One Patient's Positive Perspectives

Posts tagged ‘diagnosis’

Lupus Fact & Blog of the Day No.15 – Dominate Your Diagnosis & Four Types of Lupus

Lupus Awareness Blog No. 15 – Dominate Your Diagnosis

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Working on daughter’s quilt

Today I want to introduce you to a fellow lupus blogger, Leslie.

Leslie loves to quilt, do wool applique and make handmade cards.   She was diagnosed with systemic lupus over ten years ago and faced a “huge adjustment” from “being an independent person” and she began to realize how difficult it was for her to ask others for help.

She knew that she and others in her community with lupus needed support, and started facilitating an LFA lupus support group in Pennsylvania.

In Leslie’s search to stay out of the “rut” that chronic illness can easily put us into, she read “Being Sick Well” by Jeffrey H. Boyd, and gained a helpful perspective.

She describes a defining aspect of her outlook and blog vision in her first post.

“The only course of action is to keep the diagnosis under control-govern it, rule it, dominate it.  This is something we have to choose to do day by day sometimes moment by moment as we strive for autonomy from the diagnosis of chronic illness.”

“In this blog we will explore together strategies that have the potential to help us reclaim our lives, body, soul and spirit, from the diagnosis.”

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Loves to quilt & applique

To find out more about Leslie’s interesting story, read a three-part biographical post series about her lupus journey.

  1. Part One: Pre-diagnosis: Rashes and Miscarriages
  2. Part Two: Diagnosis and Rheumatologist
  3. Part Three: Support Group, Work, Reynauds, Sjogrens and Faith

I trust you will find her blog an encouragement and refreshing mix of facts and faith as you join her on her journey.  Her blog is one of my “faves” and is always an uplifting read.

Lupus Truth No. 15 – The Four Types of Lupus

Coping with Lupus: There are four distinct forms of lupus.

Systemic lupus is the most common type of lupus. The other three forms of lupus are cutaneous, drug-induced and neonatal.

Drug-induced lupus and neonatal are not a sustained lupus, but systemic and cutaneous lupus are auto-immune conditions that tend to stay with a patient throughout their life, since there is no known cure yet for the latter two forms of lupus.

  1. Systemic lupus – organ and non-organ threatening
  2. Cutaneous lupus – non-systemic discoid lupus
  3. Drug-induced lupus – caused by certain medications known to produce temporary lupus
  4. Neonatal lupus – affecting newborns born to mothers with lupus

To learn more about this lupus fact, please read my post from  May 15, 2012.

Adobe Photoshop PDFPlan to POP — Put on Purple — for Lupus May 17th

Perhaps change to your great grape Juicy Couture purse to get ready to “POP” — Put on Purple — for Lupus this coming Friday, May 17th!

Lupus Fact & Blog of the Day – No. 6 – Lupus Chronicles and Lengthy Diagnosis Times

Lupus Awareness Blog No. 6 – Nurse Annie’s Lupus Chronicles

Today, I would like to introduce you to lupus patient, blogger and freelance writer Annie.  In her 20-year nursing career, she gained knowledge and tools that equip her to “advocate fiercely for patients as they are often caught in the maze of diagnostic tests, etc.”

Her blog has a great feature.  On its “Contact Me” page, Annie invites readers to send her a question about lupus, and she will respond with information based on her experiences as a patient and a health practitioner.

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Nurse Annie

She explains to her readers, “Feel free to ask me something that you might not want to display publicly; remembering that any information we exchange will be held in the strictest confidence and will be sent DIRECTLY to my inbox.”

A nurse's perspectives on lupus

A nurse’s perspectives on lupus

However, I respect how Annie clearly and carefully draws the ethical line to avoid the unlicensed practice of medicine and to refrain from attempting to give specific patient’s medical advice.  Instead, she encourages her readers see their own doctor about their medical needs.  Nurse Annie urges, “Your physician knows YOU.  I know a thing or two about chronic illness and ways to cope with it and tips for interpreting…”

Nurse Annie has the knowledge to translate medical jargon, what she dubs “doctor-speak,” into simple, plain English.

Annie has a good emerging blog presence and a steadily growing reader base.  You just might enjoy reading her interesting and informative lupus blog and her winning outlook on life and lupus.  You might even ask her a medical question or two.  I can attest that she answers her emails!

P.S. – Today is National Nurse’s Day and begins National Nurse’s Week

Looking at my office calendar hung on the left side of my desk, I suddenly realized that today is National Nurse’s Day! I couldn’t help but notice the striking coincidence of today’s nurse spotlight on Nurse Annie!  I wish I could say I planned this strategically, but I did not! So, instead, I am inserting this update to today’s post, to pause briefly and recognize the nurses around us.  Nurses play a critical role in the medical care we receive, and are often the first interface between us and the doctors who direct our care.  Hats off to the nurses who care for us!

A little background from the American Nurses Association about nurses… “Often described as an art and a science, nursing is a profession that embraces dedicated people with varied interests, strengths and passions because of the many opportunities the profession offers. As nurses, we work in emergency rooms, school based clinics, and homeless shelters, to name a few. We have many roles – from staff nurse to educator to nurse practitioner and nurse researcher – and serve all of them with passion for the profession and with a strong commitment to patient safety.”

ANA Banner“May 12, the final day of National Nurses Week, is the birthday of Florence Nightingale (1820-1910). The English nurse became known as the founder of professional nursing, especially due to her pioneering work during the Crimean War (1853-1856). Due to her habit of making rounds at night, Nightingale became known as ‘The Lady with the Lamp’.”

National Nurses Week was first observed in October 1954, the 100th anniversary of Nightingale’s mission to Crimea. May 6 was introduced as the date for the observance in 1982.”  Background information provided by http://nursingworld.org/.

Lupus Truth No. 6 – Diagnosis of Lupus Can Take Time

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Diagnosis takes time

Diagnosis and Treatment: Many symptoms of lupus mimic those of other illnesses, and symptoms can come and go over time, which makes diagnosis more difficult. Because lupus can attack nearly any system of the body at any given time, lupus can seem to be a number of unconnected health problems within the same patient.

To learn more about this lupus fact, please see last year’s post on diagnosis and treatment timelines from  May 6, 2012.

Plan to POP – Put on Purple – for Lupus May 17th

Remember to change to your purple purse to get ready to “POP” — Put on Purple – for Lupus on Friday, May 17th!

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.

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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:

Come to see the butterflies, and leave with lupus awareness

bf on lavender flowers

Come to see the butterflies…

A significant number of people who visit my blog find it through search engines like Google, Bing, and Yahoo.  Since this blog is primarily about lupus, one might think that everyone who finds it is looking for information about lupus.  While that is true for many visitors, a good number also follow links here because they are looking for images of butterflies (maybe because they like butterflies as much as I do!)

No matter why people might find this blog, I am glad that everyone can leave with greater lupus awareness.  This is a place where both butterflies and lupus awareness can be found in abundance.  If you want to know more about the connection between lupus and butterflies, check out my April 24, 2012 post, “Lupus and it’s mascot: butterfly or wolf?“.  This quickly took the “LAward” for the most highly read post on this blog, well into tens of thousands of reads!

bf brown on pink

And leave with…

So, if you are one of those who found me because you were seeking butterfly images, welcome!  I trust you will take a moment to learn a little more about lupus, perhaps by stopping for a few minutes to read a post or two.  You will find at least one butterfly picture in every blog post.

If you want to find out more about lupus, please read the “Lupus Medical Information” page of this blog.  It will take you to a page with basic information about lupus and links to more detailed authoritative information.  I suggest at very least visiting the Lupus Foundation of America at www.lupus.org.

If you just want to see the pretty butterflies and don’t feel like reading about lupus, no problem!  Please just click on the “Butterfly Collecting Adventures” button or browse through posts to see the butterflies on each, and enjoy.

My hope is that maybe you will do both — enjoy the butterflies and learn more about lupus!

If all you really want is a postage stamp summary of lupus, and no more, here are a few quick points:

  • Lupus is a systemic connective tissue disease in the same family of auto-immune illnesses with rheumatoid arthritis affecting skin, organs and other tissues and body systems.
  • Many lupus patients have skin rashes, arthritis, fatigue, mental clouding, mouth/nose ulcers, a butterfly shaped rash on their cheeks and are positive for antibodies against their own body cells such as ANA (antinuclear antibodies).
  • Lupus can attack the kidneys, and is a leading cause of kidney failure.  50% of lupus patients have some level of kidney involvement.
  • Lupus is difficult to diagnose, because it affects so many systems of the body, and can easily be confused with other diseases.
  • Lupus affects each person differently, and can change suddenly and unpredictably in the same patient, going in and out of flares and remission.
  • Although lupus is potentially fatal, if found early enough and treated properly Lupus can be well-controlled.
  • Most patients can live a normal life span with little or no organ damage with standard treatments.
  • Lupus is an important women’s health issue – it discriminates unfairly against women and minorities.  90% of lupus patients are women.
  • Lupus is more prevalent in women of color: Hispanic, black, Asian, and American Indian women, with the highest mortality rate in elderly black women.
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Lupus awareness…

Lupus awareness is very important, especially for those people who don’t yet know they have lupus.  For example, many people know enough about diabetes to recognize possible symptoms in another person, and would urge someone with diabetes symptoms to seek medical advice.  So, also, knowing enough about lupus to recognize its common signs and symptoms in a friend or family member could make a great difference, or possibly even save her life.

Lupus awareness is very important.  Although there is no cure yet, there are new and exciting medications, treatments and ongoing research that can help prevent lupus from destroying the health of those who have it.  Because one out of every 150 people has lupus, it is very likely that someone you know has lupus.

Thank you so much for stopping by, even if it was just to see the butterflies.  If you learned a little about lupus, even better!

bf flying and landing

Thank you for visiting
Lupus, the Adventure Between the Lines!

The Beatles and two childhood friends with Lupus

The girl next door had lupus

The girl next door had Lupus.  We didn’t know it at first, but one day a few years after my husband and I were married, we were visiting my folks in California and my mother told me about Julie’s illness.  Later that week, we walked over to the house next door to see Julie while she stopped in to see her mom.  Julie and I sat down with our mothers in their kitchen and shared a cup of coffee and a long catch-up chat. Julie showed us the discolored rashes on her face, and told us about some of the troubles she had with lupus.

The somber mood of that conversation about lupus haunted me.  Lupus had become the great tragedy of Julie’s young life!  It was not too much later that I was also diagnosed with lupus.

front yards where we played together

trying to beat each other at jacks

When Julie and I were both children, we never worried about things like getting lupus.  We spent our time playing with dolls on each others front porch steps, playing hop scotch, shooting marbles and trying to beat each other at jacks.  Sometimes we would get all the kids together and start singing songs with our hair brushes as microphones, pretending to be the music stars we wanted to emulate.

Once in awhile, older girl who lived across the street would round up all the neighborhood kids, including her 11 younger brothers, and coax us all to act out the play scripts she had written.  Our neighborhood playwright’s front porch also happened to be the best “stage” on the street.

Julie had a sister one year older than me, my sister was two years older, and Julie was one year behind me.  Our ages made us all perfect playmates, except for the brief periods of family kid feuds that would spawn from time to time out of our corporate immaturity.  There were 9 kids between both of our large families, and on summer days, we would all set out on foot to the public swimming pool at the high school.  It was there Julie and her older sister taught me and my older sister how to swim.

both diagnosed with lupus

I had lupus arthritis symptoms as a child, pleurisy, mouth ulcers, and rashes, but never noticed if Julie also showed signs of it earlier in her life.

The stars we emulated in our front porch “concerts” were our favorite 60′s bands the Beatles, the Beach Boys and the Monkeys, and our favorite female singer Nancy Sinatra.  We each took turns performing our loud unaccompanied renditions of songs like “I Wanna Hold Your Hand” and “These Boots are Made for Walking” on our front porch “stages,” while all the other kids sat on the grass as our audiences.  If you were not around during the 1960s, these musical details will probably mean nothing to you.  But, I can even remember watching the famous “Ed Sullivan” TV show in the early 60′s when the Beatles had just come to America from England, when their performance was broadcast on live black and white TV.

I recently viewed this Lupus Foundation of America lupus awareness video by Julian Lennon, the son of singer and song writer John Lennon of the Beatles.  Julian tells about his young childhood friend, Lucy, that died from lupus in 2009.  Lucy was the inspiration for the Beatle’s hit song “Lucy in the Sky with Diamonds.”  Julian Lennon is a Global Ambassador for the Lupus Foundation of America and benefactor of the St. Thomas Lupus Foundation in the UK.

In Julian Lennon’s video, he tells about his connection to lupus and his friend who had lupus, Lucy Vodden.

Prognosis and Hope: Lupus Fact #31 – Lupus research lengthens lives!

Prognosis and Hope: Today, people with lupus are leading healthier lives and living longer than at any time in history, thanks to researchers who continue to discover more about the underlying science of the immune system. When I was first diagnosed with lupus almost twenty years ago, this was not the case, and prognosis that people heard was not encouraging.  Today life expectancy for lupus patient is much longer, and the information available about lupus life expectancy is more accurate and much more encouraging!

Other people’s negative lupus outlook

Lupus diagnosis, and other people’s’ negative idea of the prognosis

The first thing I heard from people after my lupus diagnosis was that my life expectancy might only be about ten years.  Some people acted as if I had received a death sentence, and it sure sounded like the statistics were pretty grim. I was a young wife and mother, my doctor was more encouraging than everyone else, and I was concerned, confused, and frankly a little afraid.  Why did everyone else think I was going to die prematurely, but my doctor said lupus was the good news in the diagnosis he had considered.  I was diagnosed twenty years ago.

Lupus information in “dark ages” before the Internet

Lupus information in the “dark ages” before the Internet

My lupus diagnosis came during the early days of the Internet, when finding out information required physically going to a library and spending time in study. Although this sounds very cliché, “back then” we didn’t have the world’s information at our fingertips, not at work, at home, and certainly not in mobile devices! We didn’t even handheld electronic devices then, and there were only a few of the earliest mobile phones out there, in the hands of the wealthy few.  It was definitely a totally different age and time, very unlike today’s information highway and instantaneous access to knowledge.  What a vast difference a mere two decades have made!

Most of the medical and patient information books about lupus in the libraries were ten to fifteen years old.  The bookstores were a little better, but not much.  They all said much the same thing about lupus life expectancy as the widely held “live ten years” fable.  There was little up-to-date information available to support a different outlook. Unfortunately, the false negative impression about life expectancy prevailed in what people thought then about lupus. Even though researchers had better information, the word was getting out very slowly, the old-fashioned way.  Access to accurate information was slim and hard to find.  Everyone pretty much still believed the ill-conceived fable.  I asked myself and my doctor, “do I only have about ten years to live?”  Fortunately, he knew better and encouraged me to be positive, but convincing other people was another matter!

Positive research results misconceived as negative news

How the grim 10-year lupus life expectancy myth started

I recently learned where the original wrong concept about lupus life expectancy started.  Years ago, a major lupus research study was conducted over a ten-year period,  and the patients’ lupus status was  carefully followed for 10 years, and then the study ended.  The widely publicized results of this ten-year research project were shared with the medical community and the public.  The outcome was very good news for lupus patients.  At the end of the 10 year study, more than 80 percent of the lupus patients who started out taking part in the study were still alive. But that is not what people “heard” when they learned about study.

Somehow, the news reports and information that was repeated from report to report about the study became slightly turned-around and turned upside-down to communicate a vastly different, almost opposite message! Instead, a false conclusion was propagated, misinterpreting the ten-year study results to say that “life expectancy for lupus patients is ten years.” Maybe it would have been less confusing if the researchers had explained it this way, “most lupus patients survive at least ten years after their diagnosis, or longer.”  But the idea went out that way, and that is what seemed to stick in everyone’s minds.  So, when I received my prognosis, the first thing people thought was that I would probably die in ten years.  I am so glad that was wrong!!

New lupus outlooks!

Myth-blasting information, new lupus drugs and better prognosis

Now, there are some wonderful brand new medicines, such as the new biologic drugs like Rituximab (Rituxan) and Belimumab (Benlysta,) the latter of which was approved over a year ago by the FDA just for lupus, in March of 2010.  Belimumab is the first new drug approved by the FDA for systemic lupus in over fifty years.  Before that, the FDA had only approved three drugs for lupus: 1) aspirin, 2) prednisone, and 3) hydroxycholoroquine (Plaquenil.)

Our doctors and rheumatologists now know so much more about lupus than when the old “10-years” study was done.  And even though that study really gave good news, the news is even better now.  Doctors have learned more about lupus in the last ten to twenty years than in the 100 years before that.  There are more new biologic drugs in research and development, and many are successfully progressing through clinical trials. Some of these new drugs will stand next to belimumab to help treat lupus in more effective ways.

This is the best time in history to have Lupus… although Lupus is still incurable, it is very, very treatable!

Yes, lupus can be fatal.  In its most severe, organ-threatening flares, it can attack a patients organs, such as their kidneys, and quickly get them into serious medical trouble.  This level of life-threatening lupus involves only the smallest percent of lupus patients. The key for all lupus patients is to get prompt medical attention, and to interrupt every single flare as fast as possible.

Lupus Foundation of America leads in lupus awareness

The role of lupus awareness in lowering mortality rates

One of my passions is helping spread two kinds of lupus awareness.  Early diagnosis and treatment leads to less escalation of lupus severity, and that can mean lower mortality rates.

First, lupus patients need to know how to look at their disease in a way that will allow them to be victorious in reaching their goals and dreams.  They need to know how to quickly get the medical care they need, and to find their best niche for happiness and a productive life.  They need to be encouraged to cope with the hard parts of lupus, and to be resilient and to not let lupus destroy them or their joy.

Second, other people need to know more about lupus.  Doctors, employers, family, friends and the community need to understand lupus better.  They need to understand the importance of research, and more public involvement raising funding for research will help this important lupus research continue.

LFA Lobbying

LFA lobbying in Washington, DC for lupus research funding

I heartily support the efforts of the Lupus Foundation of America (LFA) in getting the word out to raise lupus awareness, and to encourage financial investment in major lupus research.   One of those activities is a well-organized annual grass-roots congressional lobbying campaign, involving patients from all over the United States.

Once a year, members of the Lupus Foundation of America converge on Washington, D.C.  and arrange meetings with congressmen and senators to lobby for specific research funding and other critical education and clinical trials and doctor education.  This lobbying that I participated years ago helped get funding for research in biologic drugs at the National Institutes of Health. We sat down in senators’ and representatives’ offices and talked to them about lupus, and asked them to support specific bills and efforts to fund lupus research.   LFA lobbying efforts have been successful, and much-needed research has received essential federal funding over many recent fiscal years.

Fruit of my lobbying efforts

Reaping benefits of my own lupus lobbying efforts!

A few years after my first lobbying experiences, when lupus drugs that NIH had been researching moved into clinical trials, I participated in a phase III clinical trial for  the biologic drug, Rituximab.  The two infusions I received immediately stopped lupus from attacking my liver and central nervous system, kept me working, and helped me reclaim a more normal personal and professional life.  I enjoyed a near remission for over five years and my lupus quieted down.  Now, I am being helped by another biologic drug, Belimumab, that came to market through later research and clinical trials and was ultimately approved by the FDA just for lupus.

Celebrating Lupus Awareness Month, May 2012

I never expected when I went to Washington to lobby for lupus research funding, that I would enjoy fruits of my lobbying efforts in my lifetime!  What could be better than that?

Today, I am celebrating the progress of in lupus research and treatment achieved over the last decade, on this, the last day of Lupus Awareness Month for 2012!  I trust this series of daily May posts about “31 Lupus Facts” has been informative, encouraging and helpful to you in your personal connection to lupus.

Living with Lupus: Fact #25 – Cutaneous lupus may someday be more than skin deep

Living with Lupus: About 40 percent of people who were originally diagnosed with cutaneous lupus, which affects only the skin, will go on to develop systemic lupus that can affect any organ in the body.

More than skin deep?

Has cutaneous lupus become more than skin deep?

One of the most difficult things for a patient diagnosed with cutaneous lupus to accept is, if they have other health complaints that they feel are due to systemic disease, and their doctor does not agree.  Over the years in my connections with the Lupus Foundation of America, my participation in lupus online discussion groups and support groups, and from blogging comments and emails I receive, I have met a number of cutaneous lupus patients in this situation.

Some cutaneous lupus patients think they may have systemic lupus, but feel their doctor is discounting their reports of other complaints and symptoms.  As a result, some have become increasingly discontented with their treatment and some even grow bitter toward their health care providers. This mindset does not seem to help them get anywhere with their doctors, at all!

Advice for fellow patients…

Advice to fellow lupus patients

When a patient has a cutaneous lupus diagnosis, the statistics and common sense cannot help but make them wonder if their disease could be more severe, or if over time, it will progress into systemic lupus. It is natural and somewhat founded to have some apprehension or even fear of lupus worsening.  My advice to these fellow patients for coping with this aspect of lupus is always pretty much the same.

  1. Develop and keep a positive, non-whining relationship with your doctor! They are just people, but they are the door you must go through to get correct diagnosis and treatment. They are not perfect people, nor do they have perfect medical skills and instincts. The practice of medicine is an intellectual art, not just science, and there is no perfect formula to use to reach an accurate diagnosis.
  2. Be patient and use your best people skills with your doctor. The rules of human nature and interpersonal communication still apply to the doctor-patient relationship. Respect that, and treat your doctor like a V.I.P. because for a lupus patient, he or she.is one!
  3. Communicate proactively and positively with your doctor. If you have one who will not engage in two-way discourse with you, find a new doctor!
  4. Keep a log with basic information about major symptoms and write an outline of things between appointments that you want your doctor to know about.
  5. Talk to your doctor about how frequent, how long-lasting or how severe the significant health events have been.

Starting office visit with focus

Getting the office visit off on the right foot

Working along side high level professionals and lawyers throughout my three decade career in law offices has taught me something very important that also applies to interacting with this type of professional in the medical field.  The doctor is an executive, so they want to hear what in business circles is referred to as an “executive summary.”  Start your conversation with your doctor with two or three main highest priority pieces of information, ask a couple of important brief questions, and then express your most important specific key concern.  Get right to the point, right up front.

Your first few sentences in the conversation is where the doctor will focus mentally throughout the entire office visit.  Set the tone and theme of the visit by getting your most important information out in the beginning, clearly, concisely and succinctly.  It is important not to wait until the end of your visit to bring up the most important thing that concerns you in a “by the way, what about this…” comment as the doctor is ready to leave the room.  By that time, the doctor is mentally done and ready to disengage and move on to the next patient.  He or she has already taken in all the facts, mulled them over for a while, and then formed mental conclusions.  An updated diagnosis has been made, tests have been ordered and prescriptions have been written.  Don’t wait until the end to bring up the real reason you made the appointment.

If, as a patient with a cutaneous lupus diagnosis, you think you may have signs of systemic lupus, start out with that conversation.  Be prepared to discuss specific symptoms you have, while not trying to tell your doctor what you think your diagnosis should be. Remember, the doctor sees the diagnosis as his or her job, not yours! He or she will base their diagnosis on things they can observe in the office visit, things you tell them, and information that lab and other diagnostic tools bring into the picture.

Patient with patience

Be a patient with patience, let the doctor make the (right) diagnosis

Be patient, since your doctor may not be able to make a medically responsible diagnosis until he or she follows the status of your health for a while. Mild systemic lupus is probably the hardest to diagnose, because of the mildness of changing symptoms.  Also, misdiagnosis can be very dangerous.  For example, multiple sclerosis and lupus have many similar symptoms, but the treatments are radically different and misdiagnosis can be dangerous if drugs for the wrong condition are actually prescribed.  The doctor wants to be sure they are making a correct diagnosis the first time.

If, at the end of the day, your doctor still does not think you have systemic lupus, be glad. That means they have not seen enough serious concerns to decide that you have more severe or organ threatening disease. Your doctor may still find you are in the lower risk (majority) group of lupus patients that includes those whose diagnosis is limited to cutaneous lupus.

Priorities, people skills and pro-activeness!

Remember to do your job to make the most of your office visits, to communicate important information up front that may help your doctor make the best decisions, and always remember your people skills! Remain a proactive partner in your medical care to get the diagnosis and ongoing treatment you need and deserve.

Diagnosis and Treatment of Lupus: Fact #11 – Lupus racially discriminates!

Diagnosis and Treatment of Lupus:  African Americans, Hispanics/Latinas, Asians and Pacific Islanders, and Native Americans are diagnosed with lupus two or three times more often than Caucasians; however, lupus affects people of all races and ethnicity.

Lupus racially discriminates!

The Lupus Foundation of America website is my data source for the charts, where it indicates that “Lupus is two to three times more prevalent among people of color, including African Americans, Hispanics/Latinos, Asians, and Native Americans.”  Unfortunately, the highest lupus incidence and mortality rates are among elderly black women.

This chart demonstrates the unfairness of lupus in the prevalence and incidence of lupus in women of color.

The U.S. Department of Health and Human Services, Department of Minority Health publishes these lupus facts:

“Black and Hispanic/Latina women tend to develop symptoms at an earlier age than other women. African Americans have more severe organ problems, especially with their kidneys.

Between 1979 and 1998, death rates from lupus increased nearly 70% among black women between the ages of 45 and 64 years. Possible reasons include an increasing incidence of SLE, later diagnosis, less access to health care, less-effective treatments, and poorer compliance with treatment recommendations.  Each year during the study period, death rates were more than five times higher for women than for men and more than three times higher for blacks than for whites.”

Lupus Patients of Color are 71%

The National Institute of Arthritis and Musculoskeletal and Skin Diseases reports the following gender-related lupus facts:

“Anyone can get lupus. But 9 out of 10 people who have it are women. African American women are three times more likely to get lupus than white women. It’s also more common in Hispanic/Latino, Asian, and American Indian women.

They also tend to have more severe disease than whites. For example, African American patients have more seizures and strokes, while Hispanic/Latino patients have more heart problems. We don’t understand why some people seem to have more problems with lupus than others.”

Concerned about lupus discrimination

As a Caucasian woman with lupus, I am concerned about the discriminatory demographics of lupus and it’s unfairness toward my “lupus sisters” of color. While we cannot change the genetic and racial predispositions of any auto-immune disease such as lupus, we can help spread awareness about it.  We need to take the message of lupus awareness to the populations most heavily affected by it, to help promote early diagnosis and treatment.  We should get involved in organizations such as the Lupus Foundation of America and support their efforts on behalf of all lupus patients.

Everyone should know about lupus, and should learn to recognize the most common symptoms in themselves or someone else. Increased awareness impacts earlier diagnosis, which in turn has long-term impacts on decreasing the severity and mortality of lupus.  We can fight lupus discrimination with lupus awareness!

Diagnosis and Treatment Lupus Fact #6 – A diagnosis often takes years

Diagnosis and Treatment: Many symptoms of lupus mimic those of other illnesses, and symptoms can come and go over time, which makes diagnosis more difficult. Because lupus can attack nearly any system of the body at any given time, lupus can seem to be a number of unconnected health problems within the same patient.

lupus discoid rashes

Lupus rashes are easily be dismissed by doctors diagnosing them as eczema or allergic skin reactions and rashes.  Before my lupus diagnosis, over the years my discoid lupus rashes were diagnosed as a  “sun allergy”, eczema, strawberry allergies, and infected rashes.  Lupus joint pain, stiffness and inflammation are easily misdiagnosed as osteo arthritis, tendonitis or suspected to be rheumatoid arthritis.  The brain fog of lupus, and its more severe lupus involvement in the central nervous system is at times misdiagnosed as multiple sclerosis, or even depression.  My lupus oral and nasal ulcers were misdiagnosed for years as infections, and even suspected and biopsied to see if they were cancerous lesions.

Hard to diagnose

These changing presentation of lupus symptoms can take years before  a doctor finally puts the different pieces together and sees the connection between the various symptoms and lupus.  Consequently, lupus can often take three to five years or more to diagnose, and as many doctors.  It is important the a patient who suspects they may have lupus to continue to persist in seeking medical care and a diagnosis.

My lupus adventure, short and sweet

Brevity is a challenge!

As one of the last couple of posts in the thirty-day health writer’s challenge, it has been suggested I should try to tell my lupus story, with extreme brevity, short and sweet, as a six-sentence story.  In this day of micro-blogging, brevity is said to be a skill worth honing, so this challenge may be worth giving it a try.  I have seldom been as brief as six sentences in anything I write.  My staff even sometimes says of me, “ask her what time it is, and she will teach you how to build a clock.”

Please forgive me if, to stay within these constraints, I yield to the temptation of breaking into light-hearted rhyme!

Lupus and Me, the Short and Sweet

Lupus short and sweet

In only six sentences the challenge shall be
to tell you a story about lupus and me.
Well, all of my life they suspected and tested,
after a long string of docs, SLE was detected.
There’s been lots of medicine, chemo and stuff,
to quiet the lupus has always been rough.
I need exercise to strengthen, nutrition’s a must,
and lots of support from dear souls I can trust.
Always seeking to be a victor, and not a victim,
I look to the Lord and His strengthening within.
For this autoimmune illness, they still have no cure,
so, I advocate as part of my lupus adventure.

By Lupus Adventurer
Copyright May, 2012

If you like the short take on a story and want to read more of them (or if it’s the short version, wouldn’t that be reading less?) check out other people’s six sentence stories at the blog http://sixsentences.blogspot.com, and the 6S web site.

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