As most of you know, Esella was put under anesthesia 1-11-11 (good luck??) to have a cortisone injection in her knee to stop the arthritis from attacking that joint. They had wanted to see her 6 weeks later for a follow up. Her doctors were thrilled with the result! The inflammation was basically gone. However...her bad leg (right) is now 3/4 of a cm longer than the other. Aparently the increased blood flow caused by the arthritis causes bone overgrowth....which is what causes the serious deformities... like this:
They said they don't 'worry' unless its over a cm..and since the inflammation appears to have halted, she should "grow into" it.
In addition to the overgrowth, Esella has not yet regained full range of motion in her knee and still bears most of her weight on the 'good' (left) leg when standing. So, she begins physical therapy on Thursday.
Then there is the finger...her middle finger on her right hand was noted to be possibly affected at her first rheumy appt in December. It has since actually gotten WORSE, swelling quite a bit since then. I haven't been able to get a picture of it, but here is a picture that is similar to Esella's finger (hers is not quite as swollen, however):
It basically is not yet responding to her current drug therapy (naproxen, aka Alieve). The doctors told us fingers take longer to respond to the medications. They also told us it is very common to have to move to Methotrexate when fingers and other small joints (like toes) are affected. If you do not know what MTX is, it is actually a Chemotherapy agent. Want to hear something ironic? My dad was on this same drug for Chemo 21 years ago! You can read here about this medication:
Methotrexate Info on WebMD
They want Esella to continue on the current drug therapy until our next appt in May and then I guess we will discuss what the next step will be if her finger is still resisting treatment.
In addition to her joints, Esella has to be followed closely by a pediatric Ophthalmologist. WHY, you ask? Well because apparently it is not enough that Arthritis is attacking her joints, but believe it or not arthritis can also attack the EYES!!!! It sounds crazy but Esella is at risk for a condition called Uveitis . Apparently 1/8 children with JIA will develop Uveitis. And girls diagnosed before age 2 are at the HIGHEST risk, which is basically Esella since her symptoms began just before her second birthday. Children who test ANA positive are the highest risk group, and Esella is ANA negative. However that really doesn't mean much.
Here is an article about a recent study:
Study Identifies New Risk Factors for Dangerous Eye Complication of Juvenile Arthritis
So Esella goes back to the Ophthalmologist in May the week after hew next Rheum appt. Let's HOPE/PRAY that the Arthritis does not attack her beautiful eyes!
And so we continue with her Naproxen twice a day and hope it will do the trick!
So that is the update on Esella's arthritis battle. She is an amazing little girl!!
1 comment:
Katie, I promise you MTX sounds bad but it helps them so much. I was terrified to give it to J but we didn't have any other option. I hope Esella doesn't need it but if she does, it should help control the JA.
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