Despite settling into a weekly routine of medication, Kenzie’s health only worsened. Her new immune-suppressing medication left her vulnerable, making her sick every other week. Unfortunately, this also meant more flare-ups. For a time, while we waited for the medicine to take effect, Kenzie refused to straighten her left arm when she walked. I noticed the persistent swelling in her feet, the occasional complaints of finger pain, and the aches in her knees. She frequently spiked fevers in the evenings, and mysterious rashes would appear. From what I had learned about JIA, flare-ups typically affected specific joints, but Kenzie’s pain seemed to have no boundaries.

Eventually, her body adjusted to the medication, and we saw small victories. The swelling subsided, she straightened her arm again, and she rarely limped or complained—except for the usual toddler bumps and bruises. But whenever she fell ill, her entire body seemed to shut down. With fevers spiking to nearly 104°F, she could barely move, consumed by pain. I couldn’t understand why the medication failed when she needed it most. My instincts screamed at me, but I tried to silence them—I already had enough to worry about.

One particularly tough day, Kenzie had her two-year-old check-up with the cardiologist. She was scheduled for an echocardiogram, and while I didn’t expect any alarming news, doctor visits always left me uneasy. That feeling had become my new normal. Keeping a toddler still for a 30-minute scan was impossible, so my “no screen time” rule went out the window. Survival mode took over, and by the time it was done, I was a sweaty mess while Kenzie was ready to burn off her pent-up energy.

I had grown used to the waiting game—test results always took time—but two hours of waiting for the echocardiogram results stretched my patience thin. I should have known bad news was coming. When our cardiologist finally walked in, his usual joyful demeanor was gone. His face was serious, and my heart sank.

Proverbs 15:13: “A happy heart makes the face cheerful, but heartache crushes the spirit” 

“I’ve got good news and bad news. What do you want first?”

“Neither,” I muttered. He smirked briefly before glancing at Kenzie’s chart.

“Let’s celebrate the fact that Kenzie’s heart holes have officially closed, and the artery we were monitoring has grown enough that it’s no longer a concern.”

“That’s great,” I replied, though my heart braced for the bad news.

“Yes, that’s one issue resolved. However, we’ve found a new concern. Kenzie has a significant amount of inflammation around her heart—about 5 mL of fluid.”

“What does that mean?”

“It’s called pericarditis. This can cause fatigue and breathing difficulties in children. Have you noticed any symptoms?”

“No… but she just got over being sick. Could that have triggered this?”

“Yes, illness can cause temporary inflammation, and often, pericarditis goes unnoticed. However, because Kenzie has juvenile arthritis, I want to monitor her heart more closely. We’ll start with a steroid to reduce the inflammation, and I recommend an echocardiogram every two weeks for the next several months.”

“And if it doesn’t go away?” I asked, my voice unsteady.

“Many children live normal lives with this, but if the fluid increases to 10 mL, we’ll have to surgically remove it.”

Silence.

Proverbs 3:5: “Trust in the LORD with all your heart and lean not on your own understanding” 

“Do you have any other questions?”

I did. But I shook my head, too stunned to speak. He handed me an information packet about pericarditis, then sent me on my way. I hate those packets.

After scheduling the next echocardiogram, I took my two-year-old to the car in silence. I kept my head down, afraid strangers would see the tears welling in my eyes. Not that I could have spoken anyway—the lump in my throat was too big.

Numb and overwhelmed from yet another diagnosis, I sat in the driver’s seat and called my husband. He had more questions than I had answers to.

I had questions, too.

What now?

The only thing left to do was make one more phone call.

“Mom?” I choked out, my voice trembling. “I have bad news… It’s about Kenzie’s heart.”

As I shared the new diagnosis, my own heart shattered even more. This was a matter of the heart—both literally and in the deepest, most painful way.