The wolf was really active all summer and did his best to blow down my house. My body is bruised and battered from our daily battles with rashes up and down my arms and, as always, my wolf face. I look in the mirror and see the wolf staring back at me from my green and gold eyes to the malar rash that spreads across my cheeks and nose. The wolf smiles because he thinks he's winning. But I know that I will never give up so he will NEVER win.
I am certainly maimed; the rashes up my hand and forearms look like burns and my "blush" no longer can be passed off as rosy cheeks since it extends from my jawline to my forehead and across the whole bridge of my nose. My body is so tired of fighting; I wake up every morning exhausted from the night's battle. If it was up to my body, it would have quit a long time ago. But not me. I will never quit and the wolf knows it. That is why he chose me; the wolf loves a challenge and he loves the hunt. His determination is almost as strong as mine.
Th wolf has gained a lot of momentum as the years have passed and my illness has continued to progress from lupus to lupus plus osteopenia, sjogren's syndrome, Raynaud's phenomenon, and more. There is so much more to add to that list but that's for a future post. The wolf really believes he is going to win soon, and I feel his strength growing in me as he senses my body weaken more and more. I am hanging on the edge by my fingertips but I still will never quit. I was born a fighter and will die fighting.
The wolf has been been waiting a long time, silently stalking me. He preys on weakness so I must remain strong especially at my weakest. I must believe I am stronger; it's my only chance of survival. I am a fighter, I am a survivor and I am stronger than the wolf. I'll blow his house down before he does mine.
Keep fighting, my warrior friends, and never let anyone or anything break your spirit.
xoxo
Lupus Celebrity
"Lupus LA is thrilled to welcome Shante Broadus to our board. The commitment the Broadus family has made to the fight against lupus is critically important to the success of our organization and we know that they will have a huge impact on lupus awareness worldwide," says Lupus LA Chairman Adam Selkowitz.
Shante Broadus, wife of famed musician and entertainer Snoop Dogg, became devoted to the organization after their young daughter Cori was diagnosed with lupus. After discovering the disease is more prevalent among women of color, Shante realized the organization needed a voice and her family's celebrity status could help inform people of the disease that affects over 1.5 million Americans.
Since then, Shante and her family have been very involved in Lupus LA events and support groups, and in speaking with press outlets to help build awareness about lupus.
I hope that Snoop continues to use his celebrity to talk about lupus to help spread awareness. It would be incredible if Snoop could be as well known for lupus as he is for his pot use, lol. Seriously, Snoop, we need your support. It is awesome your wife is actively involved, but you talking about lupus and supporting lupus will make much more press. And I can't think of anything better to honor your daughter than to give back by helping in the fight for a cure for lupus. Your little girl and her sustained health is in my prayers.
xoxo,
Lupus Celebrity
SIMON
Seymour has revealed she was struck down with the incurable condition at the age of 18, when she was at the beginning of her modeling career.
The 36 year old underwent treatment and is now "in remission", but admits the deadly illness has encouraged her to live life to the full.
She says, "When I was an 18-year-old model, I developed lupus, a disease where the body's own immune system attacks healthy cells and tissues."
"I was in terrible pain and had to be put on a cocktail of drugs. I have been in remission for years, but it's made me much more aware of my own mortality."
Pop star Lady
I applaud Terri for going public with her lupus diagnosis. This is such a brief article so I am very interested in learning when she went into remission and if she attributes it to any medicine, therapy, etc. I am always so fascinated and filled with hope when I hear that others have gone into remission.
I also wonder if she came forward due to Lady Gaga's admission in early June. I think anyone in Hollywood who has lupus would be floored by all of the press Lady Gaga receives every time she mentions lupus. Also, a majority of the public reaction was very positive and supportive. Hopefully, this will result in more celebrities disclosing that they have lupus even if motivated only by gaining press coverage. I used to believe that celebrities with lupus chose not to disclose this because then they would cost more to insure them on movie sets, etc. But that doesn't make sense because I am sure the insurance companies require medical records for such large amounts of insurance so they wold know if a celebrity has lupus. So the only thing I can think of is they are worried about discrimination; they fear they will not be hired if there is concern that they could get sick during filming, be too fatigued, etc. But after such an outpouring of public support for Lady Gaga, I hope that Hollywood has become more accepting. Lady Gaga has had such an impact on awareness of lupus; I would hope that others would want to do the same. I believe everyone was put on this earth for a reason and if a celebrity gets lupus, they should use their celebrity to create more awareness, acceptance and support for lupus sufferers.
I hope Terri continues in healthy remission. Hopefully she will follow Lady Gaga's lead and use her celebrity status to benefit lupus through charitable donations, interviews, etc. I also hope she shares more in future interviews about her experience with lupus and details on her remission and what she attributes it too.
xoxo
Lupus Celebrity
Earlier this month, Lady Gaga frightened fans when she revealed to Larry King that she had been tested for lupus and that results had shown she was "borderline positive" for the disease.
"Lupus is in my family and it's genetic, and it's funny, 'cause my mother told me the other day that my fans were quite worried about me, because I did talk about the fact that I was tested for lupus," Gaga told King. "And the truth is, I don't show any signs, any symptoms of lupus, but I have tested borderline positive for the disease. So as of right now, I don't have it. But I do have to take good care of myself."
And in the upcoming issue of Rolling Stone magazine — which hits newsstands last Friday — Gaga expounds even further on her condition, telling writer Neil Strauss that she doesn't want her fans to worry about the disease and that she's already taking steps to ensure she'll remain healthy in the midst of her seemingly endless world tour.
"It's more making sure that I reduce stress in my life to make sure I don't develop [the disease]," she said. "I make much more of an effort now to minimize the drama or the stress. ... I take care of myself. I drink and still live my life, but I could never let my fans down. That would kill me to have to face that extra obstacle every day to get onstage. It's completely terrifying, so I'm just really focused on mind, body and soul."
Gaga also said that, though she's been tested for lupus, she's not interested in following doctor's orders when it comes to preventing the disease. Rather, since lupus is thought to be hereditary, she's sought the advice of her family on how to live.
"It's in my family, so I don't really listen to doctors very much when it comes to it, because it's so personal," she said. "I talk to people that I know that have it or my father, whose sister died from it. There's nothing to worry about, but I do get very tired sometimes, and I naturally wonder [about the disease]."
And to that end, Gaga admitted to Strauss that she does worry sometimes about the effect her schedule (and her fame) has on her health but that she continues to press on, no matter what those closest to her may be saying.
"I don't want to be [a hypochondriac], so most of the time, I'm like, 'F--- it, I'm fine,' " Gaga told Strauss. "At a certain point, you're so beyond the point of exhaustion that you don't know: Do I have a health problem that may or may not be real, or am I just really tired?"
American College of Rheumatology criteria for a lupus diagnosis
The American College of Rheumatology (ACR) has developed clinical and laboratory criteria to help physicians diagnose and classify lupus. If you have 4 of the 11 criteria at one time or individually over time, you probably have lupus. Your doctor may also consider the diagnosis of lupus even if you have fewer than four of these signs and symptoms. The criteria identified by the ACR include:
What does borderline positive lupus mean? Probably Lady Gaga was referring to her ANA test. All tests have a normal range of values. If a test value is at the upper limit of the normal range or slightly over, it's often referred to as "borderline." The importance of a borderline ANA test depends on the other criteria that are present. A borderline positive ANA will probably be ignored by the doctor if there are only one or two other criteria suggesting lupus, yet could clinch the diagnosis if there are already three or four positive criteria. Gaga told Larry King that she does not have any symptoms of lupus so the borderline ANA would not be significant at this time. Even if the ANA was a high positive, that does not mean she would automatically have lupus. Some people have a positive ANA who never develop lupus. That is why it is only one of the eleven criteria listed above.
Well, I am glad that she spoke about it and clarified her testing since lupus has been consumed with all things Gaga this past week. I have never seen anything like that before, seriously at least 95% of all lupus news last week was related to Lady Gaga. Hopefully she will still be a voice for lupus in memory of her aunt and continue to take good care of herself if she or her doctors are concerned ithat lupus could be an issue in her future. I am glad that I got to know your music more this past week as I fantasized how you could change the face of lupus as our lupus celebrity. I know in this lupie, you have a new fan.
xoxo
Lupus Celebrity
When my local lupus organization posted Seal concert tickets on their facebook site to be auctioned, I made sure I was the highest bidder. I had plans of making a statement at the concert even before I'd even won them. Two weeks later, I received the email to say I was the highest bidder. I was so excited. I was going to LA the following week so I could only make it to the first concert held at Sydney’s State Theatre. Even though I would have usually dressed up, or worn a nice dress, I decided that I would get noticed a lot more if I was wearing orange - a colour along with purple, associated with lupus.
I was running late for the concert, but that didn’t stop me. I called into a store on the way and bought some orange satin and a few permanent marking pens. At a pizza shop, and right there at the table I made my sign that read, ‘Life without lupus’ in big black text and then it was a mad dash to the city for the concert.
I didn’t have time to do my hair so I tore a side of the satin sign off and wore it as a head scarf and did my makeup on the way. We found parking and walked to the theatre. I was excited to be there. While we were inline waiting to collect the tickets, I could see people looking at me, reading my lupus shirt. That’s what I wanted, so I could put the word lupus in people’s minds.
When Seal came out it was excellent. We were sitting in the 4th row, and although we were in the light, I wasn’t sure if he could see me. But we made eye contact and he gave me a smile and that was enough for me. The first few songs were quiet, so I was nervous to hold up my sign, so I wore it on my shoulders like a superman cape and sat forward so that people could see it from behind.
As the night progressed and people started dancing in the aisles, I thought, 'Ok, now's my chance.' I made my way to the front of the stage and was shaking the sign behind my head. As Seal came over to my side of the stage, I held it up to him so he could read it, and he took it from me. I couldn’t believe it! He was holding it up while he was singing and then when the song finished, he held it up again and gave a shout-out for lupus. He said that lupus is an interesting disease and that he'd suffered from lupus for the past two and a half decades. He then turned to me and asked my name. I timidly replied,"Erin" He thanked me for being there and danced around with the sign tucked in his back pocket.
The music stopped and it was time for the encore. The whole crowd was clapping and cheering. Seal came back on stage, walked to the centre and said, "This song is very special to me and I feel it only appropriate to dedicate this song to you Erin." He reached out holding my hand and starting singing.
I used to see people on TV crying at concerts and thinking that? Why would you cry? Suddenly uncontrollable tears of joy streamed down my face.
After the concert finished and people were leaving, I was invited backstage to meet with Seal. He thanked me again and we chatted a little, took some photos then he had to go. My actions were pre-meditated. I wanted people to think about lupus. And I thought what better opportunity and place to do it - at a concert of a high profile celebrity such as Seal, whom many people don’t realize has lupus.
Although It was my plan I could never of imagined it turning out the way it did. It was unbelievable when Seal thanked me and reached out holding my hand dedicating the last song of the night to me!!!!!! No words could describe how I felt, and I still get tingles talking about it. It's absolutely by far the best moment I've had since being touched by lupus - and a story I'm happy to share to spread the word.
Congratulations Erin for spreading the word about lupus in such a public way. Check out her great lupus video below my post from YouTube - click the link to my YouTube channel and it is the only one right now in my favorites. Sorry for the extra step but to put youtube on my site, I need to pay more each month. I am working on getting advertisements on the site so I can hopefully afford to pay the monthly fee for better services. So for now, bear with me!
Seal, absolutely amazing, you are making the lupus community so proud. Please keep up the great work and use your publicity for spreading awareness.
Sorry I haven't been on for over a week - a combination of a flare and depression. I don't know if the depression is due to the steadily warming weather in Florida and not wanting to hibernate in this house all summer like I must. I have been fighting the depression all winter though so I don't know; it is probably a combination of a lot of things. I am sure everybody out there could write a book on our lives and how depressing it is when we are in the right -or wrong- frame of mind. Well, more to come soon, hope you were missing me too.
xoxo
Lupus Celebrity
TO CHECK OUT ERIN'S GREAT LUPUS VIDEO, TO CATCH CURE, CLICK HERE
http://www.youtube.com/user/lupuscelebrity
During Lupus Awareness Month in May, the Lupus Foundation of America (LFA) wants to know -- Are you in the band? We hope you’ll join us and Band Together for Lupus™ to raise awareness and educate others about lupus. It’s estimated that 80 percent of the public know little or nothing about lupus. Together, we can change that, but we can’t do it alone. Just think of the impact we can make if we all did one thing to raise awareness of lupus.
Better awareness of lupus in the general public. One of the easiest and most visible ways you can help achieve this outcome is by wearing your purple wristband, not only during Lupus Awareness Month, but also throughout the year. Other simple things you can do include sharing the LFA’s lupus fact of the day on Facebook or Twitter, or sending an awareness ecard to friends and family.
It might seem small, but if you sign this petition, we can Band Together for Lupus and raise awareness of this life-altering disease
Rob Thomas, lead singer for Matchbox 20, has recorded a song about autoimmune diseases called "Her Diamonds." His wife suffers from a lupus like condition. I am not sure what that could be besides APS. Some reports says she HAS lupus but I can't find it confirmed by anyone officially. It is a beautiful song and if you enjoy it, please buy it on iTunes so we show their is a market for these songs. Any celebrity exposure is good for our cause. To check out the video for free on You Tube, click here .
I read one comment that I think hit the nail on the head about what the video means;
What i get from this video is that there is a girl; she is crying over something that she knows that she cant change, but she cries anyways. She feels like nothing will get any better and she cant win; she's tired of crying though, but she dont know what to do to fix it. When she breaks out of the ice it signifies she is done crying; she cant take it no more; and realizes there is a chance. And the sun shining through the window signifies hope for a better day.
Wow, that is very insightful and makes the video even deeper in meaning. I haven't broken through my ice yet by any means but I hope I am melting a little bit. I am so ready to be free of the pain, anger and sadness over having such an alienating, incurable disease. Thanks Rob and I hope you continue to use your celebrity to put a spotlight on lupus and other autoimmune diseases.
Song Lyrics:
Oh what the hell she said
I just can't win for losing
And she lays back down
Man there's so many times
I don't know what I'm doing
Like I don't know now
By the light of the moon
She rubs her eyes
Says it's funny how the night
Can make you blind
I can just imagine
And I don't know what I'm supposed to do
But if she feels bad then I do too
So I let her be
And she says ooh
I can't take no more
Her tears like diamonds on the floor
And her diamonds bring me down
Cause I can't help her now
She's down in it
She tried her best but now she can't win it
Hard to see them on the ground
Her diamonds falling down, way down
She sits down and stares into the distance
And it takes all night
And I know i could break her concentration
But it don't feel right
So by the light of the moon
She rubs her eyes
Sits down on the bed and starts to cry
And there's something less about her
And I don't know what I'm supposed to do
So I sit down and I cry too
But don't let her see
And she says ooh
I can't take no more
Her tears like diamonds on the floor
And her diamonds bring me down
Cause I can't help her now
She's down in it
She tried her best but now she can't win it
Hard to see them on the ground
Her diamonds falling down
She shuts out the night
Tries to close her eyes
If she can find daylight
She'll be alright
She'll be alright
Just not tonight
And she says ooh
I can't take no more
Her tears like diamonds on the floor
And her diamonds bring me down
Cause I can't help her now
She's down in it
She tried her best but now she can't win it
Hard to see them on the ground
Her diamonds falling down
I can't take no more
Diamonds on the floor
No more, no more, no more
Diamonds falling down
I can't take no more
Diamonds on the floor
No more, no more, no more
Diamonds falling down
I can't take no more
Diamonds on the floor
(No more, no more)
Her diamonds falling, all her diamonds
Diamonds falling down
I can't take these diamonds falling down.
On the forum I visit regularly, someone brought up that their doctor wanted her to try reducing her plaquenil from 400 mg. to 200 mg. I was not sure why he would do that but when I viewed the FDA data for clarification, I found some other surprises like it is highly toxic and can be fatal for children who ingest even small doses. This has never been discussed with me by any of my doctors and I have 2 young boys at home. If you are like me taking 18 pillsevery day not including my daily pain pills, you sometimes drop one or it falls down the sink. Now that I know how toxic it is, i will just be that much more careful going forward. And if I ever do drop one, it will have to be found before the kids can be in our bathroom, no exceptions. I am not worried about my 6 year old, but my 20 month son puts everything in his mouth so if he saw it, he would eat it.
You can read the whole write-up below or just go to the bold sections to see what information was news to me. And I also found the answer to our original question of why a doctor would cut dosage by 50 percent. Yes, the FDA write-up directs doctors to cut the dosage after it has started working usually between 1 to 3 months although in my experience it was at least 6 months until I started feeling a noticeable difference in my pain levels . The reason they want us to attempt to reduce it is, at higher dosages, the risk of side effects is much greater. But a theraputic dosage long term is defined as 200 to 400 mg. so if like me you need 400 to notice any improvement, we should be okay but nothing higher than 400 mg long term is ever advised.
This just reinforces that we need to be our own advocate and research treatment options and risks for ourselves and not trust our doctors implicitly.
Sweet dreams,
xoxo
Lupus Celebrity
PHYSICIANS SHOULD COMPLETELY FAMILIARIZE THEMSELVES WITH THE COMPLETE CONTENTS OF THIS LEAFLET BEFORE PRESCRIBING HYDROXYCHLOROQUINE.
Hydroxychloroquine sulfate is a colorless crystalline solid, soluble in water to at least 20 percent; chemically the drug is 2-[[4-[(7-Chloro-4-quinolyl)amino]pentyl]ethylamino] ethanol sulfate (1:1).
Plaquenil (hydroxychloroquine sulfate) tablets contain 200 mg hydroxychloroquine sulfate, equivalent to 155 mg base, and are for oral administration.
Inactive Ingredients: Dibasic Calcium Phosphate, Hydroxypropyl Methylcellulose, Magnesium Stearate, Polyethylene glycol 400, Polysorbate 80, Starch, Titanium Dioxide.
The drug possesses antimalarial actions and also exerts a beneficial effect in lupus erythematosus (chronic discoid or systemic) and acute or chronic rheumatoid arthritis. The precise mechanism of action is not known.
Plaquenil is indicated for the suppressive treatment and treatment of acute attacks of malaria due to Plasmodium vivax, P. malariae, P. ovale, and susceptible strains of P. falciparum. It is also indicated for the treatment of discoid and systemic lupus erythematosus, and rheumatoid arthritis.
Use of this drug is contraindicated (1) in the presence of retinal or visual field changes attributable to any 4-aminoquinoline compound, (2) in patients with known hypersensitivity to 4-aminoquinoline compounds, and (3) for long-term therapy in children.
Plaquenil is not effective against chloroquine-resistant strains of P. falciparum.
Children are especially sensitive to the 4-aminoquinoline compounds. A number of fatalities have been reported following the accidental ingestion of chloroquine, sometimes in relatively small doses (0.75 g or 1 g in one 3-year-old child). Patients should be strongly warned to keep these drugs out of the reach of children.
Use of Plaquenil in patients with psoriasis may precipitate a severe attack of psoriasis. When used in patients withthe condition may be exacerbated. The preparation should not be used in these conditions unless in the judgment of the physician the benefit to the patient outweighs the possible hazard.
Usage of this drug during pregnancy should be avoided except in the suppression or treatment of malaria when in the judgment of the physician the benefit outweighs the possible hazard. It should be noted that radioactively-tagged chloroquine administered intravenously to pregnant, pigmented CBA mice passed rapidly across the placenta. It accumulated selectively in the melanin structures of the fetal eyes and was retained in the ocular tissues for five months after the drug had been eliminated from the rest of the body.
Antimalarial compounds should be used with caution in patients with hepatic disease or alcoholism or in conjunction with known hepatotoxic drugs.
Periodic blood cell counts should be made if patients are given prolonged therapy. If any severe blood disorder appears which is not attributable to the disease under treatment, discontinuation of the drug should be considered. The drug should be administered with caution in patients having G-6-PD (glucose-6-phosphate dehydrogenase) deficiency.
The 4-aminoquinoline compounds are very rapidly and completely absorbed after ingestion, and in accidental overdosage, or rarely with lower doses in hypersensitive patients, toxic symptoms may occur within 30 minutes. These consist of headache, drowsiness, visual disturbances, cardiovascular collapse, and convulsions, followed by sudden and early respiratory and cardiac arrest. The electrocardiogram may reveal atrial standstill, nodal rhythm, prolonged intraventricular conduction time, and progressive bradycardia leading to ventricular fibrillation and/or arrest. Treatment is symptomatic and must be prompt with immediate evacuation of the stomach by emesis (at home, before transportation to the hospital) or gastric lavage until the stomach is completely emptied. If finely powdered, activated charcoal is introduced by the stomach tube, after lavage, and within 30 minutes after ingestion of the tablets, it may inhibit further intestinal absorption of the drug. To be effective, the dose of activated charcoal should be at least five times the estimated dose of hydroxychloroquine ingested. Convulsions, if present, should be controlled before attempting gastric lavage. If due to cerebral stimulation, cautious administration of an ultrashort-acting barbiturate may be tried but, if due to anoxia, it should be corrected by oxygen administration, artificial respiration or, in shock with hypotension, by vasopressor therapy. Because of the importance of supporting respiration, tracheal intubation or tracheostomy, followed by gastric lavage, may also be necessary. Exchange transfusions have been used to reduce the level of 4-aminoquinoline drug in the blood.
A patient who survives the acute phase and is asymptomatic should be closely observed for at least six hours. Fluids may be forced, and sufficient ammonium chloride (8 g daily in divided doses for adults) may be administered for a few days to acidify the urine to help promote urinary excretion in cases of both overdosage and sensitivity.
Like chloroquine phosphate, USP, Plaquenil is highly active against the erythrocytic forms of P. vivax and malariae and most strains of P. falciparum (but not the gametocytes of P. falciparum).
Plaquenil does not prevent relapses in patients with vivax or malariae malaria because it is not effective against exo-erythrocytic forms of the parasite, nor will it prevent vivax or malariae infection when administered as a prophylactic. It is highly effective as a suppressive agent in patients with vivax or malariae malaria, in terminating acute attacks, and significantly lengthening the interval between treatment and relapse. In patients with falciparum malaria, it abolishes the acute attack and effects complete cure of the infection, unless due to a resistant strain of P. falciparum.
Plaquenil is indicated for the treatment of acute attacks and suppression of malaria.
In recent years, it has been found that certain strains of P. falciparum have become resistant to 4-aminoquinoline compounds (including hydroxychloroquine) as shown by the fact that normally adequate doses have failed to prevent or cure clinical malaria or parasitemia. Treatment with quinine or other specific forms of therapy is therefore advised for patients infected with a resistant strain of parasites.
Following the administration in doses adequate for the treatment of an acute malarial attack, mild and transient headache, dizziness, and gastrointestinal complaints (diarrhea, anorexia, nausea, abdominal cramps and, on rare occasions, vomiting) may occur. Cardiomyopathy has been rarely reported with high daily dosages of hydroxychloroquine.
One tablet of 200 mg of hydroxychloroquine sulfate is equivalent to 155 mg base.
Malaria
In adults, 400 mg (=310 mg base) on exactly the same day of each week. In infants and children, the weekly suppressive dosage is 5 mg, calculated as base, per kg of body weight, but should not exceed the adult dose regardless of weight.
If circumstances permit, suppressive therapy should begin two weeks prior to exposure. However, failing this, in adults an initial double (loading) dose of 800 mg (=620 mg base), or in children 10 mg base/kg may be taken in two divided doses, six hours apart. The suppressive therapy should be continued for eight weeks after leaving the endemic area.
In adults, an initial dose of 800 mg (= 620 mg base) followed by 400 mg (=310 mg base) in six to eight hours and 400 mg (=310 mg base) on each of two consecutive days (total 2 g hydroxychloroquine sulfate or 1.55 g base). An alternative method, employing a single dose of 800 mg (=620 mg base), has also proved effective.
The dosage for adults may also be calculated on the basis of body weight; this method is preferred for infants and children. A total dose representing 25 mg of base per kg of body weight is administered in three days, as follows:
First dose: 10 mg base per kg (but not exceeding a single dose of 620 mg base).
Second dose: 5 mg base per kg (but not exceeding a single dose of 310 mg base) 6 hours after first dose.
Third dose: 5 mg base per kg 18 hours after second dose.
Fourth dose: 5 mg base per kg 24 hours after third dose.
For radical cure of vivax and malariae malaria concomitant therapy with an 8-aminoquinoline compound is necessary.
Plaquenil is useful in patients with the following disorders who have not responded satisfactorily to drugs with less potential for serious side effects: lupus erythematosus (chronic discoid and systemic) and acute or chronic rheumatoid arthritis.
PHYSICIANS SHOULD COMPLETELY FAMILIARIZE THEMSELVES WITH THE COMPLETE CONTENTS OF THIS LEAFLET BEFORE PRESCRlBlNG Plaquenil.
Irreversible retinal damage has been observed in some patients who had received long-term or high-dosage 4-aminoquinoline therapy for discoid and systemic lupus erythematosus, or rheumatoid arthritis. Retinopathy has been reported to be dose-related.
When prolonged therapy with any Antimalarial compound is contemplated, initial (base line) and periodic (every three months) ophthalmologic examinations (including visual acuity, expert slit-lamp, funduscopic, and visual field tests) should be performed.
If there is any indication of abnormality in the visual acuity, visual field, or retinal macular areas (such as pigmentary changes, loss of foveal reflex), or any visual symptoms (such as light flashes and streaks) which are not fully explainable by difficulties of accommodation or corneal opacities, the drug should be discontinued immediately and the patient closely observed for possible progression. Retinal changes (and visual disturbances) may progress even after cessation of therapy.
All patients on long-term therapy with this preparation should be questioned and examined periodically, including the testing of knee and ankle reflexes, to detect any evidence of muscular weakness. If weakness occurs, discontinue the drug.
In the treatment of rheumatoid arthritis, if objective improvement (such as reduced joint swelling, increased mobility) does not occur within six months, the drug should be discontinued. Safe use of the drug in the treatment of juvenile arthritis has not been established.
Dermatologic reactions to Plaquenil may occur and, therefore, proper care should be exercised when it is administered to any patient receiving a drug with a significant tendency to produce dermatitis.
The methods recommended for early diagnosis of "chloroquine retinopathy" consist of (1) funduscopic examination of the macula for fine pigmentary disturbances or loss of the foveal reflex and (2) examination of the central visual field with a small red test object for pericentral or paracentral scotoma or determination of retinal thresholds to red. Any unexplained visual symptoms, such as light flashes or streaks should also be regarded with suspicion as possible manifestations of retinopathy.
If serious toxic symptoms occur from overdosage or sensitivity, it has been suggested that ammonium chloride (8 g daily in divided doses for adults) be administered orally three or four days a week for several months after therapy has been stopped, as acidification of the urine increases renal excretion of the 4-aminoquinoline compounds by 20 to 90 percent. However, caution must be exercised in patients with impaired renal function and/or metabolic acidosis.
Not all of the following reactions have been observed with every 4-aminoquinoline compound during long-term therapy, but they have been reported with one or more and should be borne in mind when drugs of this class are administered. Adverse effects with different compounds vary in type and frequency.
CNS Reactions: Irritability, nervousness, emotional changes, nightmares, psychosis, headache, dizziness, vertigo, tinnitus, nystagmus, nerve deafness, convulsions, ataxia.
Neuromuscular Reactions: Skeletal muscle palsies or skeletal muscle myopathy or neuromyopathy leading to progressive weakness and atrophy of proximal muscle groups which may be associated with mild sensory changes, depression of tendon reflexes and abnormal nerve conduction.
Ocular Reactions:
The incidence of corneal changes and visual side effects appears to be considerably lower with hydroxychloroquine than with chloroquine.
Other fundus changes include optic disc pallor and atrophy, attenuation of retinal arterioles, fine granular pigmentary disturbances in the peripheral retina and prominent choroidal patterns in advanced stage.
The most common visual symptoms attributed to the retinopathy are: reading and seeing difficulties (words, letters, or parts of objects missing), photophobia, blurred distance vision, missing or blacked out areas in the central or peripheral visual field, light flashes and streaks.
Retinopathy appears to be dose related and has occurred within several months (rarely) to several years of daily therapy; a small number of cases have been reported several years after antimalarial drug therapy was discontinued. It has not been noted during prolonged use of weekly doses of the 4-aminoquinoline compounds for suppression of malaria.
Patients with retinal changes may have visual symptoms or may be asymptomatic (with or without visual field changes). Rarely scotomatous vision or field defects may occur without obvious retinal change.
Retinopathy may progress even after the drug is discontinued. In a number of patients, early retinopathy (macular pigmentation sometimes with central field defects) diminished or regressed completely after therapy was discontinued. Paracentral scotoma to red targets (sometimes called "premaculopathy") is indicative of early retinal dysfunction which is usually reversible with cessation of therapy.
A small number of cases of retinal changes have been reported as occurring in patients who received only hydroxychloroquine. These usually consisted of alteration in retinal pigmentation which was detected on periodic ophthalmologic examination; visual field defects were also present in some instances. A case of delayed retinopathy has been reported with loss of vision starting one year after administration of hydroxychloroquine had been discontinued.
Dermatologic Reactions: Bleaching of hair, alopecia, pruritus, skin and mucosal pigmentation, photosentivity, and skin eruptions (urticarial, morbilliform, lichenoid, maculopapular, purpuric, erythema annulare centrifugum, Stevens-Johnson syndrome, acute generalized exanthematous pustulosis, and exfoliative dermatitis).
Hematologic Reactions: Various blood dyscrasias such as aplastic anemia, agranulocytosis, leukopenia, anemia, thrombocytopenia (hemolysis in individuals with glucose-6-phosphate dehydrogenase (G-6-PD) deficiency).
Gastrointestinal Reactions: Anorexia, nausea, vomiting, diarrhea, and abdominal cramps. Isolated cases of abnormal liver function and fulminant hepatic failure.
Allergic reactions: Urticaria, angioedema and bronchospasm have been reported.
Miscellaneous Reactions: Weight loss, lassitude, exacerbation or precipitation of porphyria and nonlight-sensitive psoriasis.
Cardiomyopathy has been rarely reported with high daily dosages of hydroxychloroquine.
One tablet of hydroxychloroquine sulfate, 200 mg, is equivalent to 155 mg base.
Lupus Erythematosus
Initially, the average adult dose is 400 mg (=310 mg base) once or twice daily. This may be continued for several weeks or months, depending on the response of the patient. For prolonged maintenance therapy, a smaller dose, from 200 mg to 400 mg (=155 mg to 310 mg base) daily will frequently suffice.
The incidence of retinopathy has been reported to be higher when this maintenance dose is exceeded.
Rheumatoid Arthritis
The compound is cumulative in action and will require several weeks to exert its beneficial therapeutic effects, whereas minor side effects may occur relatively early. Several months of therapy may be required before maximum effects can be obtained. If objective improvement (such as reduced joint swelling, increased mobility) does not occur within six months, the drug should be discontinued. Safe use of the drug in the treatment of juvenile rheumatoid arthritis has not been established.
In adults, from 400 mg to 600 mg (=310 mg to 465 mg base) daily, each dose to be taken with a meal or a glass of milk. In a small percentage of patients, troublesome side effects may require temporary reduction of the initial dosage. Later (usually from five to ten days), the dose may gradually be increased to the optimum response level, often without return of side effects.
When a good response is obtained (usually in four to twelve weeks), the dosage is reduced by 50 percent and continued at a usual maintenance level of 200 mg to 400 mg (=155 mg to 310 mg base) daily, each dose to be taken with a meal or a glass of milk. The incidence of retinopathy has been reported to be higher when this maintenance dose is exceeded.
Should a relapse occur after medication is withdrawn, therapy may be resumed or continued on an intermittent schedule if there are no ocular contraindications.
Corticosteroids and salicylates may be used in conjunction with this compound, and they can generally be decreased gradually in dosage or eliminated after the drug has been used for several weeks. When gradual reduction of steroid dosage is indicated, it may be done by reducing every four to five days the dose of cortisone by no more than from 5 mg to 15 mg; of hydrocortisone from 5 mg to 10 mg; of prednisolone and prednisone from 1 mg to 2.5 mg; of methylprednisolone and triamcinolone from 1 mg to 2 mg; and of dexamethasone from 0.25 mg to 0.5 mg.
Plaquenil tablets are white, to off-white, film coated tablets imprinted "Plaquenil" on one face in black ink. Each tablet contains 200 mg hydroxychloroquine sulfate (equivalent to 155 mg base). Bottles of 100 tablets (NDC 0024-1562-10).
Dispense in a tight, light-resistant container as defined in the USP/NF.
Store at room temperature up to 30° C (86° F).
sanofi-aventis U.S. LLC, Bridgewater, NJ 08807
Revised October 2006
©2006 sanofi-aventis U.S. LLC
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This report is a little depressing but it is important that we know realistically where scientists and pharmaceutical companies stand on lupus drug development. It is a long article but make sure you read the section towards the end about B cells and how they are learning more how they can impact lupus. As I understand, Benlysta, ONCE approved - it has to be approved - will only suppress the B cells, not your whole body like immunosuppressants do. I marked the 2 sections below in BOLD in case you can't get through the whole article, at least read more on B cells and Benlysta so you understand some of the current research.
xoxo
Lupus Celebrity
At a teleconference in February sponsored by the Lupus Research Institute (LRI), researchers expressed cautious optimism about developing drugs for systemic lupus erythematosus (SLE) because basic research is uncovering new details underlying the complexity of the disease. Clinical development success, however, continues to evade companies.
Conference participants noted that at least until very recently lupus was handled like an orphan disease, with the pharmaceutical industry largely ignoring it because of its perceived rarity and the fear of not recouping drug development costs. More Americans are diagnosed with lupus, they said, than with cerebral palsy, multiple sclerosis, sickle cell anemia, cystic fibrosis, or AIDS; about 1.5 million individuals in the U.S. have the disease.
But as recent history continues to demonstrate, pharma’s reluctance to dive into the murky development waters of antilupus drugs remains well-founded despite the market opportunity. The odds against successful development of a therapy for lupus remain high, with only Human Genome Sciences and GlaxoSmithKline’s (GSK) Benlysta showing Phase III success.
Current treatments for lupus vary depending on the extent of the disease and may change over time. Some medications used to ease symptoms include nonsteroidal anti-inflammatory drugs, antimalarials, corticosteroids, and immunosuppressive medications. “Today, we do have therapies that work,” remarked Lee Simon, M.D., an associate clinical professor of medicine at Harvard Medical School. “In the 1950s, 95 percent of people were dead within five years of diagnosis. Today, 95 percent of patients survive five years out. But the treatments we have carry a heavy toxic burden. So, we need new drugs that work as well, if not better, with less harsh side effects.”
Predicted Successes that Failed
In a 2006 report, Decision Resources said that Roche and Aspreva's CellCept and Biogen Idec and Genentech’s Rituxan would emerge as “the leading therapies for the treatment of SLE, driving the market to more than quadruple from $300 million in 2005 to $1.3 billion in 2015.” The report further said that “Although corticosteroids and antimalarials will continue to be used as mainstay treatments for the disease, their major market sales will be dwarfed by the increased use and resulting sales of novel agents including CellCept and high-priced biologics including Rituxan and Human Genome Science/GlaxoSmithKline's LymphoStat-B.” LymphoStat-B is now known as Benlysta.
These predictions haven’t exactly panned out. Roche and Aspreva discontinued CellCept development in 2007, because the drug was unable to demonstrate superiority to intravenous cyclophosphamide. About a year later, Genentech, now part of Roche, and Biogen Idec reported that Rituxan failed to meet its primary and secondary endpoints in SLE. In 2009, the companies announced that Rituxan also did not significantly reduce disease activity in patients with lupus nephritis, which is an inflammation of the kidney and a complication of SLE. This March also saw a lupus trial failure from Roche and Biogen Idec’s Ocrelizumab, another anti-CD20 mAb like Rituxan.
Nearest Shot on Goal
The only remaining SLE contender cited in the 2006 Decision Resources report is Benlysta. This mAb, which belongs to a new class of drugs called BLyS-specific inhibitors, recognizes and blocks the biological activity of B-lymphocyte stimulator, or BLyS, a naturally occurring protein that was discovered by Human Genome Sciences. Elevated levels of BLyS prolong the survival of B cells, which can contribute to the production of autoantibodies like anti-dsDNA antibodies that target the body’s own tissues.
Benlysta successfully met its primary endpoint in two Phase III trials in patients with abnormal levels of anti-dsDNA antibodies at the time of trial enrollment. If approved, Benlysta will become the first new therapeutic approved for SLE in about 50 years. According to Lazard Capital Markets analyst Terence Flynn, global sales could reach $3 billion by 2014.
Basic Research on B Cells in Lupus
Future clinical successes in SLE may be related to the development of more drugs aimed at treating molecular characteristics that are more specifically related to the disease. “I think one of the reasons that there is a measure of excitement in lupus and in other complex diseases that we've been confronted with for a long time is the advent of a whole series of new molecular tools that allow us to address basic issues,” commented Salk Institute neurobiology professor Greg E. Lemke, Ph.D.
For example, Petar Lenert, M.D., Ph.D., and colleagues, authors of a 2009 paper published in Arthritis Research and Therapy, said that more selective approaches to weeding out B cells that promote lupus may be better than nonselective B-cell depletion. Autoreactive B cells produce the autoantibodies characteristic of lupus but also contribute to disease pathogenesis by presenting autoantigens to T cells and secreting proinflammatory cytokines.
Dr. Lenert and other scientists have shown that intracellular nucleic acid sensing receptors that function in innate immunity, like toll-like receptor (TLR) 7 and TLR9, may play an important role in SLE. Dual engagement of rheumatoid factor-specific AM14 B cells through the B-cell receptor and TLR7/9 results in proliferation of autoimmune B cells. Therefore, Dr. Lenert explained, strategies that preferentially block innate immune activation through TLRs in autoimmune B cells may be preferred over nonselective B-cell depletion.
Dr. Lenert’s group found that a certain type of double-stranded DNA-like molecule that carries autoimmune-inhibitory sequences could selectively reduce the activity of autoreactive B cells and dendritic cells. When given to mice with lupus, the compounds delayed death and reduced kidney damage. The authors concluded that use of this specific class of nucleotides could result in a new approach to autoimmune disease therapeutics. Dr. Lenert was more circumspect in a conversation with GEN about the role of TLRs in autoimmunity. “It’s an area that requires much more research,” he said.
The search for and development of a lupus drug that induced tolerance in B cells directed against double-stranded DNA by cross-linking surface antibodies, however, proved to be La Jolla Pharmaceuticals’ undoing. The firm had to discontinue development of Riquent in February 2009 after it failed in lupus nephritis. La Jolla was delisted from NASDAQ this March, and Adamis Pharmaceuticals terminated its proposed merger with the firm; Riquent was La Jolla's only clinical-stage drug.
Dr. Lenert’s concerns that the field requires further research remains the defining characteristic of current drug development efforts for SLE. Perhaps the Phase III success of Benlysta will encourage companies to keep on trying against tough odds.
I love Dr Oz almost as much as Oprah. He describes things so clearly in the most basic terms and takes the fear out of things for me. As I mentioned in an earlier post, I would love to get a complete health analysis from him where they run any and every test imaginable to find out what is ailing you, And since women with lupus age 35 to 44 are 50 times more likely to be diagnosed with myocardial ischemia, it would be great to see a cardiologist of Dr Oz's caliber meet with a lupus patient and explain what concerns, symptoms, etc. are red flags to call your doctor asap and for him to explain ways in which we have some control over heart inflammation.
Myocardial ischemia is an intermediate condition in coronary artery disease during which the heart tissue is slowly or suddenly starved of oxygen and other nutrients. Eventually, the affected heart tissue will die. When blood flow is completely blocked to the heart, ischemia can lead to a heart attack. Ischemia can be silent or symptomatic.
Dr. Oz has the potential to put a spotlight on lupus and I applaud him for already having the topic lupus and men on his new show. I read this great article by him that I wanted to share with you. Hopefully that is the last post of the night and I will get some sleep instead of the horrible insomnia I have been plagued with again. It is almost 2 and I am wide awake. I know it is stress but with lupus, besides avoiding the sun, sleep is one of the most restorative things I need and when my body gets thrown off from lack of sleep, the insomnia usually leads to a flare.
I am hurting anyway but it always seems like it can get a little worse, doesn't it? Well here is an article to cheer us up and give us some hope. My favorites are #4 and #9. It is so great that he appreciates educated, questioning patients which we know is hard to find a lot of the time in other doctors. Thanks Dr Oz and please contact me if interested in a volunteer to be a guinea pig for anything if there is even the possibility it could have long term benefits and help me have some pain free days. I haven't had one of those since my son was born 20 months ago. because I trust you. OK, I must be getting tired because now I am actually addressing DR Oz and believing he will read and respond to this blog-- lol.
Sweet Dreams,
xoxo
Lupus Celebrity
WHAT DR. OZ KNOWS FOR SURE
WASHINGTON, DC -- April 13, 2010 -- A gene variant suspected of helping protect people of Asian and African descent from malaria may increase their susceptibility to lupus, according to a study published Proceedings of the National Academy of Sciences.
The study was led by Kenneth Smith, Cambridge Institute for Medical Research and Department of Medicine, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom.
For the study, Dr. Smith and colleagues genotyped nearly 5,000 patients with lupus and malaria from Kenya, Hong Kong, and the United Kingdom.
The researchers searched and tested patients' DNA for a FCGR2B gene variant known to be more common in Asians and sub-Saharan Africans.
Previous studies had linked a polymorphism of the gene to an immune system response that may enhance lupus susceptibility and malaria resistance.
The researchers report that the FCGR2B polymorphism appeared more frequently in patients with lupus who were from Hong Kong than in controls,
and less frequently in Kenyan children with severe malaria compared with Kenyan children in the general population.
The results are consistent with well-established observations that lupus is more prevalent in people of Asian and African descent than in Caucasians, and may support the authors' theory that malaria's high mortality rate could be driving an increased susceptibility to autoimmune disease in specific ethnic groups.
SOURCE: Proceedings of the National Academy of Sciences
While laws vary from state to state, there are some definite taboo areas with regard to interview questions that employers should be avoiding. Following are some of the basic subject areas and questions that if asked during the course of the interview, might be viewed as illegal questions being asked with the intention to discriminate:
It should be noted that just because an illegal question has been asked does not necessarily mean a crime has been committed. Just because the question has asked does not establish intent. It is up to a court of law to determine whether the question or any resulting information was used in a discriminatory manner.
Since lupus is both genetic & environmental, I tell my oldest son there is very little chance he will get lupus period, end of story so he does not spend his life worrying. Statistically, there is only a 10% chance and it is much less common in boys than girls. I am determined to keep their environmental trigger risks low with a couple of rules. I tell him the doctor told Mommy there are 2 things that it is important that kids who have a parent with lupus do:
1) Always wear sufficient sunscreen - no exceptions for how long outside or what the weather is like.
2) Eat well & limit sugar intake
Top 10 Worst Foods for Kids to Eat:
One-third of all U.S. children are overweight or obese, according to the TeensHealth web page. The main cause is overeating, with little regard to the actual nutrition offered by the food. Changing eating habits is not easily done, but minor changes in the type of food consumed can quickly reduce the amount of calorie intake each day. Eliminating the worst foods is one way to improve kids' nutrition.
Hot Dogs
Hot dogs are high in fat and sodium and loaded with preservatives such as nitrates. The average dog has 464 calories with 32 percent of the daily fat, 15 percent of the cholesterol and 44 percent of the recommended daily sodium. This is balanced against the positive nutritional facts of 16 grams of protein and 8 percent of the daily dietary fiber. There are better alternatives for protein and fiber.
My oldest loves hot dogs but we only give him turkey dogs on wheat rolls to try to make it as healthy as possible.
Soda
TeenHealth classifies sodas and energy drinks as "empty" calories that you don't need. The average soda has 10 to 12 teaspoons of sugar in each 10-ounce can. Dr. Marjorie Fitch-Hilgenberg, assistant professor of dietetics at the University of Arkansas, states that soda should be treated as a dessert item, not the meal's beverage.
Our kids have had no soda and we will hold it off as long as we can. They primarily get milk or water, the only time the oldest get juice is in his lunch box for school or if he asks for it. But no more than 1 glass a day. Since 7 - 8 months of the year I am forced to stay inside, I want to make sure they are not having too many empty calories. They are still very active, running around inside, but they probably have a lot more down time, especially in the summer, than most kids.
Sticky Candy
Candy is high in sugar, and sticky candy contributes to tooth decay, according to the American Dental Association.
I didn't know this. We don't let our oldest eat much sticky candy due to choking concerns but he does love skittles which we will stop. I also like to know for my own reference. I have had so many cavities in the past 4 years (due to the Sjogrens Syndrome).
Doughnuts
Doughnuts are in high calories and provide little nutritional value. Breakfast should provide nutrients to supply energy, but sugar pastries do little to provide such nutrients.
We only do this on really special days like when on vacation at Disney one day. When he eats a donut otherwise, it is a dessert, not a meal.
Prepackaged Lunch Kits
Registered dietitian Liz Weiss reports that lunch kits are high in fat, saturated fat and sodium and low in fiber, vitamins and minerals. Many of them contain half the daily allowance of saturated fat and all of the sodium necessary for the average adult.
We have used these a couple of times for really busy school days when I don't have time to make lunch but I never liked them anyway because they have a piece of candy in a lot of them and I don't like him having candy during the day, especially at school. Now I will never buy them.
Sugary Breakfast Cereals
Most non-vitamin fortified breakfast cereals have sugar, artificial flavors and coloring and little nutrition. The fiber and vitamins added during the cereal manufacturing can be supplied in better food choices, such as fruit.
My oldest got the taste of some yummy cereal at friends houses, my parent's house, etc. so he wanted to start buying them. Instead of depriving him and making him want them even more, I let him get ones that have whole grain but tell them they need to mix it half Cheerios, half the other cereal so at least they are eating some good with the sugary stuff. And if my oldest is not with me in the grocery store, I only buy good cereal that I know they still like such as raisin bran, granola, etc.
Microwavable Prepackaged Dinners
These are convenient, but are high in fat, salt and preservatives. Not only are the dinners inadequate nutrition for growing children, they fail to teach children proper eating habits or how to prepare healthy meals. The average sodium content ranges from 700 to 1,800 milligrams for each dinner, an unhealthy amount for children to consume in one meal.
We have bought Stouffer's, no preservative meals but only on occasion. Those do not have preservatives but still a lot of sodium so it can stay on the store shelf for a long time. I wish I could make everything from scratch, maybe some day I will be organized enough, well rested enough and not flaring to do it consistently, long term.
Juice Drinks
Juice is high in sugar content, calories and acid that destroys dental enamel. Dr. Fitch-Hilgenberg warns against drinking juices that are not 100 percent juice. Fruits are a healthier option since they also provide the necessary daily fiber and additional vitamins.
French Fries
French Fries are fatty and soaked in oil. The fat count for this food averages 18 percent of the daily fat requirement and 7 percent of sodium, with only a minimal amount of dietary fiber, protein and calcium.
We have started to cut down french fries and starches in general for the kids. When we make dinner,we make a lot of vegetables and meat, no starch. For our fast food nights, we are getting the alternative instead of french fries like apples slices or if everyone really wants fries, we will get one small and split it between the four of us.
Toaster Pastries
Pastries have the same bad effect as doughnuts: high sugar and low nutritional content. Also, many of them have preservatives that allow the product to be stored for a year or more.
The kids have never had these but the oldest does eat dessert every day and it is usually the pre-packaged, high preservative sugary something or other. I am going to try to make more dessert and store it for him. I have a sweet tooth too so I hate have a lot of sweet stuff in the house but homemade is definitely better for us lupies too.
xoxo
Lupus Celebrity
BENLYSTA inhibits the biological activity of B-lymphocyte stimulator, or BLyS®. BLyS is a naturally occurring protein discovered by HGS which is required for the survival and development of B-lymphocyte cells into mature plasma B cells. Plasma B cells produce antibodies, the body’s first line of defense against infection. In lupus and certain other autoimmune diseases, elevated levels of BLyS are believed to contribute to the production of autoantibodies – antibodies that attack and destroy the body’s own healthy tissues. The results of prospective observational studies show a significant correlation of elevated levels of BLyS with SLE disease activity.
BENLYSTA acts by: (1) specifically recognizing and binding to BLyS, (2) inhibiting BLyS’s stimulation of B-cell development, and (3) restoring the potential for autoantibody-producing B cells to undergo the normal process of apoptosis (programmed cell death). Preclinical and clinical studies show that BLyS antagonists such as BENLYSTA can reduce autoantibody levels in SLE. The results of two pivotal Phase 3 trials show that belimumab can reduce SLE disease activity.
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Figure 1. BENLYSTA (belimumab) specifically binds to and inhibits the biological activity of BLyS. Preclinical and clinical results to date show that BENLYSTA can reduce the levels of circulating B cells, including precursor cells to the plasma B cells that produce the body’s normal and abnormal antibodies. This suggests that BENLYSTA may prove useful in the treatment of lupus and certain other autoimmune diseases. |
FLARES
DISEASE ACTIVITY
STEROID USE
FATIGUE AND QUALITY OF LIFE
SAFETY
In BLISS-52, belimumab was generally well tolerated, with rates of overall adverse events, serious adverse events, infections and fatalities comparable between belimumab and placebo treatment groups. Serious infections were reported in 5.9% of patients on placebo and 6.1% of patients on belimumab. The most common adverse events were headache, arthralgia, upper respiratory tract infections, urinary tract infection and influenza, and were also comparable between belimumab and placebo treatment groups. No malignancies were reported.
For the full article, go to HGSI's website HERE.
Sweet Dreams
xoxo
Lupus Celebrity
Definition of myocardial ischemia
Well, I think it was a typo but ischemia was spelled wrong in the last study but below is the best plain language definition I could find for Myocardial Ischemia. So remember, any women with lupus ages 35 to 44, we are 50 TIMES MORE LIKELY to get this than a healthy woman. I am definitely talking to my GP doctor about this next time I see him. I highlighted some sections below I found especially interesting for those of you that like to "speed read" like my husband ![]()
xoxo
Lupus Celebrity
Definition of Myocardial ischemia
Myocardial ischemia is an intermediate condition in coronary artorary disease during which the heart tissue is slowly or suddenly starved of oxygen and other nutrients. Eventually, the affected heart tissue will die. When blood flow is completely blocked to the heart, ischemia can lead to a heart attack. Ischemia can be silent or symptomatic. According to the American Heart Association, up to four million Americans may have silent ischemia and be at high risk of having a heart attack with no warning.
Symptomatic ischemia is characterized by chest pain called angina pectoris. The American Heart Association estimates that nearly seven million Americans have angina pectoris, usually called angina. Angina occurs more frequently in women than in men, and in blacks and Hispanics more than in whites. It also occurs more frequently as people age—25% of women over the age of 85 and 27% of men who are 80–84 years old have angina.
People with angina are at risk of having a heart attack. Stable angina occurs during exertion, can be quickly relieved by resting or taking nitroglycerin, and lasts from three to twenty minutes. Unstable angina, which increases the risk of a heart attack, occurs more frequently, lasts longer, is more severe, and may cause discomfort during rest or light exertion.
Ischemia can also occur in the arteries of the brain, where blockages can lead to a stroke. About 80-85% of all strokes are ischemic. Most blockages in the cerebral arteries are due to a blood clot, often in an artery narrowed by plaque. Sometimes, a blood clot in the heart or aorta travels to a cerebral artery. A transient ischemic attack (TIA) is a "mini-stroke" caused by a temporary deficiency of blood supply to the brain. It occurs suddenly, lasts a few minutes to a few hours, and is a strong warning sign of an impending stroke. Ischemia can also effect intestines, legs, feet and kidneys. Pain, malfunctions, and damage in those areas may result.
Decreased mortality rates associated with SLE can be attributed to earlier diagnosis (including milder cases), improvement in disease-specific treatments, and advances in general medical care. According to the CDC, one third of SLE-related deaths in the United States occur in patients younger than 45 years, making this a serious issue despite declining overall mortality rates.
Infectious complications related to active SLE and immunosuppressive treatment are now the most common cause of death in early active SLE, and accelerated arteriosclerosis is a key cause of late mortality. The Framingham Offspring Study demonstrated that women aged 35-44 years with SLE were 50 times more likely to develop myocardial aschemia than healthy women. Causes of accelerated coronary artery disease (CAD) in persons with SLE are likely multifactorial, including endothelial dysfunction, inflammatory mediators, corticosteroid-induced atherogenesis, and dyslipidemia associated with renal disease.
This study is very disturbing! I know medicine has made lots of advances in the past 50 years which has significantly decreased mortality rates in lupus but still NO new drug has come out in over 50 years! Benlysta and others are on their way and will hopefully all be FDA fast tracked and this time next year our conversations on drug choices should be very different then they are today and not include drugs used now as much like MTX, methotexrate, and I know there are a lot more total immunosuppresants that others could list so feel free to comment and add on to this list. Steroids & prednisone might always be needed with lupus but hopefully with much less frequency and length of time as they are prescribed now. We need more drug companies focusing on lupus to get more drugs options available for us and as a result, increase the successful treatment of a higher % of lupus patients.
This new study says 1/3 of lupus deaths are in patients younger than 45 years old and it looks like they attribute it mainly to infections from active SLE and/or immunosuppresants . For older cases of death, it was primarily from heart issues. I am supposed to go on an immunosuppressant next, I am 38 and I have never had my heart checked other than blood work at initial diagnosis and the stethoscope. My heart risks besides having LUPUS: 1) I have the MTHFR gene - only one if I remember right 2) I have high homocysteine levels (low in the high range but still high enough that I am on folbee every day for the rest of my life). 3) I have very low HDL levels (lowest around 6, highest 18 although with lupus fog I can ALWAYS be a little off especially when I am trying to pull something out from my brain). All alone might mean nothing but the three combined with this lupus study data? I think it is time to look at my heart some more for inflammation or other issues. And probably the same for many of you!
They are saying we are 50 times more likely than other women to have myocardial aschemia! I have no idea what it is but I will research it and post some more info. soon. Any suggestions on what heart testing I should request from my gp doctor?
This disease is never ending and the doctor appointments alone are so exhausting but I owe it to my kids to try to stay as healthy as possible and educated about my risks. Then with the help of my doctors and any advice anyone reading my blog wants to share to determine which I think are my most dangerous risks and test / treat anything needed. I will live with this pain for a lifetime, I just want to be given the opportunity to continue to live long enough to raise my babies and see them settled and finally give me some daughters to spoil until they give me some grandchildren and then I will be moving next door to one for 6 months and the other for 6 months. Better yet, my husband and I will rent a huge RV and drive it 6 months to one son & 6 months to the other
Can you imagine my poor daughter in laws? haha...all out of love.
XOXO
Lupus Celebrity
The natural history of SLE varies from relatively benign disease to rapidly progressive and even fatal disease. SLE often waxes and wanes in affected individuals throughout life, and features of the disease vary greatly between individuals. The disease course is milder and survival rate higher among persons with isolated skin and musculoskeletal involvement than in those with renal and CNS disease.
SLE carries an average 10-year survival rate that now exceeds 90%. Prior to 1955, the 5-year survival rate was less than 50%. Decreased mortality rates associated with SLE can be attributed to earlier diagnosis (including milder cases), improvement in disease-specific treatments, and advances in general medical care. According to the CDC, one third of SLE-related deaths in the United States occur in patients younger than 45 years, making this a serious issue despite declining overall mortality rates. In 1976, Urowitz first reported bimodal mortality in early versus late SLE, noting that SLE-related deaths usually occur within the first 5-10 years of symptom onset.
Infectious complications related to active SLE and immunosuppressive treatment are now the most common cause of death in early active SLE, and accelerated arteriosclerosis is a key cause of late mortality. The Framingham Offspring Study demonstrated that women aged 35-44 years with SLE were 50 times more likely to develop myocardial aschemia than healthy women. Causes of accelerated coronary artery disease (CAD) in persons with SLE are likely multifactorial, including endothelial dysfunction, inflammatory mediators, corticosteroid-induced atherogenesis, and dyslipidemia associated with renal disease.
Charlene DeGidio never smoked marijuana in the 1960s, or afterward. But a year ago, after medications failed to relieve the pain in her legs and feet, a doctor suggested that the Adna, Wash., retiree try the drug.Ms. DeGidio, 69 years old, bought candy with marijuana mixed in. It worked in easing her neuropathic pain, for which doctors haven't been able to pinpoint a cause, she says. Now, Ms. DeGidio, who had previously tried without success other drugs including Neurontin and lidocaine patches, nibbles marijuana-laced peppermint bars before sleep, and keeps a bag in her refrigerator that she's warned her grandchildren to avoid.
"It's not like you're out smoking pot for enjoyment or to get high," says the former social worker, who won't take the drug during the day because she doesn't want to feel disoriented. "It's a medicine."
For many patients like Ms. DeGidio, it's getting easier to access marijuana for medical use. The U.S. Department of Justice has said it will not generally prosecute ill people under doctors' care whose use of the drug complies with state rules. New Jersey will become the 14th state to allow therapeutic use of marijuana, and the number is likely to grow. Illinois and New York, among others, are considering new laws.
As the legal landscape for patients clears somewhat, the medical one remains confusing, largely because of limited scientific studies. A recent American Medical Association review found fewer than 20 randomized, controlled clinical trials of smoked marijuana for all possible uses. These involved around 300 people in all—well short of the evidence typically required for a pharmaceutical to be marketed in the U.S.Doctors say the studies that have been done suggest marijuana can benefit patients in the areas of managing neuropathic pain, which is caused by certain types of nerve injury, and in bolstering appetite and treating nausea, for instance in cancer patients undergoing chemotherapy. "The evidence is mounting" for those uses, says Igor Grant, director of the Center for Medicinal Cannabis Research at the University of California, San Diego.
But in a range of other conditions for which marijuana has been considered, such as epilepsy and immune diseases like lupus, there's scant and inconclusive research to show the drug's effectiveness. Marijuana also has been tied to side effects including a racing heart and short-term memory loss and, in at least a few cases, anxiety and psychotic experiences such as hallucinations. The Food and Drug Administration doesn't regulate marijuana, so the quality and potency of the product available in medical-marijuana dispensaries can vary.
Though states have been legalizing medical use of marijuana since 1996, when California passed a ballot initiative, the idea remains controversial. Opponents say such laws can open a door to wider cultivation and use of the drug by people without serious medical conditions. That concern is heightened, they say, when broadly written statutes, such as California's, allow wide leeway for doctors to decide when to write marijuana recommendations.
But advocates of medical-marijuana laws say certain seriously ill patients can benefit from the drug and should be able to access it with a doctor's permission. They argue that some patients may get better results from marijuana than from available prescription drugs.
Glenn Osaki, 51, a technology consultant from Pleasanton, Calif., says he smokes marijuana to counter nausea and pain. Diagnosed in 2005 with advanced colon cancer, he has had his entire colon removed, creating digestive problems, and suffers neuropathic pain in his hands and feet from a chemotherapy drug. He says smoking marijuana was more effective and faster than prescription drugs he tried, including one that is a synthetic version of marijuana's most active ingredient, known as THC.
The relatively limited research supporting medical marijuana poses practical challenges for doctors and patients who want to consider it as a therapeutic option. It's often unclear when, or whether, it might work better than traditional drugs for particular people. Unlike prescription drugs it comes with no established dosing regimen.
"I don't know what to recommend to patients about what to use, how much to use, where to get it," says Scott Fishman, chief of pain medicine at the University of California, Davis medical school, who says he rarely writes marijuana recommendations, typically only at a patient's request.
Researchers say it's difficult to get funding and federal approval for marijuana research. In November, the AMA urged the federal government to review marijuana's position in the most-restricted category of drugs, so it could be studied more easily.
Gregory T. Carter, a University of Washington professor of rehabilitation medicine, says he's developed his own procedures for recommending marijuana, which he does for some patients with serious neuromuscular conditions such as amyotrophic lateral sclerosis, or Lou Gehrig's disease, to treat pain and other symptoms. He typically urges those who haven't tried it before to start with a few puffs using a vaporizer, which heats the marijuana to release its active chemicals, then wait 10 minutes. He warns them to have family nearby and to avoid driving, and he checks back with them after a few days. Many are "surprised at how mild" the drug's psychotropic effects are, he says.
States' rules on growing and dispensing medical marijuana vary. Some states license specialized dispensaries. These can range from small storefronts to bigger operations that feel more like pharmacies. Typically, they have security procedures to limit walk-in visitors.
At least a few dispensaries say they inspect their suppliers and use labs to check the potency of their product, though states don't generally require such measures. "It's difficult to understand how we can call it medicine if we don't know what's in it," says Stephen DeAngelo, executive director of the Harborside Health Center, a medical-marijuana dispensary in Oakland, Calif.
Some of the strongest research results support the idea of using marijuana to relieve neuropathic pain. For example, a trial of 50 AIDS patients published in the journal Neurology in 2007 found that 52% of those who smoked marijuana reported a 30% or greater reduction in pain. Just 24% of those who got placebo cigarettes reported the same lessening of pain.
Marijuana has also been shown to affect nausea and appetite. The AMA review said three controlled studies with 43 total participants showed a "modest" anti-nausea effect of smoked marijuana in cancer patients undergoing chemotherapy. Studies of HIV-positive patients have suggested that smoked marijuana can improve appetite and trigger weight gain.
Donald Abrams, a doctor and professor at the University of California, San Francisco who has studied marijuana, says he recommends it to some cancer patients, including those who haven't found standard anti-nausea drugs effective and some with loss of appetite.
Side effects can be a problem for some people. Thea Sagen, 62, an advanced neuroendocrine cancer patient in Seaside, Calif., says she expected something like a pharmacy when she went to a marijuana dispensary mentioned by her oncologist. She says she was disappointed to find that the staffers couldn't say which of the products, with names like Pot 'o Gold and Blockbuster, might boost her flagging appetite or soothe her anxiety. "They said, 'it's trial and error,' "she says. "I was in there flying blind, looking at all this stuff."
Ms. Sagen says she bought several items and tried one-eighth teaspoon of marijuana-infused honey. After a few hours, she was hallucinating , too dizzy and confused to dress herself for a doctor's appointment. Then came vomiting far worse than her stomach upset before she took the drug. When she reported the side effects to her oncologist's nurse and her primary-care physician, she got no guidance. She doesn't take the drug now. But with advice from a nutritionist, her appetite and food intake have improved, she says.
Other marijuana users may experience the well-known reduction in ability to concentrate. At least a few users suffer troubling short-term psychiatric side effects, which can include anxiety and panic. More controversially, an analysis published in the journal Lancet in 2007 tied marijuana use to a higher rate of psychotic conditions such as schizophrenia. But the analysis noted that such a link doesn't necessarily show marijuana is a cause of the conditions.
Long-term marijuana use can lead to physical dependence, though it is not as addictive as nicotine or alcohol, says Margaret Haney, a professor at Columbia University's medical school. Smoked marijuana may also risk lung irritation, but a large 2006 study, published in Cancer Epidemiology, Biomarkers & Prevention, found no tie to lung cancer.
DRUG INTERACTIONS: Using non-steroidal antiinflamatrory drugs (NSAIDs) before or during methotrexate treatment may result in serious adverse events because NSAIDS may increase the blood concentrations of methotrexate. Combining methotrexate with drugs that adversely affect the liver or kidneys may result in additional liver or kidney toxicity.
PREGNANCY: Methotrexate should not be used in pregnancy,as it can be toxic to the embryo and can cause fetal defects and spontaneous abortion (miscarriage). It should be discontinued prior to conception if used in either partner. Male patients should stop taking methotrexate at least 3 months prior to a planned conception and females should discontinue use for at least one ovulatory cycle before conception.
NURSING MOTHERS: Methotrexate is excreted in breast milk and should not be used by nursing mothers.
SIDE EFFECTS: Methotrexate can be well tolerated, but also can cause severe toxicity which is usually related to the dose taken. The most frequent reactions include mouth sores, stomach upset, and low white blood counts. Methotrexate can cause severe toxicity of the liver, kidneys and bone marrow, which require regular monitoring with blood tests. It can cause headache and drowsiness which may resolve if the dose is lowered. Methotrexate can cause itching,, skin rash,, dizziness, and hair loss. dry, non-productive cough can be a result of rare lung toxicity.
WARNING: Methotrexate has rarely caused serious (sometimes fatal) side effects. Therefore, this medication should be used only to treat cancer or more severe cases of psoriasis or rheumatoid arthritis. Methotrexate has caused birth defects and fetal death. Women must avoid becoming pregnant while taking this medication. Pregnant women who have psoriasis or rheumatoid arthritis must not use methotrexate. (See also Precautions) If you have kidney problems or excess body water (ascites, pleural effu sion), you must be closely monitored and your dose may be adjusted or stopped by your doctor. Methotrexate (usually at high dosages) has rarely caused severe (sometimes fatal) bone marrow suppression (decreasing your body's ability to fight infections) and stomach/intestinal disease (e.g., bleeding) when used at the same time as non-steroidal anti-inflammatory drugs (NSAIDs such as indomethacin, ketopro Therefore, NSAIDs should not be used with high-dose methotrexate. Caution is advised if you also take aspirin. NSAIDs/aspirin may be used with low-dose methotrexate such as for the treatment of rheumatoid arthritis if directed by your doctor. If you are using low-dose aspirin (81-325 mg per day) for heart attack and stroke prevention continue to take it unless directed otherwise. Consult your doctor regarding safe use of these drugs (e.g., close monitoring by your doctor, maintaining stable doses of NSAIDs). In rare instances, this drug may also cause liver problems when it is used for long periods of time. If you are using methotrexate long-term, a liver biopsy carinii pneumonia), skin reactions, diarhhea and mouth sores (ulcerative stomatitis). (See also Side Effects.) Lumps (tumors/abnormal growths) may very infrequently appear during methotrexate use. If this occurs, the drug must be stopped and treatment may be needed. Consult your doctor immediately if new lumps/growths occur. When used to treat tumors, methotrexate sometimes causes side effects due to the rapid destruction of cancer cells (tumor lysis syndrome). Tell your doctor immediately if you experience symptoms such as irregular heartbeat or muscle weakness. Although rare, this medication when used with radiation treatment may increase the risk of tissue and bone damage. Discuss the risks and benefits of your treatment plan with your doctor.
Obtained from medicinenet.com
I am not going to read or worry about it anymore. I know I need some more help and this is the next step unfortunately. Another comment!! THANK YOU! I was not as smart / lucky as you to buy HGSI at $3 ; I gave it a lot of thought but just couldn't handle the risk
but I scooped it up as soon as the market opened the day Benlysta passing phase 2 was announced. Thank you for the information on the FDA estimated approval time line. That even reinforces more that I need to get on MTX now because I can't handle the pain until the 3rd quarter. But that would be great if they qualified for fast track. As you said, it has been over 50 YEARS, if any drug should qualifies for fast track approval, a lupus drug should!
Another night of falling asleep on the couch around 9 once all the kids fell asleep and then waking up at 3 am. My mind is not tired at all and surprisingly my body feels okay with my last pain pill at 8!! I have been feeling a little better the last 2 days and the only thing I can attribute it to is I changed anxiety pills to Xanax so I have been less anxious during the day and added Flexural as a muscle relaxant. With Flexural and Mirapex for restless leg syndrome taken at night, I am sleeping a little better. Oh funny story. I went to a play with my MIL and SIL during the week and I had just gotten the flexural. I can't make it more than a 1/2 hour through a movie without intense muscle aches from sitting in the same place. I went to the movies for the first time alone with my husband in years on our last anniversary (Transformers, yes, I am such a boy's Mom
and I spent the last 1 1/2 hours in intense pain and totally miserable. So, back to the play with MIL & SIL. We are all so excited to see this awesome play and I decide to take a pain pill and one of the new muscle relaxants on the chance it will prevent the pain from ruining my fun. Very, very bad idea. I ended up sleeping part of the first half and the majority of the 2nd half. I kept waking up and trying soooo hard not to fall asleep again to no avail. My sister in law even said I was snoring a little! I have to laugh but at the time I was upset, embarrassed, and hadn't figured out yet that it had to be the muscle relaxant. My MIL spent a lot on the tickets, it was the first time in years that the 3 of us had gone out alone together and I fall asleep! But she (MIL) was completely cool about it and didn't notice as much because I was angled more towards my SIL. Oh yeah, I forgot to mention, my luck, I was sitting BETWEEN them, haha!!
So hopefully this isn't a fluke and I am feeling a little better. It would be nice to take a break from this flare I have had pretty consistently since my son was born 18 months ago. Oh, my baby is getting so big, I don't want him to grow up but at the same time it is incredible to learn more of his personality,. He is going to be quite a character, keep his parents on their toes, just like his older brother does. I love my boys more than anything in this world and I am so blessed. I was real achy today but I had promised my oldest he could go to the grocery store with me. Whenever we go someplace just the two of us, we keep the radio off and just talk the whole time. He says to me as we are getting out of the car at Walmart, I am so glad that we go to the store together so we can talk the whole time and then he took my hand without the ususal argument that he is too old and we walked into the store together. It just melted my heart. And it reinforces that it is QUALITY time that is important to kids. It doesn't matter if I am too tired to get out of bed, we lay in bed and play flight if Mommy is slightly sick, read and color if Mommy is a little worse for wear and watch movies or tv when Mommy is really hurting and has 3 heating pads on her neck, her feet and her hands and can hardly think of anything but the pain and fatigue. So then i snuggle with him while he watches his movie and Mommy sleeps. It is all quality time and I need to stop feeling guilty.
Well. good night all and sweet dreams. More Comments Please --- if you are reading and liking this, let me know. I would love to hear from you! And to comment # 4 (yeah!) enjoy the HGSI ride. I will be thinking of you as it climbs and congratulations on your remission! If you attribute it to anything, PLEASE let me know, I would love to here more as I am sure anyone else reading would too. I am very much looking forward to my own remission...I know it will come for me and all of you luppies out there. Big, gentle hugs.
xoxo
Lupus Celebrity
Well, I couldn't lower to .25 of prednisone today like I planned. I was in too much pain this morning. I will try again tomorrow. I had insomnia again last night but instead of reading or going on the computer I painted my nails and washed my face with a neutrogena microdermabrassion machine my husband got me. It's called the healthy skin rejuvenator. You can use it every 3 days but I am lucky if I use it every couple of weeks. It says it is the anti-aging power treatment for wrinkles, pores, age spots and firmness. My malar rash is so much more noticeable for a day or two afterward but my skin and pores are so much clearer. I hate blackheads so much and this is the first thing I have found that really helps keep them clear besides facials. And I can't afford facials at the spa every month so this is the next best thing I have found...well, actually my husband found it. He has been on very good behavior lately!
I also get pimples from prednisone and from my hormones in general. I went to one of the top dermatologists in my area to talk about my malar rash and when he heard I have had the rash since I was diagnosed in 2005, all he wanted to talk about was my acne and giving me pills to treat it. I was thinking, I take over 20 pills a day to manage my diseases and you want me to add another one so I don't have PIMPLES?!? Do you see the rash all over my cheeks and nose? Do you know that it is so bright most of the time that no makeup can hide it? Pimple pills? Please, that is the last thing I am concerned about!
Hardly anyone talks to me about my rashes. My Mom said once that she gets so upset for me about them and doesn't know how I cope so well with them. But my Mom is beautiful, looks a lot like Jackie Kennedy Onassis. So for her she always put so much stock into her looks and it means a lot to her. Me, I never felt that way. I am not ugly, I have been told before that I am beautiful, pretty, cute, etc. but she is one of those REALLY beautiful people, who just always was noticed for her looks.
But kids are the best. We had my husband's cousins visit us and the little girl just stared at me for a minute one morning and asked bluntly, why do you have red stuff on your face? It was just so refreshing because they are so innocent and honest. My rash was really angry that week and very bright. I feel like telling people that I am not blind, I KNOW when my rashes are so blatant that you have to be blind not to notice it. But no one says anything, they are afraid to hurt me I guess. And ironically I feel so much happier when someone asks me about them or lupus. Most of the time my voice gets shaky like I am about to cry while talking about my constant pain, fatigue, muscle aches, etc. but it still feels good to explain why I can't attend lots of events, why you never see me taking the kids to the playground or community pool or playing in our driveway like a lot of other mothers do, why I can't go out in the sun and heat and why I cancel on people last minute because I am too tired, sick, or depressed and sick of being sick and tired. It just helps to make them more aware of my struggles. I cancel on people a lot and I feel guilty, especially if they are someone who doesn't know much about lupus and how hard it is to get through a normal day when I am flaring let alone take a shower, put on makeup, put on any clothing fancier than my pajamas, get in the car and drive to them or clean up my house for them if they are visiting us and then to be social & upbeat. On a bad day, my muscles are so weak that I can't even hold my arms up long enough to shampoo my hair and forget about a blow dryer. Hence the new perm; no need to ever blow dry.
But back to people not talking about my rashes. I used to act the same way when I heard someone died. I would avoid talking to people about their loved one's passing because I was so afraid of upsetting them more. And the same when I knew people whose children have mental illness, drug problems, etc. I did not feel comfortable bringing it up and was scared they would not want to talk about it and I would upset them.
But then I watched a show on Oprah, I really love some of her shows, and the guest was Elizabeth Edwards who was talking about when her son died at age 17. I am really paraphrasing here because it was a while ago and the lupus fog (my memory) is bad, but she was talking about people not knowing what to say when he died and how much she appreciated it when someone would bring him up and she could talk about him. She said that her and a lot of other parents with the same loss biggest fear is that their child will be forgotten. So when people talk to her about him and recall memories, she knows he is still alive in that person's heart and mind. It helped me so much in my personal life. Now when I am talking to someone who lost a loved one, I ask how they are doing and lend an ear for anything they want to vent, share, laugh about, etc. There is always deep pain too but I can tell it still means so much that I brought it up and they can talk about their spouse, parent, etc. Also, I know a family with a schizophrenic son. I used to never ask about him because I didn't know what to say and didn't want to upset them. The first time I saw them after watching the show, I just asked "how's **name** doing?" I could see how happy they were to talk about it and they thanked me for asking. Even though he was committed at the time and it was a really difficult period for them, they were so happy that I brought it up and we talked for a while and I asked questions and learned more about the whole situation. It was really wonderful to see how much it meant to them so now I make sure to ask about him every time I see them.
That's how I feel about my lupus rashes, although obviously to a much lesser degree. It is the elephant in the room that not many will talk to me about but they all are thinking about it (at least that is what I think they are thinking). That's why kids are so refreshing. The only thing I worry about is when another kid asks my oldest son, what's wrong with your Mom's face? I am sure at some point, he will be embarrassed about my disease. But teenagers are embarrassed about almost everything about their parents during some stages. Oh well, that is 8 years away. By then, lupus could be cured or advanced enough that I will be able to live a more normal life and hopefully the sun won't be my enemy.
Sweet dreams to all of you awake like me and reading this. It is after 5 am and the pain hasn't stopped yet. Once again, I fell asleep on to couch around 8:30, woke up at 1:30 from the pain. I forgot to take my medicine before I went to sleep again! It just sucks because then the pain gets ahead of me and it is so much worse and takes a lot longer to get to the point where I can function at all. Right now it is a toe curled, teeth clenched pain with body aches all down my legs and feet and stabbing pain in my neck and mid back. And I am down to 4 pain pills left, I can't fill my next prescription until Monday and I need 25 pills to get me through the weekend. I am going to have to call my doctor in the morning. And I was just there and he asked if I was going to make it through the month or did I need more and I said I was fine, ugghh. So it is not an issue with getting it approved, just that some of the office staff that I don't know can be pissy and say they need 48 hours. I am just going to have to tell them I will not be able to physically make it through the weekend if I don't get more today and if I don't hear from them go down there and wait to talk to the nurse. Because I would have to go to the hospital if I was without pain pills for 2 days. The pain is so overwhelming that some mornings and everytime I wake up in the middle of the night I cry until they kick in. I just lay down in a fetal position and say in my head, "please God, please God, please God" over and over and over until the pain meds start working.
WOW, I got another comment! Thank you, thank you, thank you!! Whose going to be next? It is so nice to know I am not alone out here, typing away for nothing! Whose going to be the first to SUBSCRIBE?!? Come on, if I am going to be a spokesperson for lupus I need a big fan base! This is our year and our decade, lupus is going to be talked about as much as other diseases, we are going to have new drugs and treatment choices and one day, someone will discover why we get this horrific disease and how we can go into permanent remission or be cured. That is a sweet dream for tonight, what would I be doing right now if I was cured....good night all.
xoxo
Lupus Celebrity