it
might be a reaction to too much
sun exposure. He put her on
cortisone and advised staying
out of the sun. Although San
Nicolas followed this advice,
there was no improvement.
Kendyl's cheeks turned a bright
red, and she developed foot
pain. She also became more
tired, and all her cuticles
became painful and seemed to be
infected.
San Nicolas learned later
that the cuticles weren't
infected. Instead, the disease
was causing the blood vessels to
atrophy. When Kendyl's cuticles
grew, they turned brown from
lack of blood flow.
After another false
diagnosis, San Nicolas was
referred to a San Francisco
specialist who confirmed JM
through a blood test. It is not
uncommon for doctors to
misdiagnose JM sufferers since
the disease is so rare that most
doctors won't encounter it
during their careers.
Although Kendyl had a
difficult time taking her pills
and dealing with medication side
effects, she responded well to
treatment. Now approaching her
eighth birthday and another year
at Franklin Elementary, Kendyl
is symptom-free. Her disease is
in remission, meaning she has
been off medication for at least
a year. San Nicolas is still
cautious, however, because
relapses could happen at any
time.
One-third of JM sufferers
will go into permanent
remission, one-third will enter
remission and suffer relapses
and one-third will always be on
medication. JM affects each
patient differently. Some have
mild symptoms while others might
die as a result of the disease.
"I will always worry about
it," says San Nicolas. "As a
person who never got sick, I
thought it was just a rash. But
it was something terrible. Now I
question everything. If she gets
sick, I wonder if it will
trigger (the disease). What
happens when she grows up and
gets pregnant; will it trigger
something?"
San Nicolas was able to
provide much-needed support when
Suzy Clement's daughter was
diagnosed with JM. Mielle, also
a Franklin student, started
having red blotches on her
cheeks in early 2007. By fall of
that year, the
six-and-a-half-year-old had
developed muscle weakness and
soon couldn't walk far without
getting tired. To walk up
stairs, she had to pull on the
railing or push on her legs. Her
parents, Clement and Lenny
Gonzalez, thought her
kindergarten schedule might be
wearing her out. But soon,
Mielle couldn't go up stairs at
all. She wasn't able to get up
off the floor without crawling
to a piece of furniture and
using it to push herself up.
Initially suspecting lupus, her
doctor referred her to a
pediatric rheumatologist. The
diagnosis was JM.
Mielle initially responded
well to treatment. But the drugs
commonly used to treat JM are
strong with powerful side
effects. Mielle began a high
dose of the corticosteroid
Prednisone, which can cause mood
swings, increased appetite and
weight gain, altered weight
distribution, bone density loss,
stunted growth, high blood
pressure and cataracts. She also
began Methotrexate (a
chemotherapy drug when used in
higher doses), which can
partially take the place of
corticosteroids after it has had
time to build up in the body.
Mielle has experienced
various plateaus during the
course of her treatments. She
switched doctors and now goes to
Stanford every week for
intravenous injections of
Methotrexate. She is also on
Prednisone and Cyclosporine, an
immuno-suppressant drug
typically used in organ
transplant recipients to prevent
rejection of a new organ.
Although her strength has
improved and she is occasionally
able to ride her bike for brief
periods, she still has a facial
rash and signs of active
disease, such as inflammation.
Her weekly treatments often
leave her so exhausted that she
needs to sleep most of the
weekend. She also deals with
mood swings and anger, a side
effect of the Prednisone.
"Mielle recently told me, 'My
brain feels like it wants to
jump out of my head and beat
someone up,'" said Clement.
One problem of dealing with
an uncommon disease is that
treatment methods vary, and
effectiveness is not guaranteed.
"There's no standard protocol
of treatment," said Clement.
"Every case and every kid is
different. Kids don't respond to
treatments the same way. So your
kids start to feel like an
experiment. Your 6-year-old is
taking a combination of toxic,
lethal chemicals, but that's
what we have to do. It's bad
enough knowing your kid has this
disease and she has to undergo
this treatment with horrible
side effects. But we don't know
if it's going to work or if what
we're giving her is right."
Next month, the Gonzalez
family, which includes
16-month-old brother Lucien,
will travel to Chicago to seek
more aggressive treatment from
one of the few facilities
specializing in JM. Even in a
best-case scenario, Mielle will
be under treatment for at least
two to three more years. Her
medical bills are costly for
self-employed photographers
Clement and Gonzalez, who pay
completely out-of-pocket for
their medical insurance.
This Saturday, the Gonzalez
family and friends will host a
multi-family yard sale that
includes a wide variety of items
donated by community members.
Proceeds will help pay for the
Gonzalez family's medical bills
and a portion will go toward JM
research.
Items for sale include toys
and other items for babies and
children, furniture, clothes and
bikes, and more. Friends of the
family, who are musicians, will
be playing for tips, and Mielle
will be hosting a lemonade
stand.