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Natalie, Age 8

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Natalie

Natalie was 3.5 years old when she started to complain about her left ankle hurting. She had attended a bounce house party and we thought she had twisted her ankle. It seemed to get better by the end of the week. 

The following week on New Year’s Eve she stepped off a brick and fell to the ground in pain. We figured she had hurt her ankle again. On Jan. 1, 2009 we were in urgent care and they figured she just twisted her ankle, and gave her a boot and told her to stay off it. 

After a week, the swelling had not reduced and numerous X-rays showed nothing wrong with her foot/ankle bones. They put a cast on her for two weeks. After the cast was removed I noticed her ankle was warm but the orthopedist was baffled by it, the swelling was still there. 

He referred us to a bone specialist (now we are in the first week of March). He found nothing wrong with her bones and I asked if she could possibly have arthritis (my sister had planted that seed in my head because she read it in her self-diagnose medical book). He left and came back some time later and agreed, since the onset was mostly in girls between the ages of 3-6 years old, that it was possible. 

He ordered labs and sent us to the eye doctor immediately. The eye doctor examined her eye and said yes she has inflammation in both eyes. The rating is from 1-4 and Natalie was at a 3+. She was given prednisolone eye drops and we had to put drops in her eyes every hour while she was awake to control the inflammation and avoid permanent eye damage. 

We were given an appointment to see the pediatric rheumatologist in the first week of April. From the beginning of March to the beginning of April Natalie's JRA exploded; not only was it in the left ankle, but in her right knee, left wrist and right middle finger. By the end of March, she could no longer walk; she had to be transported in a stroller. 

I continued to take her to preschool and stayed there to administer the eye drops and to pick her up and move her from station to station. At our urging the only appointment we could get was with her pediatrician and he could only prescribe naproxen for the pain; it helped her a little. 

By the following week were in the rheumatologist’s office discussing different meds and settled on methotrexate pills. We braced ourselves for the side effects. After her first dose she responded well and the swelling began to go away. By the second week she was walking again! She continued to improve in all her joints but the inflammation in her eyes persisted. Meds were increased in hope of reducing the steroid eye drops; over prolonged period of use they can cause cataracts. 

Since then Natalie’s joint inflammation has been controlled but her eyes continued to be a problem. As of November 2012 her eyes have been "quiet" and she has not had any eye drops since. We continue to inject her weekly with methotrexate (switched to injections since the med works better that way). Natalie is monitored every 3 months by her eye doctor and 6 months by her JRA doctor.


Natalie

Natalie was 3.5 years old when she started to complain about her left ankle hurting. She had attended a bounce house party and we thought she had twisted her ankle. It seemed to get better by the end of the week. 

The following week on New Year’s Eve she stepped off a brick and fell to the ground in pain. We figured she had hurt her ankle again. On Jan. 1, 2009 we were in urgent care and they figured she just twisted her ankle, and gave her a boot and told her to stay off it. 

After a week, the swelling had not reduced and numerous X-rays showed nothing wrong with her foot/ankle bones. They put a cast on her for two weeks. After the cast was removed I noticed her ankle was warm but the orthopedist was baffled by it, the swelling was still there. 

He referred us to a bone specialist (now we are in the first week of March). He found nothing wrong with her bones and I asked if she could possibly have arthritis (my sister had planted that seed in my head because she read it in her self-diagnose medical book). He left and came back some time later and agreed, since the onset was mostly in girls between the ages of 3-6 years old, that it was possible. 

He ordered labs and sent us to the eye doctor immediately. The eye doctor examined her eye and said yes she has inflammation in both eyes. The rating is from 1-4 and Natalie was at a 3+. She was given prednisolone eye drops and we had to put drops in her eyes every hour while she was awake to control the inflammation and avoid permanent eye damage. 

We were given an appointment to see the pediatric rheumatologist in the first week of April. From the beginning of March to the beginning of April Natalie's JRA exploded; not only was it in the left ankle, but in her right knee, left wrist and right middle finger. By the end of March, she could no longer walk; she had to be transported in a stroller. 

I continued to take her to preschool and stayed there to administer the eye drops and to pick her up and move her from station to station. At our urging the only appointment we could get was with her pediatrician and he could only prescribe naproxen for the pain; it helped her a little. 

By the following week were in the rheumatologist’s office discussing different meds and settled on methotrexate pills. We braced ourselves for the side effects. After her first dose she responded well and the swelling began to go away. By the second week she was walking again! She continued to improve in all her joints but the inflammation in her eyes persisted. Meds were increased in hope of reducing the steroid eye drops; over prolonged period of use they can cause cataracts. 

Since then Natalie’s joint inflammation has been controlled but her eyes continued to be a problem. As of November 2012 her eyes have been "quiet" and she has not had any eye drops since. We continue to inject her weekly with methotrexate (switched to injections since the med works better that way). Natalie is monitored every 3 months by her eye doctor and 6 months by her JRA doctor.

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