn't really improved much, so we had to make the decision whether or not to put her on Methotrexate which is a very potent steroid with some scary side effects....if we chose not to put her on this medication, we were putting her joints at risk of severe damage in the future...if you don't treat the inflammation, it continues to "eat away" at your joints putting you at risk for bigger problems later like needing a joint replacement. Some of the side effects are mouth sores, decreased appetitie, fatigue, liver problems and some other scary things that I won't mention :-) We met with her primary care doctor for input and read all we could. We decided that the benefits of methotrexate outweigh the risks at this point, and with careful monitoring some of the side effects can be prevented or at least caught early enough to so we can stop the problem before it gets worse.
Tough as nails So as of now she has been taking the methotrexate which is given weekly as an injection in her thigh. She takes her folic acid pill once daily and the naproxen which she takes twice daily. She does this all without any complaints or tears...all she needs is a squeeze from daddy, a princess band-aid and maybe a few M&M's after her shot and she's good to go :-)
Since starting the Methotrexate her energy level is through the roof, she is running and playing harder than ever before! It has certainly made a huge difference in how active she has been and her inflammation markers are down a considerable amount!
Pain in a 4 year old The hardest part about Arthritis is that you would never know that she had it unless you really watch her every day. She has grown up with it so she doesn't know that she shouldn't be in pain. When she is she doesn't complain because pain is normal to her.
We are hoping that the progress with Methotrexate continues and she stays pain free most days. She still has days where her knees hurt, but they are less and less.
Long Term Our daughter will probably live with this disease the rest of her life. The best case scenario would be that she is able to get off of the stronger meds and only takes over the counter pain relievers when she over does it. The other side of the coin is joint damage, replacement and daily pain. Lets hope for the best case!
Quarterly Labs Our daughter has blood drawn every three months to check the progress of her disease and to be sure that her meds aren't affecting her body adversely. She climbs up in the chair herself and holds her arms out. Normally she doesn't even shed a tear. Daddy does sometimes, but she doesn't :) She also has to have her eyes checked every four months to make sure that there is no swelling. Arthritis in a child can affect the eyes just as much as it can affect the joints...but with the methotrexate the likelihood of her having inflammation in the eyes is very low.
Living with a child with JRA Living with a child with JRA isn't much different from any other child. She does all the normal kid stuff and if you didn't know she had Arthritis you could never tell. As parents there are some things that we do to try to help her out. Mostly we ask her often when she is active if her legs hurt, if they do we try to wind down whatever we are doing. We also have to be very careful about how she sleeps, we stayed overnight at Grandma and Grandpa's and she slept on a pad that she had always slept on. However, when she woke up she complained of her shoulders hurting really bad. She actually couldn't get up off the floor because she couldn't push with her arms. The next night she slept in the real bed and dad slept on the floor, all was well.
Thank you so much for reading about our daughter's story and letting us tell it. Her JRA has made her one tough little girl. I am so proud of her and am constantly amazed at how she handles all the doctor's visits, needles and medication.
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Sincerely, The "A" Team.
Disclaimer: All information here is the opinion of one parent and should not be taken as medical advice. Please consult proper medical staff before making any decisions regarding care.