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news News Thursday, November 15, 2018 Thursday, November 15, 2018 4:34 PM - Thursday, November 15, 2018 4:34 PM

Modern therapies for juvenile rheumatoid arthritis help Nick pursue his dreams

Modern therapies for juvenile rheumatoid arthritis help Nick pursue his dreams

Dominic Robinson is a young man on the move. The high school senior can often be found exploring with his friends, playing games or seeking out some new comic books. As a standout track runner at Alexandria Senior High School, "Nick" (as he likes to be called) is currently trying to help his team get to the state championships. His passion for running is one that began early, a product of his early youthful exuberance.

“I was definitely very busy as a child,” he recalled. “My parents told me the second I started walking, I ran, but I didn’t take running seriously until they started doing "run days" in elementary school. I was never able to keep up because of my asthma back then, and my height was not ideal for running, but I wasn’t going to let those things hold me back from what I wanted to do. I vowed to myself that I would be the best runner I could be, and I just fell in love with the sport.”

By middle school, Nick was receiving interest from college track programs and by his freshman year, he was a nationally ranked runner. He won multiple state track titles, and qualified for the Junior Olympics. A path to the Olympics was quickly taking shape. By his sophomore year, however, Nick began experiencing problems with his legs – issues that, as a runner, might have initially seemed an expected consequence of the sport.

“As a long-distance runner, you kind of get used to various leg issues, so you think it’s just soreness or something like that,” he said. “But it got to where every time I ran, I could feel my legs get continually weaker – I think I knew something was wrong. Then one day I was in school and I fell down in the classroom out of nowhere, and I just couldn’t move.”

Alarmed, Nick’s parents began scheduling appointments with physicians throughout the Alexandria, Louisiana area. Given Nick’s history as a long-distance runner, most medical assessments assumed a sports-related injury. Pain medications and physical therapy were frequently floated as treatment options. Meanwhile, Nick’s condition continued to deteriorate at a rapid pace. Despite undergoing physical therapy, Nick began to require the use of a walker due to the pain and weakness in his legs. As further medical advice and therapy failed to yield results, use of a wheelchair became necessary. Losing hope and desperate for answers, the Robinson family returned to their pediatrician, who recommended consulting with physicians at Shriners Hospitals for Children — Shreveport.

Upon their first visit to the Shreveport Shriners Hospital, the Robinson family met with pediatric rheumatologist Sarwat Umer, M.D., and received something that had proven elusive for the better part of a year – a diagnosis. Dr. Umer identified juvenile rheumatoid arthritis (JRA) as the cause of Nick’s lower extremity weakness, pain and swelling of his knees. Though still struggling and using a wheelchair, Nick and his parents found themselves relieved to finally have a name to associate with their battle.

“That was the greatest feeling because it was nine months of not knowing what was happening and constantly having doctors say ‘I’m sorry I can’t help you,’” Nick said. “Just hearing her say what it was and knowing there was a way that I could get better was a great relief.”

Under Dr. Umer’s direction, Nick began receiving steroid injections directly into his knees, and began treatment with medication commonly used for rheumatoid arthritis. Nick’s initial response to the treatment was positive, allowing him to begin walking again without the use of assistive devices. Unfortunately, the benefits of the injections were short lived. Nick’s inflammation returned, along with his need for assistance in performing daily activities.

In response to Nick’s recurrence, Dr. Umer and her team began treatment with a sophisticated anti-inflammatory medication. While cautioning that recovery via the new treatment approach would take time, Dr. Umer encouraged Nick and his parents to stay strong in the face of the serious physical and emotional struggles.

“When we treat teenagers for JRA, we often see kids who had at one point led very full lives that are suddenly taken from them, and when getting them back to their baseline they can feel isolated and alone,” Dr. Umer said. “I had to assure them that this was going to get better, even if we had to change the therapy mode, we would get him well.”

With time and adjustments to the frequency of medication, Nick’s symptoms slowly began to improve. Now in remission with medication, Nick is back on the move and regaining focus on his goals. He has rejoined the track team, and recently completed his first organized race since resuming the sport (he came in second place). While he still has an eye on competing in the Olympics, Nick has added a new aspiration for the future: a career helping others through their illnesses.

“I want to work in either psychology or some form of therapy,” he said. “I know that a person going through an illness can feel really alone. We all feel kind of hopeless and lost sometimes, and I just want to be there to let them know that I know that fight, and that there is a chance to get better.”

Nick running in a cross country competition