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When little things mean a lot

A juvenile idiopathic arthritis diagnosis is scary, but we relieved Olivia’s symptoms—and her fear.

Young girl with a bright ice cream pop on her shirt smiling in her home.
Olivia is happier than ever, thanks to Dr. Gottlieb, whom she calls “Queen Gottlieb.”

One morning when she was 3 years old, Olivia Hirschorn woke up with one knee extremely swollen. Her mom, Yana, first assumed her very active toddler had fallen without her noticing. The Port Washington, NY, family had no way of knowing that this morning would mark the start of a nearly five-year odyssey of medical care. 

“Her knee was so swollen that she couldn’t walk. My husband and I were just shocked about how swollen it was,” Yana said. It was clear she was hurting—and that concerned the Hirschorns, so they called their pediatrician.

Though fairly certain the swelling was the result of a typical toddler tumble, the Hirschorns’ pediatrician ordered a panel of blood tests. When the test for celiac disease, a condition in which the gastrointestinal tract is hypersensitive to gluten, came back positive, the doctor was pretty sure that was the culprit, as the inflammation triggered by celiac could cause swelling. Yana was told to put Olivia on a gluten-free diet and wait for the swelling to subside. But after months, the swelling simply wasn’t going away. That’s when she and her husband, Gregg, decided to make an appointment with a rheumatologist at Cohen Children’s Medical Center.

“Her knee was so swollen, and it was just so tough for Olivia. She couldn’t walk when she got out of bed; she was literally crawling,” Yana recalled. “She was losing range of motion in that knee.” At Cohen Children’s, the first thing the Hirschorns heard was that their daughter likely had juvenile idiopathic arthritis (JIA). Bloodwork confirmed the diagnosis. JIA, formally known as juvenile rheumatoid arthritis (JRA), is an autoimmune condition in which the body’s immune system mistakenly attacks its own tissues. Though it’s a chronic condition in adults, children can outgrow JIA. 

It was during that visit that Yana and Olivia first met pediatric rheumatologist Beth Gottlieb, MD, who initially administered a cortisone shot to Olivia to help reduce the swelling and pain. The treatment worked temporarily, but soon, the swelling was back—and spreading to other parts of Olivia’s body, including her ankle.

Yana is so glad she followed up on a recommendation to see Dr. Gottlieb. “Everyone kept telling us, ‘You have to get an appointment with Dr. Gottlieb—she’s the best,’” Yana said.

Dr. Gottlieb has worked to get Olivia onto a medication regimen that wouldn’t trigger her celiac disease. Today, at nearly 9 years of age, Olivia is a happy, active little girl.

Young boy and girl swinging on a swing set in their backyard.
Once barely able to walk, Olivia’s unstoppable now.

“She’s so much better now. It’s like night and day,” Yana said. “She dances. She takes classes in ballet, hip hop, jazz and tap. She plays basketball in the winter and softball in the spring. Before, she was really limited because of the swelling and pain. But her treatment really has been life-changing for her. She can do all the things she wants to do.”

Yana credits Dr. Gottlieb for getting Olivia to that place. She said she is so glad they were able to schedule that appointment so many years ago. Dr. Gottlieb’s warm, compassionate style of care has made all the difference for her daughter—and for her, as well. She said Dr. Gottlieb always takes the time to listen so neither she nor Olivia are ever afraid to ask questions.

“Dr. Gottlieb is someone who is always happy to see Olivia,” Yana said. “Olivia will always talk to her about what was going on and how she is doing. She really listens so Olivia feels like she can ask her or tell her anything.”

That includes when Olivia may feel afraid. Olivia’s condition requires a fair number of injections. And, Yana said, Olivia was not a big fan of needles. Yet, Dr. Gottlieb found a way to help with Olivia’s fear, too.

“Dr. Gottlieb made it amazing. She told Olivia she had ‘magic cream’ that helps numb the area before she gets the shot,” Yana said. “She made something that really scared Olivia into a nonissue. And when you are so young and getting a lot of shots, like Olivia, it’s the little stuff like that which ends up making a really big difference. She’s just really, really wonderful.”

Young girl playing the viola next to her bed.
Olivia loves music—she takes dance classes and practices the viola.
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