In many ways, Ben Bissett is like lots of 14-year-olds.
He loves spending time with his loving family and friends, enjoys school and takes part in sports when he can.
One of his main passions is supporting local football club Millwall, despite his mother Kerry’s objections, as she supports their arch rivals Charlton Athletic.
But unlike many other people his age, Ben has arthritis.
He has juvenile idiopathic arthritis (JIA), which means his immune system is overactive and attacks his joints.
The condition causes Ben pain, especially at night and first thing in the morning.
But thanks to the care and attention of those close to him, Ben is still able to do many of the things he enjoys.
Ben was diagnosed with JIA in December 2013, eight months after he was first taken to a doctor.
After diagnosis, Ben was placed on a drip of steroids for four hours a day, from Friday to Sunday for two weeks in a row because his arthritis had become so severe.
The impact of JIA can be severe on joints if left untreated and so it’s important that appropriate treatment is found and followed quickly to try to get the condition under control.
Ben is currently on methotrexate and etanercept, and he has previously taken steroids. Sadly, Ben has had some side-effects to methotrexate which has meant that the dose has had to be reduced.
Coping with symptoms
While Ben's health has improved since the toughest times, he still has inflammation. In the past couple of years, Ben has experienced a lot of pain, which has affected his sleep. The pain did recently go completely, but it has unfortunately returned.
Mum Kerry said: “Some of the worst times have been at bedtimes, when Ben has been in real pain. There isn’t a lot I can do apart from say, ‘think positive thoughts’, and try to use distraction techniques.
“It’s been horrible at times."
Kerry said that while it can be tough, encouraging young people with arthritis to do their physiotherapy and exercises such as swimming is important.
Ben said: “I try to go swimming twice a week, even if it isn’t for very long."
Big step forward
Recently Ben went shopping with his Mum and came home with a pair of new football boots, a purchase which had particular significance for the football-mad teenager.
Ben was sadly unable to use his last pair of football boots because of his arthritis, and he's grown out of them. But he's already been able to put his new pair to good use.
He said: "I'm really pleased to be able to join my school friends in PE, especially as we're playing football and I've not been able to join in PE since mid-year seven.
"My first pair of boots, which I never got to wear, were size four. I've had to buy a new pair in size 10. I've even scored a couple of goals. After some more physio my next goal will be to go on a course to become a referee."
Watching your child struggle with their health isn't easy for any parent.
Mum Kerry said: “After diagnosis, it may still be a long journey.
"I remember thinking 'it'll all be better in a week or two'. But with most medications, you have to allow three to four months.”
Kerry has this advice for parents in a similar situation: “Keep pushing. It's hard, but you need to keep pushing for answers.
“Parents need to be able to let off steam. I think it's useful for parents to find a link to other parents of children with arthritis. Other people just don’t understand.”
Helping to carry the load
Ben, who lives in south-east London with his parents and younger brother Adam, has a positive outlook. He said: “I've got really nice friends.
“I've told them about my arthritis and they're very understanding. When my arthritis is bad, my friends carry my bag for me.
“I love playing football, but sometimes my arthritis won’t let me play. I have friends over and we watch films together instead.
“I enjoy school. It’s boring when I have to stay at home. My form tutor has moved my classes downstairs so I don’t have so far to get around. If I need to go upstairs, there's a lift. I haven’t missed any days this term. I'm very proud of that.
“I'd like to go to university. I'd like to be a football referee when I'm older.”
About the drugs Ben takes
Methotrexate is a disease-modifying anti-rheumatic drug (DMARD) and it’s the first-line of defence against JIA.
Etanercept is an anti-TNF drug. It blocks a protein (TNF) that can cause joint inflammation and so reduces inflammation.
Steroids also reduce inflammation. People with JIA are often prescribed steroid tablets or injections.