Arthritis in children
Eleven year-old Michelle Crossman from Johannesburg is one out of a thousand children that have juvenile arthritis. But, luckily she was diagnosed early.
‘In August 2010, she started with a lot of nose bleeds, lots of bruising across her body and general un-wellness. I actually became very scared’, says her mother Dianne Crossman.
After repeated visits to a paediatrician without any improvement, Dianne requested that her daughter, Michelle, undergoes an immune screen test.
‘I said to her [the paediatrician]: ‘It’s crazy that this child is always sick. Every two weeks she is on antibiotics and landed up in hospital a couple of times and we never seem to get to the root cause of the problem’. And so, I requested an immune screen and her tests came back positive with juvenile arthritis’, says Dianne Crossman.
Michelle was then quickly put on treatment after the diagnosis. But the treatment took a bit of time before it kicked in.
‘Three months into the diagnosis she couldn’t walk and for a period of about four months she was fluctuating between a wheel-chair and crutches. At times she would crawl to the bath-room or I would carry her on my back and she was unable to go to school. She was crying 24 hours in pain. It was terrible… an absolute nightmare to see my child suffering. And I was unable to help her, despite seeing the best doctors and being on the best treatments’, says Dianne Crossman.
Michelle is on lots of medication and still gets severe bouts of arthritis. Just last week, the 11 year-old landed up in hospital again.
‘I am a lot better than I was last week, but my shoulders are still sore when I swim. When I do have a lot of pain I take my mind off it by thinking of something else’, says Michelle Crossman.
Young Michelle says one of her worst experiences with this disease is when it makes her immobile and she’s forced to be on a wheel-chair or to walk with the help of crutches. The experience hurts her, especially because many people don’t understand her condition.
‘Other people… when I’m in a wheel-chair or crutches… they look at me like I’m a totally different person when I’m really not. I’m normal. I’ve just got a disease’, says Michelle Crossman .
But what is juvenile arthritis? Dr. Gail Faller is a paediatric rheumatologist working at the Donald Gordon Medical Centre.
‘When we talk about juvenile arthritis we are talking about arthritis in children which begins before the age of 16. It’s very much like adult arthritis in that the children experience pain in their joints, they experience swollen joints, they get very stiff and they’re unable to wake up easily in the morning and get out of bed’, says Dr. Faller.
She says early diagnosis and treatment is essential because it can help to avoid joint damage and disability.
‘It’s very under-diagnosed around the world, particularly in South Africa. We find, particularly the children who have to use the public health services, are sent in very, very late. Too late means the child arrives in a wheel-chair… and I would never ever like to see a child with arthritis in a wheel-chair because it’s unnecessary. Children with arthritis, nowadays, with the amount of good treatments we have, with physiotherapy, occupational therapy and rehabilitation have a completely normal life’, says Dr. Faller.
She says the cause of juvenile arthritis is not really known, but it is believed that it can be genetic.
‘We don’t really know what causes arthritis in young children. It’s not the same, for example, as adult wear and tear arthritis, which we know may come about from sports injuries or just old age. This is pure inflammation in the joints of young children. Some of it is definitely genetic… We have families where we’ve got family members like parents, uncles or grand-parents with arthritis. The child might be carrying a gene and something sets it off. So, they might get an infection or be allergic to something and the gene activates the arthritis’, says Dr. Faller.
She says parents need to look out for early symptoms.
‘Any child who complains about pain in their joints during the day that goes on for more than two to three weeks must be seen by a doctor. Any child who wakes up stiff in the morning – even if it’s an active child who is good at sports, they should not wake up stiff in the morning everyday of the week and struggle to get going… Any child who limps, complains about back-ache and stops coping at school with writing, colouring, painting and climbing’, concludes Dr. Faller.
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