August has definitely not been the month of great progress for this girl with her JA.  Earlier this month we increased her dose of Orencia.  She had been in so much discomfort that we and her previous Rheumatologist believed this to be the next step.  So luckly when she was first placed on Orencia her Rheumatologist sent in her prior approval to the insurance for the higher dosage so we really didn't have a delay in receiving her higher dosed meds.  As you can see in the picutres she was extremely happy when the medication arrived.

Last week we met her new Rheumatologist here in North Carolina.  She really liked him and felt like he listened to her and made her feel comfortable even if she wasn't the most forth coming with her current level of pain.  No worries, the new Rheumatologist was extremely thorough and had no trouble finding all of her "bad" spots.  It was discovered during her exam that she has visibly active arthritis in both of her knees, and in five fingers (two on her right hand and three on her left).  Normally this would type of visit would end with a change in plans for her medications and overall treatment plan but not this time.  Right now he is choosing to keep her on the higher dose of Orencia, mainly because we were only two weeks into the higher dose and this medication is very slow reacting.  So for now his plan is to have her continue the course and return in six weeks (normally we visit the Rheumatologist once every three months) and see how she is after two full months on the higher dosage.  He also indicated that he would like to get her started in some physical and/or occupational theraphy as well once we get some control over the arthritis.  She is definitely back sliding in her overall battle and it's been a very hard thing to watch.



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