The Tiffany Family: Adjusting to Life with JA 

Meet the Tiffany family, and learn how they are adjusting to life with Juvenile Arthritis, and how camp helped them find community. 

These days, the word “vacation” takes on a whole different meaning for the Tiffany family. Trips to Disneyworld have been replaced with trips to Bethesda, Maryland so that two of the Tiffany girls, Natasha, 17, and Cassandra, 13, can participate in studies at the National Institute of Health. Both girls have recently been diagnosed with juvenile arthritis, but their situation is a bit unique from other kids with JA—each has a twin sister without the condition. 

As if travelling with four teenagers isn’t stressful enough, managing Natasha and Cassandra’s health challenges can make family trips even more difficult to navigate, says the girls’ mother, Adeliza. While, Nikita, 17, and Elinor, 13, can go all day like energizer bunnies, their sisters’ conditions make it nearly impossible for them to go a few hours without taking a nap or break. This is very new territory for the family, especially for Natasha, who was once a star soccer player and had hopes of joining the military. 

For years, Natasha had periods of knee and hip pain, but as a competitive student athlete, her pain didn’t seem out of the ordinary. It wasn’t until she sustained a hip injury from a soccer tackle, and started to experience debilitating pain in her hands, that she saw a doctor for her symptoms. At first, even Natasha’s doctor wrote off her pain as a result of her active lifestyle and passion for drawing, but a trip to the hand orthopedist confirmed that she had JIA, the most common form of juvenile arthritis.  Since her diagnosis in July 2014, Adeliza explains that “the kid [Natasha] was two years ago is very different from the kid she is now,” and says it’s a struggle for her daughter to get through an entire day without pain and fatigue. 

For Cassandra, diagnosis happened a little differently. A self-admitted clumsy child, she preferred participating in band to playing sports, so her symptoms went largely unnoticed. Then, her mom noticed that pinky finger was more swollen and irritated than usual. Also, her coordination seemed to be getting worse. So, during one of Natasha’s trips to the doctor, Adeliza asked a question that confirmed her worst nightmare: Cass also likely had JIA.  Looking back, Adeliza regrets not seeing the signs sooner—bulging joints, stiff walking, the persistent clumsiness—but says that her daughter “never once complained about the pain,” so it never occurred to her that something might be wrong. 

For Natasha and Cassandra, managing their symptoms is also complicated by the fact that neither of them can tolerate steroids for pain management. They, and their doctor, are still figuring out which biologics works best for them, and each has her own set of unique health problems which make pain management even tougher. Natasha also has fibromyalgia (a chronic arthritis-related condition that causes widespread pain and fatigue), polycystic ovarian syndrome (a hormonal disorder that causes enlarged ovaries and other symptoms) and suffers from frequent migraines. Cassandra has had recurrent respiratory infections since she was an infant, as well as Cushing’s Syndrome (a disorder that occurs when you have higher than normal levels of the hormone cortisol) that developed as a result from taking inhaled steroids as a child. 

Now a high school senior, Natasha faces an additional challenge: deciding where she should go to college while still learning how to manage her disease. A talented artist and aspiring med school student, she’s considering an undergraduate degree in medical illustration. The challenge? Her school of choice is in Richmond, Virginia, several hundred miles away from her rheumatologist and parents in Texas. 

Natasha says location is her main limitation when it comes to choosing the right school. Because cold weather makes her symptoms worse, “letters from schools in New York or Michigan get thrown into the trash without much more than a glance.” She also favors universities with a medical school so she might find an on-site rheumatologist, and prefers public schools because, unlike private schools, they are required to accept 504 plans for disabled students.  

For 7th grader, Cassandra, graduation is still a ways to go, but talking to teachers and peers about her condition is a new learning process. Though their school system has been “overwhelmingly supportive,” Adeliza says there are times when her daughters just don’t get the attention they need. 

That’s why meeting other kids with JA and attending programs like t Camp JAM are so life-changing, says Adeliza.  The Arthritis Foundation’s Camp JAM, a 4-day, 3 night camp for boys and girls ages 8-17 with juvenile arthritis and other rheumatic conditions, teaches kids how to advocate for themselves as they experience arthritis-related challenges. It also gives kids a chance to meet others like themselves and build friendships that last a lifetime. Natasha has participated in camp for two years in a row and says she’s met some of her best friends there. She loves it so much she even plans on becoming a camp counselor next year when she turns 18. 

For Cassandra, the best part of camp is that “you don’t have to explain the word arthritis to anyone.”  No one asks why you have to take a break, or why you need help with something, they just get it. Even something as simple as having nap time on the schedule makes a world of difference, says Adeliza. It makes her girls feel normal, and like it is “OK” that they sometimes require a little extra down time. In some ways, nap time is just as important to her girls as all the other activities the camp plans, she jokes. 

Keeping a sense of humor is one way Adeliza says her family copes with her daughters’ diagnoses. She says it’s better to just laugh it off when one of them has trouble opening something, or to joke with Natasha that she’s really “71 not 17” rather than dwell on their situation. That, and setting aside one-on-one time with her other daughters is key, she says. In fact, Adeliza plans “designated skip days” for Nikita and Elinor to make up for the time and attention their sisters receive because of their JIA. Nonetheless, she admits that aligning Natasha and Cassandra’s needs with the rest of the family’s is “a piece of the JA puzzle” she and her husband are still figuring out. Until then, Adeliza and her family will take on arthritis the only way they know how: with a little bit of wit, and a lot of patience.

I Want to Contribute
I Need Help
  • Donate


    Every gift to the Arthritis Foundation will help people with arthritis across the U.S. live their best life.

  • Volunteer


    Join us and become a Champion of Yes. There are many volunteer opportunities available.

  • Live Yes! INSIGHTS

    Live Yes! INSIGHTS

    Take part to be among those changing lives today and changing the future of arthritis.

  • Partner


    Proud Partners of the Arthritis Foundation make an annual commitment to directly support the Foundation’s mission.


Ways to Give

Every gift to the Arthritis Foundation will help people with arthritis across the U.S. live their best life. Whether it is supporting cutting-edge research, 24/7 access to one-on-one support, resources and tools for daily living, and more, your gift will be life-changing.

Make a Donation

Help millions of people live with less pain and fund groundbreaking research to discover a cure for this devastating disease. Please, make your urgently-needed donation to the Arthritis Foundation now!

Become a Member

Become an Arthritis Foundation member today for just $20 and you'll receive access to helpful tools..... and more. 

Make a Honor or Memorial Gift

Honor a loved one with a meaningful donation to the Arthritis Foundation. We'll send a handwritten card to the honoree or their family notifying them of your thoughtful gift.

Gift Planning

I want information on ways to remember the AF in my will, trust or other financial planning vehicles.


Volunteer Opportunities

The Arthritis Foundation is focused on finding a cure and championing the fight against arthritis with life-changing information, advocacy, science and community. We can only achieve these goals with your help. Strong, outspoken and engaged volunteers will help us conquer arthritis. By getting involved, you become a leader in our organization and help make a difference in the lives of millions. Join us and become a Champion of Yes.

Become a Volunteer

More About Volunteering


Give Just 10 Minutes.

Tell us what matters most to you. Change the future of arthritis.

By taking part in the Live Yes! INSIGHTS assessment, you’ll be among those changing lives today and changing the future of arthritis, for yourself and for 54 million others. And all it takes is just 10 minutes.

Your shared experiences will help:

- Lead to more effective treatments and outcomes
- Develop programs to meet the needs of you and your community
- Shape a powerful agenda that fights for you

Now is the time to make your voice count, for yourself and the entire arthritis community. 

Currently this program is for the adult arthritis community.  Since the needs of the juvenile arthritis (JA) community are unique, we are currently working with experts to develop a customized experience for JA families. 

How are you changing the future?

By sharing your experience, you’re showing decision-makers the realities of living with arthritis, paving the way for change. You’re helping break down barriers to care, inform research and create resources that make a difference in people’s lives, including your own.

Get Started


Meet Our Partners

As a partner, you will help the Arthritis Foundation provide life-changing resources, science, advocacy and community connections for people with arthritis, the nations leading cause of disability. Join us today and help lead the way as a Champion of Yes.


Our Trailblazers are committed partners ready to lead the way, take action and fight for everyday victories. They contribute $2,000,000 to $2,749,000


Our Visionary partners help us plan for a future that includes a cure for arthritis. These inspired and inventive champions have contributed $1,500,00 to $1,999,999.


Our Pioneers are always ready to explore and find new weapons in the fight against arthritis. They contribute $1,000,000 to $1,499,999.


Our Pacesetters ensure that we can chart the course for a cure for those who live with arthritis. They contribute $500,000 to $999,000.


Our Signature partners make their mark by helping us identify new and meaningful resources for people with arthritis. They contribute $250,000 to $499,999.


Our Supporting partners are active champions who provide encouragement and assistance to the arthritis community. They contribute $100,000 to $249,999.