Instinct often speaks louder than words in motherhood. This is what led Lakshmi, a devoted new mother, to bring her usually happy, active, 17-month-old baby girl to the doctor. It all began with a series of subtle physical signs the toddler was exhibiting. Was Lakshmi being overly cautious as a first-time mother, or was there something wrong with her baby? After thorough examinations and tests, a serious diagnosis transformed this family’s world.
Lakshmi and her husband were elated when their first child, who they delivered at Washington Health, arrived healthy and without incident. “My pregnancy and her birth went smoothly. She was no trouble at all,” said Lakshmi. They relished watching their beautiful baby grow and learn to walk, talk and play. She was healthy and full of joy, but after her first year, a few issues started to appear.
The baby began to wake up fussy in the mornings and seemed a bit stiff for the first 10 – 15 minutes. But maybe that’s normal for a growing child, or perhaps she just was not sleeping well? It seemed like she had a slight limp after waking up, but soon, she was back to her normal self—actively playing all day. She developed dry skin, but then, it was cold in January, so Lakshmi was advised to apply moisturizer to what seemed to be a case of eczema. The baby also had a bout of pink eye, but again, that is not unusual for curious young children who touch everything then rub their sleepy eyes, right? Something shifted, however, when the dry skin changed to more of a rash and Lakshmi noticed one of her baby’s legs felt stiff and would not straighten out all the way. Her maternal instinct took over. Something was not right, so she sought medical help.
Lakshmi brought her baby to Washington Health to see Shilpa Jayaramaswamy Sulochana, MD, since her baby’s pediatrician Bhaskari Peela, MD, was out that day. Dr. Sulochana did not suggest a “wait and see” approach; instead, she immediately ordered blood tests, lab markers and imaging on the very first day. Thereafter, Drs. Sulochana and Peela worked together on the case. An X-ray showed swelling around the baby’s knee joint and a DNA antibody test and other markers came back positive. Lakshmi’s baby was diagnosed with juvenile idiopathic arthritis (JIA), which came as a shock for this new family.
JIA, characterized by inflammation and stiffness in the joints, can be daunting for children and parents alike. The most common type of arthritis in children, it is an autoimmune disorder causing persistent joint pain, swelling, and stiffness. Symptoms can also include fevers, rash, eye inflammation, and stiffness upon waking. While the exact cause is unknown, early diagnosis and treatment are crucial to prevent permanent damage. This diagnosis required courage and resilience, but it also came with hope.
A Network of Support
Lakshmi’s baby was referred to a pediatric rheumatology specialist at UCSF Benioff Children’s Hospital in Oakland, who met with the family the following Tuesday. With their families overseas, though Lakshmi and her husband have a strong circle of friends, they lack immediate family support in the Bay Area. However, the medical team, made up of the UCSF rheumatologist and Washington Health pediatricians, provided both advanced medical expertise and emotional support to the family.
“Lakshmi and her husband were shocked at the diagnosis because there is no family history of JIA that they know of and she had always been such a normal, happy baby,” Dr. Peela said. “We educated them about JIA, assured them it was not because of anything they did, and praised them for following their instincts which thankfully led to an early diagnosis.”
Lakshmi’s baby began a treatment plan that includes weekly shots of an immunosuppressant medicine called Methotrexate and an oral anti-inflammatory. There is currently no cure for JIA, but it is a highly manageable condition. With early medical intervention, and aggressive therapies, most children achieve long-term remission (periods with little to no symptoms) and can live normal, active lives.
“Our daughter is so young, and we were weary about giving her injections at home, so Dr. Peela invited us to bring her to Washington Health every week for her shot,” said Lakshmi. “One Friday we couldn’t go in, so we gave her the shot at home. On Saturday – Dr. Peela’s day off – she called me to make sure our girl had received her medication. That is how thoughtful, compassionate and caring Dr. Peela is.”
The baby girl is now nearly 2 years old and thriving. With a combination of effective medication and her supportive family, she is back to joyfully exploring, full of energy and curiosity — now free of pain. This is a result of consistent, dedicated care every single week.
“I call Lakshmi regularly to check in and make sure everything is going well for her baby and the family,” shared Dr. Peela. “I tell her she is a wonderful mother and did everything right. Receiving this diagnosis and navigating all that comes with it is tough. I remind parents they are the soul builders for their children. They need to stay strong so their child can recover faster and sense their confidence that everything will be all right.”
For Lakshmi, witnessing her daughter’s resilience is a profound reminder of the power of maternal intuition and the importance of seeking support. When it comes to our children, that little voice that says something is not right can lead to life-changing discoveries.
For more information on Dr. Peela, go to www.washingtonhealth.com/find-your-physician/bhaskari-peela-md/