This Infernal External Itching!!!

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Hello there! Tonight I had to write about a common symptom that is experienced by lupus patients the world over. It is itching. 

I am interested because as I write this, I am literally stopping and scratching. The itching comes and goes. It is horrible. It can range from my scalp to my legs to my arms to my face and neck. Well, you get the point. I scratch so hard, especially in my sleep, that I have been known to draw blood.

In the interest of research, I visited several web sites and health forums to see if I am in the minority or majority.It appears that most lupus patients experience this itching at various times in their disease course. Nice to know, yet I wish there were some types of treatment to help the itching stop. Personally, I tend to over take my benadryl, like every three hours or so, to help lessen my itchies. Does it work? Some, but not really well. 

I read that some use cortisone cream. That is my next course I will try. For some reason, after reading others experiences, it seems that itching either precedes a flare or appears during a flare. The concensus seems to be that it appears when disease is active. Yippee!

To help those who do not have this symptom, let me explain how it feels. When you get a normal itch, you scratch and it is taken care of. This itching I get is bone deep, unrelenting itching. No amount of scratching seems to help. It absolutely demands attention because it is hard to stop it. Even in sleep, it can and does wake you up. I have drawn blood from night scratching. Even then it is not stopped.

Apparently the medical community in general are not sure whether lupus is causing this itching or if it is some other underlying issue. Some medical professionals think it is caused by dermatomyositis. Others think it is a form of vasculitis. I have posted about vasculitis in this blog before so if you want to read more about it, feel free to check out that post.

This time I am going to see about dermatomyositis. From what I read on the Mayo Clinic site, it is a form of skin rash that develops. Well shoot, that is not what I have. I do not have a rash where it itches, just this underlying itching. I may get a rash after I scratch it to pieces, but that would hardly be the same thing.

So, I will try cortisone creams and see if they help. I will update the progress or lack thereof. In the meantime, I wonder if you all could tell me if you have experienced this infernal external itching yourselves. I am interested is seeing how many of you have had this too. This is not a scientific study by any means, but I am interested because I wonder if it is indeed lupus related or something entirely different. Your feedback will help. Thanks and here’s to pain free days!

Jen 

Venting…

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Hi everyone! I would like to first of all say thank you to all of you who are making this blog such a success! It amazes me that anyone would want to read this blog. Thank you to those who do and it really makes me feel validated and hopefully it is helps one person in some small way to see what we lupies go through.

Now on to the venting part of this blog. If you do not want to hear it, now is the time to stop reading. I am really upset this evening. This has been building for some time but I have reached th epoint that I am ready to vent about it.

Have you ever met a person who is intent on putting you down no matter what? I have. This person is always asking me things like, “why do you take so much medicine” and “do all of your doctors know how much medicine you are taking?”. This evening, the question was “do your doctors know you take benadryl?”. I know, this doesn’t sound that bad, but it is most every day. I am being questioned about all kinds of things like this.

Ok, I admit I am taking a lot of medicines. The plain fact is though, that I am on far less medications than I have been in the past at times. I am only on about six medications right now, plus some over the counter meds and ALL of my doctors are aware of what I am taking. I have a medical TEAM that send each other updates so they are all on the same page in my health care.

The inherent implication in these questions is that this person thinks I should not be taking all these meds. Now, let me tell you something about this person. This person takes four medications and numerous vitamins and supplements. All told, probably eight to ten different pills a day, maybe more. So why the interrogation every day in some way?

This same person also ridicules me and tries to put me down each time I open my mouth or do something. Fault finding is the order of each day around this person. It is wearing thin.

While I may be sensitive to the put downs, it is not saying a lot about the person doing it. I am so thankful my husband is being such a big support for me during this. I have discussed it with him and he is running interference when needed and giving me major backup when I am around this person.

Why not just avoid this person you may ask? Truth is, I cannot. It is an unfortunate circumstance to be sure, but sometimes it builds up and I find I want to vent. So, there is the negativity I am releasing.

I wish people would just realize that it is bad enough to have to live with this disease or any other chronic disease and we do not need to be belittled or harrassed about it. I think if I can get up every day and deal with it, then these types of people need to learn to mind their own business and shut up. Nuff said…

Tramadol

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Tramadol is the pain medication I am on. I began on a low dose and titrated up. When it still was not relieving the pain, my rheumatologist upped the dosage. He actually doubled it. I am getting more of a relief at this point but the pain is still breaking through. In the interest of educating others about this disease, I have decided to include this information from the webpage rxlist.com. Happy reading!

What is tramadol (Ultram)?

 

Tramadol is a narcotic-like pain reliever.

Tramadol is used to treat moderate to severe pain. Tramadol extended-release is used to treat moderate to severe chronic pain when treatment is needed around the clock.

Tramadol may also be used for other purposes not listed in this medication guide.

Tramadol 50 mg-EON

 

round, white, imprinted with E 311

Tramadol 50 mg-MYL

 

round, white, imprinted with M, T7

Tramadol 50 mg-PAR

 

round, white, imprinted with G, TI 50

Tramadol 50 mg-PP

 

oval, white, imprinted with R 714

Tramadol 50 mg-TEV

 

oval, white, imprinted with 93, 58

Tramadol 50 mg-URL

 

round, white, imprinted with MP 717

Tramadol 50 mg-WAT

 

round, white, imprinted with 466, WATSON

Ultram 50 mg

 

oblong, white, imprinted with ULTRAM, 06 59

//

 

What are the possible side effects of tramadol (Ultram)?

 

 

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using tramadol and call your doctor at once if you have any of these serious side effects:

  • seizure (convulsions);
  • a red, blistering, peeling skin rash; or
  • shallow breathing, weak pulse.

 

Less serious side effects may include:

  • dizziness, drowsiness, weakness;
  • nausea, vomiting, constipation, loss of appetite;
  • blurred vision;
  • flushing (redness, warmth, or tingly feeling); or
  • sleep problems (insomnia).

 

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

What is the most important information I should know about tramadol (Ultram)?

 

 

You should not take tramadol if you have ever been addicted to drugs or alcohol.

Seizures (convulsions) have occurred in some people taking tramadol. You may be more likely to have a seizure while taking tramadol if you have a history of seizures or head injury, a metabolic disorder, or if you are taking certain medicines such as antidepressants, muscle relaxers, or medicine for nausea and vomiting.

Take tramadol exactly as it was prescribed for you. Do not take it in larger doses or for longer than recommended by your doctor. Do not take more than 300 milligrams of tramadol in one day.

Seek emergency medical attention if you think you have used too much of this medicine. A tramadol overdose can be fatal. Overdose symptoms of a tramadol overdose may include drowsiness, shallow breathing, slow heartbeat, extreme weakness, cold or clammy skin, feeling light-headed, fainting, or coma.

Tramadol may be habit-forming and should be used only by the person it was prescribed for. Tramadol should never be given to another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

Tramadol can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Do not stop using tramadol suddenly, or you could have unpleasant withdrawal symptoms such as anxiety, sweating, nausea, diarrhea, tremors, chills, hallucinations, trouble sleeping, or breathing problems. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.

Do not crush the tramadol tablet. This medicine is for oral (by mouth) use only. Powder from a crushed tablet should not be inhaled or diluted with liquid and injected into the body. Using this medicine by inhalation or injection can cause life-threatening side effects, overdose, or death.

What should I discuss with my healthcare provider before taking tramadol (Ultram)?

 

You should not take tramadol if you have ever been addicted to drugs or alcohol, if you are currently intoxicated (drunk), or if you have recently used any of the following drugs:

  • alcohol;
  • narcotic pain medicine;
  • sedatives or tranquilizers (such as Valium);
  • medicine for depression or anxiety;
  • medicine for mental illness (such as bipolar disorder, schizophrenia); or
  • street drugs.

Seizures have occurred in some people taking tramadol. Your risk of a seizure may be higher if you have any of these conditions:

  • a history of drug or alcohol addiction;
  • a history of epilepsy or other seizure disorder;
  • a history of head injury;
  • a metabolic disorder; or
  • if you are also taking an antidepressant, muscle relaxer, or medicine for nausea and vomiting.

Talk with your doctor about your individual risk of having a seizure while taking tramadol.

Before taking tramadol, tell your doctor if you are allergic to any drugs, or if you have:

  • kidney disease;
  • liver disease;
  • a stomach disorder; or
  • a history of depression, mental illness, or suicide attempt.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take tramadol.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tramadol may also cause serious or fatal side effects in a newborn if the mother uses the medication during pregnancy or labor. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Tramadol can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Tramadol should not be given to a child younger than 18 years of age.

How should I take tramadol (Ultram)?

 

Take tramadol exactly as it was prescribed for you. Do not take it in larger doses or for longer than recommended by your doctor. Follow the directions on your prescription label. Do not take more than 300 milligrams of tramadol in one day.

Take this medication with a full glass of water.

Tramadol can be taken with or without food, but take it the same way each time.

Do not crush the tramadol tablet. This medicine is for oral (by mouth) use only. Powder from a crushed tablet should not be inhaled or diluted with liquid and injected into the body. Using this medicine by inhalation or injection can cause life-threatening side effects, overdose, or death.

Do not crush, chew, break, or open a controlled-release, delayed-release, or extended-release tablet or capsule. Swallow the pill whole. Breaking or opening the pill may cause too much of the drug to be released at one time.

If you use the tramadol extended-release tablet, the tablet shell may pass into your stools (bowel movements). This is normal and does not mean that you are not receiving enough of the medicine.

Tramadol may be habit-forming. Tell your doctor if you feel the medicine is not working as well in relieving your pain. Do not change your dose without talking to your doctor.

Do not stop using tramadol suddenly, or you could have unpleasant withdrawal symptoms such as anxiety, sweating, nausea, diarrhea, tremors, chills, hallucinations, trouble sleeping, or breathing problems. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.

Store tramadol at room temperature away from moisture and heat.

Keep track of how many pills have been used from each new bottle of this medicine. Tramadol is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription

What happens if I miss a dose (Ultram)?

 

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose (Ultram)?

 

Seek emergency medical attention if you think you have used too much of this medicine. A tramadol overdose can be fatal.

Overdose symptoms may include drowsiness, shallow breathing, slow heartbeat, extreme weakness, cold or clammy skin, feeling light-headed, fainting, or coma.

What should I avoid while taking tramadol (Ultram)?

 

Do not drink alcohol while you are taking tramadol. Alcohol may cause a dangerous decrease in your breathing when used together with tramadol.

Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by tramadol. Tell your doctor if you regularly use any of these other medicines.

Tramadol can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What other drugs will affect tramadol (Ultram)?

 

You may be more likely to have a seizure (convulsions) if you take tramadol while you are using certain other medicines. Do not take tramadol without telling your doctor if you also use any of the following medications:

  • an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam); or
  • an antidepressant such as amitriptyline (Elavil), citalopram (Celexa), clomipramine (Anafranil), desipramine (Norpramin), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor); paroxetine (Paxil), or sertraline (Zoloft).

Before taking tramadol, tell your doctor if you also use:

  • carbamazepine (Tegretol);
  • warfarin (Coumadin);
  • digoxin (Lanoxin, Lanoxicaps);
  • ketoconazole (Nizoral);
  • erythromycin (E-Mycin, E.E.S., Ery-Tab);
  • rifampin (Rifadin, Rimactane, Rifater);
  • St. John’s wort;
  • quinidine (Quinaglute, Quinadex, Cardioquin, Quinora); or
  • drugs that make you sleepy (such as cold medicine, other pain medications, muscle relaxants, and medicine for seizures, depression or anxiety).

This list is not complete and there may be other drugs that can interact with tramadol. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

 

Your pharmacist can provide more information about tramadol.

Common medications for lupus

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These medications will vary from person to person because lupus is different in each individual and only your doctor can decide what is the best line of treatment for your symptoms. This is just an overall guide. Some people will never have to take most of these drugs while others may have to take most of them at some point in their disease. This information is from the Lupus Foundation of America’s web page. Please refer to their page for more information.

Medications to Treat Lupus Symptoms

Anti-Inflammatories

Anti-inflammatory medications help to relieve many of the symptoms of lupus by reducing inflammation and pain. Anti-inflammatories are the most common drugs used to treat lupus, particularly symptoms such as fever, arthritis or pleurisy, which generally improve within several days of beginning treatment. For many people with lupus, an anti-inflammatory drug may be the only medication they need to control their lupus.

  • Aspirin is inexpensive and available over the counter. It has pain-reducing, anti-inflammatory, and anticoagulant (blood-thinning) properties that can control some of the symptoms of lupus. However, aspirin can cause stomach irritation.
  • Acetaminophen, known to most people as Tylenol®, is also used to reduce pain. Although it causes less stomach irritation than aspirin, acetaminophen does not help with inflammation and cannot control any of the disease activity of lupus. Most people have no side effects when taking Tylenol, but in rare cases acute liver failure has occurred.
  • Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) suppress inflammation and are especially useful for joint pain and stiffness. Examples of NSAIDs are ibuprofen (Motrin®), naproxen (Naprosyn®), indomethacin (Indocin®), nabumetone (Relafen®), and celecoxib (Celebrex®). People often respond better to one particular NSAID than another, so you may need to try several different products to determine the most effective one for you.

Like aspirin, NSAIDs can cause stomach irritation. NSAIDs may also cause serious gastrointestinal (GI) complications, such as a bleeding ulcer. To reduce the chance of these problems, NSAIDs are usually taken with food, milk or antacids, or may be accompanied by other medications such as misoprostol (Cytotec®), omeprazole (Prilosec®), lanzoprazole (Prevacid®), and others.

Side effects of NSAIDS, such as abnormal urine test results, occasionally may be mistaken for signs of active lupus. Recognizing this possible complication of NSAID use is important, because the symptoms will go away when the drug is stopped. In general, you should always be cautious about taking too much of any NSAID, as excessive amounts can reduce the blood flow to your kidneys and may interfere with their ability to remove waste from your body.

Corticosteroids

Corticosteroids (also known as glucocorticoids, cortisone or steroids) are synthetic (man-made) drugs designed to work like the body’s naturally occurring hormones produced by the adrenal glands, in particular cortisol. Hormones are the body’s chemical messengers that regulate most of the body’s functions. Cortisol helps regulate blood pressure and the immune system, and it is the body’s most potent anti-inflammatory hormone. Corticosteroids prescribed for autoimmune diseases are different from the anabolic steroids that weightlifters and other athletes sometimes take to increase strength.

Steroid medications work quickly to decrease the swelling, warmth, tenderness, and pain that are associated with inflammation. They do this by lessening the immune system’s response. Prednisone is the most commonly prescribed steroid for lupus. Prednisolone and methyl-prednisolone (Medrol®) are similar to prednisone, and some physicians prefer to prescribe these if you have liver problems.

Most people take steroids in pill form, but topical creams or gels are often used for cutaneous (skin) lupus. Steroids in liquid form are sometimes injected into muscles or directly into joints, and in some cases into skin lesions. Pulse steroids are large liquid doses given intravenously (injected into a vein) over several hours; the beneficial effects can last for weeks so pulse steroids are sometimes prescribed to control a lupus flare, or for people who cannot tolerate steroids in pill form.

Your doctor will try to keep your steroid dosage at the lowest effective level. Once the symptoms of lupus have responded to treatment, the steroid dose is gradually reduced (tapered). As an alternative to tapering, or stepping down the steroid dose, your doctor may choose to have you take steroids on an every-other day basis — one day on, one day off.

Steroids can produce a variety of side effects. The most common are changes in appearance (acne, a round or moon-shaped face, weight gain due to increased appetite, and hair growth). Steroids can cause fluid retention and a redistribution of fat, leading to a swollen face and abdomen, but thin arms and legs. Also, the skin becomes more fragile and bruises easily. Steroids can suppress growth in children. Steroids can also cause irritability, agitation, excitability, insomnia, or depression. These changes in appearance and mood are more apparent with high doses of steroids.

Side Effects of Long Term Steroid Use

  • Increased risk of infections poses the most danger. If you are taking steroids you must take extra care to clean and protect any open wounds. Infections are one of the leading causes of death in people with lupus.
  • Avascular necrosis of bone, which occurs most often in the hip, is the destruction of the bone itself and is quite painful. Relief from pain often requires total surgical joint replacement.
  • Osteoporosis (bones become fragile and more likely to break) leads to bone fractures, especially compression fractures of the vertebrae with severe back pain.
  • Muscle weakness
  • Cataracts
  • Suppression of growth in children

Antimalarials

Antimalarials are used in combination with steroids and other medications, in part to reduce the dose required of the other drugs. Antimalarials are most often prescribed for skin rashes, mouth ulcers, and joint pain, but also can be effective in mild forms of lupus where inflammation and blood clotting are a concern. Antimalarials improve lupus by decreasing autoantibody production, protecting against the damaging effects of ultraviolet light from the sun and other sources, and improving skin lesions.

The two types of antimalarials most often prescribed today for lupus are hydroxychloroquine (Plaquenil®) and chloroquine (Aralen®). Unlike the rapid response seen with steroids, it may take months before antimalarial drugs improve your lupus symptoms.

Side effects from antimalarials are rare and usually mild; they include upset stomach and changes in skin color. These side effects usually go away after the body adjusts to the medication. In high doses certain antimalarial drugs may damage the retina of the eye, causing vision problems. With the low doses of antimalarials used in the treatment of lupus, the risk of this complication is extremely low. However, as a precaution, people treated with antimalarials should see an eye doctor (ophthalmologist) regularly.

Women who are pregnant should continue to take their antimalarial medication as prescribed, in order to avoid a lupus flare. Although this medication can cross the placenta, the possibility of eye and ear toxicity in the infant is very low. In fact, recent studies suggest that the risk of flare for the mother is greater than the risk of fetal toxicity.

Immunosuppressives (Immune Modulators)

Immunosuppressive medications are used to control inflammation and the overactive immune system, especially when steroids have been unable to bring lupus symptoms under control, or when a person cannot tolerate high doses of steroids. However, there can be serious side effects from these drugs, so if you are being treated with immunosuppressives you should be carefully monitored by your physician. Immunosuppressive drugs reduce your body’s ability to fight off infections, and increase the chances that you could develop viral infections such as shingles (chicken pox, or herpes zoster). It is extremely important that you pay attention to even the smallest cut or wound, and let your doctor know if any sign of infection begins, such as redness, swelling, tenderness, or pain. These drugs may also increase your risk for developing cancer.

Each immunosuppressive drug has unique side effects. Therefore it is important that immunosuppressive drugs be given only by physicians who are experienced with the use of these medications.

Cyclophosphamide (Cytoxan®) was developed to fight cancer. Although in its early years of use it was taken in pill form, today Cytoxan is taken through the vein (intravenously, or IV). It has been shown to improve kidney and lung disease, but can affect a woman’s menstrual cycle and can cause bladder problems, hair loss, and sterility.

Methotrexate (Rheumatrex™), also developed to fight cancer, is known as the “gold standard” — the best drug — for the treatment of rheumatoid arthritis. It has also been shown to be very effective in treating skin lesions, arthritis, and pleuritis in people with lupus. However, the drug can cause sun-sensitivity, liver damage, including cirrhosis, and lung infections. If you are taking this drug you should not drink alcohol, especially if you have a history of kidney disease. If you are taking high-dose methotrexate you should not use NSAIDs; caution is also advised when taking aspirin. Nausea, mouth sores, and headaches are the most common side effects of methotrexate.

Azathioprine (Imuran®) was developed to prevent rejection of kidney transplants. It blocks inflammation pathways in lupus and helps to lower the steroid dosage and improve liver and kidney disease. However, it may cause pancreatitis and an allergic form of hepatitis, so liver function tests and blood counts should be done regularly.

Anticoagulant

Because blood clots can be a life-threatening symptom of lupus, these drugs are used to thin your blood to prevent it from clotting too easily. Anticoagulant medications include low-dose aspirin, heparin (Calciparine®, Liquaemin®) and warfarin (Coumadin®). In particular, if you are being treated with warfarin you must be monitored by your doctor to be sure your blood does not become too thin. Anticoagulant therapy may be lifelong in some people with lupus. Very recent research has shown that people’s genetic makeup may influence how they respond to warfarin; specifically, that people with variations in two genes may need lower warfarin doses due to differences in how the body breaks down (metabolizes) warfarin and regulates the ability of warfarin to prevent blood from clotting. Therefore the dosage and administration of warfarin must be individualized for each person.

Frequently Asked Questions

 

I don’t want to go on prednisone. Are there any other treatments available?
In addition to corticosteroids, lupus can be treated with non-steroidal anti-inflammatory drugs, anti-malarial medications, and chemotherapy drugs. There can be situations where steroids are the best choice of therapy and the other medications are not indicated or are ineffective.

What side effects can I expect from taking steroids?
Prednisone is a double-edged sword. It is a very effective anti-inflammatory agent in lupus, and it works fast. But over time, the side effects of higher doses of the medication can be significant. People taking steroids may have side effects that include weight gain (especially in the cheeks and over the back of the neck), acne, hair thinning on the scalp, new facial hair (on the chin or above the lips), mood swings and difficulty concentrating. Your doctor may also discover that your prednisone has caused higher blood pressure, higher glucose levels and higher cholesterol. Prednisone can also weaken bones and damage the blood supply to joints, which usually occurs first in the hips.

Does long-term prednisone use cause diabetes?
Cortisone and its analogues are “stress hormones” that prime the body for times of challenge. Thus, the rise in sugar in the body is a natural byproduct of a preparation for stress in tissues of the muscles, brain, and heart for example. This is why an increase in the stress hormone results in an increase of the body’s stores of glucose. Long-term prednisone use can cause diabetes in someone who has a tendency to be diabetic. Moreover, the higher the dose of prednisone, the greater the likelihood that the blood glucose (sugar) level will rise. Obesity and a genetic background that includes diabetes also gives a person a greater chance of developing diabetes.

 

Woohoo!

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Well, today I felt a little better than I have in some time now. I am choosing to magnify the positive and eliminate the negative today. I was so fortunate to get quite a bit accomplished and feel better for it. I think the prednisone is kicking in, although still in lots of pain yet. I am hoping the doctor will help me out on that one somehow. At this point, I will go back on the chemotherapy if that is what it takes. I am sick and tired of being sick and tired!

Lupus is so not fair and so not fun! I know, we are not promised to have happiness and light all the time but you know, I wish I could have a few good days in a row! I am beginning to think I am going to have to deal with this wolf in a much more aggressive way for a time. My doctor knows how bad I hate and detest using prednisone, but when I am on it, it does help so I  will  take the moon face and weight gain if it gives me more time to spend with my family.

It is an ironic trade off. My joints hurt more with more weight, yet the medicine to help me makes me gain weight. The paradox is that prednisone is the least of all the “poisons”, or as we lupies call it, the meds, we have to take. High doses create problems like osteoporosis (which I have) and can cause you to have side effects as described below (from wikipedia)

Prednisone’s side effects are legendary in both the medical and patient communities. Patients usually ingest this non-synthetic corticosteroid drug orally. However, doctors administer prednisone in the form of intramuscular injection, too. Medical professionals prescribe prednisone for many medical conditions.

Prednisone turns into the steroidal product prednisolone after the liver has processed prednisone following administration. Its most common use is as an immunosuppressant that acts on almost the entire immune system. This makes it very useful in the treatment of autoimmune diseases, inflammatory diseases like severe asthma, severe poison ivy dermatitis, ulcerative colitis, rheumatoid arthritis and Crohn’s disease.

Doctors also use prednisone to treat the symptoms of many kidney diseases such as nephrotic syndrome, and to avoid and reverse tissue rejection following organ transplantation. The usual adult dose at the beginning of treatment ranges from 20 to 80 milligrams per day. The dose for children may be 1milligram per kilogram of body weight, with a maximum dose of 50 milligrams.

The side effects of prednisone include adrenal suppression, which can occur with periods of prednisone use to surpass seven days. Adrenal suppression refers to the body’s inability to synthesize natural corticosteroids, resulting in a dependency on the prednisone taken by the patient. This is why doctors do not recommend the cessation of prednisone when the patient has taken it for longer than seven days. They reduce the dose gradually over a few days in the case of short-term prednisone use, and over weeks or months in the case of long-term treatment. Stopping prednisone treatment abruptly can cause the life-threatening Addison’s disease, in which in the body no longer produces sufficient amounts of adrenal steroid hormones

The short-term side effects of prednisone use include high blood glucose levels. This happens most commonly in patients that are already has diabetes mellitus or is using medications that increase blood glucose. Other short-term side effects of prednisone include insomnia, euphoria and, in some cases, even mania. Using prednisone for long periods can cause side effects such as Cushing’s syndrome, weight gain, osteoporosis, glaucoma and type II diabetes mellitus. Upon withdrawal of prednisone after long-term use, patients also suffer from depression. Almost all long-term users of prednisone experience a reduction in their sex drive, as well.

Prednisone use can affect the eyes as well. The most common side effects in the context are glaucoma and cataract formation. These usually occur with topical or intraocular administration of prednisone, but they can also appear with oral, intravenous, or even inhaled administration.

Prednisone use of any period can give rise to many other side effects such as unnatural fatigue or weakness, abdominal pain, blurring of vision, peptic ulcers, infections, pain in the hips or shoulders, osteoporosis, occurrence of acne and sleeplessness. Some of the less serious side effects of prednisone include weight gain, stretch marks on the skin, swelling in the face, nervousness, increase in appetite and hyperactivity.

Doctors treat these side effects of prednisone symptomatically, since it is not always feasible to stop prednisone administration even when severe side effects occur. These are situation where they have to weigh the disadvantages of using a drug against the advantages and make an informed decision. One must remember that while prednisone definitely does give rise to many side effects, it is also a life-saving drug.

It is not to be taken lightly, this drug and yet, it is only the front line defense for lupus. Systemic lupus erythrematosis, or SLE, is not a pretty disease. While some are lucky enough to not develop a lot of issues with lupus, some have lots of issues. For each person it is different. That is why, when you meet someone with lupus, you never know the battles they are having.

So, in conclusion, I hope if you read this, you are a little more educated on one of the drugs used to treat lupus. I am hoping to educate anyone who reads this blog. It is my ultimate goal. In the meantime though, I will write about life experiences and share them here so others may learn the value of life and living, and treat others with dignity and empathy.

disappointed

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Today I actually did the things I had on my list and a few besides that! That is great! Wonderful! So, I feel a sense of accomplishment in getting these things done. Why then, the name of this post?

As much as I feel good for doing so much with so little energy today, I still feel disappointment. My body is hurting in so many places it would be easier NOT to name them. My feet in particular, and my ankle on the right side are the main culprits, but the rest of me feels like the feeling you get when you have the flu. You know, all achy and run down.

I have taken my neurontin for the feet and my tramadol for pain, but I am still in a mess of pain. As I said before, I am dealing with this on my own because I am apparently bringing everyone around me “down”. I would run to ER (like I could run) but as I said last night, they tend to shoo you out instead of addressing the issues at hand.

You see, for those of you who do not have a chronic, incurable disease, it is nice to have the ER for the emergencies in life. That is why it is there. However, when you have a chronic disease and appear at the ER, unless you are at death’s door, you will be patted on the hand and basically told that there is nothing they can do for you and to just go home and rest. Nonsense you say? I beg to differ. I have been to the ER on numerous occassions looking for some type of help with the things this disease does to my body, only to find that because I am a woman, I am treated like a child who has a little splinter in my hand.

I can say this because my husband has had to go to the ER for similar issues as mine and he is not only whisked in and thoroughly checked out, he is treated with respect. Now I know there are good doctors out there. I know several personally. The problem arises when you have so many things hurting and acting up and they cannot or will not try to help.

Let me state here that I am not looking for pain medicines. I have been on narcotics, as well as many different types of pain remedies. I do not like to take them unless it is severe enough. I do not get a “buzz” when I take them. Instead, it reacts like an amphetamine to me. You see, when one is chronically ill, pain meds do what they are supposed to do and knock the pain down. When that happens, I tend to feel so much better that I try to do all the things I can before I feel like total c-rap again. I have read studies where it has been proven over and over again that those with TRUE chronic pain do not get addicted like those who take them recreationally. They actually DO THEIR JOB in the chronically ill people.

Not to put too fine a point on it but the whole issue then seems to be that I suffer in pain, in bed, while I should be able to enjoy some things every so often. If I could find a magic potion that made me feel good, I would shout it from the rooftops. I would love to be able to just jump up and run to the store without having to worry about how far I will be walking, if I can get it all done, and how much it will hurt me after the fact.

I am mad, basically, because my pain is very real, and my meds are not working and I need someone to listen to me while I vent. If I call my family doc, they will refer me to the rheumy, who will either prescribe something or send me to the neurologist, and so on and so on…round and round we go. Been there done that and tired, too tired to care about this little game anymore. I will do my best to deal with the pain, and all the other issues because of it and I promise that I will nto inconvenience any one else because I am puny.

I pledge to:

Not whine about the pain

Not show my weaknesses

Not bring others down

Not stop even when it hurts

Do all my daily chores daily no matter what

I know there are many more for the list, but that is it in a nutshell.

Good night everyone and thanks again for letting me vent!