— Lupus Survivors (@lupussurvivors) October 31, 2017
#LUPUS Study: “Cardiac Tamponade is Common but Treatable in Lupus Patients” via #LNT #HeartOfLupus
Cardiac tamponade, the accumulation of fluid around the heart, affects nearly 6 percent of lupus patients in India, a new retrospective study shows.
But researchers found new risk factors that predict this condition, which may help identify patients at risk. Treatment with high-dose immunosuppressives reduced the risk for fluid reaccumulation and the need for surgery in these patients, the team reported.
The study, “Cardiac tamponade in systemic lupus erythematosus,” was published in QJM: An International Journal of Medicine. It was conducted by researchers at the Institute of Post Graduate Medical Education and Research in Kolkata (IPGMER), in India.
Lupus is an autoimmune disease that affects several organs, including the heart. Pericarditis, an inflammation of the layers surrounding the heart, is the most common heart manifestation of the disease, affecting 9% to 54% of lupus patients. While it has a lower incidence (less than 2.5%), cardiac tamponade may also manifest.
Cardiac tamponade is characterized by the accumulation of fluids in the space between the heart and its protective membranes, leading to heart compression and low pumping capacity. But despite its severity, little is known about cardiac tamponade in lupus patients.
In a study led by Rudra Goswami, a post-doctoral trainee in the Department of Rheumatology at IPGMER, researchers evaluated the incidence of cardiac tamponade, its clinical features, potential risk factors, and treatments in a cohort of Indian lupus patients.
The study included 409 lupus patients. Among them, 25.4 percent had pericarditis and 5.9 percent had cardiac tamponade.
Patients with tamponade were older and had later lupus onset, compared to the remaining lupus patients. All 24 patients with cardiac tamponade experienced shortness of breath; 12 had increased jugular venous pressure; 11 had chest pain; and eight had low blood pressure.
All patients with cardiac tamponade had accumulations of liquid around the heart (pericardial effusion), 14 with large effusion, seven with moderate effusion, and three with small effusions.
They showed higher prevalence of pleuritis, which is an inflammation of the membrane surrounding the lungs, inflammation of the pancreas, and were more prone to present anti-nucleosome antibodies, a biomarker of lupus.
Additional analyses confirmed that pleuritis, anti-nucleosome antibodies, and the size of effusion were all predictive of cardiac tamponade in lupus patients.
All patients underwent aspiration to remove the accumulated liquid. Three patients required more than one aspiration due to re-accumulation of liquids, and only one required surgical treatment. The majority of patients received corticosteroids and immunosuppressive drugs, which were found to be effective in preventing progression of cardiac symptoms and reducing the need for surgery.
“We made a few important observations, such as the importance of concomitant pleuritis and anti-nucleosome antibody positivity in addition to size of pericardial effusion as predictors of tamponade,” the researchers wrote.
“We also feel that immunosuppression with methylprednisolone and IV cyclophosphamide are essential, especially to reduce risk of reaccumulation and surgery,” they added.
This is a classic if you’re living with chronic illness. ICUMI or need a little inspiration, read it again. (& again) & follow Tala on Periscope at @Tala_NoExcuses
Einstein said, “Once we accept our limits, we go beyond them.” I won’t boast to think that I know what precise meaning he attached to these words, but I can discuss what it means to me.
In social media, I use the hashtag #NoLimits a lot. It is meaningful after being told what my limitations were and what I could no longer do after certain injuries and health conditions entered the picture. My friends and close followers have seen me throw down in more than one social media scrap over this topic too, and probably more of them in recent months. As I continue to claw my way back into capabilities and strengths, I find it an even greater offense for anyone to try to put us “defectives” in a closed box. (Please don’t get mad at me for using the word “defective” here and there… it’s a reference to the…
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Got #LUPUS? 1.5 million US & 5 mil worldwide do! SLE is an autoimmune disease where ur body attacks it’s own healthy cells-Share 4 a Cure! http://ow.ly/i/zZfdF
RT New York Jets It’s #Lupus Awareness Day at @MLStadium! All funds collected @ gates will fund lupus biomedical research
It’s Lupus Awareness Day at @MLStadium!
— New York Jets (@nyjets) October 29, 2017
Joy. A feeling that can be simple or grand, experienced in a multitude of ways, and occur when least expected.
It may be the sound of your child saying your name for the first time, getting the job you have always wanted, or the thrill of attempting a new adventure. It is a word that conjures up different visions for each of us. And sadly, it is a feeling that often gets lost in the shuffle of living with a chronic illness. Instead, the focus becomes managing pain, a new lifestyle that was never asked for, and trying to figure out the unknown. With all this happening, how can one ever get the feeling of joy back.
Chronic illness has a special way of reminding us that we need to slow down. Just to be clear, slowing down does not mean you have given up or you are letting your disease win. It simply means you are respecting where your body is right now and reaping the benefits. By slowing down, we can enjoy the moment we are in in its purest form.
We are a busy society with very full schedules that generally don’t allow for self-care. Instead, we keep going until our bodies finally say, “no more.” At this point, a full flare takes over – our bodies amazing way of demanding we slow down and take care of ourselves.
Self-care is 100% necessary for everyone, but even more so when living with a chronic illness. At first it might selfish to set time aside for yourself. But keep at it. Soon, you will see that it not only helps your body, but also allows you to feel joy in ways you may never have experienced it.
A few simple self-care starter ideas:
Finding gratitude while in pain takes time and patience with yourself. I remember when my knee had been swollen for months and I could barely move it. The pain was awful. However, each night as I rubbed it, I said thanks to it for getting me where I needed to go or holding me up in class as I taught, despite the pain it was in. Almost immediately, I began thinking of all that my knee does for me while in pain rather than hating it for the pain.
To me, gratitude is magical. When I reflect on one good thing that is happening, my mind instantly thinks of another one and then another. Feeling joy rather than anger is a much better place to be.
While your health condition may intertwine itself in all parts of your life, it is not your entire existence. Other things are still happening around you. Look for those things – a delicious meal, snuggling with your child to read a book, or enjoying a glass of wine with a good friend. Feeling terrible all day every day takes a lot of work. Separate your illness, even for a short time, and feel the energy that comes from the joy remaining in other areas of your life.
I often tell my students and own kids that when you know your purpose in life and you are making it happen, joy naturally follows. I am surprised at how many people don’t know their purpose in life. What I suggest is thinking about things that you are naturally drawn to repeatedly or the things that others complement you on. For some people, their purpose may be as simple as having a smile that turns other people’s days into beautiful ones.
Do you know your purpose? It changes as life brings us new challenges. When you find it, absorb all the joy that it brings with it.
One of the best feelings is when you share something wonderful, no matter how small, and the person you are sharing it with beams. They don’t try to compete with you or even feel the need to share something of their own. They just bask in your joy. Find those people, surround yourself with them, and then give that gift right back.
Joy is ever-changing. What brings you joy today may be different tomorrow. Keep searching for it. Keep spreading it. It is a gift that we in the chronic illness community need a lot more of.
To read more from Cathy please visit her personal blog