ALTERNATIVES TO SURGERY ALSO TYPES OF TREATMENT

This disease can strike youngsters as well as adults. Treatment options include surgery to replace damaged joints.

Once you have juvenile arthritis, there is a 50/50 chance you will have it as an adult, according to Janna Zeltwanger, who has lived with the disease for 33 years.

It also can go away, Zeltwanger explained. "It's so variable because some kids will get arthritis in one joint, and if they've gotten it under control with medication, they may never have to continue on medicine and might be fine. And then there's other kids who do have to stay on medication for the rest of their life.

"If the disease has been pretty difficult as a child, you're going to have it as an adult, because it's already worn away the cartilage of your bones, and you're going to have bones rubbing against bones. The older you get, the more degeneration you have with it."

Surgery is one option

Surgery is one way to replace the joints that have been damaged by the disease.

"I've had the surgery, and when they told me that they could do surgery and that I could walk without pain, (I was) very glad about it, because now something can be done. Some people are very frightened and don't choose to have surgery because a lot of the things are things you can choose to have or choose not to have, similar to having braces," explained Zeltwanger.

"It's a lot harder on young children to have some of the surgeries, because it means being in the hospital away from your families and being away from school and maybe being at home more and not being able to do some of the activities after school that you want to do."

The joint replacements don't last forever. Often you might have to have surgery again in 15 or 20 years. Doctors are doing tests, however, on surgeries where they try to put back into the bones some of the cartilage that has been worn away.

Other alternatives to surgery include splints and braces, both of which Scott Richey uses. He uses splints to keep his wrists from moving; the braces do the same thing for his ankles.

"I wear my splints all the time," explained Scott, "about 20 hours a day. I have to wear these every day, but I don't have to wear my braces every day, only about six times a week."

Since he has had rheumatoid arthritis, he can no longer bend his wrists back and never will be able to. The splints keep the condition from worsening.

On Scott's first day of school, all of his classmates got together to learn about rheumatoid arthritis and his braces and splints so they wouldn't feel uncomfortable around him. Now they pamper him when he isn't feeling well.

Types of medication

The treatment program for rheumatoid arthritis includes medication, exercise and sometimes a special diet. Medicines can include aspirin, liquid gold salt and steroids. Usually treatments start with a fast-acting medicine like aspirin, which has few side effects. If that is ineffective, stronger medicine is prescribed. Common side effects for all arthritis medicines are nausea, skin rashes, kidney problems and blood disorders.

Exercise also can be very important to the treatment to keep the muscles strong and the joints flexible. A special diet including balanced portions from the five food groups can help arthritis sufferers avoid the two main diet problems associated with their disease: excessive weight gain and a poor appetite leading to weight loss or a lack of essential nutrients.

Arthritis is the No. 1 crippling disease in the country affecting adults and children. Feelings of blame and guilt sometimes plague children with the disease because they feel that they are alone in the world and no one else feels the same pain.

But coping with the disease can make them stronger people.

"You get to a point where you decide that there are people who are worse off than you are and that you're glad that this is all you have to deal with. (It) does make you a better person," explained Zeltwanger. "You learn to be more grateful for things that are important in life, not just the physical things."