Lupus

Pregnancy & Lupus

December 27, 2021 ·

I’ve sat down with hundreds of young women as they find out they have lupus. Once a diagnosis is made, the conversations are largely one-sided. Explaining what lupus is, how we diagnosis it, and what we are going to do about it can take a while. I’ve seen every possible emotion you can think of wash over the faces of women as they absorb this news: relief at an answer, sadness at what it means, anger at why them, and then fear for their future. The fear, for many, circles around concerns over the possibility of a pregnancy with lupus.

Lupus can affect anyone, but young women are the most commonly affected. Women in their teens, twenties and thirties, or what we call in medicine, the child-bearing years. Discussing issues related to pregnancy is a necessary component to a well-rounded lupus treatment strategy.

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Know the Prednisone Side Effects

December 23, 2021 ·

Let me be clear – I wouldn’t want to be on prednisone either. In fact, when suffering from a wicked case of vertigo, I fought my doctor buddies who advised I take a Medrol dose pack to ease the symptoms.

“I’m going to gain weight!” “I’m going to have anxiety!”

As a Rheumatologist, I am well-versed in all the possible side effects of prednisone (and similar meds) and feared the worse.

But I also know that there is a time a place for prednisone. Not only was I currently in need of the benefits of prednisone, many of my patients are as well. But there ARE side effects that need to be considered and discussed.

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Complements & Lupus

October 21, 2021 ·

If you have ever seen a Rheumatologist or there has ever been concern for lupus, you most likely have had your complement 3 (C3) and complement 4 (C4) tested. Unfortunately doctors do not do a great job of explaining these tests or their results, but are more often than not, considered when your doctor is assessing whether your lupus is “active” or “quiet.”

The complement system is complex and most doctors, aside from rheumatologists and immunologists, do not remember the specifics of the “complement cascade.” But you don’t need a PhD in immunology to have a basic understanding of how complements work and what they can teach us about our body.

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Know the facts about your dsDNA antibody

June 15, 2021 ·

Most lupus patients are familiar with the dsDNA antibody blood test. Like the ANA result, it is a blood test most closely related to lupus. Occasionally a positive dsDNA result can be seen in other conditions. But, the presence of a dsDNA antibody is considered specific for a diagnosis of lupus. As there are multiple ways a lab may detect a dsDNA, there still remains the possibility of a false positive, but a positive dsDNA result warrants a trip to the rheumatologist. (Reminder = “false positive” simply means the test is positive, yet the patient doesn’t have the condition associated with that result) Patients often are referred to a rheumatologist with a notebook full of labs, mostly of all varieties of antibodies and it is overwhelming.

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Transitioning from the pediatrician’s office

June 1, 2021 ·

Being diagnosed with a chronic medical condition during childhood or adolescence shapes the lives of the patient and their family. In Rheumatology, the pediatric rheumatologist can become an additional parent and a partner. Pediatric hospitals and clinics become homes away from home. They are often painted bright colors, have comfy furniture and entertainment throughout the halls as everyone tries to make the heartbreaking reality of disease in children more palatable. Thankfully, treatment success in rheumatology is the norm and there will come a day in most patient’s lives when they need to say goodbye to their pediatric rheumatologist and find a new adult-focused rheumatologist. Transitioning from the pediatrician’s office is a day most patients and parents dread. This process, known as “transition,” is an integral part to any young person’s care.

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