One Patient's Positive Perspectives

Posts tagged ‘arthritis’

Lupus, Benlysta and a little browsing with brunch

This morning was a repeat of many Saturday breakfast brunch rituals.  Today it was omelets, bacon, toast, homemade plum jam,  strawberries and bananas with coffee.  I really enjoy sleeping through half the morning each Saturday, but then I get up mid morning and usually make a hot brunch for everyone in the house.

Before our daughter and son-in-law came to live with us, breakfasts usually just included my husband and me, but these days, it includes them as well.  We often enjoy a chatty social time during the cooking, and at last the cook (me) gets the last, best, fluffiest omelet — when the skillet is finally well seasoned and everyone else is fed.  So, now I sit down to enjoy the fruits of my cooking and a little browsing with brunch.

Benlysta Twenty-Two Month Update

It is time for an update on my Benlysta treatments, since yesterday was month twenty-two in my treatment.  However, the last infusion almost didn’t happen, after nearly sleeping the day away in lupus exhaustion and fatigue.

Yesterday began with a start, after awaking from a dead sleep in the quiet house.  It didn’t seem like morning at all!  What time was is?  Groping through fogginess to find a watch on the bedside table from the night before, the startling realization shook me that it was 12:15 p.m.  The morning was gone and it was lunch time,  and sudden panic and urgency swept over me, while a feeble surging trickle of adrenaline was coaxing my body and brain into wimpy “fight or flight” mode.

Panic and Rush to Get Ready

With the realization that my Benlysta infusion appointment was scheduled for 1:00 p.m., only forty-five minutes from my waking moment, I jumped out of bed, stumbling as I faltered to get the waiting my sandals on my feet.  I was still dizzy with sleep.  A look in the mirror didn’t help my hurry.  My night sweats had turned my wavy hair into a rat’s nest of randomly angled mess, and there was no remedy but the shower!  Hurrying, with tooth-brush in hand and  mad splashing of water and shampoo,  within a couple of minutes I was out of the shower and drying.

It crossed my mind while holding my towel, that I could easily have slept right through the entire day — completely missing my infusion.  I was grateful for whatever had shaken me out of slumber, thinking, “thank you Lord!”

I was finally clean, dry and almost presentable, but still desperately needed clothes!

Quickly grabbing some necessary under-things, shorts and a favorite shirt, I dashed through a cursory grooming and took my morning meds with a splash of orange juice.  Grabbing my purse, I jumped in the car and realized my heart was racing with urgency.  It was now 12:55 and I was very late, but still determined.

Late, but determined

Photo by LA's Daughter-in-Law © 2013I pondered that we had postponed my Benlysta infusion last week, so that we could travel out-of-town to visit family.  I didn’t want to postpone the Benlysta another week!  My joints were already reacting to the resurgence of those little nasty Blys proteins that confuse my wayward B-cells.  I really wanted Benlysta soon to blast the increasing Blys population and quiet my Lupus back down again.

Calling up the hospital cancer infusion center while I headed for the freeway, the gal put me on hold for over ten minutes.  By the time we finally spoke, I was almost halfway there.  She was kind about my tardiness and told me to keep on driving.  Arriving twenty minutes late, they quickly processed me and a nurse promptly whisked me back to the infusion room.  Soon the powerful biologic drug was dripping into my vein and on its way into my system to once again fight my lupus.

Update on Benlysta’s Effectiveness

August  2013The Benlysta does its thing well, and has been greatly moderating my lupus.  My CNS lupus involvement remains subdued and quiet, my fatigue is greatly reduced, and my liver has remained symptom-free.  Minor symptoms of lupus — discoid rashes, mouth and nose ulcers, arthritis and bouts of milder fatigue are still present, but my overall physical strength and health are continuing to build up, as the lupus has continued to stay much quieter over a long period.

August will mark my two-year Benlysta treatment anniversary.

More lupus facts, melodies and familial autoimmune maladies

Familial Autoimmunity

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Me (youngest one) and my siblings 50 years ago

This original post was written once on Saturday May 18th, but went into the netherworld of glitches in cyberspace.  Today, I am reviving that attempt.  The day I started this post would have been my mother’s 80th birthday, and remembering her prompted me to take a very special look at our familial autoimmunity.

Over just four generations, my family has many autoimmune examples including lupus, rheumatoid arthritis, gout, psoriasis, thyroid disease, diabetes, severe allergies and asthma.  All month-long we had thus far been spotlighting various lupus bloggers, but this post is different.  Long over the intense grief that followed the loss of my mom, now she is remembered with twinges of recurring lament over her failure to survive a massive stroke at 65.

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Me (shortest) with siblings (in front)
and cousins (behind)

My mother was part of an autoimmune heritage that began with her mother, and extends through four generations through me to my daughter.

Happily, our four generations also share a deep love of music, also passed down from mother to daughter like a beautiful melody unrelated to our shared autoimmunity.  This post is about melodies and autoimmune maladies.

Grandma with RA

Warming hands in soapy water

My grandmother Bonnie had rheumatoid arthritis.  My mother remembered her mother arising each morning with aching, swollen, stiff hands.  Grandma would walk over to the kitchen sink and massage her hands in the dish pan’s warm soapy water, while her painful hands were soothed by its penetrating comfort.  Then, she would grab a kitchen towel to dry her hands, and then neatly fold and set it back on the kitchen counter.

Next, on most mornings, grandma would go to the piano in their old-fashioned parlor and sit down to play.  My mother followed her, watching, but sometime was still sleeping at this hour and woke to the strains of music wafting through the house.  Although it was equipped as a player piano, grandma played it herself every morning without running the player scroll.  Grandma explained to her that it felt better in the long run if she made her painful hands gently play the piano, so they could become stronger and more able to fight the arthritis that tried to cripple them.

Playing piano in the mornings

My mother explained that my grandmother took quinine every day for her rheumatoid arthritis.  By the end of her life,my grandmother was diabetic and blind, perhaps from the diabetes, or from her cataracts from a lifetime of steroids,  or perhaps from collection of quinine on her retina.  Quinine is the drug from which modern-day Plaquenil is derived.

Oranges, quinine and grandma

I cannot break into a fresh orange without remembering my mother tell me about the quinine in its peel, and how good quinine was for me.  It was often in this context she would mention her mother’s RA. We never knew what actually caused my grandmother’s late-life sight loss, but she lived to the age of 83, finally succumbing to complications of her diabetes.

Mom with Gout

Mom and her gout

My mother never showed any signs of RA, but she did suffer from gout, another form of autoimmune arthritis.  Her gout came and went in occasional flares and episodes.  When uric acid levels built up too high in her blood, she eventually suffered pain when it began to spill over from her blood into her swollen, red finger and toe joints as painful uric acid crystals.

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My mom @ 1990

My mother described the intense pain and we could see the obvious redness, distortion and swelling of her joints.  Gout only bothered her acutely a few times, because with the diagnosis she learned about specific diet changes that help control uric acid build up and prevent flares, so she managed it fairly well.

Mom watched and learned

As a little girl, my mother liked to watch and listen to grandma play the piano, and eventually learned to play a little herself.  She told me about times she would enjoy sitting at the piano herself, and how she learned to change the songs on the player roll.  Mother also loved to try to play the keys along with the automated pianist as it rolled its way through the songs.  My mother grew to love music, and infected me with that love, too.

Me with Lupus

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Reading to my grandchildren

My childhood foreshadowed my adult lupus diagnosis with many signs and symptoms of this autoimmune disease.  At the age of  five,  signs of knee and hip arthritis appeared, and by sixteen arthritis invaded my hands and fingers.  Growing up, there were several episodes of discoid lupus rashes on my hands, face and neck that showed up after playing outside in the sun.  My parents called the rashes a “sun allergy.”  Then, there was a year of unexplained severe anemia in my early childhood, along with severe episodes with unexplained high fevers in the absence any signs of infection.  Throughout childhood there were countless episodes of weeks of extreme fatigue.

All these recurring and varied signs and symptoms led my doctors to repeatedly test me for my grandmother’s autoimmune diseases: diabetes and rheumatoid arthritis.  With tests always being negative, my family doctor would diagnose “unknown virus” and put me on a diabetes diet at five as a precaution.  The diet was a good thing, overall, because it was a healthy balanced meal plan, very much like the Weight Watchers plan I am following today.

bf on musicMy autoimmunity finally was clearly diagnosed as lupus when I was thirty-something: not surprising, considering the known familial autoimmune heritage from the two generations before me.  Any earlier history of auto-immune disease in our family remains unknown, however, my sister had her thyroid removed after autoimmunity destroyed it.  One of my brothers is showing signs of major arthritis, and I encouraged him just this week to discuss our familial autoimmunity with his doctor.

Now, I am under a good treatment plan for my lupus, and stay active, exercise and play the piano almost every morning.  Even when my joints are swollen, I try to exercise gently, do mild yoga stretches and I sit down to play music.  I hope to retire from my government legal management position in a few years, and move into my second career as a music teacher.  I look forward to this less stressful future occupation.

Daughter with Psoriasis

my kids @ 1989

My kids when they were little

My daughter inherited the genetic autoimmune legacy and has severe psoriasis and has severe asthma.  Her psoriasis is the head to toe variety that is measured in percentages of total skin involvement.  She never has a time when she does not have countless plaques on arms, legs and body.  Thankfully, her lovely face and contagious smile are mostly spared from its marring eruptions, although her scalp has constant aggressive flares.

In her teen years when she first developed psoriasis, its severity broke my heart.  I amazes me how gracefully she bears this autoimmune burden.  She plays many instruments, teaches elementary band, choir and general music.  She watches and waits, ever alert for signs of psoriatic arthritis that might threaten her dexterity and ability to play the flute and other instruments that she loves.

My son has four children and the oldest has severe asthma, just like my husband and daughter.  He is a young assistant pastor, church choir director and plays a little piano too.  His son is learning piano, just like my husband, my grandma, my mother and me.

Lupus Facts @ Prognosis and Hope

Lupus & Normal Life Span: With current methods of therapy, 80 to 90 percent of people with non-organ threatening lupus can look forward to a normal lifespan.  The 10 to 20 percent of Lupus patients with more severe lupus can expect to live a long, productive life with proper early treatment.

For more information about this lupus fact, please read my full post on this subject from last year - May 28, 2012

Pregnancy Outcomes: Advancing technology and better understanding of the disease have improved pregnancy outcomes. Today, 80 percent of women with inactive lupus can have successful pregnancies.  First, it is a great idea to learn about the issues and risks of pregnancy in lupus.

For more information about this lupus fact, please read my full post on this subject from last year – May 29, 2012

Working with Lupus and Accommodation: Most people with lupus are able to continue to work. However, some may need changes to their work environment and schedules, such as flexible work hours, job-sharing, and telecommuting.

For more information about this lupus fact, please read my full post on this subject from last year – May 30, 2012

May is Lupus Awareness Month – Encouraging and Educational

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May Lupus Awareness

May is very special to me for several reasons.  First, I have several special birthdays that all happen throughout May — my mother’s birthday would have been this month, a brother, a sister, my son and my grandson all have birthdays in the next four weeks.  May also has Mother’s Day a couple of Sundays from now.

May is also very special, because it is Lupus Awareness Month.  All month long, I am planning to showcase different lupus patients and bloggers.  I am looking forward to the opportunity to stretch out and expand my network of connections in the lupus community.

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Lupus Awareness Adventures!

A year ago, this blog published daily posts on different lupus topics.  In addition to my piece on each lupus patient, I will plan to provide a link to  the blog post for the lupus topic of the day from last year.

Lately, life has become very, very busy!  So, while making a departure from my normal posting patterns, it is my hope that this coming month’s posts will be encouraging and educational.

Come along on May’s Lupus awareness adventures with me!

Lupus Adventures at the Arizona, Walk to End Lupus Now 2013

LFA 2013 Walk Registration

Registration & Check in Area

Walk Day

Today, I am sitting here in the shade of a ramada at Chapparal Park in Scottsdale, Arizona enjoying some beautiful spring weather.  I am writing from the registration table at the Lupus Foundation of America (LFA) Walk to End Lupus Now in Scottsdale, Arizona and joining today’s festivities as a virtual walker.  The other (real) walkers took off on the 3.1 mile long course a little while ago.  Today’s walk is much too far a walking distance for my lupus arthritis and joints, and too much sun exposure for lupus sun sensitivity.  Alas, I am relegated to the ranks of sun dodgers sitting here in the cool shade of the registration table.

LFA 2013 Walk Kris from LFA

Key LFA Staff Joined Us

Attendance at today’s walk is impressive!  Key members of the LFA national office staff joined us to support and help with today’s walk arrangements.  Countless participants turned out, so we spent more than an hour checking in a massive crowd of  pre-registered and walk-in teams and individuals.  Including the over $39,000 dollars tracked online ahead of time, today’s fund-raising efforts should net many thousands of dollars to support the LFA.

Many sponsors supporting the walk

Many sponsors supporting the walk

We had several sponsors today helping with costs of putting on the event, including co-sponsor, the City of Scottsdale that donated park access without charge for the event.

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Walk T-shirts & Prizes

Also, we had support from AllSup disability representation company, Data Doctors computer services, GoDaddy.com, Blanco mexican restaurant, TinySolder.com screen printed clothing.  Additionally, health partner Arizona Arthritis & Rheumatology Research (AARR), the research arm of a large Arizona rheumatology practice, sent representatives to speak with today’s walkers about current and future lupus research studies.

LFA 2013 Walk Anne

Anne from Glendale, AZ

Today’s walk was a complete success!

As I sat around in my shady oasis, I met several interesting people today.  The first I want to highlight is Anne from Glendale, AZ.  Anne agreed to let me tell her story and told me a little about how her lupus problems have frustrated her over the years.  Her CNS Lupus was diagnosed in June, 1999 on a date she remembers vividly after many years seeking a correct diagnosis.  Before lupus interrupted her career, she worked in and around the Arizona legal community as a court reporter.  Eventually, her central nervous system lupus disrupted her job-related mental skills and triggered her medical retirement.  She began receiving Social Security Disability benefits, and these eventually converted to Social Security Insurance retirement benefits after she reached normal retirement age.  Anne was a joy to speak with and we shared a few enjoyable minutes in the shade chatting.

LFA 2013 Walk Elizabeth

Liz and Friends after the Walk

Also camping out at a shaded picnic table after the race, Elizabeth and her group of close friends and family conversed about their lupus connections with me.

Liz was hospital nurse for many years, until she reached a point where she felt her CNS lupus might be posing a medical risk to her patients.  It was a wake up call when she realized she was using way too many post-it notes “all over her patient’s medical records” to keep track of their information and things she needed to do in their treatment.  She felt her CNS lupus might be a threat to the lives of her patients.

Eventually, Liz retired because of the  essential physical and mental functions her nursing career required.  She shared her amazing story of personal strength and persistence.  Nearby, the family and friends on her walk team demonstrated the genuine and encouraging support circle every lupus patient needs and hopes for.

LFA 2013 Walk Finshers

Finishers Cross the Line

Also, in my shaded corner of today’s walk was Toni, today’s walk chair, as she stood briefly after the walk talking with ex-nurse Liz and David, the Arizona LFA representative.   Tony moved so quickly without stopping I never managed to snap a good picture of her!

Toni is an amazing woman with lupus who eventually retired from her army career.  While serving our country in Afghanistan, acute lupus kidney failure quickly sent her stateside and terminated her activity duty status.  Eventually, lupus led to her medical retirement.

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The winning team raised thousands!

Toni’s team brought in today’s highest combined contributions totaling well over $4,000  from over 60 individual donations ranging from $5 to $500 dollars each. Her team’s efforts are an outstanding example of people joining small efforts together to make a great difference!  Her team of sponsors and walkers showed their overwhelming support of Toni and the Arizona 2013, Walk to End Lupus Now.

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The day after the walk

The day after the walk…

Now it is “tomorrow” and Sunday afternoon, and I am finally finishing up my summary about yesterday’s walk.

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My husband, advice giver and walk volunteer!

Today, I have stayed home from church to rest — in strict adherence to my husband’s wise and persuasive advice.  After yesterday’s walk, I rested all afternoon while my husband volunteered to do our weekly laundry for me.  Today, I feel as if I walked 30 miles yesterday, but all I did was watch a throng of people do all the walking!  I just sat in the shade chatting, taking a few pictures, processing walker registrations for a couple of hours and watching as real walkers completed their course.

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Lupus is unpredictable!

Lupus is unpredictable and funny that way.  Sometimes, just having an eventful day is enough to bring on exhaustion and fatigue in its wake the next day.  Today, somebody (lupus!) pulled my plug and I am all out of steam to run my little engine.

Alas, today I am not even the “little engine that could.”  I thought I could, but I can’t!

Thank you, donors!

Last, but not least, I would like to extend a very special thank you to  my family, friends and co-workers who supported me and invested in the Arizona Walk to End Lupus Now, 2013.

More walk pictures…

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LFA 2013 Walk Taylor

LFA 2013 Walk Walkers

LFA 2013 Walk David from AZ LFA

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Lupus Adventurer in Conference and Classroom

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A month of education!

It is hard to believe that it has been a few weeks since I have had a minute to sit down to write!  It seems that April was filled with nothing but classrooms, conferences and training sessions.  I have been an attendee, performer, and instructor all in a short one-month time keeping very, very busy.  My educational adventures are not quite complete, but this has truly been a month full of learning.

Duet

LA (left) sings duet with friend

Early in April I had the pleasure of attending a statewide women’s Bible conference hosted annually by my church.  I shared the privilege of singing a duet at one of the sessions with one of my best friends.  The music went well, and the weekend was one of spiritual recharge, excellent bible teaching, good music and warm fellowship.  I saw many old friends, and made a few new ones before getting ready to leave Arizona for the east coast.

Hair curls, manicures, pedicures but no lupus cures...

Flying out to Maryland

Next, I flew out to Maryland for a week-long professional legal management conference, and during off hours enjoyed some fresh salmon dinners and sailboat watching on the shores of the Potomac.  In my hotel room I worked on a PowerPoint presentation I would be using the following week back in Arizona.

Returning to work the following Monday, I jumped right into my role as teacher.  Enlisted by the Human Resources and Safety Offices to teach a two-week series of classes, as part of my government employer’s Safety Training Week, my education-filled month continues!

Ergonomics Wordle

Teaching Ergonomics Class

Every morning this past week (and all of next) is taken up teaching classes to my fellow employees about Ergonomics and Back/Lifting Safety.  I have enjoyed getting to know co-workers better, and found interaction with the class members very enjoyable.  With the help of my assistant, it has proven to be a bit more fun than work, and I am grateful to share some information that can help prevent co-workers’ injury!  I am looking forward to the remaining classes next week.

As part of our safety training week, I also attended a class on CPR, and learned the new “no breathing” method of cardiac chest compression.  I was pleasantly surprised to learn that, even with my joint and lupus arthritis challenges, I was able to do this type of CPR.  I had always been afraid I would not hold up long enough to do anyone any good in an emergency.  I learned that using my body weight to make the compressions, and not my not-so-strong muscles, I could potentially save someone’s life without wearing myself out before paramedics could arrive.  Click here, to read more about this easy to learn CPR method.

Dr. Amy H. Kao, Director of Biomedical Informatics at Lupus Center of Excellence at  WPAHS

Dr. Amy H. Kao, Director of Biomedical Informatics at Lupus Center of Excellence at WPAHS

This simple live-saving CPR would be a good thing for lupus patients, their friends and family (perhaps anyone) to learn.  To find out more about lupus and the heart, check out this 2009 Lupus Foundation of America educational web chat with one of the nation’s leading lupus and cardiology researchers, Dr. Amy H. Kao, M.D., Cardiovascular Health and Lupus.

Dr. Kao explains that, “young women with lupus have as high as 50-fold increased risk of having a heart attack compared to healthy women of similar age.”

Perhaps, after considering all my educational activities, the new CPR method was the most important.

Let’s hope I never have to find out!

Join Lupus Adventurer in Arizona Walk to End Lupus Now April 27, 2013

Walk to End Lupus Now LogoWalk to End Lupus Now – Arizona 2013

I am extremely excited to announce that on April 27th, the Lupus Foundation of America, Arizona Chapter and the City of Scottsdale, Arizona are sponsoring the  Arizona 2013 Walk to End Lupus Now™.  This spring, all over America and the world, local communities are holding their own Walk to End Lupus Now™ in an annual fund-raising campaign to support the Lupus Foundation of America.

Butterfly: Lupus Adventurer's Blog Mascot

Would you join Lupus Adventurer’s Walk Team?

My team’s goal is to raise $500.00

I would be extremely honored if each one of my readers would consider supporting the Walk to End Lupus Now™ in any of these four ways.  Would you please consider supporting me and my team?

1. Sign up to join my walk team as a walker if you live in Arizona and can come out on the day of the walk.  I would love to meet you!!

You have probably noticed that my identity is a careful mystery here on my blog, out of necessity for internet security reasons.  However, the Lupus Foundation of America Arizona and National offices staff know my true identity.  If you are able to join my team and you can come out on the day of the walk, I would be honored to meet and get to know you personally on the day of the walk.

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How could you support us?

2. Sign up to join my walk team as a virtual walker, and get supporters to sponsor you or simply make a modest donation.

3. Sign up to sponsor me for the walk – Although I am unable to physically walk due to lupus arthritis and sun sensitivity, in my “virtual walker” role I will be busy supervising the walk registration booth. Supporters can sponsor me personally at
http://lupus.donorpages.com/Arizona2013/LupusAdventurer/
.  I will collect no money myself.  All donations supporting me or my team can be made directly online for the Lupus Foundation of America.

purple cheerleader4. Join my walk team as an enthusiastic member of our cheering team, and encourage my team with your comments here or on my Lupus Adventurer Virtual Walkers Team Page.  I know everyone cannot support us with money.  However, your encouragement and prayer support for the safety of the lupus patients, and their friends and family who come out on the day of the walk would be simply awesome!

AZ Lupus Walk Home Page PixWhy have a 2013 Walk to End Lupus Now™?

The purpose of the 2013 Walk to End Lupus Now™ is to raise funds for the Lupus Foundation of America (LFA).  The Arizona walk goal is to raise $50,000 for the 90,000 people living with lupus in the Arizona area. Your donation will help me reach my personal fundraising goal of $500, and I hope that you’ll help me reach this goal!  I realize these are tough times for many people, but every bit helps!!  Separate small donations together would be enough to make a difference.

Lupus Now Lupus Adventurer Team Page 2013Join the Lupus Foundation of America and thousands of walkers in nearly 60 cities across the nation to raise money for lupus research, increase awareness of lupus, and rally public support for the estimated 1.5 million Americans who suffer from its brutal impact.

Walk to End Lupus Now™ events give all people affected by lupus the opportunity to come together for one unified purpose, to end lupus.

Before donating, I would urge you to check out the Lupus Foundation of America‘s web site at to learn more about this year’s Walk to End Lupus Now™ and to verify the credentials of the walk registration site.

Arizona Walk Information Site:


http://lupus.donorpages.com/Arizona2013/

Lupus Adventurer Virtual Walkers Team Site:


http://lupus.donorpages.com/Arizona2013/LupusAdventurerVirtualWalkers/

Lupus Adventurer’s Personal Walk Page:


http://lupus.donorpages.com/Arizona2013/LupusAdventurer/

Thank you so much for considering your role in support of the 2013 Walk to End Lupus Now™.

Lupus fatigue midst the hope that springs eternal

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Hope midst lupus flare

Hope springs eternal, and so it must be for me with my lupus.  Over the past few weeks, I struggled daily with overwhelming fatigue and bone-tired exhaustion from a long, low-grade lupus flare.  Discoid lupus rashes have popped up on my scalp, fingers and expanded in size and aggravation where they already were stubbornly persisting.  Mouth and nose ulcers, and lupus rashes in some very unusual places, such as the opening of my ears have emerged anew.

My job has suffered, while many days  I was only able to work half-days and was struggling to fulfill work responsibilities.  It has been a challenge to feel hopeful in the midst of such weariness.

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Hope is still there

However, hope is still there, deep down, flowing inside me through a place far below the surface of the flare, ever-present and encouraging.  Hope.

Hope that tomorrow will be better, that increased steroids and today’s Benlysta infusion will shut down my flare, and that I will do better in my work again soon.  I must persist in my hope that I will be able to better meet the needs of my family again, that I will feel like cleaning house, maybe even as soon as tomorrow.  I have abiding faith and hope that God will enable me to get my eyes off of myself again to look outward instead of focusing inward so much, as I unfortunately have been doing of late.

I am convinced that hope and faith do not look down, backward or inward, but rather upward, forward, and outward.

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Hope looks upward, forward, outward

Hope depends upon faith.  Faith in someone or something bigger, stronger, wiser, more powerful than myself.  There is no question now that this someone on which to direct my faith is not me.  Hope comes from faith, and the ability to relinquish and invest my trust into that one I have faith in.  My ultimate source of all hope is  the Lord, for He alone is greater than my finite mind can comprehend — in his vast wisdom, love, mercy, power, strength and so much more.

I can trust Him, and I can trust that these things that He permits (not causes) to come into my life because of lupus, such as this month’s weariness, will not always be the way they are today.

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Infusion and hope

So, I hope.  I sit here at the infusion center with Benlysta flowing into my veins, and hope.

My flare will ebb, my rashes will be relieved, my strength will return, my medications will work, and I will be better tomorrow than I am today.  I will choose to have faith, to trust, to have hope and look up, not down.  From deep within me where God himself has graciously touched my heart, I know joy welling up and arising through my weariness.

The joy of the Lord is my strength, and my joy will be greater than the flare and weariness of today.  Today I choose joy, not because of how I feel or because of fair weather, but because of the One in whom I trust for tomorrow.

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Choose hope. Tomorrow the sun shines!

All day a fierce late winter storm blew through Arizona.  I traveled down the freeway to the hospital in a driving afternoon rain, with windshield wipers slapping back and forth in a sloppy rhythm.  The downpour drenched my clothes in the mere 30 steps from my car to the hospital front doors.  The nurse greeted me with a warm welcoming hug, but I gave a decidedly damp one in return.

Although it rains, and my joints hurt and I am tired, I still have hope and believe.  Tomorrow, the sun shines!

Today, in my lupus flare, weariness and pain, I choose to rejoice.  I choose hope.  I choose joy.

Lupus Fatigue and Finding a Fighting Spirit

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A tidal wave of lupus fatigue.

As I stand barefoot on my cold, wet beach and watch the receding tidal wave of lupus fatigue ebb away from my shore, I see surrounding me the vast lifestyle devastation the overwhelming flood of tiredness left in its wake.  Mayhem is everywhere.  Laundry sits unfolded, dust accumulated, real and junk mail sit in an unsorted stack overflowing my desk, and my rugs and floors are looking pretty sorry indeed! All around is a general sense of disordered clutter and mishap.

While seeking a means to withstand the exhaustion and bone-tired feelings, all my work seemed half-abandoned at home and at the office.  I spent many days sleeping until noon, some days telecommuting, some days lounging in pajamas all day, a few days going in for half-days, but braved only a couple of full in-the-office work days.  The siege of fatigue waters have left an unkempt landscape about me as my physical weariness finally begins to recede.

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Domestic and professional
disorder after a flare

Once again, I begin to pick up the scattered domestic and professional pieces of my normal life following a lupus flare.

Although this flare has been quite disabling and my lupus arthritis was very aggravated, I am thankful that neither my central nervous system lupus nor neuropathy flared.  Through the last couple of weeks, these often clear manifestations of my lupus have remained unusually quiet, and for this I am grateful.  At least, this was not an all out every system lupus attack, it was merely physical and not mental.  The only predictable thing about lupus is its unpredictability.

Butterfly in the Snow

Hope and snow yesterday!

I had hope yesterday and even more this morning that my two-week flare of lupus fatigue is finally ending.

Yesterday brought a massive real weather storm to Arizona, and parts of the Phoenix valley saw snow, sleet and hail – a rare phenomenon in our desert city!  I stood on the second floor balcony at work with co-workers, as we held our hands out to catch and look at the soft white substance that melted on our hands and accumulated on ground below.  My son-in-law, a native Phoenician, regaled us last night with a report of his first experience driving in snow.

Although we had heavy rain and icy forms of precipitation all day long, I was feeling measurably better and was able to work a full day at the office.  My joints were still very sore, but my spirits and energy were on the rise.

Lupus Alone

Birds, singing in the rain!

This morning, as I hear the birds singing outside my window, I feel a little like joining them.  Perhaps a couple of the areas of disorder that are now beginning to bother me will get tackled this morning. Earlier this morning, I stood outside in the 48 degree morning chatting with husband while his rain-soaked car warmed its engine and dripped into the puddles on our driveway. The cool, moist morning air felt refreshing today instead of wearying.

With near exuberance I heard myself proclaim, “I feel almost like myself again.”

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We will rejoice and be glad

Indeed, every storm has an ending, and today, I have once again found my fighting spirit!

I am just now reminded of the scriptural words I sang to a simple hymn I played yesterday morning at the piano.  “This is the day that the Lord has made, we will rejoice and be glad in it,” Psalm 118:24.

Montreal report shows possible connection between lupus activity and smog particulates

LA Smog by Ben Amstutz, Flicker

Photo credit Ben Amstutz, used with permission

Today, I read in Environmental Health News about a 2010 research report about lupus and environmental triggers.  A lupus treatment center in Montreal studied the possible connection between pollution and lupus flares. Citywide collection of smog readings and lupus activity for over two hundred lupus patients were reviewed over a seven-year period, leading to evidence of a possible connection between a specific smog component and increased lupus activity.

This is one of the first reports to study a connection between smog and its possible affects on lupus activity.  To read the full report, please visit the following link.  PM 2.5 Pollution Linked with Lupus Activity

Smoggy Bay Area

Smoggy Bay Area

Smoggy Beginnings

My own connection to unhealthy smog exposure dates back to my early childhood.  I grew up in the San Francisco Bay Area, and developed allergies to the region’s smog.  I remember my doctor talking to me about my condition he called “bay area throat” in the 1960s and 1970s, described then as a regional phenomenon connected with smog irritation.  I can remember summer smog alerts when I was a child.   Late summer climatic heat inversions trapped the brown smog laden air near the ground and caused rare hot weather around the Bay Area.

After high alert smog exposures, I would often develop respiratory congestion with symptoms of inflamed vocal chords and a hoarse voice.  This was a great recurring frustration when I was studying classical music and voice performance at the university there!  One time years after leaving the San Francisco Bay Area, I returned to my home church in the East Bay to do a concert with my singer/pianist husband, and lost my voice with the same symptoms.  He had to perform all by himself!

Smog exposure

High smog exposure levels in cities

Smog exposure commuting

While living in Phoenix, I was eventually diagnosed with smog-connected nasal allergies, long before also receiving lupus and asthma diagnosis.

My own lupus was not diagnosed until my early childbearing years.  After my second child was born, my ever-changing symptoms showed distinguishable patterns and I was finally diagnosed with lupus.

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Smog exposure commuting

Over the next ten years, I commuted to my jobs in Phoenix law offices every day on the city bus, usually switching buses at points in the heaviest morning commute corridor of the city.  Over those years, I had daily exposure to some of the heaviest concentrations of smog possible in Arizona, and according to an article I read, one of the ten most polluted areas in the country.

Perhaps any connection with smog in my auto-immune history is a coincidence, but perhaps smog components were one of many causes or contributing factors to my development of active lupus.  This type of possible environmental trigger should be studied more to help find or rule out smog as a possible link to triggering lupus and its flares.

http://www.google.com/imgres?start=149&hl=en&newwindow=1&tbo=d&tbm=isch&tbnid=XwwXgvq2Gv2pxM:&imgrefurl=http://www.helpowl.com/a/Chrysler/2007-PT%2520Cruiser/Research/1674%3Fsearch%3D2007%2520chrysler%2520pt%2520cruiser%2520radio&docid=vtKW39tYMB_CSM&imgurl=http://i3.ytimg.com/vi/iWetDLKDHRs/hqdefault.jpg&w=480&h=360&ei=QzCfUOb1CY7UigKm9oDABQ&zoom=1&iact=rc&dur=6&sig=110339196146817075919&page=6&tbnh=142&tbnw=179&ndsp=31&ved=1t:429,r:72,s:100,i:220&tx=66&ty=-145&biw=1600&bih=646

Avoiding smog while commuting

Avoiding smog exposure

I no longer commute on the bus for several health-related reasons:

1) Waiting for buses and walking several blocks to my destination provides too much sun exposure for my lupus and causes skin rashes and other lupus symptoms to flare.

2) My lupus arthritis prohibits my ability to walk any measurable distance.

3) Exposure to the smog aggravates my allergies and asthma, which when flared, also seems to trigger flares of my lupus.

Consider commute methods

Consider healthiest commute alternatives

Now, I drive my car a total of almost 50 miles each day commuting four days each week and telecommute the fifth day.  While driving, I keep my car windows closed, my air conditioner on (it is Phoenix, after all) with the fan set to circulate the air inside my car.

I shun the smog as much as possible!  Whether or not this helps my lupus or not, I do know it helps my allergies an asthma.

My advice to other lupus patients is to carefully consider your form of transportation carefully.  If you show any worsening of symptoms that seem triggered by exposure to smog or other environmental elements, talk to your doctor about it!

Read more about smog and health/lupus:

Lupus and teaching an old dog new tricks

Teach an Old Dog New Tricks

I just fed my dog his dinner, and am reminded once again of the age-old adage says that “you cannot teach an old dog new tricks.”  Recently, I determined to test this decidedly negative behavioral theory.  As a result, the outcome encourages me in my own efforts toward building new healthful habits to help my battle against systemic lupus.  This adventure started with an annoyance that I determined had to be stopped, and ended with profoundly reformed behavior in my aging dog. I proved that even old dachshunds with greying noses can be retrained in their declining years, so there is still hope for me.

How old is that old dog?

Rudy is fifteen years old next month, and not a pup by anyone’s standards.  In the most conservative of “dog years” that makes him equal in age to an 80 year old person, and by many people’s standards he could be as old as 105.  You can’t tell him that, because he still thinks and tries to act youthful, exuberant and only recently ceased jumping waist-high to peer at approaching visitors through the window in the kitchen door. He still thinks he is a puppy, even though he can no longer jump up on our bed due to some doggie arthritis.

15 candles cupcake

80 in Dog Years!

I miss seeing Rudy popping up and down, with his rust colored miniature long hair dachshund ears flopping up and down in mid-air as I unlocked the door each evening.  I greeted him with  the commentary, “jumping doggies”.  It was pretty cute behavior and lasted for well over a dozen years.  He is still decidedly enthusiastic about everything.

Perky behavior gone awry!

That same perky behavioral trait became a source of exasperating annoyance and began to wear on me.  At some point, it was not so cute any more.  My little dog began demonstrating some serious anti-social behavior, exacerbated after my daughter and her husband came to live with us.  He seemed ultra-motivated by the presence of four adults in the kitchen each evening, all gathering around the stove chatting socially as I finished cooking.  He didn’t like being ignored by the humans in his kitchen.

As dinner is just about ready to be served, many nights we stand around at the counter after I have put dinner on the plates to pray together before dispersing to sit in front of computers or televisions with our meal.  Other nights, we stand around and chat for a while while I finish, and then sit down at stools around the large kitchen counter and eat together.

Dog bowls

Yelping and Flipping Bowls

Paws in our prayer time

Rudy began identifying this family gathering and prayer time as an excellent opportunity to get attention and remind us it was time for his dinner or for a water refill in his bowl.  His food sits at the base of the counter, just to the side of the stove area.  Each night he started yelping, barking, jumping and cavorting to get our attention, dancing around our feet, tripping us and creating chaos.  He would grab his bowl in his mouth and flip it on the tile floor, annoying us even more.  High volume and yapping kept escalating until one of us would finally raise our voice in exasperation and shout at him loud enough to get him to stop, “RUDY!”

After the outburst, the congenial chatter was disrupted, and a stressful sense of irritation was felt by all the humans in the room.  Yelling at Rudy made everyone on edge, and we had all succumbed to the temptation, pretty much taking turns.  Four adults had become victims and Rudy was the perpetrator!  Meanwhile, after disrupting our conversation and invoking our ire, Rudy would roll around on the floor wagging his tail in front of us in victory.  It wasn’t long before we were getting pretty fed up with the dog.  What could we do?

conditioned response cartoon

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Theory: I am smarter than the dog!

I theorized that he felt rewarded by the intense attention he received after accomplishing his twisted anti-social goal to become the nightly focus.  This was clear when he often did not even eat the food we had put down to shut him up!  My sneaky little dog was pretty smart and had figured out how to make us notice him by acting out with bad behavior, much like a child, until he got our attention. Perhaps I should consider if there was a better way to meet his real little doggie need better.

Yelling at him simply didn’t work any better than it had with my strong-willed children.  Dachshunds are known for their stubbornness.  In fact, hollering fueled his (and my kids’) poor behavior more.  I knew I had to be smarter than the dog!  I pondered how to change the behavior of my old dog, and toyed with how to apply the proven concept of conditioned response to find a solution.  I wondered if it would it work at his age, or was he just too old to learn a “new trick?”

Dog food package

Control with Conditioned Response

I began interrupting his antics with verbal and visual hand commands to sit and then lay down and stay.  I consistently worked with him until he would finally respond each time and lay all the way down and stay in that place until fed.  Within just a few days he started connecting the reward of being fed or getting water with the sequence of first being made to sit in a specific position on the rug by his bowls.

I make him stay down and be quiet while I fill the bowl, and while holding it in my hand, I squat down and pat him on the head and pet him, telling him softly how much better I like him being such a good dog.  Any time he would get up from “the position” before I was done, I would stop getting him food and go back to doing something else, reminding him meanwhile to return to the “please feed me pose” using the visual command of pointing down, while saying “down.”  Once he would resume the proper pose, I would resume getting the food.

When I have his food, I signal him to stay down until I place the bowl on the floor and say “okay, go ahead.”  I stuck to this training consistently, and within a couple of days he got the idea, and within a week he had learned it.  It has been a month now, and he is consistently behaving properly in the kitchen.  If he starts his earlier antics, a hand gesture stops him and he grudgingly (but quietly) assumes “the pose” and waits for me.

Conditioned reponse cartoon mouse

Learned New Tricks

The old dog learned new tricks

As a result, he is getting positive attention and affection, on my terms instead of getting yelled at.  He has learned to quietly sit in the “feed me pose” on his own, without being told to so.  Each time, we reward him with the pat on the head, kind words and then food.  Also, we have let him know it does not work any other time.  He doesn’t get to use it to push our buttons to make us do things like give him treats.  This “communication” is only to tell us he wants food or water, and only works twice a day, at normal doggie meal times.

The problem was solved.  We again have control of our pre-dinner chat time, and my old dog has again accepted that he will not be rewarded for trying to be an annoying center of attention.  I won!  I am smarter than my dog! Hurray! (Was there a doubt?)

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What about me?

Next, I began to correlate what I had learned from Rudy, and started to think about myself and the need to consistently exercise, and to lose about 25 pounds.  I thought to myself, if my very old dog can learn a new positive behavior at this advanced stage of his life, what about me?  At 55 is it too late to get weight off and drop a couple of dress sizes?  In the last year I have gained 10 more pounds.  I don’t want to do that annually, or very soon I will have  grave health troubles!

I am inspired with new goal to drop to 155 while I am still 55.  I need to comply with my doctor’s exercise goals, and eat the healthy diet that used to be my normal eating patterns before the kids moved in with us.  I have most of a year left to  develop the self-discipline, healthier eating habits and meet my exercise and weight loss goals.

After all, if my old dog Rudy can change his behavior in a week, surely I can succeed in the adventure of accomplishing my exercise and weight loss goal this year!

Surely, I am smarter than my dog!

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