A Friend’s Trouble

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When one of your friends is diagnosed with a debilitating autoimmune disease, you want to help!  You want to find out everything you can so you can support her through the illness. What exactly is an autoimmune disease? How did she get it? What kind of treatment can she have to fight it? Is there a cure? What can you do to help her deal with it?


Why is Emily so quiet lately? Walking to the cafeteria table you see her, and yet again, she’s just sitting there, staring at her lunch tray or outHigh school girl playing a guitar in a school band the window. What is going on, you ask yourself, for the hundredth time?

This is NOT like Emily.  Your best friend is always talking, laughing, joking around, or running off to her next soccer practice, band practice, or art class.  You’ve never known her to be like this.

You have asked her what was wrong so many times!  She says “nothing” and when you told her you didn’t believe it, she said she was just tired.  Nope, you’re not believing that, either. You know something’s wrong.

Three high school girls at soccer practiceNow that you think of it, she has missed a few soccer practices.  She seemed distracted in jazz band practice and since you sit near her as she plays her guitar, you know she hasn’t really been playing well much of the time. That’s not like her at all.

You are determined to get to the bottom of it!

You don’t have to wait long. You were planning on talking to her about it again that evening and when you found her crying in the restroom, you knew it had to be bad.

Emily told you that she had been so tired that her mom insisted she go to the doctor. At the doctor’s appointment, she finally had to admit that she hadn’t been feeling well for a while. She also had to admit to the pain that has had her pretty scared. The doctor did an exam, ordered some tests, and said he would call with the results. When he called, he had ordered more tests—x-rays this time.

Then, last week, the doctor asked her parents to come to the office with Emily to discuss the results of the bloodwork and x-rays.  The physical exam results had suggested and the test results confirmed that Emily had juvenile rheumatoid arthritis—an autoimmune disease.

You are in shock!  Arthritis?  Your grandma has arthritis; only old people get arthritis, right?

Emily starts to tell you what has been happening with her. She kept it secret so long. She was really scared and hadn’t even told her parents until it got bad. It started when she was playing soccer and it got too painful to run down the field. Next, she started having trouble playing her piano; her fingers were so stiff and sore that she couldn’t even play music she had already learned. Playing her guitar was getting more difficult, too.

Her mom started asking questions when Emily didn’t want to go on their regular walks. The two of them had always enjoyed the exercise and their talks.  Emily was too tired and too achy for that kind of walking now.

By this time, you were afraid to find out about juvenile rheumatoid arthritis. Emily explained that juvenile rheumatoid arthritis was not the more common type of joint stiffness and pain that elderly people get. It was an autoimmune disease.

Emily said she was embarrassed and didn’t know what her friends and the people at school were going to think when they heard. She was at a point where she couldn’t hide it anymore. She can’t play soccer when it hurt just to walk. What excuse could she use for quitting the team? Was she going to have to quit the band? Would she have to give up playing the piano? Going for walks? Just today, her hands hurt after holding a paint brush during first period art class. Would she have to drop art?  What would people think? Would they think she had an old people’s disease? Would they think it was catchy?

No wonder Emily was crying.

You and several of Emily’s friends decide to find Three female friends sitting on a bench outsideout as much as you can about juvenile rheumatoid arthritis.  You want to understand what she has, how she got it, and what treatment she could have to make this more bearable. If you know more about it, you can help Emily through this. You think her life may have to change a little, but that doesn’t mean she has to go through this alone.  And if people at school knew something about what Emily was going through, you are sure that everyone would understand.  Emily wouldn’t have to worry so much! You and Emily’s other friends also think that making the effort to learn all about Emily’s illness will show her how much all of you support her.

Emily and her parents give their permissions to discuss her condition and her progress with students and teachers at the school.

You know there’s a lot to find out and you know it’s serious. What exactly is juvenile rheumatoid arthritis? What is an autoimmune disease? How did Emily get it? What kind of treatment is used to fight it? Is there a cure? How bad can it get?

Obviously, you need to research this condition if you’re going to help Emily.


Your Tasks

  • Decide on a plan to help Emily inform the other students about her condition and make her student life at school easier. Be specific with your ideas.
  • Make a presentation that will provide information about juvenile rheumatoid arthritis, autoimmune diseases, and the plan to help Emily at school.
  • To be able to explain Emily’s condition, you must have a thorough understanding of the immune responses occurring in her body.
  • Be able to explain her condition using correct terminology, including antibody vs autoantibody, immune responses, and autoimmunity.
  •  Research juvenile rheumatoid arthritis to prepare for your presentation. You can use any kind of presentation aid available to you, including PowerPoint. (Your teacher may have other requirements.)
  • Be prepared to answer the questions presented in this module.
  • Be prepared to answer the questions from your classmates or teacher as they play the roles of other students or teachers at the school who will be interested in finding out about Emily’s condition and in helping her cope with it.
  • Based on the results of your classroom role-playing intervention, evaluate how effective your plan was in helping students and school personnel understand Emily’s challenges and in helping Emily cope with her illness. What could you have done differently? What else could you do that may help?

Guiding Questions

  1. What is juvenile rheumatoid arthritis?
  1. How did Emily “get it”? How do people get autoimmune diseases?
  1. How is the immune system supposed to work? What has gone wrong in Emily?
  1. What other diseases are autoimmune? Name and describe at least three. Are all symptoms of the different autoimmune diseases the same? Explain your response.
  1. What are the symptoms of juvenile rheumatoid arthritis?
  1. What kinds of treatment are used?
  1. Is there a cure? Explain your response.
  1. What is the incidence of this kind of autoimmune disease?
  1. What kinds of populations or age groups does this disease usually affect?
  1. What is Emily’s prognosis (the likely outcome of a health condition)?
  2. What plan would work best in informing other students and school personnel about Emily’s condition and challenges that result? Do you think your plan would work for most school populations or is your plan specific to your school? Explain your response.

    How will you determine if your plan is effective?