New member

Posted September 21, 2004 · September 21, 2004

HI and ,

Welcome to the group.. I cant say my son has experienced any of

these symptoms but that doesnt mean anything. This disease seems to

attack each child a little differently.

YOu can read about at www.caringbridge.org/mn/nicholasb

The best advice I can give is to keep a journal. This will be so

helpful on future doctors appts Im sure everyone else has said this

too, but i think its the #1 thing a parent can do, especially in the

begining.

Good luck and keep in touch.

Hugs Helen and (7,systemic)

> My son has recently been diagnosed with JRA. He experiences a

lot of

> systemic symptoms but the Dr does not think it is " systemic JRA " .

I guess my

> question is are there others who have JRA and when they flare

experience

> any of the following: Vertigo (he awakes sometimes in the middle

of the night

> and feels as if the room is spinning) Nausea, vomiting, and a

burning

> sensation throghout his body( He feels as if he has a fever, yet

he does not)

> Any feedback would be appreciated (mom of 11 years old)

Posted September 23, 2004 · September 23, 2004

Hi Aviva,

my name is Soili and I live in Finland, in Northern Europe. My 9 yo

old son has pauciarthritis and my 8 yo old foster son has poly. We

have 9 children at the moment, since we are a foster family. All our

foster children suffer from a chronic disease of some kind. So I

understand you worrying and feeling overwhelmed.

I also work with jra kids in a RA specialized hospital as an OT (now

I'm on leave until January 2005). First thing that caught my

attention in your post was the time period your child has been

treated. 4 years, if I got it right? Things are done very differently

depending on which side of the world you are, but in our hospital 4

years seems a short time for treating poly jra. I'm sure your rheumy

had a good case giving up the meds when he did. But here it would

seem like short time, and the policy is rather to treat some extra

time that to risk a flare.

Another thing is, this could NOT be a flare (and I DO hope it's not).

I've seen many (especially teenagers) who had poly since early

childhood, and are in perfect remission, but sometimes suffer from

pain and stiffness. In examinations nothing's found. It's just their

system, that they get more muscular pain and tensions. Ibuprofen's

just the thing to give them ,and then make sure they do exercise, and

maybe some physio is in order to keep them fit and relaxed.

But, seeing the rheumy soon is the absolute must! And that's what

you were going to do.

And please remember, to keep yourself calm, if she really flares,

it's good thing she noticed the symptoms soon. It's a darn thing to

happen, but it's not the end. She beat it once, she'll do it again.

Let us now what's going on!

Soili

Posted September 23, 2004 · September 23, 2004

-Hi Aviva,

Welcome to the group, Im sorry your daughter is again having

problems. Hopefully these are short lived and shes feeling better in

no time.

This disease is such a roller coaster, I can totally understand your

frustation.. HUGS!!

hugs Helen and (7,systemic)

-- In , " avivajaye0401 " <AvivaJaye@m...>

wrote:

> Hi, My name is Aviva and I am a married mother of 5 children under

> the age of 10. My 8 year old daughter was dx'd with Polyarticular

> JRA when she was 4. She had been on Naproxen and methotrexate with

> folic acid since her diagnosis and thankfully we were able to wean

> her off the naproxen with in the first several months.

>

> Over the course of the last year, Elli was weaned off her

> methotrexate. She had been " free of symptoms " for much of her time

> on meds...but the real test came when the doc finally said she

> didn't have to take it anymore. That was about 2 months ago.

>

> Yesterday, Elli called me from school to say that her joints were

> hurting. Her fingers and knees and who knows what else. I rushed

to

> school and gave her some ibuprofen and she seemed ok for the rest

of

> the day. At 2 am she woke me up to say her knees were hurting

again

> and I just gave her another dose. That should do it til the

morning

> and we're off to see her Rheumatologist first thing.

>

> I have to admit, I'm a little frantic. I have never really

> experienced a " flare " per say. She was one of those kids who never

> really expressed pain, even when first dx'd, but I think it's

> because she really didn't know what " normal " felt like. She

> compensated for many things at first but I only recognized them

> after the diagnosis. For example, she'd leave her drawers open

all

> the time. It drove me crazy! But they were the kind that you had

to

> grasp the handle with your finger tips (palm upturned) and pull.

I

> realized after that she left them open so she could put her hand

> inside the drawer and pull it open that way. Very clever!

>

> Well, I'm off the topic. I am nervous that she's not going to

have

> that magic remission I've been dreaming about for so long. All we

> had to do was go one year with no meds and no symptoms. It's been

> only two months and it appears that we're back in it again.

>

> I've been dealing with my child with this chronic illness for so

> long and just last week my 3 year old was diagnosed with asthma.

> Now I have two chronic illnesses to deal with and I'm feeling

> overwhelmed and scared.

>

> Just happy to have found this site and I look forward to hearing

> from any of you and learning about your children.

>

> Feel free to email directly to: AvivaJaye@m...

>

> Thanks,

> Aviva

> Canada

Posted September 23, 2004 · September 23, 2004

Hi Aviva and welcome to this great place of knowledge and

compassion. I'm very sorry that you thought you were out of the

woods only to get rocked back to reality. That has happened to a

bunch of people here also. The good news is that the mtx. seemed to

work well in your daughter. That really is very good news because

it doesn't work for a certain percentage of people.

I don't know how to answer the questions of " at what point do you

wean the meds if they are doing great? " That is part of the mystery

of the disease. JRA is very unpredictible and I'm sorry you've had

a setback. Sometimes we don't like to seem too confident about the

situation even when the child is doing well because there is always

the haunting thought of a flare. But then again, you can't live in

constant fear. We just take one day at a time.

My son, Hunter, has been in pretty good shape with his joints for

about 6 months now (after first symptoms when he was 3). He is on

mtx. There's an occasional moan or gripe about a joint here and

there and he recognizes the distinct pain and immediately asks for

motrin or gets his heating pads. Luckily, no episode has lasted for

more than a few hours.

I pray that this recent episode with your daughter is short lived.

Stacia and Hunter 8 systemic, iritis

Posted September 23, 2004 · September 23, 2004

Hi Aviva:

Welcome to a great group of wonderful, caring and knowlegable people. I am

sorry to hear that your daughter is experiencing joint pain again. I hope it

is not a flare and she will be feeling better soon.

As a mom of three beautiful (okay I am modest:) girls who all have their own

medical, etc. issues, I understand your feeling of being overhwheled and

scared. It's is so hard to see our children hurt, sick, etc. We want them to

have

the 'perfect' life. It will take time, but you will feel better. I often

felt like I was getting hit with something every darn week/day/month with my

girls. As each situation came/comes along all you can do is work through that

one.

Take care.

Patty

Posted September 24, 2004 · September 24, 2004

Dear Patty,

Thank you for the welcome. I am learning quite a lot already just

from other member's questions and answers. What a wonderful forum.

It seems even more open and helpful than a real-life support group.

I guess people have the opportunity to be more frank, more honest

and more caring in this kind of environment.

I was absolutely flipping out on the day that Elli's doc said that

her inflammation is back in so many joints. I had become too

optimistic because the future is a little scary, I guess.

We have both come to terms with the situation. I explained to Elli

that we are so lucky that she responds well to her meds and that she

has never suffered any side effects. Many kids with JRA aren't as

fortunate. Also, I told her that taking the meds was a small price

to pay for a healthy body and a pain free childhood.

Patty, you are the second person to suggest that it might not be a

flare. Maybe I just don't have the complete picture. I thought a

flare is when the inflammation returns after an extended period of

time with no inflammation. Can you explain? Could the symptoms

that Elli is experiencing be just the symptoms re-emerging after the

last of her mtx left her body. That we need to recognize that she

was so well controlled on meds and that it's obvious that she can

not be off her meds (yet)?

I thought I knew what I needed to know...but there's so much more.

Thanks for filling me in and I wish the best to you and your

daughters.

Aviva (and Elli (almost 9) Poly, sero-negative)

> Hi Aviva:

>

> Welcome to a great group of wonderful, caring and knowlegable

people. I am

> sorry to hear that your daughter is experiencing joint pain

again. I hope it

> is not a flare and she will be feeling better soon.

>

> As a mom of three beautiful (okay I am modest:) girls who all have

their own

> medical, etc. issues, I understand your feeling of being

overhwheled and

> scared. It's is so hard to see our children hurt, sick, etc. We

want them to have

> the 'perfect' life. It will take time, but you will feel better.

I often

> felt like I was getting hit with something every darn

week/day/month with my

> girls. As each situation came/comes along all you can do is work

through that

> one.

>

> Take care.

> Patty

>

Posted September 24, 2004 · September 24, 2004

Dear Soili,

Thanks for the welcome. You certainly sound like a very informed,

enlightened and devoted mother. Those 9 kids are very lucky.

My Daughter's Rheumy (love these nicknames you guys use in here) is

a brilliant pediatric Rheumotologist and researcher and she's the

best in the province. I really trust her and she's taken so much

time with Elli that I believe she was doing what she thought was

best without rushing her.

What she explained to me a looong time ago was that the first order

of business was to reduce the swelling and get the joints to their

full range of motion. So, we went on meds and did a lot of PT/OT,

swim therapy, stretches, home exercises, etc.

She wanted Elli on meds (full dose according to her size) until one

year past the time that she showed no symptoms (we saw the doc every

6 weeks for 4 years). Then for the next year, she was going to

slowly wean her off the mtx. Then she was going to take Elli off the

meds and we were hoping for no symptoms at all for a whole year at

which time we could consider it a remission.

I can't tell you how many times I've said that speech over the

course of tha past 4 yrs.

So, it was exactly 8 weeks without her meds that we came to this

point. She has inflammation in nearly all her affected joints

(which is essentially all her joints, period...)

Is that a flare? or just a recurrence of symptoms? Could you help me

to understand?

Thanks for letting me vent all my fears and frustraion here...very

much appreciated.

Aviva

> Hi Aviva,

> my name is Soili and I live in Finland, in Northern Europe. My 9

yo

> old son has pauciarthritis and my 8 yo old foster son has poly. We

> have 9 children at the moment, since we are a foster family. All

our

> foster children suffer from a chronic disease of some kind. So I

> understand you worrying and feeling overwhelmed.

> I also work with jra kids in a RA specialized hospital as an OT

(now

> I'm on leave until January 2005). First thing that caught my

> attention in your post was the time period your child has been

> treated. 4 years, if I got it right? Things are done very

differently

> depending on which side of the world you are, but in our hospital

4

> years seems a short time for treating poly jra. I'm sure your

rheumy

> had a good case giving up the meds when he did. But here it would

> seem like short time, and the policy is rather to treat some extra

> time that to risk a flare.

> Another thing is, this could NOT be a flare (and I DO hope it's

not).

> I've seen many (especially teenagers) who had poly since early

> childhood, and are in perfect remission, but sometimes suffer from

> pain and stiffness. In examinations nothing's found. It's just

their

> system, that they get more muscular pain and tensions. Ibuprofen's

> just the thing to give them ,and then make sure they do exercise,

and

> maybe some physio is in order to keep them fit and relaxed.

> But, seeing the rheumy soon is the absolute must! And that's what

> you were going to do.

> And please remember, to keep yourself calm, if she really flares,

> it's good thing she noticed the symptoms soon. It's a darn thing

to

> happen, but it's not the end. She beat it once, she'll do it again.

> Let us now what's going on!

> Soili

Posted September 24, 2004 · September 24, 2004

Dear Helen,

Thanks for the kind welcome. We are all calming down here a bit. We

had great success with encouraging Elli that she could actually take

pills (6/once per week) of the mtx and prefer it over the liquid.

That was a big boost. She felt very accomplished. (and the Hershey

kiss probably helped too).

You're so right about the roller coaster effect. JRA is something I

had NEVER heard of when I went to the doc with a very cranky 4 year

old. Nevertheless, I told her pediatrician, " I'm worried about her

joints " .

I still think it was a miracle that those were the words that came

out of my mouth because to this day, I have no idea why I said it.

Anyway, we'll get back into the routine of regular visits to the

clinic, the finger pokes, the physio, the meds......we did it

before, right?

Thanks for the pat on the back. Best to you and your daughter,

Aviva

> > Hi, My name is Aviva and I am a married mother of 5 children

under

> > the age of 10. My 8 year old daughter was dx'd with

Polyarticular

> > JRA when she was 4. She had been on Naproxen and methotrexate

with

> > folic acid since her diagnosis and thankfully we were able to

wean

> > her off the naproxen with in the first several months.

> >

> > Over the course of the last year, Elli was weaned off her

> > methotrexate. She had been " free of symptoms " for much of her

time

> > on meds...but the real test came when the doc finally said she

> > didn't have to take it anymore. That was about 2 months ago.

> >

> > Yesterday, Elli called me from school to say that her joints

were

> > hurting. Her fingers and knees and who knows what else. I rushed

> to

> > school and gave her some ibuprofen and she seemed ok for the

rest

> of

> > the day. At 2 am she woke me up to say her knees were hurting

> again

> > and I just gave her another dose. That should do it til the

> morning

> > and we're off to see her Rheumatologist first thing.

> >

> > I have to admit, I'm a little frantic. I have never really

> > experienced a " flare " per say. She was one of those kids who

never

> > really expressed pain, even when first dx'd, but I think it's

> > because she really didn't know what " normal " felt like. She

> > compensated for many things at first but I only recognized them

> > after the diagnosis. For example, she'd leave her drawers open

> all

> > the time. It drove me crazy! But they were the kind that you

had

> to

> > grasp the handle with your finger tips (palm upturned) and

pull.

> I

> > realized after that she left them open so she could put her hand

> > inside the drawer and pull it open that way. Very clever!

> >

> > Well, I'm off the topic. I am nervous that she's not going to

> have

> > that magic remission I've been dreaming about for so long. All

we

> > had to do was go one year with no meds and no symptoms. It's

been

> > only two months and it appears that we're back in it again.

> >

> > I've been dealing with my child with this chronic illness for so

> > long and just last week my 3 year old was diagnosed with

asthma.

> > Now I have two chronic illnesses to deal with and I'm feeling

> > overwhelmed and scared.

> >

> > Just happy to have found this site and I look forward to hearing

> > from any of you and learning about your children.

> >

> > Feel free to email directly to: AvivaJaye@m...

> >

> > Thanks,

> > Aviva

> > Canada

Posted September 24, 2004 · September 24, 2004

Hi Aviva:

Nothing wrong with being optimistic! I believe it's better that way. The

opposite would be such a heavy burden to carry. So stay optimistic:) None of

us know the future. A new medicine, a remission and even a cure may be around

the corner.

Your explanation to Elli is very true. I always tell Caitlin that she is so

fortunate to have gotten into a clinical remission very fast. There are

children who are on meds that still hurt. She knows everyone responds

differently

and to be thankful where she is. Having children with education and medical

special needs, they have all grown up with the knowledge that everyone is

different and to be grateful for how they are and what they have.

No, I didn't suggest she might not be in a flare, I said I hope it isn't a

flare. I am still fairly new to this and we are in a similar situation with

Caitlin as to whether or not she is flaring.

There is so much to learn about this disease and I learn something new every

day from this awesome list. I hope Elli is feeling more comfortable ASAP.

Take care.

Patty

Posted September 24, 2004 · September 24, 2004

> So, it was exactly 8 weeks without her meds that we came to this

> point. She has inflammation in nearly all her affected joints

> (which is essentially all her joints, period...)

>

> Is that a flare? or just a recurrence of symptoms? Could you help

me

> to understand?

Hi again Aviva,

did Elli see the rheumy yet? These terms, like " flare "

and " remission " are a little vague in my opinion (sometimes there's

been a discussion here what they really mean to each of us). But, I'd

say if there's inflammation in several joints, not just pain and

stiffness, I'd call it flare (remember, just an opinion of mine).

What I ment before was that sometimes kids have pain and feeling of

stiffness without any inflammation/synovitis at all.

The treatment Elli's received so far sounds just great and very

intensive, couldn't be better. Seeing a jra child very often is very

important. I'm sure you'll get to the bottom of this and what's going

on with Elli.

hugs,

Soili

Posted September 25, 2004 · September 25, 2004

Welcome - my name is Sandi and I have four children (26, 24, 22 and 6) Our 6

year old has systemic jra (7 months and counting). I am new to the JRA

thing - but an old pro to Asthma. My 26 year old has it and also my

granddaughter

(3). Do you know yet if it is Asthma induced from environment, stress,

exercise or illness. MY son had attacks for the first year at the drop of a

hat(he

has not had any trouble since puberty though). My granddaughter only has

trouble when she gets a cold. This website has been extremely helpful and I

just

know it will be for you to. Sandi Ken, Hunter (ssytemic 6)

Posted October 6, 2004 · October 6, 2004

Darlene,

I would ask to be referred to a rheumatologist, or if your insurance

does not require a referral, just go see one. With an elevated RA

factor and joint pain, you need to be evaluated further by a

specialist. It is difficult to diagnose RA, because there is no one

test to say you have it or to rule it out.

RA is diagnosed by monitoring your blood work, your symptoms and if

you are suspected to have RA, trying some RA drugs and seeing how you

respond. You are best served by having this evaluation done by a

rheumatolgist, as this can be a difficult disease to treat.

Jennie

>

> Hi everyone and thanks for letting me join the group! I'm Darlene,

49 yrs

> old and I am confused. I was diagnosed with Fibro about 12 yrs ago

and in

> the past year have started having joint pain and stiffness in

multiple

> joints. I went to my PCP and he did some labs, including an

arthritis panel.

> He told me at the visit that I have arthritis.

>

> When the labs came back, the RA factor was elevated and the nurse

called to

> tell me but just said there was some inflammation going on and to

keep

> taking my celebrex. I tried to question her but couldn't get any

answer

> other than -- it could be RA and might be something else. No follow

up or

> anything.

>

> I couldn't sleep last night because i kept thinking about it. I

feel like I

> need more info than my doctor is giving me. Do you think I should

go to

> another doctor or should I just sit back and see what develops?

I've heard

> that early treatment improves outcome but maybe it's too early to

make the

> diagnosis. I don't know what to do or think.

>

> Thanks,

>

> Darlene

>

Posted October 6, 2004 · October 6, 2004

Yeah, I agree with Jennie. I know some primary doctors (and even

some rheumatologists) take the position of " well, it could be, but

let's just wait and see if it gets worse. " The problem is, it takes

most people many months to get in to see a rheumy for the first time

and most of the medications take several more weeks/months to start

being effective.

My primary doctor made an appt for me with a rheumatologist after an

initial bout of joint pain, even though he (primary) didn't think I

had RA at the time. (I also had a positive RF.) By the time my appt

came six months later, I was having no pain and no swelling, and

almost cancelled the appt, but I decided to go anyway since it's so

hard to get that initial appt. My rheumatologist put me on Celebrex

and told me to come back in three months or so. Just a few weeks

before the second appt, I started to flare big-time. My doctor put

me on Plaquenil, Prednisone, and eventually methotrexate. I still

had to wait several weeks to get the pain under control, but if I

hadn't had that intial appt at the rheumy doctor's, I'd probably

still be waiting for some relief. So in my opinion, if you've got a

positive RF and you've had some joint pain--even if it's not bad at

the moment--it's good to get your foot in the door with a

rheumatologist.

Oh, and by the way, welcome to the group. :-)

> >

> > Hi everyone and thanks for letting me join the group! I'm

Darlene,

> 49 yrs

> > old and I am confused. I was diagnosed with Fibro about 12 yrs

ago

> and in

> > the past year have started having joint pain and stiffness in

> multiple

> > joints. I went to my PCP and he did some labs, including an

> arthritis panel.

> > He told me at the visit that I have arthritis.

> >

> > When the labs came back, the RA factor was elevated and the nurse

> called to

> > tell me but just said there was some inflammation going on and to

> keep

> > taking my celebrex. I tried to question her but couldn't get any

> answer

> > other than -- it could be RA and might be something else. No

follow

> up or

> > anything.

> >

> > I couldn't sleep last night because i kept thinking about it. I

> feel like I

> > need more info than my doctor is giving me. Do you think I should

> go to

> > another doctor or should I just sit back and see what develops?

> I've heard

> > that early treatment improves outcome but maybe it's too early to

> make the

> > diagnosis. I don't know what to do or think.

> >

> > Thanks,

> >

> > Darlene

> >

Posted October 6, 2004 · October 6, 2004

Thanks Jennie,

So far, everyone i've asked has said the same thing. I need a referral to go

to a rheumatologist and I am hesitating to ask my PCP. I've been very

anxious all day trying to decide if I should go to another doctor for a

second opinion or try to open communication with my existing doctor. I've

been going to him for less than a year and he is always in a hurry and seems

to minimize everything. I don't even have a follow-up appointment and don't

know what he expects me to do. The nurse just said to keep taking the

celebrex. End of conversation. I had to take an ativan earlier because I was

approaching a panic attack. I have an appointment with my psychiatrist next

friday and if I can wait that long will ask her opinion about the labs and

my situation. She has a copy of my lab work.

It is stressful to switch doctors. I don't know what to do.

Darlene

-- [ ] Re: new member

Darlene,

I would ask to be referred to a rheumatologist, or if your insurance

does not require a referral, just go see one. With an elevated RA

factor and joint pain, you need to be evaluated further by a

specialist. It is difficult to diagnose RA, because there is no one

test to say you have it or to rule it out.

RA is diagnosed by monitoring your blood work, your symptoms and if

you are suspected to have RA, trying some RA drugs and seeing how you

respond. You are best served by having this evaluation done by a

rheumatolgist, as this can be a difficult disease to treat.

Jennie

>

> Hi everyone and thanks for letting me join the group! I'm Darlene,

49 yrs

> old and I am confused. I was diagnosed with Fibro about 12 yrs ago

and in

> the past year have started having joint pain and stiffness in

multiple

> joints. I went to my PCP and he did some labs, including an

arthritis panel.

> He told me at the visit that I have arthritis.

>

> When the labs came back, the RA factor was elevated and the nurse

called to

> tell me but just said there was some inflammation going on and to

keep

> taking my celebrex. I tried to question her but couldn't get any

answer

> other than -- it could be RA and might be something else. No follow

up or

> anything.

>

> I couldn't sleep last night because i kept thinking about it. I

feel like I

> need more info than my doctor is giving me. Do you think I should

go to

> another doctor or should I just sit back and see what develops?

I've heard

> that early treatment improves outcome but maybe it's too early to

make the

> diagnosis. I don't know what to do or think.

>

> Thanks,

>

> Darlene

>

Posted October 7, 2004 · October 7, 2004

Darlene,

Do feel it is stressful to switch doctors because you think the

doctor will take it personally? I don't believe he will. He

probably has so many patients that he can't care for them properly.

My guess that he knows this deep down, and would change the situation

if he could. Our health system in this country makes it hard for

doctors to practice the way he wants.

Write down what you want to ask him. Remember, he is not an

important person in your life, and if he gets offended you are

asking, you don't ever have to see him again. Consider something

like this:

" I would like a referral to a rheumatologist for a second opinion "

Think about the response you might get from the nurse or doctor.

They might object. They might say, " Why " and you can say, " The

friends and family I spoke with think it's a smart idea to get a

second opinion, and I agree. " My guess is they'll just give it to

you. But if they don't, just say well then I will be switching to

another PCP and end the conversation. You don't have to worry what

they think. You won't be the first patient they've lost and you

won't be the last. Even good doctors loose patients for all kinds of

reasons. It isn't a reflection on you or him.

You can do this. People ask for second opinions all the time - it's

expected. And you really need it.

Jennie

> >

> > Hi everyone and thanks for letting me join the group! I'm

Darlene,

> 49 yrs

> > old and I am confused. I was diagnosed with Fibro about 12 yrs

ago

> and in

> > the past year have started having joint pain and stiffness in

> multiple

> > joints. I went to my PCP and he did some labs, including an

> arthritis panel.

> > He told me at the visit that I have arthritis.

> >

> > When the labs came back, the RA factor was elevated and the nurse

> called to

> > tell me but just said there was some inflammation going on and to

> keep

> > taking my celebrex. I tried to question her but couldn't get any

> answer

> > other than -- it could be RA and might be something else. No

follow

> up or

> > anything.

> >

> > I couldn't sleep last night because i kept thinking about it. I

> feel like I

> > need more info than my doctor is giving me. Do you think I should

> go to

> > another doctor or should I just sit back and see what develops?

> I've heard

> > that early treatment improves outcome but maybe it's too early to

> make the

> > diagnosis. I don't know what to do or think.

> >

> > Thanks,

> >

> > Darlene

> >

Posted October 7, 2004 · October 7, 2004

Jennie,

I have been giving a lot of thought to what you said and I think you are

right.

I think I'm afraid that I will over-react and ask to see a rheumy when I don

t need one. My pain levels are low today but I have been so fatigued. I

slept almost the entire day. i would get up for 20-30 minutes and then lay

back down and go to sleep.

I think I will wait a few days and see how things look then. I'm reading

every post and getting lots of info. I am emotionally drained right now and

need to get back to clear thinking. I feel like I'm not making much sense

right now. I just wanted to let you know that I appreciate your

encouragement! I wish there was a more clear-cut diagnosis for RA. Not

knowing is really hard...