Sunday, April 30, 2017

2017–week 17

sunday: next week, layla is acolyting for the first time, so shane got her all trained.001

also sunday: first baby geese sighting of the spring!2017-04-30

one more sunday: just me and toby, playing mario kart. micah took this picture, and i love the angle he chose… making sure to get the screen in the shot, too. 007

wednesday: shane left in the middle of the night to meet his JROTC group at snohomish to head to the airport. they flew out at 6:30 in the morning for 5 days in san diego at camp pendleton. this just seemed really far away. and grown up.013

thursday: a little game of apples to apples after dinner. this particular round was quite hilarious. no, the chicken dance was not chosen as the most frightening. LOL.014

saturday: toby is just checking it out to see if layla might be eating something tasty.031

also saturday: game in north seattle. micah on second, ready to steal.033

more saturday: dave got his company’s sounders tickets. awesome seats. the kids didn’t really want to go, so we wound up taking ruth ann with us. 2017-04-301

seriously. not zoomed in. game ended in a 3-3 tie. very exciting second half.037

Sunday, April 23, 2017

2017–week 16

sunday: easter! we actually remembered to take a family picture!IMG_20170416_114949

after church, we came home, put the ham in the oven, gathered some wood from the clearing for the fire, played some corn hole, drank mimosas and hung clothes on the line for the first time this year! it was a totally gorgeous day. very unusual for easter in western washington! 024 025029032

layla helped get the apples ready for applesauce, and she and micah took turns hiding eggs for each other and for grandpa. they thought it was hilarious that they hid one egg in a pair of micah’s underwear that was hung up to dry. then we got the back porch all cleaned up so we could eat outside!033 034

this was definitely a first. we’ve never had an easter warm enough to eat dinner outside.035

as usual, micah pouted about the food.036

then we invited bailey and her family over for a fire. the wood was a little damp and stubborn to get going. dave was determined to try all sorts of crazy ways to get it going. he and shane took turns blowing through a broken broom handle to try and fan the flames without burning their faces. then they tried taping the hose of a bike pump to it to pump air in. neither worked particularly well and i went across the street to get a pallet from eric. sure way to get a roaring fire!

038039040 041

monday: bonus day of spring break for me. the kids went back to school and i scurried around trying to get all the rest of my to-do list done. didn’t quite make it, but it wasn’t totally pathetic either.001

wednesday: we are so sad that this is the LAST elephant and piggie book!!!002

thursday: layla decided she wanted to bust out the electric marshmallow roaster grandpa gave us last year and make herself a s’more after dinner… it actually worked decently!005

friday: walking the dog on the warmest day so far this year! after this, she grabbed a book and went and read on “the rock”. 019

also friday: getting warmed up for a late starting baseball game. start time 7:30pm. it didn’t end until after 10. crazy late.022

saturday: another baseball game. we had amy’s boys with us, so they tagged along, and made friends with my dad at the game. 021

also saturday: i really, REALLY did not have any motivation for cooking dinner. and so, instant oatmeal for all!020

Monday, April 17, 2017

2017–week 15

spring break week. i have a TON of pictures from this week, and i’m not entirely sure how i’m going to get them all in the book, but we shall see…

sunday: getting the second coat of paint on our chairs.001 (2)

also sunday: it was an exceptionally nice day, so we decided that dinner should be cook-out style. hot dogs and s’mores. healthy!2017-04-17

monday: micah has decided that what he wants to do for spring break is camp… in the living room. this is where he slept all week. 010 (2)

also monday: on spring break, we walk the cat… apparently. also, this is your one and only shane sighting for the week. he was off doing this and that all week long.

and, layla had an appointment for an MRI at childrens, trying to sort out what’s going on with her jaw pain, and if it is or isn’t arthritis. post-MRI frappuccino – dripping with caramel. we met with her rheumatologist afterward to go over results. yes, it’s arthritis in her jaw. so we went over the new treatment plan, which includes adding injections of methotrexate and enbrel. not what we had hoped to hear.012 (2)  013 (2)

tuesday: chairs are dry, and yesterday’s costco run resulted in some awesome cushions that were about half the price of ones we were finding elsewhere! i love them! so i got rid of the old, nasty, faded chairs that had been there, and added in all my cool dairy-themed antiques and such. love love love.2017-04-176

also tuesday: micah’s big request for spring break was a trip to the zoo. we hadn’t been in years, so it was a fun trip. the fighting grizzly bears, the “randy” otters, the wallaby w/ a baby in it’s pouch, and the idiot-proof porcupine warning signage were awesome…2017-04-171

the aviary was fun. micah had a little trouble interesting any birds in his seed stick at first, so i helped him lure this guy. and then he wouldn’t leave! micah named him “jacky” since he was nipping at his jacket, and he sat there for about 5 minutes!2017-04-173

the second half of the zoo (that we saw… we burned out before getting through it all) was fun, too. the orangutans were hilarious. one kept covering himself with blankets and the other kept trying to steal the blankets, the super comfy sloth bear, the jaguar that was acting just like a house cat trying to hack up a hairball (meant to research if jaguars do that), and the ring-tailed lemurs we only could spot because of their seemingly disembodied tails!2017-04-172

wednesday: we met some friends at the gym for an open gym session. layla was a little miffed about slumming at an open gym, but it turned out well for her. her coach was there and gave her some stuff to work on, and she wound up putting together her round off, 2 back handsprings on the in-ground while we were there.2017-04-174

thursday: micah had been harassing me to make blueberry muffins all week, and i had banana bread on my to-do list, so i spent the afternoon baking. super yummy.


friday: a little bit of time at cottage lake park. i totally did not dress warmly enough and the kids were a little mad when i wimped out sooner than they wanted to. 2017-04-175

also friday: since layla was sick most of the previous week she had a ton of math homework to make up that she didn’t understand how to do. this was a source of great stress for her, so dave sat down and tried to sort it all out with her.020

more friday: this was the day we’d been waiting for. it had been looming all week. one of layla’s new prescriptions was ready to start. it’s given by injection, once a week, and i have to do it! this was super-sucky. i had practiced on monday, giving a nurse a shot of saline, but this was still nerve-wracking. the syringes i got from the pharmacy were different from the ones i’d practiced on, and this time it was on layla. she was not happy about it. none of us were. micah was so upset he had to leave the room, and there were many tears all around. although not fun, the actual injection went okay. she said it hurt most when the medicine went in. but we survived and then had to wait and see how she was going to react to it. the most common side effects are stomach pain or nausea – usually within the first 6-12 hours. after it was all over, we snuggled up to watch a movie. her stomach hurt a little bit about 1/2 hour afterward, but after that she was fine. she slept great all night and felt decent in the morning. so relieved!!!!018021

saturday: after our old riding lawnmower burnt up last year, we’ve been using the push mower, just fine. but my dad wanted a new rider (and shane was lobbying for the cause), so the two of them went out and bought one. we still need a new bagger attachment for it, since the one off the old mower doesn’t fit, but mulching works fine as long as the grass isn’t too long. shane had to go to work on saturday morning, and dave wasn’t going to waste a dry day, so he got to mow first, much to shane’s chagrin!022

also saturday: cartwheels on the rock.IMG_20170415_193749

Thursday, April 13, 2017

going deeper with juvenile arthritis

i haven’t written too much in the last few years about layla’s arthritis. she was officially diagnosed with JIA (Juvenile Idiopathic Arthritis, or just JA) about 3 years ago, in May of 2014. She was 8. That diagnosis was almost 3 years in coming, with a lot of confusion, frustration, and various other issues and treatments in the meantime. She had just turned 6 when she had her first flare (that we know of), although we didn’t catch it for what it was at the time. I blogged plenty about that process, but around the time she was diagnosed, is when my blogging updates kind of fell off. somehow i never made a “label” for arthritis, so most of those updates will fall under the label “doctors”. my plan is to go back and retroactively label anything having to do with this, even before we knew what it was, with the JIA and arthritis labels, so the back story of all of this is easier to find, and not mixed in with posts about colds or ear infections, and goodness knows there were plenty of those back in the day!

at any rate, layla has arthritis. this is different than osteoarthritis, which is generally associated with overuse, injuries, or advanced age. juvenile arthritis, is more like rheumatoid arthritis, but not exactly. it’s an auto-immune disorder, which means various things. 1) we don’t know what causes it. 2) there is no cure. 3) it doesn’t go away – she will have this her whole life, unless something happens about number 2. 4) it is the result of the immune system mistakenly attacking the joints causing inflammation, pain, and damage to the joint. 5) the symptoms (known as flares) come and go at random. she will go months with no flares at all, and then wake up in the middle of the night with something swollen and hurting. sometimes it will hurt for a week, sometimes, only a few hours. 6) having a diagnosis of an auto-immune disease in the family, means other family members are also at risk of auto-immune disease. they tend to be genetic, although not always the same one. 7) having a diagnosis of one auto-immune disease puts one at a higher risk of being diagnosed with another. 

there are more, but that’s where i’ll stop with that. i’m still just learning what all of this means.

for the last 3 years, there hasn’t been much going on with layla’s arthritis. until recently, the only joints affected were her ankles. off and on, she has taken an anti-inflammatory (naproxen), but mostly she hasn’t needed it. she had one steroid injection in her left ankle in the summer of 2014, and that worked well. she’s had one significant ankle flare, that i can recall, since then, and i’m not even sure which ankle it was. in general, she’s had a pretty easy time of it, considering.

and i was pretty comfortable, as her parent, not worrying too much about it. i have friends, whose kids have it much worse… more joints, more flares, more medications… maybe i was smug, maybe i was delusional… i know for sure, i was thankful. nobody wants to see their kid in pain. nobody wants to make decisions about medications that will prevent damage, but have unpleasant side effects. nobody wants to see a kid be limited by something outside of their control. nobody wants to have a doctor tell their kid they shouldn’t do something they love to do because it is too hard on their body. nobody wants to worry that their other children are being overlooked in all the drama over their sibling’s medical needs. nobody wants to look into the future and wonder if their kid will be in pain or debilitated as an adult because of the progressive nature of this condition. it seemed like layla’s arthritis was mild, wasn’t going to give her more than occasional trouble, was isolated to her ankles, and responded well to the injections. nothing to worry about! easy peasy. no nasty, immune-suppressing drugs, no worries about having to quit gymnastics, no frequent visits to the rheumatologist. we were lucky.

and then this year hit. although it had been well over a year since she’d had an ankle flare, last november, she woke up one night at 1:30am in tears with the back of her right hand all red and swelled up. IMG_2056

and then a couple months ago, she started complaining about her neck hurting at gymnastics. and then in february, she started complaining about her jaw hurting. a lot. one day, i got a call from the health room at her school that she was in there, and almost in tears because her jaw was hurting so much. i hoped it might just be from the 12 year molars that were actively coming in at that point, so we made an appointment to see the dentist that afternoon. 052

but the pain was only on one side, and her mobility was limited in the TMJ, she was holding her mouth slightly off-center. our dentist referred us to a dental specialist, who we saw, but i also put a call in to the rheumatology nurse line at children’s. that’s the thing with arthritis… you never really know. if her ankle hurts, did she twist it? or is it arthritis? if a new joint is hurting, is it an injury? or is it arthritis?

her rheumatologist was very concerned. at every appointment they take measurements of various aspects of mobility. the fact that the pain in her jaw was limited to one side paired with the amount she was able to open her mouth being less than the last time he saw her, made him quite certain we were dealing with some pretty significant arthritis in the TMJ. he’d made note of it when he’d seen her previously, but the fact that she had no pain there, left it just at that – something to take note of… he ordered an MRI and also xrays of her neck, to make sure there was no injury there. in the absence of evidence of injury, the assumption is that the pain and limited mobility in her neck is also likely due to arthritis. he prepared us for the fact that we would likely need to up our game in the treatment department, and he was talking about some of those drugs that i’d been desperately hoping to avoid.

at this point, i felt like the bottom fell out of my delusion. i felt like i should have felt when we got her diagnosis 3 years ago. but at that point, it almost felt like a relief to FINALLY know what was going on with my kid. and then, after the initial onslaught of information, things settled down, and it really didn’t seem like it was going to be that big of a deal.  and now, maybe it is a big deal. and i have to wrap my head around everything i had thus far avoided.

so, on monday, we went in for her MRI. she was totally dreading it, because they have to put in an IV for the contrast. last time she had one, the nurse missed her vein the first time. she was also younger, and she remembers it as being traumatic. this nurse was awesome, she used to be a gymnast, and she used this amazing numbing medication and layla didn’t feel a thing. the MRI itself wasn’t a big deal… just a little loud and boring, but she got to watch a harry potter movie, so she was all good in that department. we celebrated afterward with a super syrupy starbucks frappuccino. (and coffee for me.)


we met with the rheumatologist afterward to go over the results.

yes, the MRI showed significant inflammation in the left TMJ, as well as some erosion in that joint. the TMJ is apparently a joint that you don’t want to mess around with. it also does not react as well (as the ankle or other joints) to the steroid injections, so that’s not really a complete treatment option. damage can happen faster there, as well as causing issues with growth. the affected side can stop growing, while the unaffected side continues to grow as normal. all reasons to not ignore this! also, the x-rays of her neck showed no evidence of injury. and we had to report a third flare in the back of her right hand. all of that confirmed that we do, in fact, need to up the treatment game.

and so we stay with the naproxen for now, but we are adding methotrexate, a drug that will hopefully get these things under control and prevent further damage, as well as eliminate pain, inflammation, and increase mobility in the affected joints. all good things, right? definitely. but it has also been known to cause stomach pain or nausea, it works by suppressing the immune system, leaving you more vulnerable to infection, and it works best when given by injection. and so… right then and there, i learned how to administer medication by injection! i gave a nurse a shot of saline in the back of her arm. it was a little traumatic… for me. she, apparently, does this all the time (bless her!) to help parents learn how to do this. i only had one minor fail, in that i sort of had to poke her twice. when you give the shot, you pinch the skin a little to give yourself a good chunk to poke, and then you release it so you have both hands available to hold the syringe still and depress it at the same time. when i released her skin, i didn’t account for the fact that it would lower, and it lowered right off of the end of the needle. oops. lesson learned, and now i (hopefully) know how not to do that to my kid! we haven’t started this yet, as it’s good to give it on a weekend, in case there are any adverse affects (like the aforementioned stomach pain). she will also be taking folic acid, which helps with those side effects.

i HATE everything about this.

we will also be adding another med – enbrel – which you may have seen commercials for. it’s a biologic medication, frequently used to treat rheumatic conditions like RA and psoriasis. this is another med given by injection, and it also suppresses the immune system. but it might take a while before this gets added. some insurance companies can be cranky about covering this and it’s very expensive. apparently there are some hoops that the dr. has to jump through on his end before the insurance company will approve it.

so, how is layla dealing with all of this?

hard to say. probably a little better than i am, although she’s not happy about having to get shots weekly, and she (rightfully) doesn’t understand why all of this had to happen to her. she, like everyone else, wishes it would just go away and she could be a normal kid and not have to worry about any of this.

i, of course, in addition to imagining the worst-case scenarios for all of this, am worried that suppressing her immune system will mean catching the stomach flu every other week… because it always comes down to vomit for me.

so that’s where we are at this point. i will try to keep this updated going forward. pray for us. none of this is easy, and i pretty much hate it all. i know there is a plan that is bigger than me, bigger than layla, and i know good can come from all of this. we just have to trust that God will use this for good, as he has promised.

Sunday, April 9, 2017

2017–week 14

sunday: i had some professional development classes to take for work, so i was chained to the computer for a good chunk of the day. this was my companion as i worked. 051

monday: very odd day. there was a threat of violence at the high school, so pretty much most of the student body stayed home. shane was among those lobbying for a day at home, so to ensure it wasn’t just a day of fun and leisure, i made him a lengthy to-do list to keep him occupied. i think it worked out very well. ;)007

also monday: when i got home from work, i took bonez on the longest walk ever, because it was such a nice day. this is some of the awesome spring color we saw on our walk. 2017-04-086

wednesday: i was making white chicken chili for soup supper at church, and was tossing my cans into this bag for recycling. i seem to have attracted the local wildlife.027

saturday: school’s out for spring break, which means it’s time for my traditional school break to-do list. i make one for every break, and usually don’t get that much of it checked off. this time, the kids’ break lined up with mine, so i threw in a few of their requests, too, not just house and work projects.037

also saturday: dave, layla, and micah went off on their first bike ride of the spring on the centennial trail.2017-04-089

and the final for saturday: micah’s second baseball game of the season (that didn’t get rained out). it wasn’t raining, but it was COLD and super windy! we were miserable, even wrapped in a blanket and with hotties in our pockets! BRR!! we finally bailed and watched the final inning from inside the car.2017-04-087

and that’s it for this week!


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