Since Krystal Dudek was diagnosed with arthritis at 18 months, her life has been marked by periods of treatment separated by periods of remission, when the disease becomes inactive. The methotrexate and steroid injections can be set aside – for a time at least.
Telling when her disease is active or inactive, though, is far from easy Krystal, an athletic 12-year-old, refuses to complain, as her mother,Carolyn, describes it. “She’ll wake up in the morning limping and I’ll say, ‘Krystal – what is wrong?’ And she’ll say, ‘Nothing.’ I’ll persist and ask again, ‘What’s wrong with your leg?’ And she’ll say: ‘It’s just really tired, Mom.’ ”
So several times a year, the family travels to Children’s Hospital & Regional Medical Center in Seattle for checkups. And her mother tries to be optimistic, but not too hopeful, while their pediatric rheumatologist examines Krystal joint by joint. One time, when Krystal’s parents thought their daughter was free of symptoms, her doctor pointed to a swollen toe on one foot.
Hope and Disappointment
“We’ve hoped and we’ve had some disappointment,” Carolyn says. But the family also has enjoyed a healthy portion of good news Carolyn is quick to say. By age 12, Krystal was enjoying her fourth remission, the previous three of which had persisted about a year and a half. Her current remission has stretched two years and counting including 20 months off medication.
Krystal’s only soreness involves her knees. But imaging tests indicate that the cause is probably athletic stresses, her mother says. (Krystal is constantly on the move, playing basketball, soccer and volleyball.)
Thankfully, Krystal’s symptoms didn’t reappear during the holidays which had been a common pattern, says her mother.
So they nervously await each checkup, trying not to wish for too much. They know the odds remain long for a sustained remission – the pill bottles expiring in the medicine cabinet – but it can happen, they periodically remind themselves.
“I just got done asking her doctor a few weeks ago, ‘Can I hope again?’ ” Carolyn recalls. “And she said: ‘Yes, you can hope again.’ ”
Enjoying a Remission: An Update
Five years after the above story was published, Krystal continues to live with the ups and downs of active arthritis. In 2009, she had a setback when routine orthodontic X-rays showed significant deterioration of jaw bones on both sides. Soon after that discovery, she began seeing a cranial facial specialist who began a series of injections with the hope of stalling or ultimately stopping the destruction. Although she is soon to have her fourth of the annual injections, her doctor has determined she also needs systemic therapy to stop the destruction.
So, after a five-year hiatus from methotrexate, she recently began the drug again. Her mother, Carolyn, says she’s a pro at giving herself the injections.
Despite this setback, the soon-to-be 17-year-old is looking forward to her senior year in high school and has her sights set on attending Washington State University after graduation.
“Krystal is a very wonderful girl. She is a kind and intelligent young lady,” says her mother. “Her arthritis has not changed those amazing qualities in her. We are very proud of her and hope to make her as well as possible before she heads out on her own for college and to start her life as an independent young adult.”