Friday, October 26, 2012

From the Voices of Families….

Recently I asked families of children with Juvenile Arthritis, if there was anything they wanted the general public to know about JA what would it be…This list below is a paraphrased summary of their very heartfelt responses.  Just a window into the lives we live, thoughts we have, and strength our children possess.  From the voices of families…
·         Juvenile Arthritis is not an old person’s disease, it’s autoimmune
·         It affects internal organs, not just joints
·         Our children are not “fine”, just because you look good or are smiling
·         It hurts, even when smiling
·         It is more than just hurting joints
·         It affect joints AND muscles, skin, internal organs, personality, mood, emotions, and engagement/activities with others
·         It can be as bad as cancer…just because my child is not bald doesn’t mean he/she is not suffering
·         Kids do not always grow out of it when adults
·         Kids’s with JA can be as severe and worse than adults’ RA
·         There is no cure
·         It is not an old person's disease - it is an autoimmune disease!
·         it affects more than our children's "health" affects school, their relationships, their play, their quality of life...
·         it can attack anyone, at any time and we don’t know why
·         during one hour of the day they can look fine, and an hour late it can hit them hard
·         it can blind, cause deformities, and even kill
·         it does not discriminate
·         We also don’t know what these drugs will do to their bodies down the road.  Will they be able to have children?
·         It affects not only their health.  It impacts their school, relationships, play, and quality of life
·         Praying for relief so my child can live a normal life…for some this comes, for others it takes much longer, and yet others continue to have bumps in the road and struggle.
·         If the cure was spices, vitamins, and other crazy mixtures, all these children would already be cured
·         The roller coaster ride is never ending…bad days, good, days, emotions, doctors, stress, expenses, meds, remission, active disease, medicated remission, …and yet life continues to go on and we try to enjoy life and a happy childhood.
·         We do everything we can to let our children be children
·         It is not the same as grandpa’s arthritis, which is osteo….this is autoimmune and my kids may be cute but they hurt BIG time.
·         When people think our kids are fine and question our requests for prayers because they look fine, it is hurtful.
·         Brothers and sisters become fearful, emotional, and wonder if they too will get this.
·         The amount of chemo our kids use over their life-time is more than some cancer patients
·         You see my child smiling…I see my child when he/she cries, gets blood work, can’t sleep, goes through physical and occupational therapy, sleeping with splint on their wrists/ankles, getting ongoing IV’s, getting MRI’s, CT scans, xrays, joint injections, scopes, surgeries, shots, throwing up, in pain, with swollen joints, with fever, with rashes, struggling to walk, and yes…I too see my child smile and am so thankful that through it all he/she finds a smile.
·         It affects every child differently.  It’s an autoimmune disease and can be mild to severe and chronic and can be different from day to day
·         It strains a marriage, couples, relationships
·         It’s hard to balance between children
·         We advocate, educate…so others will begin to understand
·         We experience many financial burdens
·         It is hard to admit that I can’t “fix it”
·         A normal life is a struggle
·         Our kids miss out on things that their friends are doing, either because of their health, because of treatment, or because they cannot be around others with a flu due to a compromised immune system
·         There are over 100 kinds of JA
·         It affects our careers/work
·         It comes out of nowhere…one day you have a healthy kid, then you don’t
·         Some children are old enough to understand the seriousness of their disease…and the young ones who don’t understand are also scared
·         For those with severe forms of JA…kids face their own mortality…talk about dying
·         They ask us many difficult questions, some that we don’t have answers for
·         Some children talk about wanting to go to heaven so they won’t hurt anymore
·         We live in the moment, not thinking too far ahead
·         The drugs cause many side effects sometimes causing a need for more drugs
·         The alternative to not taking drugs could have grave consequences
·         The continual fatigue is the hardest
·         This disease steals “time” from all of us…
·         My child is losing their hair…and prior to her losing her hair, people didn’t realize how serious this disease can be.
·         We often hear…at least it isn’t _____...but hearing this does not make this disease better to families who live with it because it is affecting our beloved children.
·         This affects the whole family….these are our children...It's a full on battle everyday!
And yet through it ALL…our children
·         Endure it all
·         Are incredibly brave
·         Know a lot about compassion
·         Experience the depths of love
·         Are amazing
·         Are young
·         Want validation
·         Need encouragement
·         Want a voice
·         Do know how to have fun
·         Are overcoming tremendous obstacles
·         Are thankful for each other
·         Are blessed to have incredible strength
·         Can smile
·         Have a much better chance with better drugs…but more research is needed
·         Are strong
·         Hope for a cure
·         Want you to tell someone…everyone…raise awareness…please…

Friday, October 12, 2012

We Spent WORLD Arthritis Day at the Hospital

We had our visit today with the doc and we are still here at Shands Hospital since it’s IVIG infusion day/night.  The good news is it’s just an overnight stay.  Parker’s doc is amazing and we are so fortunate to have her helping our kiddo.  She talked with the principal investigator physician for the RAPPORT study and bought us some time.  She got an additional 4 weeks’ worth of med.  I thought I was losing my mind a bit because I could have sworn we had until the end of December with drug.  I really thought that was what we signed up for…come to find out…YES, that is what we signed up for but because they are running out of money to run the study, we were going to be cut after the trial run was complete.  It really seems unfair on so many levels…but we are thankful for the additional time.  His doc is so very upset by this…she felt that he should get it because so many biologics have failed him but she can only do what she can do and we are frustrated right alongside of her.
In the meantime, an appeal was filed.  We are also going to appeal as parents too.  And his doc is going to call the drug company to see what can be done.  She is also contacting one of her connections at the National Institute of Health (NIH) to see if Parker could be seen up there.  We are feeling a bit desperate.  We do not want to see this disease attack his organs again.
We also talked about trying to decrease his steroids to see what happens.  We have a sense that the steroids might be holding some of the symptoms back.  So we will test that while he is still on the rilonacept.
Also, since Parker is going to need IVIG on an ongoing basis, his doc is going to try and set up home infusion…she said it kind-of works like an insulin pump.  He would get it once a week and it would run for 1.5 hours and infuses in the stomach.  There are a few advantages to this:  we would get to be home; and he would get more continuous levels of IVIG.  For those of you who are not aware, IVIG is an infusion of around 2,000 donors’ blood plasma.  This helps his immune system that is definitely not working correctly.  So we will see about that too.
If Parker cannot continue on the rilonacept and cannot get into NIH, then the only choice left is to go “backwards” and put him on what he has been on before and probably multiple biologics.   As for the symptoms that have returned…we will continue to monitor his temp, Raynaud’s, systemic rashes, and his vasculitis.  She said he has “hot spots” with his vasculitis.  And if by some miracle, he gets to continue on rilonacept long term he may still need to alternate it with another biologic because this darn disease seems to be outsmarting the drugs yet AGAIN!  Yes, it is crazy and we so want to see Parker comforted and feeling better.
Parker was super scared today and totally freaked when they told him he was going to have to share a room tonight with another patient (sweet kiddo by the way).  And even through all his fear, Parker was also super sweet…he asked the doc to come back so he could give her a hug.  He gave her a long hug and he cried.  He loves her so much and he knows that she is really trying hard to help him.  So please continue your prayers and encouragement.  We appreciate the support more than we could ever ever express.

Tuesday, October 9, 2012

Trying Not to Let Fear Take Hold...Trusting All Will Be OK

Fear can seem to momentarily paralyze us…Michael and I feel like we have been hit hard in our gut and the wind has been knocked out of us.  The last few weeks have been tough to digest.  Parker has seen progress on the RAPPORT study and for that we are incredibly thankful.  However, he is not doing as well as the other children on the study and we have seen the return of some classic systemic JA symptoms.  But today, it was made official… we cannot get the drug approved for continued use after the study and next Friday is his LAST day of the study. 
I broke the news to Parker and he totally withdrew and told me to leave him alone.  So I honored his request…as hard as it was, because this was not his typical reaction to bad news…  About 40 minutes later, one of his hospital homebound teleclasses started and when the teacher asked him how he was doing (like she does with each student during role call), he could barely squeak out “not too good”.  She said he could just listen today.  He said “ok”, muted his mic, and burst into tears.  All I could do was hug him…
Even before he voiced his thoughts, I knew what he was thinking.  He is scared of regressing even more.  He is scared he will have to go back to multiple biologics.  He is scared it will attack his lungs or heart again and he will be hospitalized.  He is scared he will be back on 2 infusions a day of kineret.  The day that we had his Arthritis Foundation Walk (May 5) was quite the celebration because that was the last night of his kineret infusion.  That night we made about a 10 minute video in case other families wanted to see what our twice a day routine entailed.  
He has been through so much such then….
During our last visit to the ped rheumy, we also had confirmation that he does have hypogammaglobulinemia and it is NOT due to his use of biologics but his messed up immune system and we were told he would probably need IVIG infusions for the rest of his life.  She also shared that she really feels he also has psoriatic arthritis in conjunction with is systemic on-set JA and all the other overlapping stuff.  And although he has been back on IVIG, his numbers are not increasing like she would like them to.   It is incredibly frustrating and concerning.
We are processing a lot right now.  Michael is coming with me on his next overnight infusion of IVIG this week, so we can talk about next steps and try to make quick decisions.  We are trusting all will be ok and trying not to let fear take hold of us.