DEAR DR. DONOHUE: Please say something about lupus. What are the symptoms? What causes it? Is it fatal? — D.F.
ANSWER: When illnesses are classified, lupus is put in the same group of conditions to which rheumatoid arthritis is assigned. It’s a multisystem disease, one that affects many organs and many tissues. Among them are joints, skin, blood cells, kidneys, nerves, heart and the nervous system. It’s a disease in which the immune system is responsible for most signs and symptoms. It wages war on involved organs. Evidence of the immune attack is seen in the strange antibodies found in the blood.
Signs and symptoms include painful joints, muscle aches and weakness, kidney involvement as demonstrated on lab tests, a drop in infection-fighting white blood cells, a similar drop in clot-forming platelets, disturbances of the heart and heart valves, and inflammation of blood vessels. Several different rashes might appear on the skin. One typical rash is the lupus butterfly rash. The cheeks become red, and those red patches are connected by a wide red line that crosses the bridge of the nose and produces a silhouette resembling a butterfly. Lupus patients lose their energy.
This all sounds very grim. However, not every patient has all these signs and symptoms. The illness tends to go through cycles when symptoms diminish alternating with periods when they worsen. Prolonged exposure to the sun can trigger an interval of worsening symptoms.
Lupus used to be fatal. It is rarely still fatal, but medicines have made this illness one that most endure without making huge changes in their lives. The 10-year survival rate for lupus patients approaches 90 percent.
I won’t list all the drugs used for treatment. Take my word. There are many effective ones.
The booklet on arthritis and lupus speaks of both illnesses in greater depth. Readers can order a copy by writing: Dr. Donohue — No. 301, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: I am a 58-year-old female and recently had a bone density test. The test showed that I have osteopenia. I know about osteoporosis. However, I have never heard of osteopenia. Will you provide some information on it? — P.K.
ANSWER: On the journey to osteoporosis, osteopenia is a step behind osteoporosis. It’s not osteoporosis, but it can become osteoporosis unless all means of prevention are taken. Exercise is one step, and it has to be weight-bearing exercise. That means you have to support body weight in moving the body. Walking is weight-bearing. For arms, weightlifting is the exercise to do — as well as for legs. The weights don’t have to be in the range of those who are into bodybuilding, but some additional weight is needed for making progress in bone-building.
Vitamin D and calcium are two other elements of an osteopenia program. Get a daily dose of 1,000 IU of vitamin D and a daily calcium intake of 1,200 mg.
DEAR DR. DONOHUE: My daughter, who is in her mid-40s, takes birth-control pills on a cycle devised by her doctor. She had had very heavy periods that resulted in blood-loss anemia. She also suffered from severe premenstrual syndrome.
Is it safe to go a full year without having periods? She has been her best this past year, both physically and emotionally. — G.S.
ANSWER: It’s safe to go a full year without a period when on birth-control pills. One such pill is Lybrel, which is taken for an entire year without any breaks for a period.
Your daughter’s doctor is following her and will change her pill schedule if he or she thinks it’s appropriate to do so.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.