oligoarticular JIA

I'm fairly convinced that Beth does have rheumatoid arthritis. She keeps her affected knee slightly bent, which is characteristic of the disease. She also has morning stiffness and stiffness after periods of inactivity, accompanied by nighttime pain and sleep issues and daytime neediness.


Children with the most benign and most prevalent subtype of juvenile rheumatoid arthritis, oligoarticular JIA, present as girls between the ages of 1 and 6 years old (with 1 to 3 years old most common), with one knee involved (or another weight-bearing joint).


If the disease involves four or fewer joints in the first six months of presentation, it remains a mostly benign condition with good prognosis (no long-term disease or problems), but eye involvement must be routinely tested for, as a complication of this subtype can lead to severe eye damage and blindness.


The earlier the disease is treated, the better the outcome. Judging from changes in Beth's personality, I would say she's had mild signs of arthritis for at least two to three months.


The MRI, which I don't think will show any injury, is still about two weeks away. In the meantime, to understand how best to care for her, I am taking her to see her regular doctor as soon as possible. She needs ibuprofen to control inflammation and pain if she has arthritis, and she needs daily exercise--preferably bike riding or swimming. 


The number of weeks involved, the approximate time of presentation, and the number of joints affected (a thorough physical exam can identify affected joints), all must be carefully recorded and monitored to ensure an accurate subtype diagnosis and subsequent treatment, with the goal of maintaining an active, normal lifestyle, controlling pain and inflammation, and ensuring psycho-social well-being. The sooner she can get a referral to a pediatric rheumatologist, the better, as controlling the inflammation is essential in protecting the joints from permanent damage. This starts with drugs classified as NSAIDs (ibuprofen and naproxen).  If these don't work to control inflammation, steroids have to be used, which have stronger anti-inflammatory action.


If the disease goes on to involve more than four joints after six months, or if smaller joints such as fingers are involved, the prognosis is more complicated.


I have to carefully avoid overprotecting her--something which typically occurs in parents dealing with the chronic pain of a child. The other siblings can grow resentful, and the affected child is less prepared to deal with things autonomously, as he or she grows older. 


I wish this were a case of jumping to conclusions after too many Internet searches, but the signs are too obvious, and frankly, I think the orthopedic doctor was pretty sure she was an arthritis presentation. He only ordered the MRI to completely rule out an injury.


Part of me wants to scream and cry and throw things, but I think I'm stronger than that now. The best thing for Beth (and the others) is that I take this in stride as quickly as possible--while still praying vigilantly for her and holding her through the pain. 


She will be better for this.......more sympathetic to others, softer around the edges, stronger internally.


What is God using to make you stronger these days?

Miss Beth

Miss Beth went to the orthopedic doctor today, who took another x-ray to rule out a break. Like the other two x-rays, this one was also normal.

He can't understand why she isn't better by now from a sprain (almost five weeks), so he ordered an MRI, which will take place on October 6th, unless she improves before then.

He scared me with more talk of juvenile rheumatoid arthritis. The fact that her hospital blood test didn't indicate this doesn't mean we're free to rule it out. Not all children with this auto-immune disease test positive via blood sample, especially in the early stages. Truthfully, an arthritis diagnosis would explain night waking with crying, indicating pain. It would explain morning stiffness, and the horrible after-nap mood she wakes with in the past few months.

Some children with rheumatoid arthritis grow out of it at or before puberty, depending on how many joints are affected. It usually affect joints in a symmetrical way, so the fact that only one knee is affected seems to make it unlikely, though in some cases it manifests this way at first.

It's a scary diagnosis no matter how you look at it. She wouldn't lead a normal life unless she was blessed enough to have a short-lived case--like several weeks or months.

Please pray?

Paradigm Shift; Just Enough

Reading Shaun Groves' blog this afternoon, I came across the most beautiful story written by a contributor at the Living Proof Ministries Blog (The lpm Blog).  This is Beth Moore's blog and the two young women who contribute are Beth's daughters, one of whom, Melissa Fitzpatrick, went to Bible College with Shaun Groves, and accompanied him on the 2009 trip to India with Compassion Bloggers.

Please take the time to read Melissa's story. The power of the cross, the grace of the Almighty, is seldom this evident.

Clutter-Free Living

How much time do you spend, as a mother, taking care of possessions, versus taking care of your family?

In the last couple years I've spent countless hours downscaling. While my home features large living spaces, the bedrooms and closets are small. Too, it has neither basement nor garage. Since mice are known to inhabit the shed, I no longer consider it storage space for anything but lawn gear.

Few homes need downscaling more than ours did, in short.

Today, as I continued processing clutter I pulled from bedroom closets, bookshelves, toy bins, the linen closet and the kitchen junk drawers (not done with the draw-junk yet), I realized that the bulk of my time goes to managing things, versus investing in the hearts of my children.

What a tragedy! And how profoundly I will regret it if this doesn't quickly reverse.

Birthing baby after baby without much extended family around created a mode of living devoted to moment-to-moment tasks. Smart living was something I could only dream about.

Yes, organizing and decluttering create temporary havoc, but they must be done if we hope to raise Kingdom-minded children capable of changing the world for Christ.....for a world-changing mindset leaves no room for clutter, neither physical nor emotional.

How I wish a Titus-2 woman had been around twelves years ago, when I married and began setting up a household! How I needed someone to pull me aside and speak truth into my homemaking soul.

Pray about every single thing you bring into your home. Every item has the potential to steal your time. Thus, take in only what you need to create a haven of rest and renewal.....and not a thing more.

If your child can't build or create or problem solve with a toy, don't buy it. If you already have four or five good quality toys, you're set. Mine don't have game systems or handheld electronics or non-academic computer software...and they're none the worse for it. Don't add more toys, and especially not toys that lead to addictions, like electronic ones.


The more toys your child has, the less blessed he is.

Don't buy more books than you have room for...or more than you can practically display. Tightly packed books rarely get read. Use book tubs and rain gutters so that enticing book covers are visible, not hidden.

Books should beckon, not clutter and collect dust.

Keep linens to a minimum....one extra sheet set for each bed. Wait until your children are older to buy a nice tablecloth, or buy just one for holidays. Do you really need placemats or tablerunners? Do you really need more than one bud vase or flower-bouquet vase?

Are you thinking you need to be organized to keep a low-maintenance home?  Wrong. You just need less stuff!

What advice can you add?   Share, please.

And maybe try this book, written from a Christian perspective by the creator of Simple Mom. There's also the FlyLady, but I found that hard to follow with a lot of littles around.

Rapheal

It came in the mail today, eagerly awaited.

Raphael, age 11, from Burkina Faso (landlocked country in west Africa), lives with his father and his mother. He is responsible for running errands and cleaning. His father is sometimes employed and his mother is sometimes employed. There are 3 children in the family.


Soccer, playing with marbles and running are Raphael's favorite activities. In primary school his performance is above average and he also regularly attends church activities and Bible class.


Raphael lives on the plains of Pissy, home to approximately 180,900 residents. Typical houses are constructed of dirt floors, adobe walls and corrugated iron roofs. Most adults in Pissy are unemployed but some work as day laborers and earn the equivalent of $20 per month. This community needs income-generating activities and tuition assistance.


Burkina Faso, with a population of 13 million, is one of the poorest countries in the world. With no coastlines and ports, the country has few natural resources, fragile soil and an unequal distribution of income. About 90% of the population is engaged in agriculture, (mainly subsistence) which is vulnerable to variations in rainfall. 


Paul checks the mail everyday, with Mary by his side, holding his brotherly hand as they cross the street. He knew what this envelope contained and they ran all the way back to the house, eager to open it with me.

Our Compassion account showed Raphael's name and age and country over the weekend, but we hadn't received his packet until today.

Burkina Faso, with a population of 13 million, is one of the poorest countries in the world. This sentence, more than any of the others, brought me to tears. One of the poorest in the world. Our new son, my children's new sibling, comes from one of the poorest countries in the world.


It's been twelve hours since the mail came. And I already love him. I already think of him and wonder what he is doing and wonder what he is having for lunch. I wonder if he carries water to and from the house many times a day. I wonder if he will be able to go to university through Compassion's tuition assistance program. Students showing promise in their studies are offered this opportunity. I wonder if he's a good runner and if he can get a scholarship for sports.

My boys already respect him, since he is older than they are. And because he does well in school.

We will be each other's graces, this boy and my family. Brought together by God.

I am so thankful. His birthday is September 29 and we made nearly the minimum child gift of $15.00 at our garage sale.

Happy Birthday, Raphael.

I pray we can come and see you one day. Being your friend, I know, will bring many happy days into our lives.

Hearing about the Compassion Sponsorship or Correspondent Program isn't something most people respond to right away. First, you hear it and think what a good idea it is. We should do that, you say. But then life gets so busy and you forget to make the call. Next time you hear about it, same thing. It probably takes three times before most people actually do the physical act of picking up a phone and getting involved.

Writing to these wonderful children is a blessing.....the likes of which I can't adequately describe. It isn't just some do-gooder activity that gives you a temporary high. Instead, it's a relationship that transforms your heart in ways you have no control over. God takes over and makes it powerful, life-changing, thrilling, joy-filled.

Don't spend another minute thinking about it. Call today, to set up a sponsorship or correspondence.

800-336-7676