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Lupus

What is lupus?

Lupus is an autoimmune disease. This means that your immune system attacks healthy cells and tissues by mistake. This can damage many parts of the body, including the joints, skin, kidneys, heart, lungs, blood vessels, and brain.

There are several kinds of lupus

  • Systemic lupus erythematosus (SLE) is the most common type. It can be mild or severe and can affect many parts of the body.
  • Discoid lupus causes a red rash that doesn't go away
  • Subacute cutaneous lupus causes sores after being out in the sun
  • Drug-induced lupus is caused by certain medicines. It usually goes away when you stop taking the medicine.
  • Neonatal lupus, which is rare, affects newborns. It is probably caused by certain antibodies from the mother.
What causes lupus?

The cause of lupus is unknown.

Who is at risk for lupus?

Anyone can get lupus, but women are most at risk. Lupus is two to three times more common in African American women than in white women. It's also more common in Hispanic, Asian, and Native American women. African American and Hispanic women are more likely to have severe forms of lupus.

What are the symptoms of lupus?

Lupus can have many symptoms, and they differ from person to person. Some of the more common ones are

  • Pain or swelling in joints
  • Muscle pain
  • Fever with no known cause
  • Red rashes, most often on the face (also called the "butterfly rash")
  • Chest pain when taking a deep breath
  • Hair loss
  • Pale or purple fingers or toes
  • Sensitivity to the sun
  • Swelling in legs or around eyes
  • Mouth ulcers
  • Swollen glands
  • Feeling very tired

Symptoms may come and go. When you are having symptoms, it is called a flare. Flares can range from mild to severe. New symptoms may appear at any time.

How is lupus diagnosed?

There is no specific test for lupus, and it's often mistaken for other diseases. So it may take months or years for a doctor to diagnose it. Your doctor may use many tools to make a diagnosis:

  • Medical history
  • Complete exam
  • Blood tests
  • Skin biopsy (looking at skin samples under a microscope)
  • Kidney biopsy (looking at tissue from your kidney under a microscope)
What are the treatments for lupus?

There is no cure for lupus, but medicines and lifestyle changes can help control it.

People with lupus often need to see different doctors. You will have a primary care doctor and a rheumatologist (a doctor who specializes in the diseases of joints and muscles). Which other specialists you see depends on how lupus affects your body. For example, if lupus damages your heart or blood vessels, you would see a cardiologist.

Your primary care doctor should coordinate care between your different health care providers and treat other problems as they come up. Your doctor will develop a treatment plan to fit your needs. You and your doctor should review the plan often to be sure it is working. You should report new symptoms to your doctor right away so that your treatment plan can be changed if needed.

The goals of the treatment plan are to

  • Prevent flares
  • Treat flares when they occur
  • Reduce organ damage and other problems

Treatments may include drugs to

  • Reduce swelling and pain
  • Prevent or reduce flares
  • Help the immune system
  • Reduce or prevent damage to joints
  • Balance the hormones

Besides taking medicines for lupus, you may need to take medicines for problems that are related to lupus such as high cholesterol, high blood pressure, or infection.

Alternative treatments are those that are not part of standard treatment. At this time, no research shows that alternative medicine can treat lupus. Some alternative or complementary approaches may help you cope or reduce some of the stress associated with living with a chronic illness. You should talk to your doctor before trying any alternative treatments.

How can I cope with lupus?

It is important to take an active role in your treatment. It helps to learn more about lupus - being able to spot the warning signs of a flare can help you prevent the flare or make the symptoms less severe.

It is also important to find ways to cope with the stress of having lupus. Exercising and finding ways to relax may make it easier for you to cope. A good support system can also help.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Medicines

Medicines can treat diseases and improve your health. If you are like most people, you need to take medicine at some point in your life. You may need to take medicine every day, or you may only need to take medicine once in a while. Either way, you want to make sure that your medicines are safe, and that they will help you get better. In the United States, the Food and Drug Administration is in charge of ensuring that your prescription and over-the-counter medicines are safe and effective.

There are always risks to taking medicines. It is important to think about these risks before you take a medicine. Even safe medicines can cause unwanted side effects or interactions with food, alcohol, or other medicines you may be taking. Some medicines may not be safe during pregnancy. To reduce the risk of reactions and make sure that you get better, it is important for you to take your medicines correctly. You should also be careful when giving medicines to children, since they can be more vulnerable to the effects of medicines.

Myelodysplastic Syndromes

Your bone marrow is the spongy tissue inside some of your bones, such as your hip and thigh bones. It contains immature cells, called stem cells. The stem cells can develop into the red blood cells that carry oxygen through your body, the white blood cells that fight infections, and the platelets that help with blood clotting. If you have a myelodysplastic syndrome, the stem cells do not mature into healthy blood cells. Many of them die in the bone marrow. This means that you do not have enough healthy cells, which can lead to infection, anemia, or easy bleeding.

Myelodysplastic syndromes often do not cause early symptoms and are sometimes found during a routine blood test. If you have symptoms, they may include

  • Shortness of breath
  • Weakness or feeling tired
  • Skin that is paler than usual
  • Easy bruising or bleeding
  • Pinpoint spots under the skin caused by bleeding
  • Fever or frequent infections

Myelodysplastic syndromes are rare. People at higher risk are over 60, have had chemotherapy or radiation therapy, or have been exposed to certain chemicals. Treatment options include transfusions, drug therapy, chemotherapy, and blood or bone marrow stem cell transplants.

NIH: National Cancer Institute

Pain Relievers

Pain relievers are medicines that reduce or relieve headaches, sore muscles, arthritis, or other aches and pains. There are many different pain medicines, and each one has advantages and risks. Some types of pain respond better to certain medicines than others. Each person may also have a slightly different response to a pain reliever.

Over-the-counter (OTC) medicines are good for many types of pain. There are two main types of OTC pain medicines: acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs). Aspirin, naproxen (Aleve), and ibuprofen (Advil, Motrin) are examples of OTC NSAIDs.

If OTC medicines don't relieve your pain, your doctor may prescribe something stronger. Many NSAIDs are also available at higher prescription doses. The most powerful pain relievers are opioids. They are very effective, but they can sometimes have serious side effects. There is also a risk of opioids. Because of the risks, you must use them only under a doctor's supervision.

There are many things you can do to help ease pain. Pain relievers are just one part of a pain treatment plan.

Penis Disorders

Problems with the penis can cause pain and affect a man's sexual function and fertility. Penis disorders include

  • Erectile dysfunction - inability to get or keep an erection
  • Priapism - a painful erection that does not go away
  • Peyronie's disease - bending of the penis during an erection due to a hard lump called a plaque
  • Balanitis - inflammation of the skin covering the head of the penis, most often in men and boys who have not been circumcised
  • Penile cancer - a rare form of cancer, highly curable when caught early