Rather than answer everyone individually, I'm going to just post what we know here and direct people to it, thus saving me repeating myself and creating a record of sorts. :)
So, most of you know that Micah's been having knee and foot pain for the last while. (He actually had some over the summer and in the fall that we're now realizing may well have been related. Everything would come and go. We just figured he'd tweaked something and then it would heal for awhile and then something else, we thought, would happen. Heck, he's an active teenage boy, lol.) In any case, things got noticeably worse in January and we finally went to see the doctor at the start of February. She ordered a number of blood tests and x-rays and ruled out any specific injury. Her best guess based on the various results and his descriptions was that it was some sort of juvenile rheumatoid arthritis. With that, she referred us to Children's Hospital in Denver and their pediatric rheumatology department. (Apparently, they're the only pediatric rheumatologists in a five state region.) We managed to make an appointment for the start of March (a month away at that point).
During February, then, Micah kept a log of how he was feeling each day, things we tried, what worked, what didn't, and the like. We found that mostly more activity helped and sitting all day did not. Mondays and Tuesdays were usually the worst, as karate and rock climbing are on Wednesday, Thursday, Friday and Saturday. We started adding extra sessions of rock climbing and exercises at home. The pain continued to be only on his right side...knee, ankle, heel and toes.
Yesterday, we went down to Children's. (The original appointment had gotten rescheduled to the end of March but, fortunately, they placed Micah on a priority call list, and we were notified of a cancellation and able to get in only a day after when the original appointment had been. Whew.) We met with a doctor who examined Micah and asked questions and gave us lots of information. That part of the exam took about an hour. She then ordered more blood work, more x-rays and an MRI (all of these will help establish a baseline and the MRI will check on whether his lower back is being affected right now). We went downstairs to have the first two done right then and are working on scheduling the MRI soon up here in Fort Collins. (Children's, might I just say, is a very well run place from what we could see yesterday. Impressed by how smoothly everything went.)
In the end, the diagnosis is juvenile idiopathic arthritis (the "correct" term for juvenile rheumatoid arthritis). Technically, that's just a broad term that covers a bunch of types of juvenile arthritis. His is likely enthesitis-related, often referred to as spondyloarthritis (involves inflammation of the joints and places where tendons attach to the bones). There is no cure and it's something he'll likely deal with long term, but they stressed that everyone is different so they mostly just monitor symptoms and try to manage pain.
For the pain, the doctor recommended basically a higher dosage ibuprofen, though Micah's been trying to decrease how much he takes anyhow, as he doesn't like relying on it. She couldn't officially recommend dietary changes, as there have been few/no studies that effectively show anything, especially for kids (because most dietary studies don't involve kids, obviously)...but did say to feel free to try that. Micah wants to, so we'll give that a go while also probably continuing with the increased activities.
Mostly, everything is manageable. Some days don't bother him at all. Some days suck. It's a bit overwhelming to him that this is something that's not going away anytime soon, but we'll just have to wait and see. We have more questions now that we've started more specific research. We'll get to them when we go back for his follow up at Children's once the MRI is completed. And that's where we are for now. :)
Wednesday, March 20, 2019 at 10:25AM ;)
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