KarmaGirl KarmaGirl

Living with Lupus part 2

Living with Lupus part 2

What I do to keep healthy

My previous article was a bit of a glimpse into what it is like to live day by day with Lupus.  It was just a slice of my daily life, but I didn't talk about things that I do to try and help myself stay healthy and active.

There is a balance that has to be found in life.  With me, my biggest struggle is finding a way to manage pain enough to stay active, but to not take so many medications that I'm stressing my liver.  You can't live without your liver, and since mine's not that great, I concentrate on making sure I do what I can to help it out.

There are 4 main categories that I will throw things in for this article: 1) Diet, 2) Activity, 3) Medication, and 4) Daily routine.

#1- Diet.  Don't underestimate food.  If you eat like crap, your body has to deal with that crap.  I have spent the last 14 years of my life trying to figure out what foods trigger flares, rashes, and fatigue.  Here is some of what I've learned about myself:

Meat- it's what's rotting in your colon.  It produces ammonia during digestion, which then causes your liver to have to convert it so that your kidneys can rid it from your system.  This taxes your liver and kidneys.  You also then get the cholesterol to deal with, and animal protein to digest, which is much harder on your body.  In the past 5 years, I have gotten my cholesterol into the "normal" range, and have increased my liver functions by not eating meat.  I was a vegetarian longer than that, but I was also making other changes, so I'm not sure what affected what before the past 5 years.

Veggies- Eat them.  Get at least 6 servings of fruits and veggies a day.  They have nutrients that your body needs to heal itself.

Dairy- Dairy can be evil.  I am allergic to it (gives me hives).  I would suggest using it in moderation.  You don't need dairy to get calcium and Vitamin D- there are plenty of other foods that will provide that, assuming you aren't just eating junk.

Eating out- Don't do it often, and don't eat fast food.  There is too much salt and fat in restaurant food.  There is no sense in getting a flare over food.

Soda- It's a can of delicious chemicals that you should really moderate.  It doesn't help your body at all, so only have it as a treat.  

 

#2- Activity.  Keep moving, even if it hurts.  When I was diagnosed with Rheumatoid Arthritis 27 years ago, the thought then was "if it hurts, don't do it".  Luckily, a doctor told me that I would be in a wheelchair by 21.  Why was that lucky?  Because, being the young shit-head that I was, I thought "well, if I'm going to be in a wheelchair anyway, why should I care if I'm hurting my joints?"  Luckily, I kept active and ended up staying mobile.  If you don't keep moving, you will end up in bed feeling sorry for yourself, and soon you will decide one day to just stay in bed and let somebody else clean up your poo.  Don't do that- get your ass up and move.

 

#3- Medication.  Now, this is a tricky one.  Everyone senses pain differently, so not all pain meds work the same, and not everyone needs the same treatments.

This is what I take on a daily basis:
1) Armour Thyroid - I've had my whole thyroid removed due to 32+ cysts and nodules
2) Hydrochlorothyazide - BP medicine.  Most people with Lupus have high blood pressure
3) Effexor XR- This is for pain management, though it has helped my OCD a bit.  I rather be on Cymbalta, but my insurance won't pay for it, and I don't want to pay $200 a month.

Now and then I get a flare that won't go away and I go on Plaquenil for a couple months.  I could avoid some flares by staying on it, but I just don't want to put my liver through that.

Pain Management:
1) Good Old Naproxen
2) Tramadol for when Naproxen just isn't enough
3) Vicodin for when Tramadol doesn't cut it
4) Flexeril for when my muscle spasm for no good reason

Then I have a very interesting one- vaporized nicotine.  Now, this is not "smoking", it's nicotine in a suspension that is used for other medical uses, such as asthma inhalers.  Nicotine is not cancer causing, and after many tests, it has actually lowered my bp.  Seems like an odd treatment?  Well, they have been testing nicotine post-op for quite some time.  There are studies going on, like the one I'm in, that shows that it is very effective at pain management.  Why? It is believed that Nicotine raises the level of dopamine in the brain.  The brain converts dopamine into norepinephrine.  Now, if you look at Cymbalta, which is approved for pain management, one of its main features is that is raises levels of norepinephrine.  If anyone is interested in further information of how I use Nicotine and what equipment I use, let me know and I'll write its own article.

 

#4- Daily routine.  This seems like something that isn't a factor in keeping healthy, but it is.  It's important to go to bed and get up at the same time each day.  Now, I have insomnia and sleep apnea, so I don't always sleep much, but keeping yourself in a routine is a good thing.

I have also identified skin irritants, such as perfumes, anything that's not cotton, many lotions, soaps, etc. that I avoid.  I make sure that I start my day with a shower, check for any body parts that have a new rash or other afflictions, and then apply topical treatment to the rashes.  Keeping clean and keeping the rashes under control is important since Lupus effects the skin heavily, and your skin can really throw you for a loop if it's not healthy.  I also use very little make-up and try and be as gentle on my skin as possible.

Eat at about the same times everyday.  Eat smaller meals and more of them.   With Lupus, as mentioned, your liver is at risk.  Smaller, frequent meals are easier on your digestive system, are less taxing on your liver, and help maintain glucose levels.

Have downtime.  It's easy to get so busy that you get too stressed and cause a flare.  Make sure that you take at least 30 minutes each night to just calm down before going to bed.  I find sitting in a quiet room petting dogs is the best for calming me down.  It lets my brain settle, and it's always great to snuggle with wiener dogs.  If I am really stressed, I will opt for a 20 minute session of meditation.  I see it as a "reset" for my brain.  Lupus also effects brain chemicals, so it's easy to get a bit on the bat shit crazy side.  Prevent that my giving your brain a rest.

 

Well, I probably have more to say, but I've already written a book.  If there is anything that anyone would like more detail on, or has questions about, let me know! 

 

 

 

293,767 views 63 replies
Reply #26 Top

Quoting KarmaGirl, reply 24
Have any of you guys tried Cymbalta for pain management?

yes. And not to 'bad' mouth, as each experience is to the individual, but that was one of the drugs I just came off of last month and went through some hellish withrdraw over, along with lyrica. I have been on some wicked drugs but the cymbalta and lyrica take the freaking cake for withdraw. I would rather go through the three or four days of hell getting off of cigarettes in October than I would dealing with those two drugs again.

Quoting DrJBHL, reply 22
You should have been informed. Period.

 

That's what we have you for. Geesh. Wake up and smell the coffee, whydontcha.

Reply #27 Top

@  calcium and iron.  I'm no expert.  Somewhere along the way I learned that taking Ca and Iron at the same time wastes much of the benefit.  Something about Calcium and iron using the same channels through the cell membrane.  Was recommended to take them at different times during the day.  Hope this helps, even if only a little. 

Reply #28 Top

Quoting PoSmedley, reply 26
That's what we have you for. Geesh. Wake up and smell the coffee, whydontcha.

On anyone else's thread you'd have been shopped into oblivion for that. As it stands, you're unlikely to come off the List. Evah.

Reply #29 Top

Yeah, Cymbalta is not ready to get off.  It has terrible withdrawal symptoms.

BTW, vitamin D is something that anyone with bone pain should get checked regularly since a deficiency can increase bone pain. 

Reply #30 Top

Quoting KarmaGirl, reply 29
It has terrible withdrawal symptoms.

It should not be withdrawn suddenly. An SSRI (like) withdrawal syndrome can occur. Cymbalta is an SNRI drug, but has very similar withdrawal symptoms. VERY unpleasant. 

Eli Lilly, the manufacturer of duloxetine - brand name Cymbalta - warns that "one should not suddenly stop taking this medicine, as this may cause withdrawal symptoms such as dizziness, pins and needles sensations, nausea, difficulty sleeping, intense dreams, headache, tremor, agitation or anxiety. Withdrawal symptoms are temporary and are not the same as addiction." These responses could constitute physical dependence on the drug, but SSRI users do not experience the craving, impulsive use, or long-term relapse risk seen in drug addiction.

During marketing of other SSRIs and SNRIs (serotonin and norepinephrine reuptake inhibitors), there have been spontaneous reports of adverse events occurring upon discontinuation of these drugs, particularly when abrupt, including the following: dysphoric mood, irritability, agitation, aggressiveness, dizziness, sensory disturbances (e.g., paresthesias such as electric shock sensations), anxiety, confusion, headache, lethargy, emotional lability, insomnia, hypomania, tinnitus, and seizures. Although these events are generally self-limiting, some have been reported to be severe.

Patients should be monitored for these symptoms when discontinuing treatment with Cymbalta. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose but at a more gradual rate.

Tapering process may be moot for some patients, and they will still have discontinuation/withdrawal symptoms.

Many patients on the drug longer than the Lilly test trials on discontinuation (which only studied patients after 9 weeks of exposure to cymbalta), report anecdotal evidence of major withdrawals from cymbalta lasting from weeks to many months. Since duloxetine is a newer drug (FDA-approval 2004), not many peer-reviewed articles have been published on its adverse effects or withdrawal phenomena, and effect of long term use is still unknown.

Reply #31 Top

Quoting DrJBHL, reply 30
It should not be withdrawn suddenly.

They had me taper off but I think they gave me half assed instructions on it and thought the replacement they were tapering me 'on' to would make it go easy.

They were wrong.

They were very very wrong.

My wife can verify that they were wrong if she ever comes out of the attic where she went to hide from me.

Because they were very very very wrong.

Reply #32 Top

Quoting DrJBHL, reply 30
Eli Lilly, the manufacturer of duloxetine - brand name Cymbalta - warns that "one should not suddenly stop taking this medicine, as this may cause withdrawal symptoms such as dizziness, pins and needles sensations, nausea, difficulty sleeping, intense dreams, headache, tremor, agitation or anxiety.

Okay, so getting off it too quickly produces what I face/endure most days.  Please remind me NOT to take it... thus avoiding the potential trauma of coming off it.

Reply #33 Top

I went cold turkey with Cymbalta.  I don't recommend it.  I think I was talking to Elvis for a couple days.

Reply #34 Top

Quoting PoSmedley, reply 31
Because they were very very very wrong.

Quoting KarmaGirl, reply 33
I think I was talking to Elvis for a couple days.

Yikes!!!! :(O  I swear, some of these drugs they give you side effects sound worse than the condition you are afflicted with...

Reply #35 Top

Being on it is fine- it's just getting off it that makes you want to peel your skin off.

Reply #36 Top

Quoting KarmaGirl, reply 24
Have any of you guys tried Cymbalta for pain management? Effexor XR works the same way. It seems to help you cope with pain more than actually get rid of it. The only downsides are that it takes about 2 weeks for it to start working and it's a real bitch to get off from.

Tried Lyrica and Cymbalta briefly because they rendered no relief within a week. I keep asking the doctor if they've watered down the drugs I did in the sixties...the ones that within an hour you knew you we're doing drugs...or they were doing you...I forget which...lol

I've pretty much gotten to the point where I ask what the side effects are...and if he names more than 2 I don't want them. I recently asked for another prescription of Xanax 1 mg...and it at least works well enough that I can get some sleep without waking up every hour or 2.

Going in soon for another EMG test to see if they can find anything there. Basically my left arm from my finger tips to my shoulder and up to my neck...as well as my left side mid section feels like Popeye's arm looks...and this is constant. On bad days it feels like someone stuck a bicycle pump in my arm and is being pumped up to the point of exploding. And as times goes by I occasionally get new symptoms...if I turn to the left or right..and sometimes just standing in one place for to long...I get these intense muscle cramps that no amount of stretching gets rid of.

The worst thing that sucks...if I lay on my back in just the right position...which unfortunately varies day to day...I "almost" feel normal...until I get up...then it's right back to the same thing.

Reply #37 Top

Quoting KarmaGirl, reply 33
I think I was talking to Elvis for a couple days.

Ah, so that was you?  Wondered who was butting in!  Yeah, we had a good conversation going about kissing cousins and hot hula girls getting 'blue' in Hawaii, next thing he's sayin': "Scuse me." and that's the last I heard from him.

As for Effexor, I now take Pristiq, which is next gen Effexor and does the same job for me... minus one annoying side-effect.  When I was taking Effexor I had this problem with jaw clenching and grinding my teeth... which is something you don't need when approaching 60 and yer fangs ain't what they used to be.  Pristiq alleviated that problem for me, however, and I've not noticed any other side-effects with it at all.

I was taking Tramadol but a recent policy change meant there was massive price jump and now I simply can't afford it, not at plus $60 a month.  I need to go back to my doctor to see what else she can prescribe that would relieve pain as effectively.  I can usually manage with the other pain on a lesser med, but I do need something fairly substantial for the spinal pain in the lower back and neck, otherwise there's days I can barely move or walk for the pain.

Although I do not have Lupus itself, I do suffer some of the symptoms you describe, so I will be formulating a better, healthier diet along the lines of your recommendations to see if there are any improvements.  I have an issue with dermatitis, among others I'm hoping will improve if not go away altogether.

:)

Reply #38 Top

Starkers, bummer about the Tramadol.  That is one of the few pain meds that work for me without making me feel sick (liver doesn't like many drugs).  Stupid that they won't cover it.  Will they cover levorphanol?  It acts much the same, but you would have to take a higher dose.

Reply #39 Top

Oh, I forgot to mention my favorite lotion for chillin' out my skin rashes: Dermarest Eczema Medicated Lotion.  You can get it at a lot of places, or on Amazon for about $12.  It's not super heavy like a lot of them, but it works really well and you can apply it a couple times a day without feeling greasy.  

Reply #40 Top

Quoting KarmaGirl, reply 38

Starkers, bummer about the Tramadol.  That is one of the few pain meds that work for me without making me feel sick (liver doesn't like many drugs).  Stupid that they won't cover it.  Will they cover levorphanol?  It acts much the same, but you would have to take a higher dose.

Thanks for the heads up, I'll ask my doctor about leverphanol during my next visit.  I was also told about a pain relief med that applies along the lines of nicotine patches to quit smoking.  Apparently, while it is slow release, you can get an instant hit for severe pain by pressing on it somewhere.  I don't know the name of it as the person who told me has only seen her mother use it, but I'm sure my doctor will know more when I ask her about it.

Quoting KarmaGirl, reply 39
Oh, I forgot to mention my favorite lotion for chillin' out my skin rashes: Dermarest Eczema Medicated Lotion.

I have used that before and recall it being quite good at relieving the itch and burning sensation that comes with dermatitis... and it is available in Australian pharmacies so is easy to get.   A company named Fauldings makes a similar cream that I've also used with good results, so I will look them both up when next at the pharmacy.  I'm currently using a prescription steroid cream that I'd rather not use as it thins the skin, thus making it more fragile and susceptible to breakage, just at the slightest cut, graze or knock.

Reply #41 Top

There are a few pain meds that they do through patches.  Nicotine is actually one of them (they apply it post op).  The big on is Morphine.  However, she is most likely using Fentanyl.  It is absorbed into the fat under where it is placed and then slowly releases into the blood stream.  

Reply #42 Top

Quoting KarmaGirl, reply 41
However, she is most likely using Fentanyl.

That sort of sounds familiar, though from another source. I know somebody who has similar issues to me and I think he mentioned it to me once.  I have a friend who suffers with chronic lower back pain, and I'm sure that's what he said his doctor prescribed him.  Hmmm, I have quite a bit to talk with my doctor about now, though Morphine isn't something I want to take in its pure form. 

When I was in hospital after my motorcycle accident I had a reaction to it that I'd rather not experience again.  I'm not allergic or anything, but after a couple of days I began to experience some strange sensations and weird, intense dreams, so my doctors switched me to Pethadine, which did the trick.  I've since used some Morphine derivatives without a problem, but I'd still rather not use it in its pure state if I don't have to.

Reply #43 Top

Quoting WebGizmos, reply 36
I've pretty much gotten to the point where I ask what the side effects are...and if he names more than 2 I don't want them.

You need to differentiate between potential side/adverse effects (possible), and those you actually experience. You could get hit by a meteor, but have you? To disqualify a possibly good treatment out of hand is self defeating. Once again returning to the problem of prediction. You know you don't react in a predictable manner to all things, but to find out if one will work or not, and how well as well as the actual pluses vs. the actual minuses you have to try the med.

 

Tramadol really is excellent... for some.

 

Reply #44 Top

Quoting DrJBHL, reply 43
Tramadol really is excellent... for some.

It was for me... knocked pain on the head... 'til 'policy' put it out of reach, price-wise.

The alternative 'policy' allows is Codalgin Forte... Paracetamol with a touch of Codeine, but I'd rather not use that as it is harsh on the digestive system and causes constipation.... not that the policy makers give a toss about the harm it causes.  As usual, the wealthy get their pick of the good meds while we get the harmful crap in the left overs.

>:(

Reply #45 Top

Starkers, I am so sorry about the Tramadol. It only ever helped my headaches and nothing else, but I have met a lot of people who swear by it. In the states, there are a few 'generic' versions of it like Ultram that cost half that without insurance and only $9.00 with. Is there not a generic version available there? I may be wrong, I don't know. I just don't understand how they price this stuff at all and why it's always the one that actually works for you is the one you can never afford. Freakin healthcare. It's horseshit wrapped in a riddle wrapped in an enigma and then slathered with more horseshit.

Something that worked for me early on was Avenza (not sure on the spelling). It was a time released, 'synthetic' morphine. Even came along with that warm fuzzy feeling when it kicks in. That was cheap here.

 

Reply #46 Top

Quoting PoSmedley, reply 45
Is there not a generic version available there? I

I was using the generic version... but that, too, has been removed from the PBS, along with a number of other meds pensioners and low income families relied on.  It will come back to bite the government at the next election, but the next bunch of liars won't restore any of them.

No, I'm back to speaking with my doctor and hoping to be prescribed something effective that will remain attainable, cost-wise.

Quoting PoSmedley, reply 45
I just don't understand how they price this stuff

Me either!  I seems to me they assess how much they think the market can bear and add a couple of bucks for good measure.  This means the wealthy and high/middle income earners can afford it, and pensioners/low income earners will have to sacrifice food on the table or forego other items to fill the scripts.

Reply #47 Top

Quoting starkers, reply 46
No, I'm back to speaking with my doctor and hoping to be prescribed something effective that will remain attainable, cost-wise.

Can you or I should ask..'do your countries laws' permit you to order 'on-line'?

 

http://www.pharmacychecker.com/compare-drug-prices-online-pharmacies/tramadol-50+mg/40027/67895/

Reply #48 Top

Quoting PoSmedley, reply 47


Quoting starkers, reply 46No, I'm back to speaking with my doctor and hoping to be prescribed something effective that will remain attainable, cost-wise.

Can you or I should ask..'do your countries laws' permit you to order 'on-line'?

 

http://www.pharmacychecker.com/compare-drug-prices-online-pharmacies/tramadol-50+mg/40027/67895/[/quote]

I'm not sure what the stance here in Australia is on that..  I will check up on it, however.... and thanks for the link, Po`... if the legality works out okay I'll certainly investigate it.

Reply #49 Top

Quoting starkers, reply 48
if the legality works out okay I'll certainly investigate it.

There are a lot ..a LOT of links and info on this. There are a lot that say they can sell it to you 'without' a prescritption'. I would avoid those unless it comes down to having to take such a chance. I don't think the legality is as big an issue as whether or not your are getting what you pay for and not a bunch of sugar pills, ya know.

I just got the call this morning that my insurance has approved the spinal cord implant. I go in on the 26th for the trial. Very nervous.

Reply #50 Top

Best of luck to you, Po'.

The online meds thing is risky... one doesn't know if the med is real or not, was stored/shipped properly or not.

I'd make darned good and sure the "Pharmacy" has an excellent reputation and that it's "kosher".