Understanding Juvenile Idiopathic Arthritis (JIA) Audiobook
Eleanor has an invisible illness. She doesn't know why she feels too sore to play soccer with the other kids. The Medikidz take her on a journey through the human body to help her understand the symptoms of juvenile idiopathic arthritis (JIA), and explain this chronic illness to her friends. Listen to this audiobook version of our award-winning comic book Understanding Juvenile Idiopathic Arthritis (JIA).
Rebecca: Hi there and welcome to a special audiobook installment of Jumo’s In My Words podcast series.
At Jumo, we produce everything from comic books that explain difficult medical conditions, to videos where families share practical insight and their stories of hope. Learning how to manage life after a diagnosis can be stressful and confusing, and we aim to make that a little easier.
Ok, let’s get started! Today’s story comes from our Understanding JIA comic book. JIA stands for Juvenile Idiopathic Arthritis. Eleanore is upset. She’s too sore to play soccer with the other kids in gym class, but she’s not really sure why. But after a quick trip with the Medikidz through a human body with JIA, she’s able to understand what’s going on inside her body and explain it to her friends.
Kid 1: Heads up!
Eleanor: Huh? Ow, that hurt!
Kid 2: You sure you don’t wanna play? We can’t play without equal teams.
Eleanor: I want to play, but I just can’t. I have arthritis and it’s too sore. It’s hard for me to--
Coach: Let’s go! Back on the field.
Girl 1: But we only have three-
Coach: So do drills. Fundamentals. Fail to prepare, prepare to fail!
Eleanor, I know you have a doctor’s note saying you don’t have to participate.
Skinderella: Eleanor looks like she’s having a rough time with her JIA.
Axon: Gastro, get off Abacus! Don’t you know he’s a highly sophisticated piece of equipment?
Pump: Get up guys, we’re expecting a visitor.
Abacus: I’m free! What day is it? Time had no meaning under there.
Skinderella: Teleporting now!
Eleanor: Hey, Aren’t you…
Gastro: ...the Medikidz! Yeah!
Narrator: Pump is the heart specialist and the heart of the team! He’s got super strength and speed.
Skinderella holds the team together with her knowledge of skin and bones. She can show you with her morphing powers.
Axon and his robot Abacus know all about how your brain works. Axon is the smartest guy around and his glasses can see through anything!
Chi is the lung expert. She can fly and teleport the whole team all over Mediland...and then there’s Gastro. The authority on your tummy, your bottom and everything in between!
Axon: We live on Mediland. It’s a planet that looks and works like the human body.
It’s got a brain…
Pump: ...a heart…
Skinderella: ….bones and joints...
Gastro: ...a stomach and intestines!
Skinderella: We’re going to explain your JIA by taking you on an adventure through Mediland.
Axon: JIA stands for Juvenile Idiopathic Arthritis.
Eleanor: …young! I know that from Latin.
Arthritis is Latin for sore joints.
Axon: Yes, but--well those were easy.
Eleanor: So what does Idiopathic mean? Is that the cause?
Gastro: I don’t know.
Axon: It means-- Hey!
Chi: Gastro’s almost right, which is surprising. Idiopathic means we don’t know the cause.
Gastro: I think that wasn’t a cheese stick as much as it was a glue stick.
Eleanor: So I’m young and have arthritis and nobody knows why.
What’s next? A math test?
Chi: JIA sounds scary, but it’s much less so when you understand what it is.
JIA affects your joints, so that’s where we’ll start.
Narrator: A joint is where bones meet, like in your fingers, elbows or knees.
Inside a knee joint...
Skinderella: The joints we’re interested in are called synovial joints.
Axon: There are three things that make a synovial joint move smoothly: the capsule, the synovial membrane and the cartilage.
They’re well oiled machines!
Synovial joints have synovial membranes that make fluid. The fluid makes it easier for the joints to move.
The capsule’s job is to hold the bones in the right positions so the joint can move properly.
Chi: Whoa! Mediland just raised a knee. How many times, Axon, do I have to tell you not to poke Mediland?!
Gastro: Wheee! This is fun!
Eleanor: This is fun, but I’m a bit worried about the landing.
Axon: Oh, I wouldn’t worry about that.
Eleanor: Err, I was expecting more of a bang than a bounce!
Gastro: That’s because cartilage covers the ends of your bones and cushions them like a shock absorber.
Axon: This means your joints can handle impact when you jump and run around.
Pump: I think you had better put your joints to use and start running Axon!
Chi: All the parts work together to make your bones slide over each other easily instead of banging and rubbing.
Eleanor: Do you hear that?
Uh, guys, we have company.
Skinderella: Meet your immune system!
Pump: When a bug gets into your body, the immune system attacks.
It’s your body’s natural defense army that protects you from invaders.
Eleanor: Oh, so they’re the good guys! Great!
Hello down there!
Skinderella: Err, usually yes...
Pump: …but uh, in JIA things are a bit different.
Eleanor: Different in a good way?
Pump: Uhm, not exactly.
Skinderella: The immune system thinks the knee is the enemy and attacks it!
Medikidz, we’ve got incoming, get ready!
Immune System Commander: Hearty breakfast, now a full scale attack. It’s a good day.
Immune System: Commander, there seems to be some sort of force field around the knee. How shall we proceed?
Immune System Commander: Charge! Victory or death! There is no surrender!
Immune System: Speak for yourself. If the other option is death, I’m surrendering.
Skinderella: The immune army charges into the joint and starts to attack.
Pump: Phew, it’s getting hot in here!
Eleanor: I don’t want to panic anyone, but it’s going from puddle to pool in here real fast!
Immune System 3: Mayday, mayday! I appear to have been hit by some sort of nerd ray.
Skinderella: The attack causes the synovial membrane to make too much fluid and the synovial membrane also becomes angrier, tougher and thicker than normal!
Immune System 1: I don’t think we thought this through.
Immune System 2: You think?
Chi: The extra fluid, the immune army and the thicker synovial membrane are filling up space inside the capsule!
Eleanor: No wonder my joints get stiff, there’s hardly any room to move!
Axon: Over time, your cartilage gets worn away by the thickened, toughened synovial membrane.
Uhm, need a little help here please. I’m not known for my physical prowess.
Pump: Once all the cartilage is gone, the bones start to rub against each other.
If this happens it’s serious because you can’t grow new cartilage.
Abacus: This can change the shape of your joints and make them harder to move.
Axon: Which means it isn’t easy for you to get around and do the things you usually do. Chi, get us out of here!
Narrator: On the surface of Mediland’s knee...
Axon: [cough] I’m going to be coughing up synovial fluid for weeks. [cough]
Pump: As you know, JIA makes your joints swollen and sore.
Eleanor: Whoa! Not exactly solid ground!
Chi: Be careful Eleanor! It’s the excess fluid in the joint that’s causing the swelling on the surface of the knee.
While swelling and soreness are common effects of JIA, you may experience other things.
Narrator: Inside the mouth...
Skinderella: JIA can also cause problems opening your mouth.
Eleanor: Errr, Mediland may want to do closed mouth smiles for a while.
Chi: JIA doesn’t stop here...
Narrator: At the eyes...
Pump: Some kids with JIA get uveitis, or eye inflammation. They may have no symptoms at all, but if it isn’t treated, they may get blurred vision or blindness.
Immune System: Bet you didn’t see this one coming!
Eleanor: Man, someone needs to tell my immune system to relax!
Skinderella: To make sure JIA is the problem, doctors have to run tests.
Chi: Tests that we should get started on!
Narrator: On Mediland’s knee...
Axon: We’re going to need some supplies.
Eleanor: Wow! You guys have a spaceship?!
Gastro: Doesn’t everyone?
Pump: Usually, the doctors know it’s JIA from your symptoms and from examining you.
They may also do tests such as blood tests and urine tests to look for different causes of arthritis, including infection.
Immune System: It’s cramped in here.
Immune System: I’m thirsty.
Immune System: I’m bored.
Axon: No infection detected, just whining.
They may also do tests, like an ultrasound, that look inside your joints.
[Boom, Boom, Boom, Boom, Boom]
Gastro: Look, that’s the knee!
Axon: The doctors may also do an MRI...
Skinderella: ...an x-ray or a bone scan.
With these scans, your doctors can literally see inside your joints!
Axon: You might not need all of these tests. It’s different for everyone.
Now to visit other affected joints!
Eleanor: Ooooh baby, I’m so driving one of those!
Axon: In your dreams!
Skinderella: Once your doctors know it’s JIA for sure, the next thing is to find out which type of JIA.
Axon: There are many different types of JIA. The main ones are…
Oligoarticular, polyarticular and systemic, enthesitis-related, and psoriatic.
Abacus: Oligoarticular is the most common type.
Eleanor: Oooh! I get it! Articular means joint in Latin...and Oligo is Greek for a few.
Axon: Ooh, you just think you’re soooo smart you--
Axon: Don’t be ridiculous there are no moles living on--Oh!
That kind of mole!
Eleanor: Who taught you how to drive?!
Axon: Videos off the internet mostly.
Skinderella: Let’s try to stick to the point and on the road!
Axon: Skindy, get that thing out of my face!
Eleanor: Okay, so that must mean oligoarticular JIA only affects a few joints, right?
Skinderella: Right! Usually four or less. It normally affects big joints, like your knees, wrists or ankles.
Narrator: At the fingers….
Skinderella: Another type is polyarticular JIA.
Poly means many.
Pump: Polyarticular JIA affects five or more joints.
Chi: Systemic JIA is the most serious. It affects your whole body.
Axon: Dangerous! Look out!
Skinderella: A rash is breaking out!
Eleanor: Err, thanks!
Axon: It looks like we’ve got a fever, a rash and swollen glands!
Sometimes organs such as the liver and spleen can become inflamed too.
Pump: Sometimes in JIA, the immune army attacks your tendons and ligaments too!
That’s called enthesitis-related arthritis, or ERA.
Axon: Tendons are the ropes that hold your muscles onto your bones. Enthesis is the name of the places where your tendons attach to your bones…
Eleanor: ...and itis means sore and swollen, right?
Axon: You hear that?
Narrator: In psoriatic, arthritis is combined with the skin rash psoriasis or nail changes.
Gastro: Never thought I’d use this word but…RUUUN!
Skinderella: All types of JIA come and go so sometimes you’ll feel better, sometimes worse.
Eleanor: Got it. Chi, this time I’m asking. Get us out of here!
Chi: Great idea!
Eleanor: You took us back to the knee?!
Chi: That’s right. We’ve got work to do!
Skinderella: Once your doctors have figured out what type you have, they can start treating it.
Axon: Let’s arm ourselves.
Pump: First up are NSAIDs.
NSAIDs stands for non-steroidal anti-inflammatory drugs.
Axon: NSAIDs help reduce the pain and swelling.
Next up are corticosteroids, which are also known as steroids. Steroids may be used to help relieve pain and swelling.
Abacus: Next are DMARDs (disease-modifying antirheumatic drugs).
Pump: DMARDs work to suppress inflammation and help prevent joint damage. Here, you do the honours!
Immune System: On your feet soldier! I have specific orders right here stating that we should be attacking...
Pump: Biologics can help reduce pain, inflammation and joint damage.
Biologics are typically used when the arthritis has not adequately responded to DMARDS.
Pump: All these medicines can have side effects, your doctors will discuss these with you.
Chi: The other types of treatment are physical therapy and occupational therapy.
Skinderella: The physiotherapist or occupational therapist will give you exercises that stretch and strengthen your muscles and joints...
Pump: …which will keep them strong and prevent them getting too stiff.
The physiotherapist will show you how to keep your joints working without hurting them.
Gastro: I don’t think I’m doing it right. Ow!
Pump: You can do some of the exercises at home to keep your joints in good shape.
Skinderella: And that’s the basics of JIA. Sometimes, though--
Eleanor: What? There’s more?!
Chi: Yeah, sorry...
Narrator: Back in the mouth….
Chi: Because JIA can affect the jaw, you might need to see a dentist called an orthodontist.
Skinderella: You’ll also need regular eye tests.
Pump: You will also need to do your part! That means taking your medicines, going to all your appointments and doing your exercises!
Axon: Living with arthritis can be hard. But you are not alone! There are many others going through the same thing as you, and there are lots of people who can support you.
Chi: That’s pretty much a wrap. Let’s get back to headquarters!
Eleanor: But what made my immune system get so confused in the first place?
Axon: Well...smart scientists all over the world have studied what causes JIA…and they came up with….we don’t know what starts it. Doctors are still trying to figure it out. Sorry.
Eleanor: That’s okay, even us geniuses don’t know everything!
So, let me get this straight.
Normally, my body’s immune army protects me from invaders...
But if I have JIA, my immune system gets confused and it starts attacking my joints.
The attack makes my synovial membrane swollen and thick so my joints start to hurt and get stiff.
The doctors will take fluid from my knee, and do scans like an MRI... an X-ray...an ultrasound...or a bone scan
to see if I have JIA.
The doctors may give you medicines such as NSAIDs, Corticosteroids, DMARDs and Biologics.
I’ll also have physiotherapy and do exercises to keep my joints moving.
Axon: You did great! You remembered everything!
Eleanor: You were right though, I’m a lot less worried now that I understand what JIA is. First thing I’m going to do is see my doctor to talk about treatment.
Axon: I have to admit Eleanor, even though I’m usually the brains here…that’s a very smart idea!
Medikidz Together: Bye!
Narrator: Later, at school...
Teacher 1: Remember, this is going to be on next week’s test, so make sure you understand it.
Girl 2: Err, do you uh-- understand?
Eleanor: Of course. we are studying photosynthesis in plants. “Photo” comes from the Greek word for light and
“synthesis” is Greek for composition.
Narrator: Math class…
Teacher 2: Jeff, what’s the answer?
Teacher 2: Wrong. Eleanor?
Eleanor: Oooh, ooh, the value of pi is 3.14159...
Narrator: History Class…
Eleanor: The battle of Waterloo took place in 1815 and was the final defeat of Napoleon.
Teacher: Very good Eleanor.
Girl 1: I thought Napoleon was an ice cream flavour.
Eleanor: Shoot! Oh, thanks.
Boy: No problem. Hey uh, Eleanor we were wondering uhm...when will you be back on the sports team?
Girl 1: We all miss you!
Eleanor: Thanks guys! I miss you too. I’m looking forward to getting back on the field.
Hope you can keep up!
Pump: Gastro! What are you--
Gastro: Pump, before you finish that sentence, I’d like you to notice the last two people who yelled at me.
Pump: Errr, carry on!
Rebecca: Thanks for listening! We'll be adding new episodes all the time. We also take requests, so if you have a great topic, let us know! Who knows, we may even interview you! Visit us at JumoHealth.com.
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