Update July 2008

This month has been okay. The good news is that her knee is doing great. Still no swelling and it is definitely not bothering her. The bad news is that her ankle and elbow are starting to swell again and they seem to be bothering her. She is limping on her ankle every now and then. She still seems to be in good spirits and is not crying all of the time like she used to. We had her blood work drawn again and the results were not good. Her sed rate is the highest it has ever been. At her Dr’s appointment he seemed surprised that there were no other joints bothering her because of her high sed rate. As of right now, we are going to increase the naproxen and not change anything else unless she starts to get worse. We are all looking forward to going on a much needed vacation next month. I can't wait to take the kids to the beach and just hang out with them by the pool. They both love the water so Im sure they will have fun. Our next Dr's appointment is in September. This is Ayla's current lab work.
sed rate 62 normal is 0-20
hemoglobin 10.3 normal is 11.2-16.0
hematocrit 31.7 normal is 33.6-48.0
platelet count 608 normal is 120-450
The sedimentation rate (sed rate) blood test measures how quickly red blood cells (erythrocytes) settle in a test tube in one hour. The more red cells that fall to the bottom of the test tube in one hour, the higher the sed rate.
When inflammation is present in the body, certain proteins cause red blood cells to stick together and fall more quickly than normal to the bottom of the tube. These proteins are produced by the liver and the immune system under many abnormal conditions, such as an infection, an autoimmune disease, or cancer

Ayla's injections June 2008

Ayla’s injections were scheduled on Friday June 6th, we drove to Columbus Thursday evening since we had to be at the hospital early Friday morning. After the night we had on Thursday, I knew getting the injections was the right thing to do. Ayla slept in the bed with John and I and she cried out in her sleep all night. She kept saying "my knee". We only got about 3 hours of sleep that night, if that. The next morning we talked to the Dr. Before the injections, and he said that he would only inject the joints that looked bad. They do the injections under ultrasound so they can see the joint and know where to inject the steroid. I held her while they were putting the medicine through her IV and she kept saying over and over "all done". Leaving her by herself while they did the injections was the hardest thing I have ever had to do and I cried like a baby after I left her. After the procedure we found out that he did have to inject all three joints. We were kind of bummed out about that because that meant that all three joints were pretty bad. Anyway, we went and bought her an elmo balloon and a big bird stuffed animal so they would be there to greet her when she woke up. The ride home went okay, she was pretty groggy all day and I just sat and played with her on the floor so she wouldn't have to walk. I tried to get her to eat but she was not interested. I finally got her to eat some chicken soup but she ended up getting sick that night. I guess I shouldn't have forced the issue.
The first couple of days she was sore but after that she amazingly stopped walking without a limp. I remember taking her everywhere saying look, look, she is not limping. We were so happy and so glad that she was feeling better. (She has always had trouble walking up and down the stairs, she would never put weight on her right leg and she would have trouble transitioning from one thing to the other. Example from the pavement to the grass or walking over a curb etc. Her little friends in the neighborhood were always running circles around her, it would always make me sad to see this.)
The swelling in her knee was gone and her ankle and elbow seemed to be doing better as well. Right now I am so excited that she is doing better and I can already see such a huge difference with her and in her personality. She is doing things now like other children her age are doing. She is running and turning around in circles and just being happy. When she started turning around in circles, I was so happy, she has been unable to do things like this until now. It puts a smile on my face to see her doing so well. We also bought her a water table and she plays in it almost every day. She loves playing in the water and it is nice seeing her have so much fun. We had a great father's day, we went out and bought flowers and pots and spent the day planting. Grandma and Grandpa Wright also came over to visit and it was a good day. We have also been able to quit physical therapy for the time being, I promised the Dr. that I would work with her at home so back to normal life for a while. It is a waiting game to see how long the injections last . Next month we will have her lab work done again to see if there are any improvements.

May update

Six weeks later we are back in Columbus and regretful to say that things are not improving. Ayla is still limping pretty bad and at her worst, she seems to be dragging her leg. Her elbow on the other hand seems to be improving. She is doing a lot better with it and it doesn't seem to be bothering her as much. After her exam, the doctor noticed that Ayla’s right ankle was swollen. Again, I felt terrible that I had not noticed her ankle. I was so concentrated on her knee, that I never thought her ankle could also be a cause of her limping. This was upsetting to hear because it seems that every time we see him, a new joint is involved. We decided to increase her naproxen dose to see if that would help. We discussed the possibility of steroid injections some time In the future if she did not improve. He gave us some literature to read on the injections and he wanted to see us back in another 8 weeks.
We were home only a couple of weeks when one morning I was getting Ayla ready to go outside and play. As soon as I put her shoe on her right foot, she started crying like she was in pain. I looked at her ankle and sure enough it was very swollen and hot to the touch. After I took her shoe off, she was okay, so I knew her ankle must have been hurting her. She was also still crying a lot like always, and still limping and sometimes dragging her leg, so after talking things over with my husband, we decided to go ahead and schedule her for injections. Of course we didn't want to put her through this but we are hoping that this will give her some relief and help her to start walking better. It has been three months and sadly, there are no signs of improvement. I just want to see her happy and not hurting. It seems like for the longest time now I can only remember her constantly crying. I know it is not her fault and as a parent, it just hurts your heart knowing that your child is in pain and that there is nothing you can do for her. I pray everyday that God will heal her and take all of her pain away. She has been through a lot these past couple of months. She does not like anyone to touch her and she knows when she goes to the Dr's. office that something is going to happen. She has had her blood drawn three times and we are getting ready for the fourth in a couple of weeks. We are due to go back in July for another eye check up. On a postive note, she has been getting in our neighbors pool lately and she loves the water. It makes me happy to see her having such a good time in the pool. She has also started talking so much, I think it is quite remarkable for her age. She is just so smart!! It has only been a few months since her diagnosis, but everything has been extremely overwhelming. I just try to take one day at a time and pray that God will give me the strength to make it through another day. I still have faith that one day the arthritis will be gone and Ayla will be a happy, healthy little girl. Until then, I will take care of her and love her the best that I can. She is my angel, and I could not imagine life without her!

The month of April 2008

This month has been okay. No dramatic improvements with Ayla. She is still limping quite a bit and the physical therapy is not going well. She cries just about the whole 30 minutes we are there. She will not let me put her down and she will not let the therapist touch her. She is very weary of new people and I do not blame her, she has been through a lot at her young age and I suspect that she is afraid. Her swelling is still there, there may be a little decrease but not much at all. We also had her eyes checked this month. With the type of arthritis that she has, she is at an increased risk for uveitis which is an infection/inflammation of the eye. The only way to check for this is by doing a slit eye exam. I have also been noticing that her eyes have been crossing at times so the Dr. also dilated her eyes and checked for that as well. Of course Ayla threw a fit and we had to hold her down. John was beside himself and had to leave, he does not handle things like this well. Everything was okay, praise God and he said he would see us again in three months for another exam. He also asked me to talk to her and explain to her about the test so that she may be more willing to cooperate the next time. I almost laughed out loud. It has obviously been a long time since he has had a toddler. There is no reasoning with a 20 month old, especially not with Ayla. I am just hoping and praying that she will start to show some type of improvement. I love her so much and it just kills me to see her struggle to walk on a daily basis. I know she looks normal to everyone else, but I see the daily struggles that she endures and sometimes it is just unbearable. Oh yeah, I forgot that we also got fitted for her knee brace a couple of weeks ago, Im sure you can guess how that went. TERRIBLE. She didn't cry, she screamed the ENTIRE time they were making the brace. I know I will never get her to wear this, she is scared to death of it as of right now.. we will see!

Our weekend out of town

This weekend we went to visit some very dear friends of ours in Indiana. Ayla cried just about the whole weekend as usual and you could tell that she wasnt feeling well. It was very apparent that her knee was extremely swollen, you could even see if through her pants because her pants were tighter on that knee. We were still giving her Ibuprofen because our pharmacy did not have naproxen stocked before we left. On Sunday morning when we got up to leave she was limping pretty bad. Of course she cried all morning until we left and needless to say, it was a miserable 5 1/2 hours ride home. We stopped at the pharmacy before we got to the house and Ayla was crying to get out. We got her out and she could barely walk. My husband and I just looked at each other and almost cried. This was the worse we had seen her and it was just heartbreaking. We were just praying that this medince would help her.

Ayla's first Easter Egg Hunt

Today we took Ayla to her first easter egg hunt. We were not sure if she was going to like it or not but to our suprise, she loved it. She had a great time picking up the eggs and putting them in her bag. She also liked taking the eggs apart and getting the candy out at the end. What a great day, I am happy that she had so much fun!!

(Picture taken on March 24, 2008, the day of her official JRA Diagnosis)

Not too many people know that "Kids can get Arthritis Too". This is my daughter Ayla's story of her diagnosis and struggles with Juvenile Rhuematoid Arthritis at the age of 18 months. I am writing her story to raise awareness of this disease and to encourage others that are affected by this disease. I know how hard and frustrating it can be, so when you are feeling down, please think of my little angel Ayla and I hope she will brighten your day! She is fighting hard to beat this disease, and so can you!

It all started in February 2008 when I noticed that Ayla was limping and crying in the mornings when she woke up. At first it was just a little , I really did not think anything of it, I just figured she was still tired and wanted to be held. Of course now looking back, I can see how all of her signs and symptoms led to the diagnosis of JRA (Juvenile Rheumatoid Arthritis). Ayla was also crying more than normal in the mornings but that really did not phase me too much because Ayla has always cried a lot. My husband always said, "I think she cries more than the average child". I can remember back to when she was 14 months, she cried ALL OF THE TIME. We even took her to the Dr. a couple of times thinking she may have had ear infections. There were many nights that she would wake up crying for no reason, so we thought. Of course there was never any medical reason for her crying, so we just thought maybe she was teething and that was that. I think now that was probably around the time when her JRA started. Around 17 months is when the limping began. I mentioned it to my husband a couple of times but by evening she would be walking and running without a problem. My husband suggested that maybe she was just having a hard time walking on the hard wood floors in the morning, so I thought that sounded reasonable enough. At around the same time, I noticed that every once in a while when I picked Ayla up to put her on my lap she would just start sobbing. I could not for the life of me figure out why because after all she was sitting on my lap. It was frustrating because I had no idea what was going on. I know now that if I picked her up a certain way and it twisted her knee or pulled her elbow, that she was in pain and would start crying. She would also cry if she barely fell down, I even made a comment to my husband saying that when she falls down you would think that she fractured a bone or something not knowing that once again she was in agonizing pain from her arthritis. It was not until early March one Saturday morning that Ayla was limping around in her diaper and my husband and I were sitting on the floor watching her limp and at the same time we both noticed that her right knee was extremely swollen. Her knee was hot to touch and she could not straighten it out. It was at that moment that we both knew something else was going on. I will never forget that moment for as long as I live. My husband and I are both in the medical field so a thousand things went through our mind as to what could be wrong with her.We took Ayla to the hospital for an x-ray that same Saturday. To our relief there were no tumors so that eased the stress a little. My husband took Ayla on Monday morning to see the orthopedic doctor. After an exam and hearing her history, he suggested that maybe she had Juvenile Rheumatoid Arthritis and he ordered some lab work. We then started her on Ibuprofen for the inflammation and pain. When my husband came home, he told me what the doctor had said, and my heart just sank. He assured me that if she did have JRA, she had the mild type because only one joint was affected and that she would eventually outgrow it. My husband went back to work and I proceeded to go to the computer and read everything I could about JRA. This was probably not the best thing to do because there are so many types of JRA and they all have different treatments and different outcomes. I just cried and wished that I could trade places with her. It just did not seem fair that an 18 month old baby had to be faced with this horrible condition. It seemed like for the next couple of weeks we were in denial. I think we expected the swelling to go down thinking that maybe she just had a bad fall and everything was going to be okay and go back to normal. Sadly, this was not the case and after we saw our pediatrician, she suggested that we see a pediatric rheumatologist to see if indeed this is what was wrong with Ayla .My husband and I were devastated and we started calling around to see who would see Ayla. We found out that were we live, there are not any rhuematology doctors that specialize in pediatrics, so we were referred to a Children's Hospital in Columbus Ohio.

Our first appointment in Columbus was on March 24th 2008. We saw the doctor there and after looking at Ayla, he confirmed that she did have JRA and that not only was it in her right knee, it was also in her right elbow. After he told us that her elbow was affected, I remembered that in the mornings she would cry when I put her clothes on. I never even thought about her elbow being involved. Of course I felt stupid then for not realizing that her arm was hurting when she had to straighten it out to put her shirt on. She was diagnosed with pauciarticular JRA and he said that she has a great chance for a full recovery. He said that she will hopefully outgrow this at some point and that it may never come back. This was very reassuring to hear but the only problem was he did not know how long she would initially have it before going into remission. It could be one year, it could be five years. He decided to put her on naproxen twice a day and wanted us to start her in physical therapy once a week. He also wanted her to wear a leg splint at night while she was sleeping. We were to see him again in six weeks for another check up and to see if she was showing any improvement with the naproxen and P.T.

By June of 2008 at 22 months, Ayla's right ankle also became swollen. She was still limping and at her worse she was dragging her leg behind her when walking. She was not able to run and play like most children her age. It was at this time that we decided she needed joint injections. Under conscious sedation, she had her right knee, right ankle and right elbow injected with a steroid. This helped tremendously, the inflammation in her right knee went down and she was no longer limping. Her ankle and elbow continued to bother her.

By August of 2008, Ayla's arthritis started affecting her neck. We noticed that her neck was stiff and she was having trouble turning it to the right or looking up. We actually noticed it right when we were leaving for vacation. I remember thinking how "frail" she was, especially at almost two years old. She should have been full of energy!At this point, the Dr. suggested that we start her on Methotrexate. We were devastated because this is a very aggressive chemo drug with a potential of bad side effects. We went back and fourth about starting her on this medicine, we were torn and didn't know what to do. We decided to wait it out a little while longer.

In October of 2008 we had discovered that Ayla's fingers and toes were starting to swell. It was when we found her left knee hot and swollen that we called the Doctor. She was started on oral steroids (prednisone) and after a few days, she was a new little girl. Feeling as we had no choice, we also started her on the oral Methotrexate.After being on oral steroids and Methotrexate for six months, we decided to wean her off of her steroids. During the six months that she was on the steroid, she was feeling great and her lab work was normal (for the first time ever). As soon as she was off of the steroid, her arthritis started to flare once again so we switched her to the injectable Methotrexate to see if that would help. She stayed on the injectable Methotrexate for another three months.

By June 2009, the arthritis was in her right jaw and she was diagnosed with TMJ. After an exam, the Dr. was also fearful that it was spreading into her hips. At this point we decided to add yet another medicine, Enbrel. This was another injectable medicine as well. She was up to around eight medicines a day by now and was getting two injections a week. The Enbrel was the answer to our prayers and after a couple of weeks, we finally had our little girl back. It took over 18 months to get her into remission with medications. She has had no signs of arthritis since the latter part of June 2009.If she continues to stay in remission for one year we will be able to wean her off of her meds. There is a 50% chance that the arthritis will come back. Because of Ayla's multiple joint involvement, the Dr's have told us that she has only a 30% chance of going into remission without meds. It is likely that she will carry this into adulthood, however, we do not know what the future holds, there is only one person who does and we will trust in him and we will deal with whatever hand life deals us one day at a time. We will always stay hopeful that she will beat this.As parents, we strive to be the best advocates we can for our daughter. Most people do not know that "Kids Can Get Arthritis Too". It is our mission to raise awareness for this disease.There is still much research that needs to be done so maybe one day our kids will not have to suffer with this. Below are a few articles that Ayla has been in regarding her Jra.

 

Ayla is now 9 years old. For the past 7 years her Arthritis has been controlled with weekly Enbrel injections and steroid knee injections when needed. I wish this is where our story ends but for the last year she has been having belly problems and neck stiffness along with weight and growth issues. Sadly, she was diagnosed with Crohn's Disease this December 2015. She still never complained and we only found out something else was going on through abnormal lab results. She is now on monthly Remicade Infusions and so far she is doing great. This new diagnosis and treatment has been hard on her but she always manages to have a smile on her face. She loves school, animals and her friends. She is learning to play the Violin and loves to sing! We will never give up on finding a cure for Arthritis and now Crohn's, until then we will continue to raise awareness and hopefully be a support to anyone who is going down the same path we have been!

Local Newspaper Article

Here is a link to Ayla's video we made when she was the youth honoree for our Arthritis Walk!
https://www.youtube.com/watch?v=-a10E4D5XHQ

If you have made it this far, thank you so much for reading "Ayla's Story". It really means alot to me! If your child has JRA or if you yourself have RA, I would love to hear from you!