P rofile
Noshini’s story: One family’s journey with JIA Being diagnosed with arthritis at any point is challenging, but to have a child diagnosed at a tender age of 3 turned one family’s life around into a testament of dedication and determination.
N
oshini was only 3 years old when she was first diagnosed with arthritis. Her mother Rajamah recalls, “She had been having fever intermittently for about two weeks. My mother, who was looking after her at that time, also noticed that she had some discomfort in one knee as when she woke up in the morning, she would drag her leg as she walked. On closer examination we realized that there was some swelling in her knee.” But they were still not prepared when the pediatrician, after doing a blood test and X-ray, said she had juvenile arthritis. Her father, Saravanan says, “We were shocked as nobody in our family, including Noshini’s grandparents had arthritis. In fact, Noshini’s great-grandmother is 95
years old and still very healthy! Was it something we ate? Medication? Air? How could this happen?” The pediatrician immediately referred them to Dr. Tang Swee Ping at Hospital Selayang, who at that time was the only trained pediatric rheumatologist in the country. It has been a long journey since that fateful diagnosis. Today, almost a decade later, Noshini, 13, is a bright, cheerful and active child whose arthritis is well controlled. In fact, at her last reading, her blood level readings were normal. And the credit goes completely to her dedicated parents and committed team of doctors who have stood by her every step of the way.
The dedicated approach
Faith in the doctors: In my conversation with Noshini and her parents several aspects stood out. First, that they had complete faith in their doctors and followed their instructions to the tee. Log book: Another aspect that stands out was their meticulous approach to Noshini’s treatment plan. Saravanan proudly displayed his “log book” where every single doctor’s visit; from the very first visit ten years ago, to the last one a week before our interview and every single medication prescribed, has not just
“There were many people who offered us unsolicited advice; from drinking energy juices to taking vitamins and supplements that boosted immunity to trying alternative therapies like ayurveda and other massage treatments. But we stubbornly stuck with our doctor’s advice and always referred back to her when we came across any information.” Saravanan, Noshini’s father
16
JOINT EFFORTS / APRIL 2016
been noted in detail but also signed and attested by the doctors at the end of each visit! Eye health: As there is always the risk of developing uveitis (eye inflammation), and in Noshini’s case cataracts (a clouding of the eye’s natural lens), due to long term steroid usage, she has an eye checkup scheduled every year. Physical activity: From the age of 7, Noshini has been having a physiotherapy session every month as initially she had trouble bending the affected knee to squat. Her parents encouraged her to be active and play sport. Says Saravanan, “When she cycles, I jog alongside her. Whenever she has no tuition or other activities, I encourage her to be active. Besides cycling she also plays badminton once a week. She also has a session with the occupational therapist once a month where she works with soft balls, terra band etc. Nutrition: On the doctor’s advice, she has a diet with lots of fruits and vegetables every day and her junk food intake is monitored. Because of her medication, Noshini had gained weight. So they had to be very particular about her diet and exercise to manage it. Medication: For many years Noshini was on Methotrexate and steroids. She had to cope with the side effects of that which included weight gain, nausea and tiredness. She also had to deal with taking her injections every two weeks. Two years ago she shifted to biologics, which is also administered through an injection every two weeks. This has helped her tremendously. Her weight has normalized and her energy levels have improved as her tiredness and pain has reduced. Concludes Saravanan, “We are very proud that despite having to take strong medication everyday and cope with its side-effects, she got 5A’s in her UPSR exams. We would like to express our deepest gratitude to Dr. Tang Swee Ping, Dr. Lim Sern Chin and Dr. Cham Weng Tarng for their dedicated care all these years. Their support has been invaluable.”