Sunday, January 11, 2015
Realities of the Journey . . . . .
Not a Fan of Oral Prednisone!
When we returned from Boston, Anna had been on oral Prednisone for about a week or two. But side effects began surfacing. Her thought processes were in a mess, and her emotions were very scattered and a bit crazy. We were in touch with her rheumatologist, and he gave us a faster taper schedule. The good news about the Prednisone: it cleared up whatever was causing Anna prolonged pain in her one big toe. That hasn't returned.
Truly Thankful at Thanksgiving
Anna had an appointment with the local pediatric ophthalmologist just before our Thanksgiving holiday. Her vision was 20/20. No inflammation, although the doctor described a "haze" or a "flare" being present --- no actual cells floating around. What he described is like a haze of humidity/steam after a summer rain---the moisture is still in the air until a front comes to blow it out to sea (we live on the East Coast, and that's how many of our weather patterns occur---it's what I'm familiar with). He wasn't worried; he was actually very pleased. Anna had also seen a new doctor---a retina specialist at Hershey Medical Center, who will be monitoring Anna's macular edema issues. A new OCT (imaging of the eyeball) at that appointment showed that the macular edema had improved since her last OCT. Good news! The retina specialist basically said let's not change anything right now, since she's improving, and we aren't exactly sure which latest change in her medications we can attribute the positive changes to.
Anna also saw the pediatric rheumatologist just after Thanksgiving. Joints remained quiet, and he was pleased with the reports on the eyes. Anna was in a negotiating mood. She had previously talked the ophthalmologist into allowing her to stop the dilating drop she was on---he said okay, although he couldn't promise that she wouldn't ever have to use it again. And then she was cheering when the prednisone taper was rushed. Since the doctor brought up the idea of maybe trying to decrease Methotrexate a little, Anna asked if she could switch back to the oral Methotrexate instead of the injectible (she has psychological issues with the shots). He agreed. We stayed at the same dose---just a different form, knowing that the injectible Methotrexate is probably more effective than the oral.
I always try to be thankful, even in difficult circumstances, but for Thanksgiving 2014, it didn't take much effort to come up with things to be truly thankful for. We were counting our blessings, indeed!
Feeling Good Towards the End of 2014!
or A TRUE Holiday!
I often spend time reflecting when a year comes to an end (it's always good to take stock of where you've been and where you're going, I think!), and after Christmas, as we moved toward a new year, I was thinking how challenging 2014 was in so many ways. This JA Journey in 2014 seemed like a hike up a high, rocky, tough mountain. But I kept thinking that at the year's end, we seemed to be nearing the top of the mountain where the view is really great---sometimes AWESOME if the weather is just right. I wasn't juggling my work schedule and projects with doctors' appointments as much; Anna was able to attend school fairly regularly, so she wasn't getting behind in her school work. I was "breathing a little easier" as far as Anna's health issues go. I was taking a break from replaying in my head doctors' thoughts, theories, and opinions (lots of variation there!) to decide which one I trust most and agree with for Anna's overall health's sake. The holidays (Thanksgiving, celebrating the birth of Jesus, and celebrating the new year) were not just holidays in name only---I felt like we had been given a true holiday from health issues (once Anna had her Remicade the week before Christmas and my son had his wisdom teeth removed the day after that---we put all health stuff on the back burner to celebrate Christmas and some time off to spend with a whole lot of family and friends.)
And then we arrive at 2015---a new year, with only the knowledge that God walks with us wherever we are. He sees and understands. He's already in our future and knows how all of the pieces will fit together once the big picture is done. There are a whole lot of options for a blog title to begin the new year:
Navigating the bumps along the way
Finding the joy when troubles come our way (from James 1:2-4)
Developing our character and endurance (from Romans 5:3)
Sometimes, during our drive to Hershey in 2014, Anna would warn me when she thought a visit to the ophthalmologist may not be a good appointment, because she knew something was going on with her vision that was not good. She forgot to mention anything to me this past week as we made that drive which has become so familiar. So when she was taking the vision test and couldn't really see the larger, circular letters, I realized that our "holiday" was officially over. Reality has set in once again, and we choose to deal with the realities.
Although the local ophthalmologist doesn't have the equipment to do an OCT in his private practice (that's why we've added a retina specialist at The Eye Center at Hershey Medical Center), he used the equipment he does have to see as much as possible into the back of Anna's left eye, he could tell that it's different than the right. Just the vision test itself gave me a good indication that the macular edema is a problem again--that's it gotten worse than it was in October. Dr. M. asked Anna when she first noticed a change for the worse in her left eye vision, and she said right around Christmas time. I later asked her why she hadn't mentioned anything to me, and she said it was very gradual, and she just forgot to mention it, and she knew she had an appointment coming up soon, anyway.
The bottom line and most probably cause of this decline: at Anna's appointment in November, she was probably still benefiting from the oral Prednisone, which she had just finished taking. Those effects have worn off. And Anna really does NOT want to go back on the oral Prednisone.
So where do we go from here? We'll see what the retina specialist says on the 20th. (I really do like her.) Time for various thoughts and statements to swim through my head now as we wait for Dr. N's opinion. Anna was not able to tolerate Sulfasalazine (problems within the digestive system many years ago when she was 4 or 5), but two of the doctors are wondering if she would be able to tolerate Diamox (a sulfa-based med), which is normally used to treat macular edema---they are considering that. Dr. Foster has prescribed Prolensa drops, which Anna continues to take, but one doctor says that prescribing Prolensa for Anna's macular edema is like sprinkling water on a raging fire. It's not going to do much at all. He doesn't know what Dr. Foster thought that would help. (Anna's macular edema had improved a bit by the time we were in Boston---it wasn't nearly as bad as it had been in August.)
Our worship service speaker this morning spoke from the book of James, first chapter. A few years ago, I started memorizing that book (only got to the first 12 verses before life got in the way of memorizing Scripture). But I love how the Lord seems to speak directly and clearly to me when it's time to face some big and hard realities of life (even more so than when life seems fairly carefree).
"Dear brothers and sisters, when troubles come your way, consider it an opportunity for great joy. For you know that when your faith is tested, your endurance has a chance to grow. So let it grow, for when your endurance is fully developed, you will be perfect and complete in every way, needing nothing." James 1:2-4 NLT
He allows these circumstances because He knows that when our faith is tested, our endurance has a chance to grow. Endurance is a foundation for character. And character produces hope. (from Roman's 5:3)
I may have quoted Victor Frankel before, from "Man's Search for Meaning," which all of my Messiah College alumni friends (from my years in college, anyway) will be familiar with---we had to read it for one of our general education courses. We may not be able to choose our circumstances, but we can choose our attitude. Victor Frankel spent time in a concentration camp, and yet he still chose his attitude.
We may be at the foot of another tall, high mountain for the coming months of 2015, but we'll choose to keep our focus on the bigger picture. Until then, we carry on with life, not letting the realities of JA and uveitis and macular edema consume us. Anna just participated in District Band this past weekend (beautiful concert of gorgeous band music), and she has County Band and County Orchestra coming up in the next few weeks, as well as playing the bassoon in the "pit" for the high school musical, "Peter Pan" in March. We love staying connected with family and friends, and appreciate the love, support, and understanding we receive from them---we are surrounded by a great support system. We "keep on keeping on." Life is still good. God is still good. His plans for us are good. We know that, and we trust Him.