The Fireflies Went Away, but then came back (just a few of them . . . )

(In the picture above, Anna is playing a "Toss the Christmas Card" game at a recent Christmas party, while her brother, Joel looks on)

It's been a long time since I updated! And well, you know, sometimes I'm never sure how many people read my blogs anyway, but it was so nice of Jacob's mom to ask how things are going. And since she asked . . . . sometime near Anna's birthday (in late September), we suspected that Anna might have pink eye (conjunctivitis). Believe it or not, this was my first experience as a mom with this condition---none of my kids had ever had it before. So I searched on the Internet to find symptoms, and I immediately found out that sometimes uveitis can be misdiagnosed as conjunctivitis. So I called Anna's pediatric ophthalmologist, and he was able to squeeze her into his schedule that morning. Even though I wasn't thrilled about conjunctivitis, I was actually very relieved that it wasn't a flare of the uveitis! (Her eyes were very, very pink, and I figured if it was uveitis, then it was a very big flare . . . because she had never had uveitis symptoms like this!).

So the doctor sent us home with sample drops (they were sufficient to combat the infection---we didn't even need to get the prescription filled).

The good news at that appointment was that Anna's eyes were totally clear of the inflammation. Her regular uveitis check was scheduled for about 10 days after this "Pink Eye Appointment." So we returned to the pediatric ophthalmologist for that appointment, only to find that a trace of white cells had returned to the left eye. Barely a trace, but a trace nonetheless. So we are keeping the same regimen of medication (the Cyclosporine, Methotrexate, Leucavorin, Pepcid Complete) for now. We go back in early January, and we'll see where we are at that point.

Her joints are fine. There was minimal concern about a part of her foot, but the pain she described was descriptive of a tendon issue rather than a joint issue. Anna had an appointment with the family doctor for a checkup last week, and the pain was no longer an issue for her, so it must have just been something minor that healed quickly. Anna continues to grow taller . . . she only needs to grow about an inch and a half to catch up to me! (But that's not saying much, since I'm pretty short!)

We continue to keep busy! Anna is greatly improving on the playing of her bassoon. She has a holiday concert tomorrow night at the elementary school. She sang with her dad at church yesterday (for the offertory) and received a great many compliments. :o)

Since I know some people are reading this blog, I'll do my best to keep it updated more frequently. I'm so glad that other Juvenile Arthritis parents find it helpful.

"They Look Like Fireflies!"

Today I feel like summer is officially coming to an end, since this was the last weekday of summer, with school beginning on Monday. (We went up to school to visit her classroom today and see all the families from our corner of town --- it was like a neighborhood party! We also took Anna for a hair trim.)

The summer has been extraordinarily busy! (Guess that's par for the course with three active kids.) I haven't added to this blog lately, because we went from June to August with no doctor's appointments for Anna. (That's a good thing!) Last week, she had two appointments: one with the rheumatologist on Tuesday, then with the ophthalmologist on Thursday. I was just a little nervous about the Thursday appointment, because we had missed a few doses of medication, plus we had lowered the dose of Cyclosporine several weeks ago (Anna was developing gingival hyperplasia---overgrowth of the gums, which is a possible side effect of the Cyclosporine). I just wasn't sure whether those variables would cause Anna's eyes to flare.

Nevertheless, she had a decent appointment, with the ophthalmologist seeing only about two cells in her left eye (right eye was clear). This may be a TEENY flare since last time, because I think eight weeks ago, the verdict was "barely a trace." We can go another eight weeks between now and the next appointment. (What a RELIEF!).

I like having Anna's eye appointments on Thursdays, because that's the day a pediatric resident from Hershey Med follows Dr. M. around (parents learn so much more information when specialists are teaching residents! At least that's what I've found to be true.). Anyway, Dr. M. let the resident look at the interior of Anna's left eye with the slit lamp instrument to see the evidence of uveitis. As the resident looked, she said, "Oh! I see! They look like fireflies!" Anna and I thought this exclamation gave us a great mental picture of what is going on in her eyes. We can handle a trace of "fireflies" in her eyes without too much worry. We just don't want those "fireflies" taking over.

I just got a new camera and am still getting used to it and the settings. I will try to post a few photos here and there as I get some good ones.

Another good appointment with the ophthalmologist!

The good news continues with Anna's eyes. They are all but clear of inflammation (just a cell or two floating around, but "well under control." I try so hard not to live life in the "what if" modes, but there are moments when my mind is working away, wondering IF in two months when we return for another appointment, IF Anna's eyes remain clear . . . will we be able to lower the doses of some medications? My preference would be the Cyclosporine. Guess we'll have to wait and see, and just be content and at peace for these next two months that her eyes aren't flaring, and having to think about what we would do IF the eyes got worse instead of better. (Sometimes I think of that, too, because she's near the limit of her current doses of Methotrexate and Cyclosporine.)

I know that so many people are praying for Anna and her eyes, and we are humbled and appreciative of all the prayers that are lifted up on Anna's behalf. Thank you. Our lives are near to normal (except for lots of medication and weekly shots and occasional blood tests). I know that not every Juvenile Arthritis patient has such an easy road. I hope that Anna's journey (these "up parts" anyway) bring hope and encouragement to all.

A New Chapter in Anna's Life . . .

Well, maybe a "sub-chapter"! And it's not related to JA or anything. Yesterday, Anna began taking lessons to learn how to play the bassoon! She "fell in love" with the bassoon when she was in second grade, and the music teacher was playing snippets of various instruments for the students to hear. Anna came home that day from school and announced with passion, "I want to play the BASSOON!" We were uncertain that it would happen this year . . . we weren't sure if she would have to begin with an oboe and then graduate to the bassoon, but the music department in our school district decided that Anna's fingers were long enough to navigate the keys, and she could start with the bassoon this year. And now she has an opportunity to have five more private lessons (the school district will pay for them) with a friend of her brother and sister, a young man who seems to be able to play any instrument that is put in his hands! Anna has always admired him (she's seen him at all the concerts we've attended in previous years when Abby and Joel were in middle school), and she is so excited! I'm realistic enough to realize that there will be highs and lows of excitement and enthusiasm levels when learning a new instrument (we've been through this before with other children!) I'll post a picture (of Anna and her bassoon--which is almost as tall as she is!) later on. When Anna was practicing yesterday, Abby had the camera---she was ushering at the high school graduation, and wanted the camera to take photos of her dear friends.

Good Appointments!

This is a funny picture of Anna! (Her brother Joel took this one.). Two thumbs up for two good appointments (actually, when the picture was taken, she wasn't even thinking about doctors' appointments, but I thought this fit!).

Anna's joints are doing well. We go back in August. Her eyes continue to very gradually improve, as well. Right eye is clear; left eye has just a very occasional cell, hardly even worth a "trace" rating . . . the doctor said between 0 and a trace! Great news! The next appointment is in seven weeks instead of six (YAY!!! For awhile, we were going every 3-4 weeks.). And the ophthalmologist is thinking that if her eyes stay this quiet for two more appointments, maybe---just maybe---we can think about lowering some doses of the medications.

Good news, indeed. Even though uveitis can fluctuate, we will be happy for the next seven weeks, and eagerly anticipate the day when we can begin lowering Anna's medications. Although I try not to think about it much, when I do allow myself, I cringe at the amount of medication that is going into her little body (I don't think she's had a break from medication since she was 23 months old). As always, we do so appreciate the prayers of everyone as we continue on this good part of the journey.

A New Photograph . . . More Updates this coming week . . .

I know it's been quite a while since I updated this blog. And I know I have some comments to respond to, also. (Sorry for the delay!) Life has been super-busy lately. We've spent a lot of time this month at some track meets and church meetings (after spending last month renovating a room in our small house). Here's a recent picture of Anna with my husband, Scott. They're waiting for Anna's brother's race to begin. Anna has two appointments next week (pediatric rheumatologist and pediatric ophthalmologist), so I will give an update within the next ten days. Promise!

Relief
A sigh of relief and a prayer of thanks to God! (not necessarily in that order!). I was a little nervous about Anna's eye appointment today, since she had missed a few of her Cyclosporine pills last week (since she had been sick). But the eyes have not changed all that much in the six weeks since the last appointment. And the doctor said that if the next two appointments are okay (he said he's happy with how she's currently doing, even though there is a trace of cells in the left eye), we might even go to eight weeks between appointments. That may not seem like much to cheer about to the average person, but for Anna and her eye doctor, this is good news indeed! I need to be thankful for the small things (like this), although in my heart, I would love to get to a point where we could begin to decrease some of Anna's medications. But with a trace of cells still present, that's probably not in the near future at all.

Chillin' out at the farm in Maryland. Can you tell that Anna loves the color green? Anything green--any shade of green!

Here's where we sit back and see what happens . . . Anna's had several viruses lately . . . respiratory, then something that included a headache, queasy stomach, and a low-grade fever. Two days later she had some intestinal troubles. Missed two days of school. So I checked with the powers that be about giving her the Cyclosporine (it's a strong immune-suppressent medication). The advice was to stop the Cyclosporine for a few days, until she regains her health. In many ways, that's a relief, and I just want Anna to feel better (on Wednesday she dissolved into tears and said she was so tired and sick of being tired and sick). On the other hand, she has an eye appointment next Thursday, and I'm just a little wary about what the "vacation from Cyclosporine" will do to the eye inflammation. Nothing to do but wait and see (and place everything in God's hands). . . at least she's more perky today, and much more herself than she has been for awhile.

Nothing significantly new here, lately! Anna caught one of those cold/bronchial viruses, so she's been coughing a lot lately. I had something similar about two weeks ago--nothing alarming . . . just one of those things where you need Vick's Vapor cream at night and a humidifier going (although I think something is wrong with the humidifier I recently bought---I may have to call the manufacturer). At least that means that we should wait another week or two for the upcoming blood test. Anyway . . . Anna didn't have to wait around anywhere (and find some way to kill time) for the regional Capital Area Science Fair, because we had such a busy weekend (last weekend), that my parents let Anna spend two nights with them in Maryand (that sure helped with logistics of last weekend). She had a blast with Mom and Dad and her best buddy cousin, who also spent the weekend with Grandma and Granddad. Mom and Dad's house is the only place she's ever spent the night (besides JRA Camp or on vacation with us). That seems rather odd in some ways, but that's just the way it's been. At least Anna's to the point where she doesn't need all that much help with organizing her medications. She has it all down-pat, and she's in a routine whereby she knows it's a regular part of her day (after breakfast for the 100 mg of Cyclosporine, and bedtime for everything else).

"Let's think of something to do while we're waiting" . . . Anna spent last Saturday at the high school science fair, where her brother, Joel, had a project which compares three types of roller coaster launches (he tied for second place---gets to go to the regional science fair on February 16th). Anna chose to go over to the college (which was hosting the science fair) with Abby and Joel. We learned last year that there is a whole lot of time between set-up and judging and awards, so Scott and I decided to stay home and get some things done (we're working on renovating a room in our house . . . a LONG, slow process in a 70+ year-old home) until about an hour before the awards ceremony (it's REALLY great to have a teenager who is a responsible driver!---and I think they enjoyed being out by themselves). Anna took paper and crayons to keep her busy during the "down time."

Anna had an eye appointment yesterday. No cells at all in the right eye (although the pressure in that eye is around 21-22, which is interesting. Normal is anything under 18 or so). Still a trace in the left eye, but better than last time, although my comment of "Good!" with a smile got a cautionary response of "Well, we can't get really excited, because this has a pattern of fluctuating." I know that. I'm a realist, and we've been on this road for quite awhile. But I am choosing to be happy for today!

Another ice storm this morning (mostly rain now). We'd rather have snow. Oh, well! Slow start to the morning, 'cause the kids had a two-hour delay.

Even though life is pretty much normalized, I've noticed in the past week that when Anna gets up from sitting (watching a movie or something), she spends about five minutes going lunges and deep knee bends. I asked her why she was stretching (I knew she wasn't "going out for a run" like her brother . . . she's not old enough to go for a run without one of us being with her!). She said that she gets a little stiff after sitting. But she was adamant about it being "no big deal, Mom! This is normal for me!" She's just a little stiff; not in pain. No big deal (although it's something I'll personally file away in my mental notes.)

Injectable Methotrexate hasn't always been readily available, but I'm very glad to have found another supplier, and one that's closer to home! When injectable Methotrexate was first prescribed for Anna, the only pharmacy in the area which could obtain it for me was the very last independent pharmacist (on our side of the river) listed in the phone book . . . I had tried calling all the others, with no success---none of them had any wholesale supplier who could get it for them. I've been driving into the worst part of Camp Hill (traffic-wise) once a month for several years now, and the pharmacy's hours are limited. Well, I tried calling the new Wegman's store, and they can order it in for me---no problem! I am SO very happy about that!

Life has seemed fairly normal lately, and this is "normal" at our house! We've worked to achieve family camaraderie, and because Anna looks up to her siblings, they can usually get her to eagerly help them when it comes to interesting tasks like the one pictured. Joel built this roller coaster for his Independent Project at school, and then he had to get it to the school. He decided that it was too big to fit into the van, so he thought he and Anna could just walk it up to the high school! They did (and I followed along with the camera and the little bucket to collect pieces as they fell off), although they had to stop several times to stabilize the contraption! Joel and Abby brought it home today (they used the van to bring it home! I took pictures of that, too, but I'll post them some other day on one of my other blogs!)

I know this has nothing to do with JA---but maybe it shows just how normal JA kids can be when the disease is relatively under control!

(I did pick up Anna's blood test results, and they're relatively normal. She has an appointment with the pediatric rheumatologist tomorrow, although I'm anticipating an uneventful appointment).

Happy New Year! Anna managed to stay up past midnight to go downtown (in our small town) to participate in the festivities with parents and siblings and cousins and aunt and uncle, and Gran, too! We love that we live close enough to walk downtown for New Year's Eve, and we like sharing the time with family, too. Once we arrived home (Anna actually chose to ride home in the car with Scott and Scott's mom, instead of walking back with the rest of us---it was really cold, and it's about 1/2 mile walk home), she was about to "hit the wall," so she gave hugs and went to bed!

Anna had a blood test on Monday morning (checking her cyclosporine levels as well as her CBC and other things), and she will have appointments with both the rheumatologist and ophthalmologist this month.