(Logan wrote this paper for his college English class and wanted to share it.)
The vast majority of people view
arthritis as an old person’s disease that is solely related to joint pain.
Because of what is assumed, people think that living with arthritis are easily
treated and cured. Despite this assumption, there are actually over one hundred
different forms of arthritis (AFPacificRegion). Many patients suffer from
various symptoms. This is known as overlap syndrome. As a result of various
symptoms, many children are on a series of different medications. Usually
patients are on medications to counteract side effects caused by other
medications. For instance, many children must take Zofran with their
Methotrexate injections, in order to prevent extreme nausea. For children with oligoarticular arthritis, which
affects four or less joints (Dunkin,
Mary Anne),
doctors may prescribe corticosteroid injections, which are applied to the
joints. Polyarticular arthritis on the other hand, pertains to five or more
affected joints. Because of the numerous joints affected, steroid injections
may be difficult, so many children are prescribed with methotrexate, a
chemotherapy used as an anti rheumatic drug (Dunkin, Mary Anne). Though methotrexate
is used for polyarticular arthritis, it is commonly used among the various
forms of JRA. Patients with JRA who haven’t experienced success with
methotrexate are usually prescribed biologics, such as Enbrel and Remicade, which
are created biologically as opposed to chemically and act as a buffer to the
patient’s compromised immune system. These drugs are generally administered
through either IV-infusions, which push the medications into your bloodstream
at a slow pace, or injections. Systemic onset JRA is a completely different
beast; this form of JRA is associated with both systemic and joint diseases,
making treatment more complicated. Because of the double-edged sword that is
systemic JRA, treatment may involve a cocktail of narcotics, anti inflammatories. biologics and
steroids. Though this has only scraped the surface of JRA treatment, nearly all
treatments of juvenile rheumatoid arthritis take on the same goal, to achieve
remission, something that can only be reached with patience and at times,
proper funding.
Over 300,000 children are diagnosed
with some form of juvenile rheumatoid arthritis in the United States alone (Advocating
for Kids With Arthritis). All of these children face adversity daily, and are
forced to go to great lengths in order to get the treatment that they deserve.
Caitlin Ryan, age fifteen, was diagnosed with JRA at the age of three. She
doesn’t “remember life without pain” and has to find alternative ways in order
to accomplish average tasks. By the age of twelve, Caitlin had both of her hips
replaced due to this disease and is still fighting (Caitlin Ryan). Danielle
Guth has had JRA since she was four years old and is now going into her senior
year of high school. Doctors, medications, and pain have become a norm in her
life, making it hard for her to participate in her school’s sports. Due to her
arthritis, Danielle has gone through extraneous pain, surgeries and has
suffered from alopecia, an autoimmune condition that causes one’s hair to fall
out (Danielle Guth). For Kristen McAllister, her JRA journey began at eight
years old. At first it was thought that her pain was due to her gymnastics, but
when she had the swollen joints examined, doctors discovered that they were
rheumatoid nodules. Kristen says that juvenile rheumatoid arthritis has been
“destroying my joints, muscles, vital organs, and eyes.” Shortly after her
diagnosis of JRA, she also discovered that the arthritis has been affecting her
eyes in the form of inflammation known as uveitis. In conjunction with JRA,
uveitis is a painless swelling of the eyes that can only be diagnosed when the
eyes are examined under a microscope. If not treated promptly and properly,
uveitis has the potential to take its victim’s vision, either partially or
completely. As a result, she was put on two weekly injections of Humira and
methotrexate yet she didn’t respond, so she is now on a monthly IV-infusion of
Remicade, solumedrol, and IVIG (Kristen McAllister).
Despite the idea of finding a cure for
this autoimmune disease being unlikely within our lifetime, there are ways that
we can make these kids’ lives more bearable. Through advocacy and raising
awareness, we can spread the word about how dangerous, and unbearable juvenile
arthritis is. As previously stated, 300,000 children in the United States have
been diagnosed with some form of juvenile arthritis (AFPacificRegion). Even
though these children make up a vast majority of children with diseases in
America, there are less than 250 pediatric rheumatologists nation-wide;
to add
to that miniscule number, 90% of these pediatric rheumatologists are clustered
in major cities (Advocating for Kids With Arthritis), making it nearly
impossible for many families to find a doctor that they like within a few
hundred miles. Every major city has at least one Arthritis walk a year, but
this isn’t enough; we need to openly talk about it with others for them to
understand, and show them how it affects these children daily. Without starting
a conversation about it, juvenile arthritis will never gain the same awareness
that pediatric cancer, or juvenile diabetes gets. In the pediatric infusion
room at some hospitals, cancer patients often receive "rewards", care packages, and/or gifts from donors.
These donations are specifically labeled for the cancer patients, even though the
patients with JRA are in the same room as them, and most likely receiving similar treatments. To add to that, every time a cancer patient is cured in many pediatric infusions rooms, a bell goes
off. The bell signifies final day in infusion room. There is a cure for many childhood cancers, due to their funding, but
there is no cure for JRA. These children who have JRA may never get to hear
that bell ringing for them, but they get to sit and watch countless cancer
patients be cured throughout their lifetime. People don’t understand the
disease, or don’t even know about it, but it is our job to spread the word.
Just like Kristen said, “By advocating and spreading awareness, you are doing
your part in turning that misunderstanding and ignorance into understanding and
support” (Kristen McAllister).
On a national level, juvenile
rheumatoid arthritis has gained little to no attention amongst the people. Here
in Florida, there is even less awareness. My brother and I will walk around
pushing an empty wheelchair, getting strange looks form people; when they ask
why we are pushing the chair, we say that we have arthritis and that we are
feeling good enough to walk. After hearing that, many will walk away with a look of doubt
that we have arthritis. Sometimes teenagers will make fun of us, by calling us cripples,
mocking the way we walk, laughing at us when we are in wheelchairs, and even by
doubting our physical abilities. On top of that, people who are elderly will try to relate
because they think they know the pain that we go though. What these people
refuse to comprehend is that there are over one hundred forms of arthritis; and
we are not equivalent to the elderly. The only people who truly understand what
my brother and I have are our friends, because they care enough to learn and
understand. Me and my brother don’t even have the same forms of arthritis. I
have spondyloarthropathy, which is essentially a permanent form of tendonitis;
while my brother has systemic onset juvenile rheumatoid arthritis, meaning that
his entire body is affected, including his vital organs. Because of our various
diagnoses, we are able to better educate people who care enough to ask what we
have. This year, our walk team was the highest fundraising team in not only the
state, but also the entire region, raising a total of $16,622 (Parker’s Purple
Playas). Not only does this give perspective on where juvenile arthritis stands
with the nation, but also in the state of Florida, where many elderly couples
who are arthritic live in the suburbs. Not only is JRA overlooked in Florida,
but so is the typical form of arthritis that impacts the elderly, which is called osteoarthritis.
Juvenile rheumatoid arthritis is hands
down, the most overlooked childhood disease in America. In addition, when not
promptly and properly treated, it can be an extremely dangerous disease. It’s
an invisible disease, meaning that you can’t tell if someone has it, unlike the
"bald head" associated with cancer. There is not the level of awareness to back JRA like
juvenile diabetes. However, with advocacy comes better funding for medical fellowships,
more doctors, medical research and advancements, and most importantly, a chance
of remission. Advocating is as simple as showing a video to a friend, or
telling them how arthritis affects children. But without voices, the message
won’t be heard, and a lack of progress is just as bad as digressing. It just
takes one conversation to gain someone’s support.
Works Cited
1. “Advocating for Kids With Arthritis.” Kidsgetarthritistoo.org. Arthritis
Foundation. 23 July 2013. <http://www.kidsgetarthritistoo.org/who-we-are/advocating-for-kids.php>.
2. AFPacificRegion. “Faces of Arthritis.”
YouTube.com. Arthritis foundation. 29
Oct 2012. 23 July 2013. <http://www.youtube.com/watch?v=8zd3xXabGZ8>
3. Dunkin, Mary Anne. “Understanding How
Doctors Treat JIA.” Kidsgetarthritistoo.org.
Arthritis Foundation. 23 July 2013. <http://www.kidsgetarthritistoo.org/living-with-ja/medical-care/treatment/jia-treatment-guidelines.php>.
4. Guth, Danielle. “JA Awareness.” Personal story emailed. 24 July 2013. 24
July 2013.
5. McAllister, Kristen. “Juvenile
Arthritis.” Personal story emailed. 24
July 2013. 24 July 2013.
6. “Parker’s Purple Playas.” Arthritis Walk. Arthritis Foundation. 5
Aug 2013. <http://sacarthritiswalk.kintera.org/faf/search/searchTeamPart.asp?ievent=1042465&team=5311275>.
7. Ryan, Caitlin. “My Personal Story.” Personal story emailed. 24 July 2013. 24
July 2013.
