Monday, July 14, 2014

We Keep Singing . . . . even though it's been a little dark

A favorite author, Cindy Woodsmall, posted a quote today:  "Faith feels that dawn will break, and sings while it is still dark."  We are a singing family, and sometimes the on-going health issues seem to have a darkness about them.  So this quote seems so appropriate to describe the year of 2014 so far.

I'm not feeling particularly eloquent tonight, but this blog needs updating.  I know many of the blog followers want to know what's going on with Anna in her JA journey.  Other JA parents like to know about life with Juvenile Arthritis and Uveitis.  It truly helps to know that none of us are on this journey alone.  We have each other, and for those of us who put our faith and hope in Jesus, we know that He is with us on this journey---no matter whether we are feeling Him or not.  For me, and for Anna, He is the source of our strength---our "strong tower," our hope, our anchor.  Despite everything that has happened these past several months, one of the true highlights of 2014 for Anna was attending the Creation Festival (Northeast)---celebrating our Creator!, and especially seeing and hearing her favorite group, "For King and Country."  She was excited to see the above photo on the Creation website, and she found herself in the picture!

The summer has been busy with trips to and from Hershey at least every two weeks, sometimes even more frequently.  (Plus a few visits to the oral surgeon, and a trip the Lancaster Cleft Palate Clinic as we begin to get her teeth into place for eventual jaw reconstruction.)  Add to that daily Pred Forte eye drops, a dilating drop at night, Remicade infusions (every four weeks), and weekly Methotrexate.  Except that Anna has not had her last two Methotrexate injections, because she developed what would seem to be a small infection from the extraction of her four wisdom teeth and four front molars (that was in mid-June).  Her ophthalmologist sighed a little when we told him that (about missing the Methotrexate recently)---her left eye has maintained inflammation at a 1+ level for the past month at least, with no improvement.  While we are so thankful that the eye is not worse, we're getting a little uncomfortable with the duration of this level of inflammation, and the negative effects it's causing for her left-eye's vision.

I've talked to God a lot about all of this!  He has answered.  I've heard Him---with loving whispers from Him, songs and peace and assurances that we can trust Him for the entire, big, beautiful picture, despite the fact that He's not planning a sudden, healing miracle in the near future (I got that message from Him, too).  So we continue to sing, praise Him in the storm, thank Him for protecting Anna in many ways (her brother ended up with a bacterial infection at Creation, but Anna didn't!, and she hasn't experienced a whole lot of really negative side effects from her various medications so far).  I also pray for her doctors a lot (and thank God for them and the wisdom and intelligence He has given them).

And when the worrying seems to get a little heavy at times, I remember the lines of a Newsboys song from their "Adoration" CD:

Lord, I don't know where all this is going, or how it all works out.
Lead me to peace that is past understanding; peace beyond all doubt.

Friday, May 16, 2014

Wrestling with God (and He continues to offer songs, people, direction, and peace)

Lay your head down tonight
Take a rest from the fight
Don’t try to figure it out
Just listen to what I’m whispering to your heart
‘Cause I know this is not
Anything like you thought
The story of your life was gonna be
And it feels like the end has started closing in on you
But it’s just not true
There’s so much of the story that’s still yet to unfold

And this is going to be a glorious unfolding
Just you wait and see and you will be amazed
You’ve just got to believe the story is so far from over
So hold on to every promise God has made to us
And watch this glorious unfolding
Oh, these song lyrics!  This "Glorious Unfolding" song must have been recently released for radio broadcast, because I've been hearing it on my favorite station, (90.3) for the past two weeks.  God has used it to speak over our life and to my heart in various ways lately.  (I own the album, so I've had an opportunity to listen to it previously and get to know the words and upbeat melody.)
In this journey/race of life, the road has been rather busy and rough lately.  We've had two infusions of Remicade so far (the latest one just last Wednesday), but Anna's vision in her left eye is worse than it has been.  The inflammation is at a 2+.  The level of inflammation has held steady since last Wednesday (at least we can be grateful it's not worse), although her vision today was slightly worse in that eye --- she couldn't read the (sight test) line she was able to read last week.  Clusters of cells have clumped on the cornea, and that's why her vision in that eye is slightly impaired.
I was SO hoping and thinking that these Remicade infusions would "fix" the problems with Anna's eyes.  I often shake my head at the society in which we live being such an "instant" society---and we've come to expect "instant" fixes to everything.  I find myself having those exact expectations, even though I really do know better.  
I've been wrestling with God---working through all of this, longing for some sort of peace in the turmoil and worry over the Anna's vision.  He's provided calm doctors with knowledge and solutions to propose.  (Calm doctors who sound confident in their knowledge and wisdom really help me to maintain a level of calmness.) He's provided friends and family who constantly keep in us their thoughts and prayers and encourage us when we need it most.  He's opened up the lines of communication with just the right people at just the right time at Anna's school, to help her work through the pressures which she puts on herself to be the best student that she can be and to accomplish all the work which needs to be done in the next few weeks as school winds down (taking into consideration a LOT of missed classes for appointments, Remicade infusions, and then another day off last week for the funeral of her grandmother).
So where do we go from here?  The dose of Remicade will be increased for the next infusion (early June).  We had the option of going back on Cyclosporine until the next Remicade infusion, but in conference with the two doctors, we decided to go with adding Methotrexate injections instead.  I am actually happy with that, and the doctors seem to think it's a good decision.  (I know so many parents balk at Methotrexate, but I'm actually more comfortable with it than with other medications, including Cyclosporine---I've come to dislike Cyclosporine for Anna.)  For the past ten days, Anna has been using the Pred Forte drops six times per day.  I am very, very grateful that she has not had problems with those drops.  In her younger years, her pressures would rise fairly quickly after just a few weeks of Pred Forte drops.  But she's been on them since January, and her pressures have remained lower than the right eye (which is perfectly fine).
I sometimes wrestle with how much to share here.  Anna would prefer to err on the side of privacy.  But we also want to provide a realistic picture for other parents and families, and hopefully at least a little bit of hope for those who are traveling this journey behind us or beside us.  Although life currently is not as "normal" as it used to be (for this season, at least), we are not in despair.   God doesn't mind that we wrestle with Him---we work out our faith and grow in our relationship with Him as we continue on this journey and work through the hard parts.  On my hardest days, my meditation often is, "May the God of hope will you with all joy and peace as you trust in Him."  I'm hanging onto hope, and enjoying the little bits of peace I'm feeling as I continue to trust in Him and hold on to every promise He has made to us --- as we continue to see how the rest of this story is still to unfold --- we know that ultimately, it WILL be a glorious unfolding---and we will be amazed!   

Sunday, April 27, 2014

"In the Arms of God, Who Won't Let Go"

God continues to speak to me through so many various songs lately as we travel this journey.  On Easter Sunday morning, we were singing a song I've sung countless times in my lifetime.  I had even prepared the PowerPoint slides for Sunday's worship service, but the relevance of the words didn't truly sink in until I was staring at the words on the wall as we sang, "How sweet to hold a newborn baby . . . but greater still the calm assurance, this child can face uncertain days because He [God] lives."  ("He Lives," Gloria Gaither | William J. Gaither; © 1971 William J. Gaither, Inc.)  Such a perfect reminder for me, especially when my heart's desire is to live what I truly believe.  Since I believe that I serve a living, loving God whom I can trust with all of my heart, then I can trust my children's "uncertain days" to Him.

And then there's a Casting Crowns song I first heard at a concert I recently attended.  Just purchased the album two weeks ago and had a chance to really listen to it yesterday as I was cleaning my kitchen.  "Just Be Held" has such beautiful words and a beautiful message:

So we continue on this JA Journey, knowing that God is painting beauty with the ashes and our lives are in His hands.  We ARE finding Him in the storm, and where we are, He holds our hearts.  We can come to Him, find our rest, in the arms of God who won't let go. (from "Just Be Held," by Mark Hall, Bernie Herms, and Matthew West)

Since I last updated this blog, we've had a flurry of activity, putting plans into place, and Anna has had her first Remicade infusion.  No problems, really, so far.  Anna doesn't always like to broadcast what's going on with her life (she wants to be known for who she is as a person--her character qualities--, and not for her diseases), but last week it was time to explain exactly what's going on to the staff at her high school.  She's been missing quite a bit of school for appointments, and will now be missing more because of infusions.  She had just been telling them, "I have health issues, so my absences are necessary."  There comes a time when the people you deal with on a daily basis need a few more details, and it was time.  (I'm SO thankful for the school district we live in---couldn't ask for more understanding staff there.)  She does have a lot to catch up on (not much gets studied or worked on during an infusion day---just mostly sleep).

I feel like some of the pieces of our life's puzzle are fitting together lately (at least as far as scheduling).  The first few Remicade infusions are now on the calendar, and some insurance details have been worked out for Anna's wisdom teeth extraction (they need to use a surgical room for that, because of the structure of her jaw and the way her tongue sits---the oral surgeon feels it's medically necessary, and insurance didn't want to cover that cost at first).  We also decided that we needed to wait until school is out to have that done.  So we now have that scheduled for the week after school lets out (two weeks after the June infusion).  That's helped to know when to schedule her next visit to the orthodontist in Lancaster.  As of right now, I don't have any short-term medical appointments that are up-in-the-air, waiting for another detail to be in place before I can nail down a specific date.   

I HAVE found some definite positives lately:  Anna's eye inflammation is down to a 1+ (while still concerning and not good, it sounds a whole lot better than a 4+!).  I was able to take all of her unused, leftover medications (Cyclosporine, Methotrexate, Leucovrin, Lidocaine for mixing with the Humria, etc.) out of the "Anna's Medication Box" on the counter and put them up in the cupboard for now.  Anna says it's a little strange not to have to remember to take medications at home (besides the eye drops she currently uses).  We are VERY thankful to stop the Cyclosporine.  Anna had a list of side effects that she was experiencing, even after just a few days of taking it.  It's good to find little things to celebrate and be thankful for.  We have NO appointments this week!  That's definitely cause for celebration!!!  

I was reminded this morning of our purpose and goal.  In all of life, in the good and the bad, our prayer is that we remain "a witness to the resurrected Jesus."  (Thank you, Pastor Dean, for those words.)  Because Jesus lives, we can face tomorrow.  We don't need to fear.  We know He holds the future.  Life is worth the living (even when troubles come) because He lives.  (Happy Easter one week late!)

Monday, April 07, 2014

We Have a Plan . . . .

As of today, we have a plan.  And we have a little breathing room.  At Anna's appointment with the ophthalmologist this past Thursday, the inflammation was better.  A 2+ instead of the 4+ inflammation a week prior.  (ANY inflammation is not good, but a 2+ actually sounds good after a 4+!)  Anna's pediatric rheumatologist has researched the latest information available to decide between Remicade and Orencia.  The plan is to start Anna on Remicade.  Then, once her eyes are quiet, he will switch her to Orencia.  This will happen soon, but we still have some things to do, like wait for the insurance company to approve the Remicade, get a TB test for Anna (that will happen this week), and settle on a time frame for the infusion.  Anna didn't realize until tonight that this means she will no longer be taking Humira.  She seemed pleased with that.  She's glad that she can give herself injections, but it's not her favorite thing to do.

I choose to share Anna's story here, because for so many years, I have wanted other parents to know that Juvenile Arthritis does not HAVE to overtake your life.  (Things I wanted to read when Anna was first diagnosed and I wanted to have a glimpse of what life might be like in the future.)  I do have to concede that for the past few months, this disease (more the uveitis than the arthritis in the joints) has interfered with our lives a little more than we would like, although not nearly as much as some families experience.  I do believe, though, that this is just a season of life.  Although we cannot choose our circumstances, we can choose our response.  So we continue to choose to pray for those who make decisions for Anna's care, for wisdom and clear direction.  We choose to find all the things we can be thankful for, and we've seen and felt so many answers to little and big prayers.  We choose to laugh and set goals for the future.  This may be a sizeable bump in the journey, but the journey is not done yet!  Stay tuned . . . . 

Saturday, March 29, 2014

Circumstances We Would Not Prefer

I LOVE the "undo" features that come with most computer software.  It is such a relief when I am creating letters and and flyers and newsletters, changing things which sometimes become a mess.  And I can just hit "undo".  The mess goes away, and I can try a better fix.

This week, I wish there was a way to "undo" the switch to Cellcept.  But no going backward in life.  We have to pick up from where we are and move forward.

If you've read my blog posts before, you know that God has a way of playing songs in my head at times.  About two weeks ago, I remember waking up early hearing the words to "Even If" by Kutlass:

Sometimes all we have to hold on to 
Is what we know is true of who You are 
So when the heartache hits like a hurricane 
That could never change who You are 
And we trust in who You are 

Even if the healing doesn't come 
And life falls apart 
And dreams are still undone 
You are God You are good 
Forever faithful One 
Even if the healing 
Even if the healing doesn't come 

Lord we know your ways are not our ways 
So we set our faith in who You are 
Even though You reign high above us 
You tenderly love us 
We know Your heart 
And we rest in who You are 

You're still the Great and Mighty One 
We trust You always 
You're working all things for our good 
We'll sing your praise 

You are God and we will bless You 
As the Good and Faithful One 
You are God and we will bless You 
Even if the healing doesn't come 
Even if the healing doesn't come

Even If lyrics © Sony/ATV Music Publishing LLC

Since the phrase "even if the healing doesn't come" kept repeating more than the rest of the song, it felt like a forewarning in some ways.  And rightly so.  Scott took Anna to see the ophthalmologist this past Thursday.  I was home with a stomach bug.  He stopped by the house before going back to work, to tell me that  in the span of ten days (since the last appointment), Anna's left eye had gone from an inflammation level of 1+ to a 4.  (On a scale of 1 to 4 for those of you who are unfamiliar.)  Scott's assessment of Cellcept for Anna is summed up in one word:  "worthless."  Her inflammation has never been this bad.  The two doctors conferred via phone while Scott and Anna were there, but Scott asked them to call me about any final decisions.

Anna's pediatric rheumatologist called me to discuss options.  We're going to go with infusion therapy.  (Something to be thankful for---there is no agonizing over all of the pros and cons of this decision for me---it HAS to be done---I AM constantly praying for clear direction.)  The question is just the choice between Orencia and Remicade.  He's doing a bit more research and will let me know and start the necessary steps for insurance approval.  That could take awhile, evidently.  So since we need to do something before we can make infusion therapy happen (could take weeks, and most likely, more than a month), we have stopped the Cellcept and started on Cyclosporine.  Anna had responded favorably to Cyclosporine in the past, until she began to experience noticeable side effects.  But since she'll be on it for weeks instead of months, the hope is that she'll be stopping the Cyclosporine before the side effects begin to appear (more hair growth, and darker hair---like eyebrows and upper lip--, gum growth, etc.)  Anna continues to take the Pred Forte eye drops four times daily, and a dilating drop at night (to keeps those cells from sticking together when they begin to cluster).

I want my friends, family, and blog-readers to know that I believe in my loving, Creator God, and I know that He is faithful, and I know that He walks with us and loves us more than we can ever imagine.  I've said that before---many times over.  Sometimes I talk about feeling calm and feeling peace.  To be totally honest, right now I'm not FEELING much of anything (but feelings are fickle---I know---we cannot rely on feelings!).  I am human, so there are aspects of this disease and this development that strike some fear in me at times, if I allow myself to dwell on that.  There are times when I receive news such as this when I know I need to absorb and process the information (and allow a few tears to escape at times), before I'm really ready to talk about this with anyone.  There are so many things going on right now (BUSY, busy schedules around this time of year, still a lot of appointments to get to, schedules to rearrange because of appointments, unexpected stomach bugs, etc.)  When life seems overwhelming and we face even more "circumstances we would not prefer" (phrase borrowed from Priscilla Shearer from the Session 5 DVD of the Gideon Bible Study), we go with what we know, not what we feel.  We hold fast to our Anchor for the Soul, because how else could we handle storms such as these?

Saturday, March 08, 2014

His Grace Is Enough . . . . (Update on Anna, family, and questions for God)

So many ways I could begin this post:  The bottom line is the update on Anna:  the injection to the elbow worked wonders!  Within days of receiving that shot of cortisone, she is back to having full range of motion and can easily do all the normal tasks of life without having to compensate for an elbow that would not extend or bend normally.  The eyes are another story.  Despite a flurry of changes in dosages and then medication, her left eye is not responding.  It's not getting worse, but it's not getting any better.  Something different though, from previous flares--despite having Pred Forte drops four times daily, her pressures remain in normal range!  And this is after six weeks of those daily drops.  SO thankful for this, since Anna's pressures usually rise quickly even when she has been on two weeks of two drops daily.  (That was several years ago.)  

The photograph above is my view of the ophthalmologist's exam room, and I've seen it many times since January, usually every 7-10 days.  Something else to be thankful for:  the location is about 20 miles away from home.  The doctor was mentioning that he has a family who comes every other week from over 100 miles away.  And I thought Anna's appointments have been really eating into our schedule--especially her school schedule!

For those readers who, like me, want to know what happens next if the inflammation continues, the ophthalmologist says he'll give it one more month.  If it's not any better, then we need to consider a different medication.  The rheumatologist had already mentioned "infusion therapy" if the Cellcept doesn't get the inflammation to subside.  We've talked in the past about pros and cons of Remicade and Orencia.  My guess is that the infusion therapy would be one of those two. 

In the midst of all of this, I have just finished up two surgical procedures (3 weeks apart) to fix two significant issues which have been plaguing me since the end of October. Thank the Lord, I've been released from the acute care of two different doctors, and all I really need to do now is get over the "anesthesia haze" which always takes me several weeks to do. 

So a lot has been going on with the family!  I have been happy, though, to get back into a Ladies' Bible Study, and we are doing Priscilla Shirer's "Gideon" study.  This has "homework" which really has us digging deeper into God's Word and seeing what God has called us to do and be, and how He uses our circumstances to accomplish His purposes, and equips us with His strength when the tasks seem hard and dangerous.    I've also been reminded that God welcomes our questions, but there are many, many times when we ask questions which He has already answered in His written Word---great incentive to get into and really learn to KNOW His Word.

There are so many times when the Lord has spoken to me, and very frequently through songs which are playing in my head when I wake up in the morning, or one passage of Scripture which constantly pops up in various places and ways during the course of a week or two.  But this past week, He was definitely speaking through a clear but soft voice in my head.  In my Bible Study homework, we were encouraged to write into one side of a chart the questions we ask God.   And then there were a sets of Scripture verses to look up---ones that would answer many of the "usual" questions that people often take issue with Him about.  None of them really answered the two questions I put down, but we were encouraged to go back to the questions on our chart, and pray about those questions, and write down what God was saying to us (encouraging us to see if we had answers from Scripture).  So my one question was, "Why isn't the inflammation in Anna's eye responding to treatment??!!"  Every time that question even hovered in the back of my brain, I would instantly hear, "My grace is sufficient."  So instead of the question just hovering, I intentionally talked to the Lord about Anna's eye inflammation.  And the answer I knew I needed to put on the other side of that chart was again speaking more loudly in my head, "My grace is sufficient."   (That verse was no where in the homework---but definitely in my head.)

So then I go to our weekly Bible Study session (yesterday), where we watch the DVD, and this week's session was powerful and inspirational.  As Priscilla Shirer was winding down this session, I was looking in the notes of the book for Session Three, and she had several Scripture references in the notes.  I looked at the very last reference in the notes, and it was 2 Corinthians 12:9.  Since my memory for Bible verses (at least bits of them, memorized in my childhood and teenage years) is fairly decent, but my ability to remember references is somewhat lacking, I wasn't sure which verse that was.  So I looked it up, and KNEW that it was definitely there for me in that moment (thinking about Anna's uveitis all week---or the past six weeks---and anticipating another visit to the eye doctor that afternoon).

2 Corinthians 12:9  (written in red letters in my little NLT Bible)  Each time he said, “My grace is all you need. My power works best in weakness.”

So there it is.  We continue to trust God and His purposes and calling on our lives.  (When we are afraid, we will trust in Him ---somewhere in Psalms!) The doctors are doing all that they know to do  (Dr. M. was going over that out loud with us---explaining that in January he dilated her eyes, even though it was a late appointment and he hadn't planned to do that---he wanted to make sure that there wasn't something else going on in her eye, and making sure that there wasn't something he missed, with such unexpected and significant inflammation after almost two years of quiet eyes).  We continue to pray for Anna's doctors and thank God for their wisdom and knowledge.  We are continually thankful that Anna so far has experienced very minimal (if any) side effects from the potent medications she puts into her body.  We live knowing that we are precious to God and He allows some circumstances in our lives for ultimate good and to show others who He is. He holds us in the palm of His hand.  (Now how can we be afraid when we know that?)  We continue to pray that the inflammation will go away.   Until it does, God's grace is sufficient.

Tuesday, February 18, 2014

Take Another Step . . . . .

We walk by faith and not by sight we know it’s true

We say it and sing it and love the way it sounds
But none of us can even begin to truly understand
What it really means ‘til all the lights go out
And there we are nothing to hold on to
But the promises God’s made to me and you

Take another step, take another step
When the road ahead is dark
And you don’t know where to go
Take another step, take another step
Trust God and take another step

If there’s an ocean in front of you
You know what you’ve gotta do
Take another step and another step
Maybe He’ll turn the water into land
And maybe He’ll take your hand and say
Let’s take a walk on the waves
Will you trust Me either way
And take another step
Take another step

Lyrics by Steven Curtis Chapman  "Take Another Step" 
(from "The Glorious Unfolding")

This week (even just these first two days) have seemed a little overwhelming---just schedule-wise.  We have so much going on, two appointments last week were cancelled because of the Thursday's snowstorm--still to be rescheduled.  No time to fit them in this week. 

Anna has several issues currently "on the table."  Her eyes at her last ophthalmologist visit were a little better but still have a ways to go before they are clear of inflammation.  She continues with Pred Forte drops (one drop to the left eye four times daily), and a dilating drop at night.  Her pediatric rheumatologist found that the measurements he takes for her TMJs were less than they have been at the last few appointments.  So he sent a disposable measuring device home with me, so that I can measure again in another week or two, to see what kind of numbers I get.  Her left elbow has continued to be a problem.  The problems have increased over the last three months.  While she doesn't complain of pain (just some morning stiffness), she has lost full range of motion in that elbow, and it's affecting her ability to do some daily tasks (like brushing her teeth and brushing her hair and getting dressed).  She can still do these things, but in a modified way, since her elbow cannot extend fully.

We'll have to wait and see on the eyes.  It may take a few weeks for the changes in medications (we changed the dose on the Humira and changed the Methotrexate from oral to injectible) to take affect.  We go back to the ophthalmologist next week.  The TMJs---I don't really know.  More injections are probably not an option.  For right now, if the measurements continue to be a concern, an MRI may be in order, even though Anna's new braces may affect the reading of an MRI.  We'll cross that bridge when we come to it.

As for the elbow, Anna's ped. rheumatologist decided that he would inject that joint today.  That went fine (as fine as injections can go!).  Anna's pretty calm and easy-going, not excitable or prone to drama, which is helpful.

So Anna went back to school today with teeth that hurt (from getting braces on yesterday at the Lancaster Cleft Palate Clinic---continue to LOVE that place and the people there!), and a sore elbow.  (She has a doctor's excuse for gym and band for a few days, until her elbow absorbs all of that medication.)

I've been thinking that life has been very full lately, with many things (mostly health-related, with both Anna and me) that are beyond our control.  I've also thought that this full, sometimes overwhelming season of life CAN have a good side---no time to sit and think about all of the ins and outs of what's going on, no time to sit and worry about what may happen if things get a little worse rather than better.  Really, just getting through these moments and days and weeks by taking another step, and another step---walking by faith and not by sight, and trusting God no matter what.

Friday, January 24, 2014

In Anna's Own Words . . . . .

As posted on Anna's Facebook page on January 23, 2014:

A recent problem has emerged involving my arthritis in my left eye. Instead of listing all of my troubles and problems at this moment I choose to go with the blessings -

Thank You Lord for
-My sight, I am not going to be blind any time soon.
-for Doctors, knowledge, and medicine.
-Messages you send me through music
-my Mom and Dad 
-Your Guidance and Help and Direction 
-Reading glasses
-a Warm house
-eye lids*
-time off so I could study this past week so I don't need to strain my eyes tonight trying to see tiny print*
-and knowing what is going to happen when I don't, because I am blind to what will happen in these next very, VERY busy weeks ahead. You're going to see me to the end regardless.

[*Dr M. decided to dilate Anna's eyes to get a better view of what was happening, so although we hadn't planned on this, Anna's pupils were dilated for the rest of the afternoon and evening, making it a little difficult to see and focus---so she was extra-thankful for eyelids and reading glasses!}

2014 May Be An Adventure!

I have a feeling that this new year will be one where we gather up our courage, hold firm to our "Anchor for the soul," and continue to plod along on this JA journey.  Since we have to go through this at all, I'm praying that at least some of you will be encouraged or informed because of our journey.  At the very least, I pray that we can be an encouragement to hold on to HOPE, seek peace, and know that you are not alone. 

Anna's first appointment for the new year was last week -- with Rusty (Dr. Long--he prefers to be called Rusty) at the Lancaster Cleft Palate Clinic, where she had bands put on her molars.  Next step in this process will be to have her wisdom teeth removed, as well as her four "first molars."  We meet with a local oral surgeon in mid-February---that's the earliest I could get.  We need to wait, anyway, for those teeth to be removed, until after the County Band Festival (next weekend) and District Band Festival (the following weekend).  She'll have brackets put on in mid-February, with jaw-reconstruction surgery in sight for spring or summer of 2015.  We continue to feel an overwhelming peace about this process and this team---which is really good, since we're traveling almost an hour for orthodontic work, when we have a multitude of orthodontists who are closer (but they don't work as an on-sight team like Rusty does with the other doctors/specialists associated with the Lancaster Cleft Palate Clinic!).

In other news . . . . sometimes I "hear" God speaking in many ways, and the other day, I happened to see Psalm 112:7 on Pinterest, and it grabbed my attention.  "They do not fear bad news; they constantly trust the Lord to care for them."  While I've learned not to put too much stock in premonitions nor to worry about things that may or may not happen, I thought about this verse a lot this past week, realizing that I spent many years (maybe even decades?) being fearful of bad news.  I want to be different---I NEED to be different if I truly claim to have a relationship with my Creator and trust His love and care for me and my family.  I want to live in such a way that I live my faith, and not just speak the words.  So if I choose to do that, I need to choose to trust the Lord, even when some days seem to bring one bit of bad news after another.

How grateful I am that the Lord had given me this verse for the past week.  Yesterday was an interesting day---from trying to tie up a lot of loose ends at work before taking next week off, and getting a phone call to tell me that some pre-admission labs for me were rather worrisome to the surgeon's office and could I please come in to have more labs done to make sure I could move forward with surgery---and having a small window of time to take care of that before picking Anna up to take her to Hershey for an eye appointment.  (Thank the Lord there was so much going on that I really didn't have much time to think and worry that day---besides watching the clock and thinking about and praying that I could get my work done and then get to the outpatient lab in one town and back to the high school in our hometown in time to get Anna and get to Hershey in time for the appointment---all of that worked out perfectly!)

We arrived in Hershey in such good time that we were able to stop by the lab and take care of labs for Anna (standing order for labs every 2 months) before heading to the ophthalmologist.  Anna had mentioned some concerns about her vision in her left eye a few weeks ago.  I wasn't alarmed, because she's never had any symptoms of uveitis, so I was thinking that maybe she had some sort of reaction to the Pred Forte eye drops.  But long story short, her left eye has had an unexpected and significant flare in just the past few weeks (we saw the ophthalmologist just five weeks ago, and she had one or two cells at that time---now she has at least 200 white cells).  So now she has symptoms (that can be a good thing . . . .).  The plan (discussed via phone between the ophthalmologist and the rheumatologist with Anna and I in the room to answer any questions) is to increase Humira, switch from oral Methotrexate to injectible Methotrexate, and increase the Pred Forte drops to four times a day for a week---we go back to check on things next Thursday.

It's still possible to find some good things instead of focusing on the bad.  Since Anna was telling me (right before yesterday's appointment) about her continued symptoms, and her research on-line to figure our her symptoms, I was mentally prepared for a not-so-great appointment.  Poor Dr. M. had challenges with his last four patients (Anna made patient #5 who required an unanticipated more detailed exam and figuring out a plan of action)---so he was running behind schedule.  Which meant I had more time to skim through magazines and pray and settle my mind and remind myself to TRUST and not worry.

This also becomes a challenge (as a mom) as Anna gets older---when she was first diagnosed, it was me who had to work through all of my feelings.  But she's now a teenager and has definite feelings of her own.  So how is she handling this?  I'll post that next.  (She told me that I could copy and paste her Facebook status from yesterday on my blog). 

Thursday, December 19, 2013

Some Updates

We've had a few appointments since I last posted, so I have a few updates to share.  We are very pleased and thankful that the appointment with the ophthalmologist showed that the inflammation in Anna's left eye is down to a "trace," and her pressures were acceptable, so she is down to one drop of Pred Forte in the left eye daily.  Not crazy about little bumps in the road, but so thankful that maybe this is just a blip and will soon be a memory.

Anna's elbow is still a bit of a bother in the mornings, but we've had discussions (between Anna and myself) about it.  Dr. G. (the pediatric rheumatologist) had suggested that she could take ibuprofen up to three times a day to help with that, but she doesn't want to do that at this point.  I told her that she needs to talk to Dr. G. about the pros and cons of just living with the pain vs. taking the ibuprofen.  (Or he may even adjust her other medications.)  If this continues, I know it will be a topic of discussion at the next appointment in February. (In less than two years, she will be considered an adult by the medical community, so she is taking responsibility for listening carefully at doctor's appointments and being part of the decisions, and being responsible for her medications---she's always been intrigued by the body and medical stuff, so it doesn't take great effort for her.)

I've included Anna's panoramic x-ray from the Lancaster Cleft Palate Clinic.  You can see the vast difference in the left vs. right TMJs, and this is why reconstructive surgery is necessary for Anna.  So we are "on the road" for this new journey---which will take about two years.  One year for the orthodontic preparations, and then surgery after that, and then some post-op orthodontics and follow-up.  So many feelings and emotions---a little bit of trepidation in stepping out to have major surgery done, knowing that it will bring temporary pain and weeks of healing, the little bit of excited anticipation at taking steps to fix something which is damaged.  But I have to tell you that the overwhelming feeling I have is PEACE in this decision.  And this is huge, because as I constantly pray for wisdom (knowing that God promises to give wisdom in abundance when we ask, as found in the first chapter of the book of James) and direction on this JRA journey, I do my best to listen to God, who hardly ever speaks audibly to me!  But He has so many other ways which I've learned to recognize.  And so with this group of doctors at the Lancaster Cleft Palate Clinic, and the answers to my prayers about the cost of the orthodontics (I was gathering information and gearing up to "present my case" to the insurance companies, only to be told that Anna's supplemental insurance through the state will cover all of her orthodontic care for this surgery---what a huge blessing and answer from the Lord!), we have experienced so many "green lights" as we've taken steps to see whether and when we should take steps in this direction.  And that peace that I spoke of earlier has been so very present every time we think about this and pray about this and make the trip to Lancaster.  Looks like we'll be doing that a little more often in 2014.

Friday, November 22, 2013

New Stuff, MANY Thoughts (I've saved them up!), and Listening to "The Voice of Truth"

 So much has happened in life since I last posted . . . .and we are overdue for an update here (this will be a LONG post!).  Anna became a first-time aunt in September -- one day after her 16th birthday!  We've been to Tennessee and back for a visit.  She also now has her driver's permit, so she and her dad are fitting in driving practice as our schedules allow.  (Scott is a much better and more patient teacher than I!)

We went through August, September, and October without many appointments, and that was a nice break/reprieve.  However, November and December seem overly FULL of appointments now!  Anna saw her pediatric rheumatologist last Friday, and today was a visit to the pediatric ophthalmologist.  I know that many scour the internet to find "real life" stories about children and teenagers with arthritis---I know I did back in 1999 when Anna was first diagnosed.  I wanted at least a vague picture of what might be in store---what kind of life could I hope for for my youngest child?  This type of thinking and questioning just comes with the struggle---the grieving process when you have a child with a chronic disease, when it seems like every expecting parent will just be happy "as long as it's healthy!"  Believe me, you CAN have a good and joy-filled life, even if you end up dealing with an on-going illness or disease.  So when we have good news, we share.  When we have not-so-great news, we also share.  I'm a realist.  This is life. We deal with "what is."

While I realize that in the early years it was easy for me to whine and sometimes wallow as I worked through my feelings, I don't want to do that anymore.  I don't want or need people to feel sorry for us.  Everyone has something that they deal with.  One of our issues in our family is Juvenile Arthritis.  I do appreciate prayers, because I know for a fact that prayer changes things---and usually changes us.  I know that God could choose to heal Anna completely, but I also know (because He told me early on, and He has given Anna some intuition, as well), that complete healing is not His plan for us in this journey at this time.  We've been blessed with so many years of mild arthritis and uveitis that was finally brought under control when Anna started Humira.

A month ago Anna mentioned that her neck was stiff.  So we mentally filed that information, checked in with her periodically about that issue, and knew that we needed to share that information with her rheumatologist.  On the morning of her appointment, she also mentioned that she's been having some trouble with her one elbow.  Anna rarely experiences severe pain, even with active arthritis, but she's noticed that her range of motion in her neck has decreased, as well as in her left elbow.  They don't hurt, she says, unless she tries to move her neck or elbow past the point of where it wants to move.  Nothing really significant or serious---but enough that it feels like a different direction (or maybe just some added bumps) in our JA Journey.  We'll deal with it.  For now, Anna can take ibuprofen (up to three times a day) if she feels like she needs it. Her TMJs are still an issue.  The last MRI showed the right side looks a bit better, but the left side still has mildly active arthritis.  Today, we found out that after almost eighteen months of clear eyes, she has mild inflammation in her left eye once again.  So Pred Forte eye drops are prescribed (twice a day), and we go back in two weeks to see if that clears it up. 

So what does a mom do when the road ahead looks like it may be more challenging?  I admit that it's easy to let the worry take over---worry for Anna's future, worry that new joints are being affected by arthritis (it was a lot more "comfortable" when we were only dealing with only the knees and TMJs, with the eyes thrown in for good measure).  But as I've struggled to know the appropriate response, I've been remembering a verse that I've been meditating on for several months:  "Be patient in trouble and keep on praying."  (Romans 12:12 NLT).  I've been hearing songs on the radio that constantly remind me that I can trust God, that He is with us always.  There's an older song that keeps coming to mind---a song from Casting Crowns, called "The Voice of Truth."   I know that we "are not fighting against flesh-and-blood enemies, but against evil rulers and authorities of the unseen world, against mighty powers in this dark world, and against evil spirits in the heavenly places." (Ephesians 6:12 NLT), so whenever I hear the whispers of worry and doubt, I am going to choose to listen to "the Voice of Truth." (link to video below)

Besides the lyrics of this song, what has "The Voice of Truth" been telling me over this past week when thinking and worrying begin to take me to mental places where I don't want to go?:

"For you know that when your faith is tested, your endurance has a chance to grow." (James 1:3 NLT)

"But the Lord stood with me and gave me strength."  (2 Timothy 4:17)

"I have made you and I will carry you; I will sustain you and I will rescue you."

"Be strong and courageous.  Do not be afraid or terrified because of them, for the Lord your God goes with you, He will never leave nor forsake you."  (Dueteronomy 31:6)

"God can restore what is broken and change it into something amazing.  All you need is faith."  Joel 2:25 

And especially this week (I love the visualization of walking through water that seems to be getting deeper and deeper---and knowing the God is with us in the midst---sometimes that's just how life seems)  From Isaiah 43, beginning with the second part of verse 1 (bold emphasis at the end is mine, because that verse and those words seemed to jump out at me when I was reading this passage):

  “Do not be afraid, for I have ransomed you.
    I have called you by name; you are mine.
When you go through deep waters,
    I will be with you.
When you go through rivers of difficulty,
    you will not drown.
When you walk through the fire of oppression,
    you will not be burned up;
    the flames will not consume you.
For I am the Lord, your God,
    the Holy One of Israel, your Savior.
I gave Egypt as a ransom for your freedom;
    I gave Ethiopia and Seba in your place.
Others were given in exchange for you.
    I traded their lives for yours
because you are precious to me.
    You are honored, and I love you.

But He's also reminded me of the verses I found back in 1999, from 2 Corinthians (NLT):

Praise be to the God and Father of our Lord Jesus Christ, the Father of compassion and the God of all comfort, who comforts us in all our troubles, so that we can comfort those in any trouble with the comfort we ourselves receive from God.

So we gather up our courage, hold tight to our faith, remember that we are precious to God, keep praying in trouble, and know that God is guiding us, and that His timing is perfect.  I'll update again soon---Anna has an appointment with the Lancaster Cleft Palate Clinic people after Thanksgiving.  We'll see what they say about Anna's active arthritis and the time frame for orthodontics and eventual jaw reconstruction.