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Bradley

Age at interview: 14
Age at diagnosis: 12
Brief Outline: Bradley has enthesitis-related juvenile idiopathic arthritis. Initially he struggled to find a diagnosis and paid privately to see different doctors. His arthritis is under control and he has a good relationship with his medical team. Bradley does not let arthritis get him down.
Background: Bradley is at school studying for his GCSEs. He lives with his parents and sister. He has is white British.

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Bradley has enthesitis-related juvenile idiopathic arthritis. Bradley takes a 20mg injection of methotrexate once a week. He takes folic acid (5mg) 24 hours after his injection. Bradley also takes diclofenac as and when needed. When he takes diclofenac he also takes lansoprazole (30mg) once daily.
 
Bradley first experienced an achy arm and an achy, swollen ankle. He went to accident and emergency twice but was told nothing was wrong. Bradley’s groin became badly swollen and he was limping. His parents paid privately for a consultation. The first consultant advised that Bradley should undergo keyhole surgery. Bradley’s parents were unhappy about surgery so paid to see a second private consultant. The second consultant gave Bradley an MRI scan which revealed that Bradley had fluid in his groin. Bradley needed more tests and spent a week in hospital under observation. Although there was no rheumatoid factor in Bradley’s blood, his doctor still suspected that he had arthritis and referred him to a rheumatologist in a different city. After further tests, the rheumatologist diagnosed Bradley as having arthritis.
 
Bradley has been taking methotrexate to help control his arthritis. Bradley says that he has a good relationship with his doctors and nurses and finds his consultations (particularly with his hospital optician) relaxing. A nurse comes to his home once a week to give him his injection. Since being on this medication his condition has improved lots and he describes himself as being able to lead a more active lifestyle. The swelling in his groin has gone down and he can walk without limping in pain. Bradley has never liked having his weekly injections or blood tests but over time he developed strategies to help overcome his needle anxiety, such as playing on his PlayStation 3 until the moment he is required to have his injections, not looking at the syringe and reminding himself that it is for the best. When Bradley feel aches and pains he says that he “just gets on with it” and never lets his discomfort get in the way of socialising or taking part in sport.
 
 

Bradley finds blood tests difficult because he does not like needles. He has had lots of blood...

Bradley finds blood tests difficult because he does not like needles. He has had lots of blood...

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I’m a terrible patient and I was going mad when I was told I had to have blood tests ‘cause I’m not too keen on needles. But I just sort of sit there, just let them do it so then it’s over quickly. I don’t know, I didn’t at the time know what the blood tests were showing, but since having methotrexate they have to do sort of six weekly, eight weekly blood tests, and you have a blood card and you record it, and you know what, and I know what the stats are for. So there’s like two for information, some for platelets, white blood cells, and all that sort of thing. And they even show if I’m getting a cold and you can tell just by looking at the numbers and the change.
 
Wow I didn’t know that. So are you quite, so you can monitor your own blood?
 
Yeah
 
In a way?
 
Yeah, kind of yeah. And my information at the time, one of the stats was something like 40, and it’s now less than 5, so it’s come down quite a long way since going on methotrexate.
 
So okay then. Did anyone teach you to read those blood charts?
 
Well it’s just like you have labelled at the top and it just has the number underneath it, then you can just look down the columns and you can tell which is which.
 
And there’s like guidelines what they should be in between. So that you can tell if they’re good or not, just by looking at that.
 
 

Bradley was “relieved” to know what was causing the pain and swelling in his joints. Being...

Bradley was “relieved” to know what was causing the pain and swelling in his joints. Being...

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Yeah, once I found out sort of what it was and what it, what actually happens inside my body. I don’t know if it is similar, like what actually happens to what would happen in grandma or grandpa or whatever, but I know that it, it probably won’t last with me forever. I’ve got a 60% chance of growing out of it, or the treatment stopping it completely. 
 
So yeah I’m not really worried, and if I have it for the rest of my life, I have it for the rest of my life. So what. It doesn’t affect me. I can just get on with it. Got the title, that’s it.
 
Were you kind of shocked that you actually had that title of arthritis? When somebody said this is what you’ve got?
 
Well actually I was quite relieved to know what I actually had and that it could be treated and I wouldn’t feel like that for much longer because then I got, I was on painkillers and methotrexate which kicked in quite quickly.
 
And since then I’ve never really had any muscle, like pains or anything like that other than just a few twinges after I’ve walked a long way. And that’s it; it doesn’t affect me in any other way.
 
 

Bradley's blood was taken at home by a community district nurse who also gave him his...

Bradley's blood was taken at home by a community district nurse who also gave him his...

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Well it’s made easier for me sort of as time’s gone on to sort of come up with some rules with the nurse. So like what I would do is I would be in my room, even when the doorbell goes I’ll stay in the room, as soon as she’s ready she’ll have the spray in her hand, like the cold spray to numb the area, and the needle in the other hand. I’ll run downstairs, sit down, say, “Go as quickly as you can.” Put my arm out, done. And I do the same for my injections as well ‘cause it’s less stressful and it can be over with more quickly and, and that’s it for another week or six weeks in terms of blood tests.
 
So the blood tests are in your home, here?
 
Yes and my methotrexate injections too.
 
And is it easier to have blood taken here or at the hospital?
 
I think it is easier taken here because you can just do your own thing, when the doorbell goes, go down, that’s it, carry on, don’t have to wait about really cause you’ve got stuff to get, I’ve got stuff to be getting on with anyway, and, and Mum doesn’t want to have to drive up to the hospital, sit and wait, come home, she could be doing dinner or watching the telly. There’s so much more you could be doing rather than sitting in a hospital and waiting for a two second thing.
 
Okay and in terms of the methotrexate, does a nurse give that to you? Is that a nurse that comes over?
 
Yeah, Community District Nurses. Yeah.
 
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