The Expert Series: Managing and preventing flares

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Host 0:00
Welcome to The Expert Series brought to you by the Lupus Foundation of America. This new monthly educational video series will feature presentations from leading experts on topics of importance for those who are affected by lupus. Our speaker today is Dr. Donald Thomas, who teaches at the Walter Reed National Military Medical Center. As an Assistant Professor of Clinical Medicine of the Uniformed Services University of Health Sciences, and author of The Lupus Encyclopedia: A Comprehensive Guide for Patients and Families. Dr. Thomas will be speaking about managing and preventing flares. I'd now like to turn it over to Dr. Thomas and thank him for joining us.

Dr. Thomas 0:40
Thank you, Alicia. Before we can talk about how to prevent and deal with lupus flares, it is important to know what a lupus flare is. The goal in treating lupus is to have it in remission, or at least slow disease activity. If there is an increase in disease activity, we call it a flare. Some of some examples of lupus flares would be the occurrence of lupus, arthritis, mouth sores or pleurisy after a time when these were not occurring. Other examples would be a someone has a mild lupus symptoms occurring person persistently, and then they worsen. For example, if someone has some pink-colored cheeks from the butterfly or Malar rash, and then it spreads out to other areas of the skin or becomes a much darker red, this would be a type of a Lupus flare.

To help you prevent and manage flares, you should one: avoid lupus triggers, two: take medications as prescribed, three: educate yourself about lupus and four have a flare plan in place with your doctor. Lupus is a unique disorder because there are things that can trigger it to become more active and cause flares. Many of these can be actively avoided by the person who has lupus although a person who has lupus is powerless in having the disease in the first place. The person who has lupus is in a unique position in that he or she does have the power to decrease the chances of becoming worse. Some examples of lupus triggers include the following ultraviolet light is one of the most well known triggers of lupus flares. Even persistent exposure to small amounts indoors from for fluorescent and incandescent lights can increase lupus to flare. So the person with lupus should be wearing sunscreen religiously every day, even if she doesn't go outside. Make sure to wear a wide brimmed hat when going outside and change all the indoor bulbs to LED bulbs, which do not give off any ultraviolet light. Cigarette smoke contains a chemical called hydrazine, which is a well known trigger of lupus flares. It is mandatory that people who have lupus never smoke and do everything in their power to stop smoking if they are smoking cigarettes is a guaranteed is a guaranteed way to make lupus worse and cause a premature death.

A sulfur-containing chemical called sulfonamides can cause lupus to flare. They are most commonly found in the antibiotic called sulfa methoxyphenyl, which is found in the brand names septra and Bactrim. This group of being a biotics is commonly prescribed by doctors to treat infections, and many doctors do not know that they can hurt people who have lupus, it is best to carry around a list of your medications and allergies at all times.

And make sure to include sulfa antibiotics in all your allergy lists. akinesia is an herbal product that increases immune system activity, exactly the opposite of what you want to what you want when you already have an overactive immune system due to lupus. Therefore, it is important to read all supplement labels and not take anything that contains that can Nisha alfalfa sprouts and mung bean sprouts may sound healthy, however, they contain the amino acid L-canavanine which can activate the immune system and increased lupus inflammation.

If you plan to add herbs, dietary supplements or vitamins to your diet, you should discuss this decision with your lupus doctor first. This is especially important as herbs or supplements may interact with medications used to treat lupus. herbs or supplements should never be used to replace medicines prescribed to control symptoms of lupus or medication side effects.

Stress can trigger lupus to be more active. So learning how to simplify one's life and avoiding stressful situations as much as possible is important. I can already hear so me of you thinking "sure that's easy for you to say. You should see how overwhelming My situation is." You are correct, we must realize that we cannot completely get rid of stress. However, all of us no matter how our situation is, we can proactively change things in our lives to decrease stress. Learn to simplify your life, set realistic expectations. Learn to say no, when you're unable to take part in things, building downtime, event downtime and relaxation into your schedule. Balance solitude with sociability, the best thing that you can do to minimize stress levels is to care for yourself. So make sure that you really take the time to prioritize you.

Low vitamin D can trigger can trigger increased lupus inflammation, because when there is a lack of vitamin D in the body, the immune system works improperly. It is imperative to make sure that you take your vitamin D that you have your vitamin D level checked on a regular basis to ensure it is not low. And if you're a toad to take a vitamin D supplement, you need to take it regularly and consider it as one of your most important lupus medications.

Next, I will talk about taking medications as prescribed. One of the most common causes of people having lupus flares is simply from not taking their medicines regularly. Numerous research studies show that around 50% of all lupus patients do not take their medications such as plaque window and vitamin D regularly. And these same people are those who are much more likely to have ongoing disease activity with their lupus. There are many potential reasons for why you may not be taking your medicines regularly. These possibilities may range from being too expensive. You're not tolerating them, you're not understanding why they are important, or you're just forgetting to take them. Your health care providers should be your health care should be a team approach between you and your physician. Make sure to be 100% honest with your doctor if you're not taking your medicine regularly. Otherwise, he or she will assume that your medicines are not working. If you're having flares and will consider changing your treatment, this would be the wrong solution. Instead, if you can find in your doctor that you're not taking your medicines regularly and why then your physician can help you come up with potential solutions to this problem.

Next, let's talk about educating yourself about lupus, it is much easier to get into the habit of taking better care of your lupus if you know as much about it as possible. It is difficult to get into a daily life habit such as wearing sunscreen every day. If you do not know the reasons behind why it is important to do so. Lupus patients who educate themselves as much as they possibly can tend to also be the ones who are best at avoiding lupus triggers, taking their medications regularly, and living a longer healthier life, rather than letting lupus cause these problems. The Lupus Foundation of America's National Resource Center on Lupus is an excellent source for educational material and tools. Also, consider getting my book called The Lupus Encyclopedia. I wrote it in easy to understand language and it goes into great detail about all the things you can do to deal with your lupus in the best possible ways. Lastly, make sure to have a flare plan in place with your doctor. Knowing what to do when you have a flare is as important as preventing flares in the first place. It is important to realize that every time you experience increased inflammation during a flare, you're potentially developing permanent damage to the parts of your body that lupus is attacking. identifying and treating the flare as soon as possible are very important. It is also important to make sure that the lupus is done attacking certain parts of the body such as the kidneys. By having your doctor do blood and urine tests. You can use our flare plan as his resource to begin to create your personalized flare plan with your rheumatologist and other lupus doctors. Starting this conversation with your physician will help you be better prepared if or when you experience a flare. I wish each and every one of you a much healthier future. Thank you.

Host 9:58
Thank you Dr. Thomas for taking the time to share your insights and important information on managing and preventing flares. For those listening in, we invite you to check out next month's presentation on financing your medical care with our very own Lupus Foundation of America health educator, Ashley Holden. If you'd like to learn more about living well with lupus, please find additional resources on the National Resource Center for lupus. Or if you'd like to talk to one of our health educators. You can call them at 1-800-558-0121. Thank you and have a wonderful day.

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