I need to lower my expectations...

Yesterday was Jenna's three month routine follow ups with the ophthalmologist and rheumatologist at Duke Children's Hospital in Durham NC. Almost four years in, and I still do not have a handle on this. With every appointment, I go in thinking that I know what's coming. Yesterday, I went in thinking that THIS is it! THIS is the appointment that changes our lives as we have come to know them! THIS is the appointment that we FINALLY get to start reducing her med doses. Ummmm, nope. 

I managed to snap some pics with my phone yesterday too (she never let's me!!) So I am going to share those while I tell of our day.

 This first pic is Jenna on the ride to Duke. It takes us about 2 hours and fifteen minutes. That used to be a torturous ride, but she has gotten used to it. This trip I let her bring the laptop to play on. :)

 Up first yesterday was ophthalmology. THIS is the appointment that always makes me the most nervous. Uveitis is often a silent disease. So it can be there, flaring, causing damage and we would never know. (I tried to get her to unfold her arms. NO doing!)

 First they check her vision. She has been complaining of difficulty seeing at distances. BOY I guess! She really had trouble with the charts.

 Then a fellow comes in to check her with the slit lamp to look for signs of the Uveitis. Jenna is such an old pro at this. They don't even need to tell her what to do anymore!

 These are the "really cool" sunglasses that they gave her. Glad you like them Toots. She needed to have her pupils dilated and lights can be painful afterwards. SO, Dr. Wallace came in, checked her over with the slit lamp and deemed her cell and flare free! WHOOT and HOLLA! She needs glasses but hey I'll take it!! She is really excited about getting glasses. She has no clue what a pain they are. Dr. W said he is fine to start reducing meds whenever the rheums are and he will see us in three months. BUH BYE!

 Off to Pediatric Rheumatology. She was very scared to stand this close to the railing for a pic, but she did it for me anyway. Thank you Bean. :) We got to see our favorite rheum, Dr. V!! YAY! We hardly ever get her. Okay, so here is where the unexpected comes in. The GREAT news is that her joints all look awesome! No signs of any active disease. No swelling, stiffness or heat anywhere. SO, my thought was that since she is doing so well AND since the Methotrexate has been making her so sick, let's get her off this crap. Ummmm, nope. WHAT?? WHY?! Three months ago at her appointment, she was having severe morning pain and stiffness. Even though she looked fine at the appointment, morning were still torture for her. Peg legged, scooting around on her butt, miserable. She was put on once daily Mobic. That has worked like magic. No more pain, no more stiffness, she has seemed to be doing better than she has in a very long time. Dr. V is concerned that if we reduce her meds now, after only three months on the Mobic, that it will bring all that pain and stiffness back. She feels that Jenna's body needs more time, that in six months if she is still doing this well we can start stretching the space between Humira injections. Okay, I can take that. Not what I was hoping for, not what I was expecting, but we can take it. We are going to TRY to change her DMARD from Methotrexate to Avara. The MTX is just making her so sick. Partially because, well, it's toxic chemotherapy. Partially, we think, because she is anticipating being sick and the anxiety of it coming is only exacerbating the effect. Here is the problem, Avara is a pill that cannot be crushed or cut up in anyway. It must be swallowed whole. Jenna can't even swallow one mini M&M or a tic tac. :( My hope is that the simple fact that if she can swallow this tiny little pill each day that she gets to skip one shot a week and not get sick is enough motivation for her to get that danged thing down her throat hole! I guess we will find out tomorrow morning.
Jenna shared a few things at yesterday's appointment. Jenna sharing thoughts and feelings is pretty rare! When Dr. V asked about Jenna's activity level I was about to tell Dr. V that it's been great! But out of the corner of my eye I saw Jenna shaking her head "No". I asked her, "You DON'T think you have been active?". Again she shook her head "No". I said, "Really? You seem to Daddy and I to be more active." Again, the shake "No". It hit me then. I said, "Do you mean you aren't as active as your friends?" This time I got a "yes" shake. Ooooooooh, well, :(. She also, for some reason, asked me about the Humira Pen yesterday. I had no clue that Jenna even knew about the pens! I said, "Why do you want to know about them?" She said, "Well, when can I get them instead of the needles? That way I can just, *insert sound effect*, get it done." After explaining how the Pen works, getting the med in super quick, which makes it hurt worse, she was all set with the pen. :p I told her that if she changes her mind to let me know and we can get her the pen. After that discussion, she asked me if Jordan uses the Pen for her injections. Jenna looks up to Jordan SO very much!!! One day, they WILL meet! I told her. "No, Jordan doesn't get injections anymore. She has to get infusions for her meds. " Jenna then asked me to explain infusions.I told her that Jordan has to go to the hospital to be hooked up to an IV for hours to get her meds through the IV. Jenna's eyes bugged out and she said, "HOURS?!" I said, "Yes, it takes hours. How many depends on the med. But still, hours." To my surprise, Jenna said, "She's lucky." I'm sorry, SAY WHA?! I asked her, "You would RATHER have infusions??" She replied with a very somber, "Yes." Well that about knocked me off my chair.

And then there was this. Jenna always draws on the table paper at any appointment. But this was new. She has never been so expressive about her arthritis.

"You have BEAUTIFUL ankle bones!"

That is what Jenna's rheumatologist said to her at her 3 month appointment this past Wednesday. "You have BEAUTIFUL ankle bones!" Who would have thought that would be music to our ears? Before she started her exam I told her that while I don't think Jenna is at 100%, I still feel she is the best she has been since her diagnosis in August of 2008. After examining Jenna, the doctor agreed. Jenna is doing GREAT. I expressed my concern over the fact that she is still experiencing periodic pain and stiffness. When a storm blows through, when the temperature drops, sometimes when she wakes up or after a car ride. I asked her, "Is this just her normal? Is this okay?" She assured me that yes, this is okay and perfectly normal. Even a child that goes into remission can still experience all of this. She does, after all, still, have arthritis. Even if she hits remission, she won't be cured. Sadly, surprisingly, this is music to my ears. I could not be more happy. She does have an awful lot of tightness behind her knees. Again, perfectly normal for a child with arthritis. Her homework before her next appointment is to get that stretched out and be able to at least reach her ankles with her fingertips. Right now she can't even sit up, she is so tight. Now, you may be thinking, "Wow she is doing so great she must be ready to taper meds!" Yeah, nope......read on.....

Jenna also had her 3 month ophthalmology appointment on Wednesday. We didn't get terrible news, but it wasn't what I had hoped and prayed for either. After nearly two years of hearing Dr. Wallace say clear and quiet, I heard the dreadful word CELLS. She isn't in a full blown Uveitis flare right now. He assured me that this could go either way. We could come back and she will be in a full blown flare. Or, these few cells could just go away all on their own. Not terrible, but not so great either. Had her eyes still been clear and quiet both doctors would have been comfortable tapering meds. Not now. These few cells have taken that chance away. Even when we go back, if they are gone, it will be risky to try tapering now. We are so blessed with amazing doctors. Dr. Wallace took the time to very patiently reassure me that since she isn't having any major, adverse side effects from the meds she is on, keeping her on them right now is really the best thing. Overall she is doing well on them, taking her off of them right now could be disastrous. We are also blessed that he understands the dangers of steroid eye drops. We are not putting her on a course of drops at this time. We are waiting to see what happens. When we go back to have her rechecked, if the cells are still there, then we will start drops. AND GET HER OFF OF THEM QUICKLY. So very thankful that he is educated on this. Sadly, many doctors are not. They, for whatever reason, don't understand the dangers of these drops being used long term. We will need to do a med change to in order to get her off the drops. But we will cross that bridge when and if we get to it.

Overall, I still consider this to be a great day for appointments. Her joints look and feel great! Her eyes have hit a teeny, tiny, minor bump in the road. It will be okay. No matter the turn it takes, I have faith, it will be okay.

Thankful

Many times I am asked how I get through the day without crying. I answer that honestly, some days I don't. Some days I do cry, I do get angry. I think that's normal. But overall, I know that we are blessed, despite our trials. Of course I have days that I wish that our daughter wasn't battling a chronic, painful disease. But, that's the hand we were dealt. I recently had a friend tell me that she is "Currently having a disagreement with God." You see her son was diagnosed with a chronic illness. She hasn't yet seen the gift in it. Or, possibly she has, but still can't "forgive God" if you will. That may offend some people but that's how I see it. When we or a loved one are handed a crappy deal, we get angry with God. What do you do when you are angry? Stay angry, or forgive. I see the blessings that her sons disease has put in her life, I think she does too, but she isn't THERE yet. For the most part, I am okay with where we are. Sure, Jenna has daily pain, wakes up stiff and unable to bend her legs or flex her feet, takes way too many medications, gets sick from those medications, has muscle weakness, walks with a limp, struggles to keep up with her peers. But you know what? I have recently learned to just watch her, just silently observe. I'm still not sure if she even notices any of these things about herself, but if she does, she doesn't seem to mind. So why should I? She adjusts and presses on, so why shouldn't I? She really is quite amazing! Just last night I was watching her sit in the recliner, playing her brother's guitar (she is teaching herself!). She stopped strumming, wiggled around, adjusted her legs, sat and looked at them for a moment, it was clear they were hurting her, then she settled and began strumming again. AMAZING! Yesterday morning I heard her coming down the stairs on her bum, slowly, because her legs and feet weren't cooperating. When she got to the bottom, she stood up, got her backpack and went about the tasks of getting ready for school. AMAZING! There is beauty in everything, even in suffering. It is up to US to find that beauty!
There is a Mom right now, sitting in the hospital with her one and only baby girl. They are on day 27 in the hospital. On day 28, she celebrates her 5th birthday. That will mark 5 years of being sick. Now, how would YOU handle all of this. Here is how this Mom handles it....with grace and thanks.....

Some of the most beautiful man made things I have ever seen were all the amazing stained glass windows in Paris. They remind me of Eleanor. When the world looks at her unfortunately they see a bunch of broken glass and pieces that don't fit perfectly. When I see her I see all the small pieces coming together, the many breathtaking colors forming an awesome little girl.I will never understand why God made her so different but I know that she was made perfect and in His image. She is exactly the little girl He knew she would be and I am blessed beyond belief to not only know her but to be able to say she is MINE!

The Eyes

 So, the GREAT news is that her eyes remain inflammation free! I am still so stunned by this. That means that since December of 2009, the Uveitis has not acted up for her. That is incredible given the difficulty we had getting it under control. The combination of Humira plus Methotrexate continues to keep her eyes healthy. It amazes me, it brings me great joy, yet I can't help but also feel a bit of guilt. You see, it isn't so easy for everyone. There are still so many little ones that struggle to find the right combo of meds to tame this beast. I hate that. I feel so lucky, so very blessed. And again, I must stress, to ALL of those that doubted and STILL doubt our move down here, had we stayed in Maine, this would NOT have happened.
Since her eyes are still healthy, we are not comfortable playing around with her meds at this time. Despite the fact that her joints continue to flare off and on, it just isn't worth the risk to her eyes to play with the meds. I called her rheum office and scheduled her 3 month follow up and asked that the nurse please speak with Dr. V about keeping meds the same for now. I got the call back before days end. What a relief, she is FINE with keeping her on the MTX and Humira for now and we will see how she is at her appointment in November. PHEW!
So for now we wait and see, again, what this disease will do. It is so hard to just let things be. To not be hyper vigilant, always on edge, questioning every little thing. I don't even know how to explain it to someone with a healthy child. But, for now, I am going to just let things be as they are. I am going to try not to ask her every morning, every afternoon, every night, "How are you? Are you okay? Are you sure?" I need to back off. I need to TRUST that if something is wrong, she will tell me. We'll see how this goes.

She was so upset about missing art class AGAIN this week. It's her most favorite enhancement class. What a pleasant surprise this was. The Art Cart was out at Duke Eye Center. :o)

You learn to take the good WITH the bad....

...when living with, or raising a child with, not one but two (or more for some folks) chronic illnesses. Jenna "Bean" went to Duke Children's today for her 3 month routine appointments. Since it's a 2 hour drive each way we do both rheumatology and ophthalmology, plus labs all on the same day. This makes for a LONG day but at least it's done for another 3 months.....typically. Today we started with rheumatology first. I really thought that everything was going to be okay. She still has a lot of pain but I had come to accept that it may be more from muscle weakness and tendon tightness than from the JIA. I even told Larry on the way there, "Maybe they will want to start weaning her meds." Something that I have been so hopeful to try. We saw one of our favorite docs there today. She is so kind, so thorough. I watched as she repeatedly, lightly passed her hands over Jenna's ankles, quietly, with her eyes closed.I don't think I took a breath. She opened her eyes and said, "There is heat AND swelling in this ankle." I told her that Jenna jumped into a too shallow part of the pool last night and hit her foot. Could that be it. Oh the look on her face. I could tell she felt bad. She explained that, no, this is a flare. While it is very possible that the pool incident aggravated it, the flare was already there. My heart deflated. Then, thinking on it.....I knew all along. Yes, the pool incident made it worse, but it was there. She has been "gimping" around up on her toes periodically for some time now with that foot. I just never suspected her ankle. THAT hasn't flared in THREE years!! But that "gimp" walk that she has been doing since last night, it's the very same one she has been doing for at least a month now. Along with her ankle flaring, we have possible jaw involvement now. Something I have wondered about for a while now. I realize that lots of kids don't LIKE to brush their teeth, but with Jenna it is a screaming fight every day and night to get this done. Well, at today's appointment the rheum was spending an awful lot of time feeling the jaw and looking at it, asking Jenna about it. Oh boy. She looks at me and says she wants an MRI done. Her jaw is out of alignment which could mean JIA in her jaw. Oh boy. To top that off, she sin't even sure how she would treat it as there is a lot of controversy over HOW to treat a child's jaw with JIA involvement. And to top that off, she needs to be sedated as this is a time consuming test done in a big, loud, scary machine. So, that is scheduled for August 31st, exactly one week after school starts. GREAT. On that same day we will also see the rheum again to see if anything has changed with the ankle. I didn't even think to ask what we will do if it is the same or worse. As far as I know she can't increase any meds she is currently on. Which leads me to our next appointment....
After her lab work and a trip to the cafeteria to feed the posse (we all went today :D) we were off to Duke Eye Center. I was terrified that since her joints are flaring that her eyes would be too. After being quiet and clear for a year and a half. I got really nervous as Dr. Wallace was making adjustments to the slit lamp. I thought for SURE he was seeing something. NOPE! Guess he was just being thorough! STILL CLEAR!!!!! In my brain I realize that the eyes and the joints can flare independent of one another. It's my heart that's the issue. SO, m fear is that if the current meds are no longer working on her body, but they are on her eyes, and we mess with the meds to control the body, what then happens to the eyes. BUT, One. Day. At. A. Time. Right now I will praise Jesus for my baby girl's crystal clear, healthy eyes. You really cannot beat that.
Also while at Duke today, I finally remembered to register Jenna in the CARRA registry!!! WHY the doctors don't mention this to the patients and families is beyond me. But, at any rate, we remembered. Jennifer Stout, the Clinical Research Coordinator came in to talk to us about it and to have us fill out paperwork. She asked how we heard about CARRA, when I said online she was surprised saying that of 300, only 2 have said they've heard about it online. Interesting. She encouraged me to please share her email, jennifer.stout@duke.edu, on my blog. She said that ANYONE can email her for info. ANYONE, even if you are not a Duke patient or from this area she will get you to the right contact person.

So that's it for now. Follow up on August 31st for an MRI and recheck of flaring ankle.

 I realize that I have not yet blogged about the Juvenile Arthritis Conference. Honestly I have been dying to, but I am still completely speechless. Words cannot describe just how amazing this event was. How big an impact it had and is still having on me. Probably always will. I know that my girls took a lot away from it as well. Next year I am hopeful that all five of us can go. Instead of words, here is a video I made.

Surgery

Really it's a crummy thing anyway when you think about it. Though it's something that we are supposed to benefit from, it's still crummy. Who says, "Oh YAY! Surgery!!"? No one.

So anyway, today was Beanz surgery to place tubes in both ears and remove her adenoids in the hopes that we can drain the fluid and stop the infections. Hey guess what? My kids was difficult. I know, right? You can't even believe it. True story. Ears were first on the agenda. That's where all the trouble started. Her ear canals are oddly shaped. Go figure. The odd shape made it difficult, impossible really, for the doctor to get to her eardrum. SO, he accidentally "scratched" her ear canal. AND, the tube is in, but not in an ideal location. Therefore, it likely will not function properly, will need to come out sooner, and will cause some hearing loss while in place. And this is just the right side. Left wasn't QUITE as bad, but non the less proved difficult and the tube is again, not in the ideal location.

Next up was her adenoidectomy. Was pretty routine, until he couldn't get the bleeding under control. He said we are not talking significant blood loss, but substantially more than normal, more than she should have bled. He feels she must have had some residual meds still in her system. It was my understanding that it was just the Motrin that would cause issues with bleeding. BUT, I read this today in the Humira patient info: Blood problems. Symptoms include a fever that does not go away, bruising or bleeding very easily, or looking very pale.
Fabulous, right? Her rheum had said that if everything went well that she could resume her meds as usual this Friday. I don't think any of this qualifies as going well. I'll be calling them tomorrow.

She then had issues coming out of the anesthesia. Some of it was normal, disorientation, fighting with all of us to get up and leave. Then there was the issue of her forgetting to breathe. Yuh. In AND out Jenna!! She needed to be put back on oxygen which freaked her out and got her all wound up again. Anyway, once we got her calmed down AGAIN and breathing on her own, we were discharged.

It has been a LONG day. She is in a lot of pain. She is fearful of MORE pain. She is tired and cranky. She is miserable and out of sorts. BOO.

I was going to post some pics but for some reason they all wanted to lay on their side. SO, in lieu of photos I am sharing a song/video. I saw many things today from friends about praising Him, in the storm or the darkness as well as in the light, in the good times. He is in ALL of it. His glory is ours to have. I praise Him, even after the day we have had.

Can someone please throw us a line....

...because I feel like we are sinking. It's been a rough couple of weeks. The good news is, physical therapy is going well, Jenna loves Miss Shirley. She has her custom made orthotics in her second brand new pair of sneakers in as many months and she loves those too. She is a flip flop and barefoot kind of girl so I though this would be a battle. She LOVES to wear them so I guess that means they feel good.
Now for the bad; Jenna "Bean" is having her surgery this Wednesday. She needs tubes in her ears and an adenoidectomy; routine surgery for a normal, healthy child. Life with a JIA child is NEVER normal and or routine. To prepare her body for surgery her rheumatologist wanted her off her MTX and Humira and the ENT wanted her off the Motrin. The rheum felt that given how long she has been on them, 2 skipped doses shouldn't affect her at all if any. WRONG. Friday May 20th was her last given dose, Friday May 27th was her first skipped dose. By Tuesday May 31st she was miserable. She came home from school complaining that her knees hurt and she wasn't able to fully extend them. I tried to get her into the tub to loosen her up, but she couldn't extend her legs to get them under the water. She laid on her hip and that worked. Since then we have noticed her fatigue worsen. All this time we thought it was a side effect of her meds. Obviously it's the disease. Also joining in on the flare up party is both feet, one ankle, both elbows and a random few digits, this is on top of both knees flaring too. Miss Shirley could see that she was compensating for pain even while doing her PT in the water this past Saturday. Her teachers at church yesterday could see that she was tired and she simply wasn't herself. She has a very grim, stone set face. If she can get through the surgery with no issues then she can have her meds again this Friday. I pray that they work just as quickly as they stopped.
Now, seeing her suffer is bad enough. Knowing that she CLEARLY is nowhere near even a medicated remission is what stinks the most. I want her OFF these meds!!!!! Seeing what a couple skipped doses is doing to her, now we see we still have a LONG road ahead. ):

My 1st Guest Post

I have had the very distinct pleasure of "meeting" some incredible people while on this journey with my Jenna "Bean". One of them is Jess. Although we have never actually met, she simply exudes a strength and light that can be seen or maybe felt even through the computer. I know, that sounds kind of strange, but seriously, she does. I felt compelled to know more about her journey, her story. So, a few months back I asked if she would be willing to put something together for me. She graciously accepted my invitation to share her story here. I didn't make it through the first paragraph without crying and by the end the lump in my throat was so big I could barely swallow past it. The following is Jess' story, in her words.

My name is Jessica, I am 16 years old, and I am battling Polyarticular Juvenile Rheumatoid Arthritis (JRA). My journey began at the tender age of 2. One afternoon, my mom came home from work to discover my right knee very swollen. She rushed me to the Johns Hopkins Hospital ER where x-rays, labs, and a bone scan (at just 2 years old, I was able to complete this test without any form of sedation) were performed; my right leg from the hip down was placed in a cast as the doctors were puzzled about what was causing my knee to be swollen, they simply figured I had broken my leg. After seeing a specialist, a week later we received the diagnosis of Pauciarticular JRA. I was started immediately on Naproxen, Methotrexate (MTX), and Prednisone to combat the disease. Despite the early, aggressive treatment, within just a couple of short months, the inflammation had spread to literally almost every joint in my tiny body. My disease was then labeled as Polyarticular JRA. At such a young age, I quickly adjusted to my new “normal”. I learned to cope with the excruciating daily pain, injections every week (I tried my best to be brave), and many visits to the Pediatric Rheumatologist and Pediatric Ophthalmologist (did you know that JRA can cause eye inflammation?). Another hurdle I learned how to jump early on was getting monthly blood work; I can safely say by age 3, I became a pro… I completed my first tear-free blood test! I was catching on quickly…

                Around age 4, my mom and I relocated to warm and sunny South Florida. Despite remaining on the anti-inflammatory, MTX, and steroids for about 2 years, my joint inflammation remained and even progressed. My medications were increased and I started Physical and Aquatic Therapy. I loved Aquatic Therapy… That heated pool was the only place I was free to move and be almost pain-free. Physical Therapy on the other hand was a nightmare, I did not like it! Sessions would wear me out and cause me to be in agonizing pain… But after 6 months of enduring this treatment plan, the majority of my inflammation was gone. I slowly improved and for the first time since diagnosis, I was able to begin weaning off the Prednisone. Eventually, I had officially achieved my first medicated remission! I still required treatment with the MTX and anti-inflammatory, but I was finally able to experience life inflammation-free. This remission, however, was short-lived. Just a few months later, the inflammation came back with a vengeance; my Rheumatologist suggested I have two cortisone injections in both knees. I underwent this procedure at 5 years old without any form of anesthetic. Unfortunately, the swelling did not respond at all to the steroid joint injections. My meds were increased again, and we found ourselves dealing with the beast – Prednisone – yet again. This trend continued for the next couple of years – I would begin to flare, be placed on steroids and have my MTX dosage increased (sometimes I was given upwards of 30mgs), then the inflammation would get better and meds would be decreased… Only to find myself flaring yet again. This vicious cycle was frustrating because the range of medications that could be given was limited and, as a result, I ended up on steroids and higher doses of MTX for every single flare. Regardless, I remained very active! I loved dance, played soccer, and karate was my favorite sport. I knew I had arthritis, but I also knew I’d never let it have me!

                Around age 11, I experienced yet another flare after doing well for a short period of time with minimal inflammation. My MTX was increased (again) and this time, my liver had a nasty reaction to the chemotherapeutic drug I had been on (without break) for the past 9 years. The Rheumatologist decided he wanted to biopsy my liver. I was placed on steroids (again) and my MTX dosage was decreased in hopes of showing improvement. A few months later, I was told I had achieved my second medicated remission! Prednisone was ended then, and for the next 3 years I continued to take my MTX, but I lived completely without inflammation.

                I felt great... My mom was ecstatic… We actually thought we had actually conquered this awful monster some like to call “Arthur”… Until December of 2009 when a small amount of inflammation was detected in my right knee. Around this time, I was also diagnosed with kneecap misalignment in my right knee and osteoarthritis caused by the damage the JRA had done to many of my joints. In January of 2010, I started having chest pains and it was discovered that I had high blood pressure. Because JRA can result in extra-articular manifestations that include inflammation of the internal organs, I was quickly sent to a Pediatric Cardiologist and a Pediatric Nephrologist for evaluation. After many tests, the worst possibilities were ruled out, and I was diagnosed with secondary hypertension and costochondritis. The swelling in my knee was minimal, but stubborn, and it remained that way until the summer of 2010. I had a massive flare that left me barely able to walk. It was difficult to relearn to cope with the pain I had been without for so many years. I was unable to volunteer with my sweet kiddos at the Children’s Hospital I visit every Friday, hang out with my friends, and enjoy my summer. That is when we decided to start on a new biologic medication called Enbrel. When I was younger, these types of medications were either unavailable or very new, so they were never an option. Within 2 days of my first injection, I was able to move again! I was so blessed to have such a great response as many kids with JRA don’t respond as well to medications and need much more potent medications.

                I was doing well on the Enbrel for a while, almost close to a third medicated remission. Then, other issues started to arise. I had been dealing with GI problems for about a year, but around November of 2010, they started to get worse. I was referred to a new GI specialist who decided to perform some tests. She took a total of 11 biopsies, 6 of which showed mild inflammation. Today, my Rheumatologist believes this may be an indication that I am in the early stages of developing Crohn’s Disease; having JRA (an auto-immune disease) increases your risk of developing other auto-immune disorders. I am to begin a new medication called Humira on June 15^th, 2011. As if that’s not enough, due to all the anti-inflammatories I had taken over the years, I now have Gastroesophageal Reflux Disease and a recent Gastric Emptying Scan confirmed a diagnosis of Gastroparesis (GP). I was started on Erythromycin to increase the motility in my stomach; sadly, the Erythromycin didn’t work. On June 2^nd, 2011, I am scheduled to have intra-pyloric injections of Botulinum Toxin (Botox) to help the GP; if this works, I will have Botox injections in my stomach on a routine basis. Unfortunately, due to the severity of my symptoms, my GI specialist believes I may also have a motility disorder of the intestines. Within the next few months, I will travel up to Children’s Hospital Boston for more specialized testing. What does this have to do with JRA? 14 years after diagnosis, I am still on Methotrexate, a chemotherapy drug. We don’t know what has caused these GI disorders… Perhaps damage from long-term use of such harsh medications? Only time will tell…

                Living with JRA is both a blessing and a curse. I don’t want to say it has taken away my childhood, but it has caused me to “grow up” a lot faster than most. When you are forced to confront pain, many pills, shots, and scary tests at such a young age, you are also forced to mature way beyond your years; I was often referred to as an “old soul” when I was little. Being a teen with JRA can be challenging. One of the most difficult things I face would have to be the lack of understanding that others have of JRA. Other kids think I’m overreacting when I’m limping when, unfortunately, it’s something I just can’t control at times. Perhaps having to take so many pills and give myself so many shots is even more difficult. The majority of my friends cannot recall the last time they got a shot… I gave myself one last Saturday. Having JRA has certainly taught me who my true friends are. I am so blessed to have such a supportive group of friends. My family, though, get me through everything. My mom is my rock and I’m so blessed to have her. She has fought so hard for me over the past 16 years and she is my best friend; I love her to death!

Today, I still battle with the same vigor as I did when I was first diagnosed with JRA. I am currently taking a total of 18 medications on a routine basis to manage my diseases, but I try not to let my JRA hold me back. I try to always look on the bright side and view my cup as “half full”. In a way, JRA has awarded me many blessings. It has given me compassion for others in pain; I devote much of my time to volunteer work, specifically with sick children. It has given me a greater outlook on life; I know my journey has been a long and tough one, but there are so many others that have it so much worse than I do. JRA has also strengthened my faith. Having JRA has allowed me to meet some pretty amazing people and inspiring little ones. I have gained new friends… Ms. Iris who draws my blood might as well join my family. JRA has also influenced my plans for the future. I have decided to become a Pediatric Rheumatologist and find less toxic and more effective therapies for children with Juvenile Arthritis. I am working hard now in school in order to accomplish that goal; the 300,000 children dealing with Juvenile Arthritis deserve it. Until then… We can’t fight this battle alone. We need help… How can you help? Donations to the Arthritis Foundation can bring us one step closer to the cure. We need more awareness for this disease. Before reading this, did you know that kids get arthritis too? Thank you for taking your time to read my story.

Where do I start???

It's all good news, I just don't know where to start! I feel so behind. Okay so we'll start with lab results. This is something that I had been very worried about, given the fact that she has not had proper labs done in over a year. They....looked.....GREAT! Sedimentation rate is WELL within normal range, WOW. Platelet count is only SLIGHTLY elevated, not a huge concern. The only other thing out of whack was her Alkaline Phosphatase. The rheum nurse explained that in kids it can be high simply based on the fact that they are generating a lot of bone. I'll take it. So, her body seems to be tolerating all the meds AND there apparently is no hidden inflammation. SO, why does she still feel so miserable??
Well, on Thursday she had her first PT session. She seemed to be feeling pretty good that day so I was sure he would think we were nuts for bringing her. Plus she was in one of her, "NO nothing hurts now or ever" moods. *SIGH* But as he was talking to her and checking her out, he was able to somehow by poking around on the back of her knees, reproduce the pain she feels and she admitted that YES, that's it. She then fessed up to her feet bothering her by days end by but that was ALL she was willing to own up to. One of the things he had her try was to stand on one foot and bend down to touch the floor and then stand back up. Most kids SHOULD be able to do this with only slight wobbling. She fell over. Partly goofing off, partly that her muscles are weak. He also pointed out that she has flat feet, virtually NO arch. We had been buying her Keds because she said they were soft and comfortable on her feet. She has always been so picky with shoes. He said they were all wrong for her feet and therefore contributing to her pain. AWESOME. He referred us to a specialty shoe store to have them properly fit her for a well constructed sneaker that would provide good stability. They guy at the store was awesome and we got her some GREAT sneakers! Never heard of the brand, "Brooks", but we will for sure be back for more when she outgrows these! Okay so back to PT. He also discovered that her hamstrings are super tight! She can't straighten her legs except when standing. With all of her hypermobility, her hamstrings are tight?? She couldn't even get into a proper position to stretch them. This will take some work. So we came home with a sheet of exercises to strengthen her hips, thighs and knees as well as stretches to loosen up her hamstrings AND instructions to get her shoes (which we did Saturday). He said he wanted to wait three weeks before seeing her again to see how much progress she could make with better shoes and doing her homework. The exercises are tough on her and the stretches painful but she HAS to do them and we HAVE to make her.
Then on Friday morning I went down to Charlotte to the Arthritis Foundation offices to meet with the person in charge of the Let's Move Together Walk. Our team is not doing so well with getting new members OR most especially with raising any money. This has had me really bugged and I thought for sure I was missing something. I had a GREAT time meeting with Stefani! I left there with some fresh ideas and some fresh energy! I am definitely feeling more positive. It's just going to take some creative thinking. While discussing different possibilities, she mentioned that they would be more than willing to go into Jenna's school to do a presentation and get them involved. I told her GOOD LUCK. Not only have I tried repeatedly and unsuccessfully to get them involved, we can't even get a 504 plan out of them. The more we talked about that, the more outraged she became. Yep. She said they're on it now. Eager to see how this plays out. She suggested 1) Requesting a transfer OUT of that school 2) Contacting a lawyer since what the school is doing is highly illegal. I told her that I would wait and see what happens with the AF contacting them. If they still won't budge, then we will take action. I just left there feeling so good, knowing that we aren't alone. I also left with some great posters, "vintage" AF walk t-shirts, shoe laces and water bottles . So excited about the possibilities! OH, I also left with packs of paper "bones" to sell to raise money! I brought them to our pharmacy and they said they would be more than happy to sell them for us! You know, "Would you like to but a bone for $1 to help support the Arthritis Foundation?" Shyeah! We have some more stuff in the works too. Simply asking people to donate doesn't seem to be working so we are going on to plan B.

Breathing a Sigh of Relief...

....so far anyway. I should have her lab results tomorrow, or the beginning of next week. Once I have those and they look okay, THEN I can really breathe I sigh of relief. Overall, it was a really good visit.

The ride there was better than it used to be thanks to our "new to us" vehicle. The highways here are still a nightmare, Larry got to witness this for the first time and he was amazed. But, it was definitely a more comfortable, smoother ride. Jenna was for the most part comfortable the whole way. A few times when I looked back she was grimacing and trying to find a comfy position, but overall she did okay. Two hours of sitting still isn't easy on anyone really.

We got there a little ahead of our appointment and were taken in almost immediately. We saw a new doctor, I can't for the life of me pronounce his name, but he was very nice, very thorough and we all liked him, we shall  call him Dr. D. He took the time to answer all of our questions and answered them in ways that we were able to understand. Gotta like that! Jenna was loose as a goose, no pain, no stiffness....NO SWELLING, NO signs of ANY active arthritis!!! WOOOOOHOOOOOO baby!!!!!!!!!! SO pleased to hear that. However, he said that given what we told him about her Fall and Winter, she likely had active arthritis then. SO, that means that yesterday was day zero on the road to being able to wean her off of meds. BOO! That is a big bummer as I thought that we started that in December of 2009 but, she is doing well now so I need to focus on that. We talked a bit about her hyper mobility. He seemed pretty amazed at how far he could overextend her joints and it not hurt her. He said that the pain that we are describing her as having (pain behind knees while seated, pain from extended walking, etc) is from her hyper mobility, not from her JIA. The good news of that is that he wants to put her in physical therapy. FUNNY, I asked the doctor that we wasted a year on about that and he said no. Hmmm....so anyway, the goal is to strengthen her muscles and tighten her ligaments and therefore, eliminate her pain :) I called today to set that up, she starts next Thursday, they said three times a week to start. WOW. Labs went great. She held still, he was in and out in the blink of an eye! I think food was her motivator but by the time we were done with the lab we were already late for her eye appointment!

On to Duke Eye Center.....we only got slightly lost in the hallways :p We arrived for her appointment thirty minutes late but they took us back fairly quickly. The resident that saw her first was great with her. He is in the right field for sure. I wish ALL peds doctors were like that. He said everything looked great to him but he knows that Dr. W likes to get a better look with another machine. It had been well over a year since they last dilated her to look behind the retina so we did that too. UGH. Poor kid apparently still remembers all of her nightmarish experiences with the doctor in Maine because she fought us like a wild animal just trying to get the dilation drops in :"( AND, they didn't take the first time, so that was a total of 40 minutes waiting for her pupils to dilate. By this point it was 2 or 3 in the afternoon, we hadn't eaten anything, and Larry had been up for 24 hours. Awesome. But anyway, Dr. W took a look with his "better equipment" saw NOTHING, looked behind the retina, saw NOTHING!!!! WOOOOOHOOOO! Eyes are still clear and holding strong! I am so very grateful for that especially given the struggles that I know so many other parents are going through right now trying to find the med combo that will work. We have been so fortunate. Dr. W said that as far as he is concerned she can start weaning anytime and he will send that recommendation over to Dr. D. But, he also said with a smile that he knows they won't go for that :) LOL!

So, that's it! We go back in three months unless something new comes up. She starts her PT next Thursday. Lab results should be ready tomorrow! Thank you to everyone that has been praying for my sweet Bean. It means more to me than I could ever express.

Oops sorry, just remembered a couple more things. We spoke with Dr. D about our troubles getting a 504 in place for Jenna. Of course, the social worker wasn't in yesterday. She will be back on Friday and he will give her the info and have her call us so that she can take care of it. This will definitely be needed now with her having PT as the latest they schedule is 5 pm and those are difficult to come by. So I may need to pull her early or bring her late. Also, I forgot to ask about the CARRA registry :( Very disappointed in myself for that. Next time though, I promise. And lastly, her official diagnosis now is extended oligoarticular juvenile idiopathic arthritis. Dang that's a mouthful!

To Each Their Own

Since her diagnosis nearly three years ago, we have heard numerous alternative therapies to treat Jenna's diseases. I appreciate that people think they are being helpful, I really do. But in all sincerity, do they really think that they know more than the doctors? In the beginning I would be intrigued when someone would offer something to try and I would research it. But, I never really felt safe or secure in the ideas. If it were me? Heck yeah I would try alternative therapies! But for my child? Is it really worth the risk if that therapy fails? Especially when you consider that her arthritis isn't only in her joints, it's in her eyes! Would you really, I mean really risk your child's eye sight just to try something that may or may not work? And before you say it, YES, I knooooow that the meds that we inject her with are dangerous. I know that, believe me I know and I hate it. But for us, when we look at everything and weigh it all out, the risks balanced with the proven success of these meds wins out hands down over anything else. Is it maybe just that people don't understand that this is an autoimmune disorder? Maybe they don't even know what an autoimmune disorder is. I know that it can be confusing, heck, nearly three years in and I'm still learning! We can't simply treat the inflammation and the pain. We need to treat the disease. Your immune system, that thing within your body, designed to protect you against illness and infection actually attacks your body therefore making you sick when you have an autoimmune disorder such as juvenile arthritis. One specific alternative therapy that I have heard of a few times but never paid attention to is antibiotic protocol. It's come up a couple of times in my arthritis family circle (love them!). I never looked into it because it simply didn't sound sensible to me. For one thing, you use antibiotics to kill a bacteria making you sick, there IS no bacteria making these kids sick. For another, how many times have we heard that antibiotics are being over used in kids and therefore a great many of them no longer work?! Most pediatricians refrain from prescribing antibiotics anymore unless for serious infection because of this. So why would I treat my child's autoimmune disorder with antibiotics? I doesn't make a bit of sense to me. Well, there is a group that has made frequent visits to my blog. I keep seeing them pop up but never thought to look into who they are or what they are about. The name of their site didn't ring any bells, but it possibly should have. Antibiotic protocol is right in the name. Finally, the other day it registered with me so I went to their site and looked around. They are of the belief that antibiotic protocol is the ONLY route to take and basically we are all fools for thinking anything different. As the title of this post says, "To Each Their Own". Treat your child's disease however you like, it's not my place to judge you, shame you or mock you. Shouldn't we get that same courtesy? And why hide out in the shadows? If you are going to visit our blogs, our discussion boards, etc., Why not speak up? You see what they are doing, and there is only a handful of them, they visit our blogs and boards, not to help us, not to educate us, but to gather information about us and our kids to share amongst themselves. WE make our lives, our stories, our information public because we want to reach out to people, have people reach out to us and all be there together for on another on this really crappy road. Why are they hiding? Not only is my blog public but I also don't moderate comments. I have been told that I am crazy for doing this. I have nothing to hide, I'm only here to help. On their site, not only do they keep certain areas under lock and key, it states clearly, "Don't mess with us. No exceptions. The WTF Management Team.". Well now, isn't that just a warm and fuzzy welcome? So basically if you don't agree with what they say, don't bother registering, becoming a member and voicing your opinion. I can't even find anything on their site or on another that they recommend that even says how AP works. What do you take? How often? For how long? They talk a lot but don't actually say anything. I plan on asking Jenna's doctors at Duke Children's this week about AP because I like to be educated and well informed. I'm actually very eager to hear what they have to say about it. My blog will continue to be public and comments will continue to not be moderated. I have a lot of people finding this blog by searching key words. If I can help even one person feel as though they are not alone then it's worth it. And if you have something to say? Say it. I won't delete your comment. Just be prepared for the comments that follow. I've been attacked once already on here, we Moms stand STRONG and UNITED.

2011 JA Conference

The site is finally up!!! WOOT! The info that we have so desperately been waiting for is here! We are going into our third year on this journey but this will be our first year at the conference. Year 1 I don't think I knew anything about the conference, or if I did, I didn't think we needed it. HA! Year 2 we just had too much going on in our lives to even think about getting there. Year 3, this is our year! I am so excited to do this, I just can't even begin to describe it. Trying to figure out if we will go as a family since the rates are all the same anyway, or if just the Bean and I will go. If it's just the two of us we will take the train which will be way easier for her. If we all go we have to drive since 4 (or 5, another long story) train tickets will be too expensive. The drive will be painful for Bean, but then we aren't tied down to the train schedule which quite frankly, bites. So, lots of decisions to be made, but, bottom line is, at the very least, Mama and Bean WILL be there! And if Daddy and Bub have to stay home, they announced yesterday on their Facebook page that they will be doing webstreaming this year. SWEET! Not the same as being there but at least they can join in and learn with us. I cannot wait to meet all of these people that I have been blessed to come to know in a virtual world. I will finally be able to speak with them face to face, hug them, laugh with them, cry with them, SHARE with them, in person, in real life. SO very blessed. Thank you God.

We were SO close!!

We almost made it through the entire Winter without any major, fever producing bug of any kind. So close, but not quite. She certainly hasn't had a great Winter. She has had lots of fatigue and pain issues but she hadn't gotten sick. Considering all that has gone through her school and the fact that NC is having yet another crummy Winter, I felt really lucky. Last Saturday she was very clingy, didn't want me leaving her side for any reason, more emotional than usual and just generally out of sorts. I just figured she was more tired than usual. Then Sunday morning she awoke with ...um....we'll just say messy pants. She's 7 now, so....that's certainly not typical. She said her belly hurt pretty bad but that she felt okay otherwise and she really didn't want to miss church. *sigh* She loves church, she cried when I told her I didn't think she should go. She assured me she would be fine. So she went and indeed she did seem okay. She was very quiet the rest of the day though and said her belly still hurt. Monday morning I decided to keep her home given the belly pain, "messy pants", and she had Humira and MTX injections Sunday afternoon. I figured a day of rest was in order. She seemed just fine all day and night so Tuesday morning we sent her off to school. Well, she came home digging in her ear and crying that it hurt really bad. Oh she broke my heart. This is the kid that has pain EVERY day in her hands, legs, feet and God only knows where else. She rarely even mentions that pain never mind cry over it. This was open mouthed sobbing, for HOURS, like, all night long hours. I was giving her Motrin, warm washcloths, nothing soothed her. By morning she had a temp of 103. Aw crud. So I called her peds office first thing. They typically have plenty of "sick kid" appointments. This time they had sick doctors. Aw crud. So they had no appointments and suggested we go to Urgent Care which actually was fine with me since they are literally right up the road. The place was surprisingly deserted when we got there so she was seen very quickly. She saw a nurse practitioner , which again, was fine by me, since I think many times they are way more thorough and have a better bedside manner. She took one look in Jenna's ear and said, "OH YEAH! It's infected alright! It's red, inflammed and full of blisters!". EWWWW! Full of blisters?? OUCH. Poor thing no wonder she was sobbing so hard and long! They had also just done a strep swab. She asked if I cared about the results as treatment would be the same. Nope, doesn't matter. She said it's likely positive since her throat didn't look so hot either. Same end result anyway, antibiotics. I finally remembered to suggest Omnicef on the 1st try. It is the only antibiotic that works for my kids yet it is always the 2nd string med. So, a 10 day course for her to kick this infection in the tail. After 2 doses, plus Motrin and Tylenol piggy backed her fever, which had climbed to 104, finally broke, left and stayed gone! Her belly is still bothering her so she is being very cautious about what she eats and how much of it. She is still even more tired than she normally is. She is resting on her own without being told and is able to laydown through an entire feature length film. That is saying an awful lot for Miss Jenna Bean! So that was Wednesday that we started the Omnicef, it's now Friday and day 3 of no school. She is enjoying being home but she misses school too. I think she will be happy to go back on Monday. If we can finish off Winter with this being her only major illness, I'll call that a success!!

On a small side note, only 26 more days until her appointments at Duke Children's!! I am so happy, excited, eager to get her back in there!

Counting My Blessings

I just feel such a strong need today to count my blessings. It is very easy with a chronically ill child to be angry and hateful. It's something that unless you are or have lived it, you simply can't understand. Most times I wish more than anything that we didn't have to know what it's like. Some days I get very angry with God for doing this to us. I get very angry with the disease for raging through my sweet Beanz body and wreaking havoc on it. Then there are days like today. I know that God has a plan and a purpose for every single one of us. I know that He loves my Bean. He isn't doing this to hurt her or to punish her. Instead it is to use her and me through her. It is my life's purpose, because of what is happening to my child, to educate myself and then educate the world to the best of my abilities. I thank God for that. It has also I know given Bean a strength that she otherwise wouldn't know. It gives her siblings compassion and understanding that they otherwise wouldn't have.

We are also very blessed that Bean, despite all that she does go through, could be much worse. I have been so fortunate to connect with other JA Moms and we all share our stories with each other, many of them now with the world via blogs. A great number of these children still have not found the right med, combo of meds and or dosage of meds. Many of them struggled just to get the diagnosis. Too many of them are having their vital organs attacked either by the disease itself or by the medications they are taking to treat the disease. Some have already had surgeries on their joints and now have more scheduled. Some of them have had to have joint replacement....IN A CHILD! Way too many of them simply cannot get the Uveitis to go away and stay away and now have permanently damaged eyes. Their eyes!!! They are just babies for crying out loud!

So please, take a moment today, and count your blessings.....

3 Days & 2 Appointments

Monday this week we brought Bean to the "rheumatologist" at Brenner Children's Hospital. I was thankful to be able to get her in so quickly seeing as how I had just called Thursday last week. What a joke, what a waste! Mondays appointment confirmed we are doing the right thing by going back to Duke Children's Hospital. Her pain has been increasing in intensity and frequency for at least a month now. Oh and still exhausted! She also has swelling that comes and goes in her toes and fingers, her knees are squishy and she has been having toes and the heel of her hand turning purple and she says that REALLY hurts. And of course interspersed with all of this is periods of time where she seems perfectly fine! I love those moments, nothing brings me greater joy than to watch her skip, dance, run (which always looks odd and hobbled) and play like a "normal" healthy little girl. But I also know what will come later on. She will be laying somewhere crying that she hurts, or taking her frustration with her pain out on all of us because she is trying to hide it and deny it exists. So this guy says non of this fits JA. That simply put, swelling and pain do not come and go with JA. It's either there or it isn't. Really? That's new to me but I was willing to set that aside to look into further on my own. Turns out that's BS. I have, since Monday, heard from adult sufferers as well as Moms of JA kids that say of course it can come and go. So my next question to him was, okay so if this indeed isn't her JA then what is it because this certainly isn't normal or okay. He asked to speak to me in another room. I braced myself because I knew what was coming. He says she is either faking it for the attention, OR because she has been told that she has this chronic illness that causes chronic pain she just has it in her head that she should be in pain. Uh huh.....so riddle me this "DOCTOR" why then is it that she pushes herself way beyond her comfort zone, typically denies anything is hurting her when clearly it is, then finally reaches her breaking point only when she is in agonizing pain and THEN and only then does she stop what she is doing?? He said he has no answer for that, he just knows there is nothing medically wrong with her and that her JRA is currently under control. Right, thank you so very much for wasting my time today and doing nothing to help my child. I recently had requested copies of her records from his office which includes all her labs. I looked them over briefly and thought they really didn't look anything like her Duke ones but at the time didn't think much of it. Yesterday Hubs and I were able to access her labs from Duke (last done Dec 09) and compare them to the labs from Brenner. He has done nothing other than a basic panel that any one of us would have at say a regular yearly exam. He hasn't run a sed rate or a CRP. Now, here is the other interesting part of that. Her last time at Duke I clearly remember there being little to no visible inflammation, maybe some squishiness in her knees, her range of motion was excellent, and yet her sed rate was 26 with normal range being 0-13. So clearly with Bean she can have inflammation that you can't see. UGH. Still kicking myself for not researching this doctor before making the switch.

Now on to today. Today was her routine opthalmologist appointment to check for a Uveitis flare. I was so nervous going in there today. With all the pain she has been in I was really worried that it had come back. If that was the case I know we would have needed to discuss another med switch. I have tried to go back through the blog to see exactly when her eyes became clear. Best I can find is in February I reported that they were still clear yet in January she had about 10 cells so closing in on one year anyway of her eyes staying healthy. WAHOO!!!!! Breathing a sigh of relief on that one. The opth and her assistant her horrified by what the doctor told us on Monday. Felt good to get confirmation of the absurdity of it all from another doctor.

The unfortunate thing in all of this is that Beanz appointments at Duke aren't until March. I'm being told by friends and family to call and explain, maybe they can get her in sooner. As awful as it may sound, I have another crisis with another child that is more demanding of my focus right now. Until we can get this crisis resolved Bean will have to wait to be seen at Duke. We will simply do our best with hot baths, Motrin, rest and massages for now. I pray that this other issue will be resolve very, very soon.

Ooooh and by the way, in case you were wondering, yeah still no 504 in place. MmmmHmmm...

This Just Isn't Acceptable

The map to the left is clearly a map of the United States. The red colored areas are where you can find a pediatric rheumatologist. The yellow colored areas are where you can find a rheumatologist that will treat children. Speaking from personal experience. Do NOT take your child to anything other than a board certified pediatric rheumatologist. A rheumatologist trained to treat adults is not necessarily trained to treat children and YES there IS a difference! So, that all being said, are you seeing a problem with this map?

IN 2007 the Health Resources and Services Administration (HRSA) called for a 75% increase in the number of pediatric rheumatologists. An estimated 300,000 children suffer from Juvenile Arthritis in one form or another yet there are fewer than 200 board certified pediatric rheumatologists in this country. Juvenile Arthritis is one of the most common chronic illnesses in children and if left untreated, or mistreated, can lead to severe disability. According to this 2007 HRSA report, 13 states do not currently have a certified practicing pediatric rheumatologist. This means that on average, children and their families will need to travel an estimated 57 miles to the nearest pediatric rheumatologist. I don't know, looking at that map, it looks like a lot farther than 57 miles for most families. When we lived in Maine we were traveling approximately 41 miles to see the one and only rheumatologist in the state that would treat children. He however was NOT a pediatric rheumatologist. To get to the nearest pediatric rheumatologist, it would have been more like 143 miles across 3 states. Considering the frequency of the appointments and the fact that my daughter can't be in a car for more than 20 minutes before her legs hurt, this wasn't acceptable. So, we up and moved. We moved from Maine to NC. When we first got here Bean was being seen at Duke Children's in Durham. FANTASTIC hospital with amazing doctors. However, that was still a 125 mile trip. EACH WAY. Way too much for Bean. And for ME to be driving that! So we switched to Brenner's Children's, which is part of Wake Forest University Baptist Medical Center. Still a fantastic place and we love her doctor. Still a 60 mile drive but it's doable. Ideally I would love for us to have a specialist right here in Mooresville. Ideally I would like lots of things. But I think you get my point here. 200 doctors for 300,000 children?? That's not acceptable. I am not even going to get into comparing the ratios of other childhood illnesses and their needed specialists. Because honestly do we want any other parent and their child to suffer and struggle like we do? No, of course not. So, what can we do? Let our voices be heard. Tell your local Congressman (or woman) about these 300,000 kids. Do they even know?? Probably not! Tell them about our day to day struggles. Tell them about our need for more specialists. If you can, plan on attending the 2011 Advocacy Summit. Ultimately I dream of a cure so that no child should suffer. But until that day comes, we need more trained and certified specialists to care for our kids.

She is in so Much Pain

My poor Bean has been in so much pain lately. I just don't know what to do for her. She is her own worst enemy of course. Seeing as how she is an active five year old she isn't exactly doing anything to help herself out but what am I supposed to do? FORCE her to lay down and rest her body?? How on Earth would I even do that? It has been at least 2 maybe 3 weeks now that she is walking funny. Complaining ALOT. She can't sit in a chair. She does this weird squat thing. Doesn't look comfy to me but hey it works for her. I can't get her to keep shoes on her feet. We keep buying different ones hoping we will find a pair that feels good. So far the only thing that feels good is bare feet. Socks are usually off too. Fine at home but out in public we get some looks ya know? Plus who knows what she is walking on. *shudder* She is complaining of pain in odd places. She has the normal leg and feet complaints but now she also has chest and eyebrow pain. Huh? What the heck does THAT mean?? Again...she is only five so getting her to articulate these pains is nearly impossible. Is it an ache or a burn? A sharp pain? Where exactly is it? Is it your heart? Lungs? Ribs? Breast bone? What do you mean your eyebrow? Is it your eye? HOW does it hurt? ARGH!! I called our regular family doctor so I could check in with her to see what she thinks about how Jenna is doing. May 19th!! That is the soonest she can see her. *sigh* Yeah I CAN call her rheumatologist but I am just not sure that he is doing all he can for Jenna. So DO I call him? I just don't know. All I know is that we have not tamed this beast sufficiently. Instead of showing signs of improvement she is getting worse. She didn't even want to go to school today. Jenna LOVES school. LOVES it. Loves her teacher, loves all her friends and the activities. Plus the playground is accessible now that all the snow finally melted. She LOOOOOves the playground. She clung to me wanting to stay home. I hugged and kissed her, pried her off my arm and sent her away with Daddy. Did I do the right thing? I just don't know. She is also SO tired. Is it the meds? The disease itself? Is it a disease? Or a condition? Anyway....I am attaching a photo taken last night. Her knees look awful to me but what do I know?

Aye, aye, aye....

This poor child. What next? I probably shouldn't ask that. So....over the past couple of weeks we had noticed Jennas knees and one ankle starting to swell. She wasn't complaining so we didn't mention it to her. I just kept subtly checking her out. By the end of last week she was complaining ALOT about pain and discomfort. Also her eyes seemed to be doing better on the drops 4 x daily. Also by end of last week....lots of pain. So I called her rheumatologist this morning and spoke with his nurse. She then spoke with him and called me back. We are increasing her methotrexate and giving ibuprofen every six hours. Lovely. Do this for 2 wks and call back. I am somehow not sastisfied. I don't know what I would have rather them said. I just don't feel sastisfied with what they DID say. A couple hours goes by and her primary doctors office calls. Her routine labs that she had done last week are off so he wants more labs done. Awesome.....cause we had to pine her to the table last week. Her platelet count is to high. Now I know that this is not uncommon in arthritis but it's even to high for her rheumatologist to think it's okay. Great! So what is going on now?! Oh and I also STILL have not heard back from Dr. Fosters office about the crazy $250 payment for her first visit. Thank GOD I started taking meds of my own.