it can always be better; it can always be worse

My son twisted his knee about 6 weeks ago.

He tried to stay active but it kept feeling worse.

After about a week, we took him to an orthopedist to look him over.

An MRI was ordered and a secondary referral was made for a rheumatologist to rule out some other symptoms that could have been caused by something like Lyme Disease.  Blood tests were taken and more doctors appointments were scheduled.

None of the symptoms were clear cut signs of typical injuries but all roads led us to Juvenile Idiopathic Arthritis.  JIA is fancy terminology for joint swelling with no known cause.  It seems like it might be a type of auto immune disease, but many kids outgrow it.  It can be treated with anti-inflamatories, steroids, and if there is no improvement there are oral therapies which carry some risk of compromised immune systems.

As a layperson, I was calm with the diagnosis.  I have an attitude of “don’t worry until it is time to worry”.  My wife on the other hand who is a pediatrician has been running through every differential diagnosis and extrapolating each outcome in her mind.  It has been very exhausting for her to find balance between mother and physician.  I feel happier being less informed and taking the treating physicians words at face value.

As we were wrapping our most recent appointment for our son, my wife was on her electronic medical records system for her practice.  She noticed a new note for a patient with some unexplained weight loss.  As differential diagnoses were being worked through, the path led them to a mass in the chest.  She was heartbroken.  At a time when she was so upset about her own son, a patient family just learned that their world was turned upside down.

Her thoughts went to the family of the boy.  She knew what they were in for.  The fear of the unknown and the upcoming pain and discomfort made her reconsider our personal situation a bit.

While she was crestfallen that her patient was ill, she also was able to take a moment to reflect upon our own son and recognize that while things can always be better, they can also be worse.


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