A final update on Azathioprine

It’s nearly been a year since I was prescribed this medication so I thought it was time to do a final update and for all my fellow sufferers, let you know my thoughts on this immune suppressant medication.

Immune suppressants are a serious thing, more serious than I originally thought. I first realised this when the packaging came with a warning label, reading ‘cyto toxic‘, I had no idea what a cyto toxic drug was which prompted me to research it. A cyto toxic medication means the drug contains chemicals that are toxic to certain cells. The next thing which made me realise that this isn’t a simple medication was the amount of blood tests you have to have. You even have to have your blood tested before you start the medication, the test is called TPMT – I later figured out this was to show how well your liver would tolerate and filter the drug. Mine was slightly low so my dose of Azathioprine will not go beyond 100mg.

At first, the blood tests were extremely tedious, they were initially every week for 6 weeks. Then they moved to fortnightly for 6 weeks and then to monthly for 6 months. I have now reached the end of the tunnel and my blood tests are once every 3 months, if I remain stable on the medication they may be moved to once every 6 months. I didn’t mind the monthly blood tests and luckily they fell on the same day my prescriptions were ready to be picked up. I believe the blood tests are for: full blood count, liver function test (as this medication can cause liver problems) and urea and electrolytes.

My consultant gave me a two-sided information sheet on Azathioprine when I firstly commenced the treatment. One side is more or less for my GP, a lot of medical jargon that I can’t understand but it did tell me how much blood work was needed and when. It was great to have a clear idea of how long each stage of the blood tests could potentially last. I was on my monthly stage for longer than expected, it was nearing 9 months, there wasn’t an issue or I would have been alerted – I just think they forgot to move me up to the 3 monthly stage until I subtlety asked “do you know when I’ll move to 3 monthly tests?”.  The sheet also educated me on vaccines and that live vaccines are not recommended on this medication – a reason unbeknown to me, but that I also needed the flu vaccination along with the pneumococcal (pneumonia) vaccination. I was also told to try and avoid people with mild ailments such as coughs/colds/sickness bugs etc, because my immune system would be lower than normal and I would pick the bugs up easily and struggle to fight them off.

Did I find this a miracle medication? Initially this medication helped with one symptom that I’m plagued by: headaches. However, this didn’t last long and I started suffering daily headaches again. I still suffer pain in my joints daily some days better than others but at some point in the day whether it lasts 5 minutes or 5 hours, I will have joint pain. I still suffer aches usually my back, arms, shoulders and legs – I suffer achiness more so in the mornings and evenings. I still suffer greatly with fatigue and it’s made worse by doing things or going places but I cannot fault the medication for not improving fatigue as I don’t believe any medication will help.

It doesn’t sound like Azathioprine has helped a great deal, but when I think back to when I was solely on Hydroxychloroquine, I am better and this medication has slightly helped. I can do just that little bit more on ‘good days’, however if I overstep the mark on a so called good day, I still pay for it on the days that follow.

Considering I was told I would pick up bugs and virus’ easily I have suffered from very few one being a cough at the start of the year that lingered for months. And more recently, a virus that spiralled me into a flare I couldn’t control and needed medical intervention. I have suffered very minor bugs but they seemed to be 24-hour bugs that I managed to fight off. I made a conscious effort to avoid friends and family with bugs, my friends have been greatly understanding of this and they cancel any plans if they or their children come down with a cold/bug. Of course, it’s harder to avoid with immediate family, especially when we are in the same house but they also make an effort to not spread their germs, they do this by not getting too close to me or touching me. I also keep a bottle of hand sanitizer in my handbag for whilst I’m out and I also have bottles in the house.

Have I suffered any side affects? Oddly enough, I have suffered none. I say ‘oddly’ because when I started Hydroxychloroquine (very tame in comparison to Azathioprine) I suffered horrendously with nausea and could barley eat. However, I have noticed a difference in my teeth, yes I just said my teeth…go with me on this one. I’m on a few online support groups for Lupus and I was alerted that immune-suppressants can cause dental problems. I asked my dentist this and she confirmed that they can indeed cause many issues. I have noticed that I can no longer use toothpaste that has a whitening agent in because it causes horrific sensitivity. And since I’ve mentioned I suffer many auto-immune diseases and take immune-suppressants, my dentist has started to put a fluoride gel on my teeth and gums at every visit, the first time she used it she told me “this lowers your risk of tooth decay”. I’ve also been told numerous times to use Sensodyne toothpaste and I did but that toothpaste is truly vile. It’s safe to say that I no longer put off going to the dentist and when I get my reminder letter, I’m straight on the phone booking in.

Would I change my treatment plan? At the moment, I would be very reluctant to change my treatment plan. It’s not a little change, it’s a whole new medication that I’d have to look into, potential awful side affects, possibly going through all those blood tests again and not to mention…learning how to spell it, seriously why are they so difficult to spell?! I honestly believe if I changed medication, a year later I would be writing about how I feel exactly the same. At the end of the day, the medication is there to control Lupus and I think Azathioprine is controlling mine, despite still suffering flare up, I have suffered no tissue or organ damage *touch wood this continues*. There is no medication that can eradicate the symptoms of Lupus. I once told my consultant “I think this is as good as it’s going to get” he didn’t verbally reply but gave me a nod as if to confirm what I just said was true. I will always feel Lupus because it demands to be felt. If my consultant was to propose a change in medication because he thought it would be best for me, then I would. But, for now I think I’ll stick to Azathioprine because like I said, I think this is as good as it gets…unless my teeth start falling out, then I’ll change my meds faster than a speeding bullet.

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The Daith piercing: it’s pierced!

I finally got around to it, better late than never! In the last week I have suffered two migraines, one of which was last night and it spurred me on to get it done today. I have the lingering remains of yesterdays migraine, which I took nothing for this morning so I could test out the ‘instant relief’ feeling a lot of people have spoke about. However, on the way to the piercer I started to wonder if this works in a subconscious way? I’m still very sceptical if this will work or not, at the end of the day, it is a controversial subject. But, for £20 it’s worth a try.

As I was filling the disclaimer form out, I was certain they were going to tell me I couldn’t have it pierced. There was a box I had to tick if I had an immune system issue and another box asking if I had taken aspirin in the last 24hrs. Of course, both answers were yes but still, they let me proceed. I asked the piercer if the pain would be like my Tragus piercing (the most painful piercing I’ve had done and I’ve got my tongue pierced!) to which she said yes. I asked that after she told me to lay down on the bed, I have never laid down for a piercing so naturally I thought “this is obviously going to be a horrific experience”. But, to my relief it was fine and she asked me to lay down because she was short and needed to be able to see properly. I heard stuff going on, and I thought it was her marking my ear or something. But, what I actually was hearing was a needle going through cartilage. Lovely.

As for the instant relief, nothing. There was no instant relief, which is making me believe this might just be a subconscious thing after all. Although, I can confirm my headache hasn’t worsened throughout the day and for that reason – I haven’t written it off just yet. I still need to see if the amount of headaches I get decreases or remains the same, I guess that’s the real test.

I mentioned in my last post about the piercing that I didn’t like how it looked and how I thought it looked oddly placed. But, now that it’s in I quite like it, so regardless of it working or not I’ll more than likely keep it in. It quite hidden, it’s not obvious that it’s there and I like that. Here is a picture of it:

The piercer told me it can take up to 18 months to fully heal, which is near enough the same time as my Tragus piercing. Although my Tragus piercing took maybe 3-4 months to heal, so I’m hoping the Daith piercing will follow suit and heal quicker than expected. I’ve had it pierced on my left ear due to my Tragus piercing being on the right and since the areas are close together I didn’t want it to look too busy. The only issue with this is, I sleep on my left side!

So overall, getting it pierced does not hurt. I felt no instant relief but I remain optimistic. And actually, after all my moaning – it’s actually quite pretty!

I will write an update post in a month or two. That way, I’ll know for sure if it’s a myth or a miracle!

The Glass Box

Years ago I attended counselling sessions for an issue unrelated to Lupus “it’s like you’re in a glass box, looking out on the world”. I didn’t think much of her words at the time, but now they are poignant to me. I was 17 and looking back I wasn’t trapped in a glass box. I didn’t enter a glass box until I became chronically sick.

I think a ‘glass box’ is a wonderful analogy for life with a chronic illness. Illness takes you on a different walk of life, life starts to revolve around your illness: have I put my meds through? Have I taken my meds? Do I have enough pain medication? If I do this, will I suffer? Activities that were once simple are now a burden and some seem impossible.

There is a door on the glass box, but it’s locked and there is no key available. There’s nothing inside the box and despite how hard you try, the glass cannot be broken to escape. There isn’t a soul on this Earth that can open the box from the outside. We are trapped within the box and like my counsellor said “looking out on the world”. We watch people go to work, school and social events. We watch people run errand after errand, watch them push their bodies to the limit in workouts for them to get showered and to move onto new tasks. We watch people do normal daily things that would break us, on particularly bad days the smallest of tasks can feel like climbing Mount Everest.

The glass box can be a lonely place, you’re trapped inside on your own but you can see and talk to people. You try to explain what’s wrong with you, how you’re feeling but to no avail. Nobody around you is trapped and they cannot enter to gain an understanding. You’re left with a lot of alone time, time often spent thinking about how your life was before you became sick and trapped. When you’re left with time to think, it often leads to frustration because you miss what you used to be – you miss being busy and active without a care in the world. There was a time you were watched from a glass box by an envious chronically sick person.

You start to accept that there is no way out and you learn to adapt to your new life. I’m starting to forget what my life was like before Lupus, most things have started to blur. I can’t fathom how I lived and got through my days, and that’s because it’s not normal to me anymore. Getting through a painful day, putting medications through and keeping track of hospital visits is now my normal. Some would find it sad that I’m starting to forget how I lived before I was sick, but to me it’s not important, if I remembered I would dwell on it and that would be detrimental to my emotional well being.

The Glass Box to me symbolises my own body and illness, boxes are unique to each person suffering a chronic illness – even if that illness is the same as mine. Before I accepted my new normal I looked out to those busy people from my glass box and thought of them as super-human for doing normal daily things. From the outside looking in, it looks like I don’t do much at all. The reality of that is I battle my body daily, my own body wants to kill itself and everyday I experience pain in every part of my body. I am weighed down by fatigue, because my body is tired from pain and from fighting itself. Accepting that I was sick with an illness that can’t be cured wasn’t easy and it took me a while but when I finally did, I realised its us, who battle themselves everyday that are the super-humans of the world.

The Daith piercing: does it work or not?

I’ve been debating getting this piercing for a while. I’d think “yes, I’ll get it” and then I’d think “there’s no way a piercing could help headaches/migraines”. It does sound odd, a piercing alleviating headaches and migraines, but apparently it’s a pressure point, so it’s almost like having permanent acupuncture in your ear. During my research for it, I have found people claiming it has also alleviated their anxiety.

I’ve never been the kind of person who would wait for a piercing or spend time researching them. Through my later teenage years, when parental consent was no longer an issue, getting a new piercing for me was just a ‘fun’ thing to do. I don’t know how getting a needle through part of your body is classed as fun, but it was. I have gone through many, my nose was pierced around 6-7 times, I’ve had my tragus and cartilage pierced, my belly button and tongue. The only ones that are still remain pierced are my belly, tragus and tongue.

So why am I now holding out? Is it because my phase of spur of the moment piercings is finally over? Or is it because I’m genuinely skeptical that this will work? It’s probably a bit of both. It’s also not a piercing I’d say is ‘pretty’, if I wasn’t sick and didn’t have daily headaches I wouldn’t be contemplating it. It’s a piercing to me, that looks randomly placed – as if the wrong part of the ear was pierced.

I have asked fellow Lupus sufferers if they have tried it out, some saying it’s the best thing they’ve done and others saying it was a waste of time. I guess, its falls on the individual in regards to it working or not. I suffer from headaches nearly everyday, whether it be a normal headache, a pressure headache or a migraine. So, for my own curiosity I have decided to get it pierced.

I plan to get it pierced at some point next week and I will be writing a series of post regarding the effectiveness of the piercing.

(Also, please keep me in your thoughts because I have a feeling it’s going to hurt like a bitch).

I recently had one of my worst flares to date…

The start of August wasn’t great, my Lupus intensely flared up. I picked up a virus and due to that, it went haywire causing an array of issues. I’m late writing about this, it happened from Saturday the 5th of August to, well, now as I’m still recovering. You unfortunately don’t wake up one morning recovered from a flare, it can take days to weeks or even months to recover.

Friday the 4th, I was my usual self, maybe a little more fatigued than usual but nonetheless – nothing dramatically wrong. However, that night I slept dreadfully, I fell asleep around 3am but even then I woke every hour with a nauseous feeling. Every time I woke up, the sun was getting brighter and at around 8:30am I decided to just get up. I sat outside with a cup of tea and by 9:30am decided to try go back to sleep, as soon as I got into bed I was back up and vomiting. By 12pm I had vomited 3 times and had given up on sleep entirely.

Sunday the 6th. I woke up, from another sleepless night and feeling worse. This was the day my Lupus started to rear it’s ugly head. I was sat drinking water and I was almost certain I was about to faint, luckily I didn’t. But, I was shaking, my head was pounding, my joint pain was relentless and I started vomiting again. Just keeping my eyes open was exhausting and I couldn’t bare the thought of moving. I couldn’t even tell you what conversations I had and with who that day, I was so exhausted and in pain I can barley recall the day. What I can recall though, is it was the first time since my diagnosis that I rang out of hours for help. I was taking Tramadol and even though it dulled the pain, it wasn’t helpful and I was still suffering. They told me I had to see a doctor and on the way there I said to myself “I can’t be bothered with this illness anymore” because I genuinely didn’t have the energy to try and fight back. I wanted to curl in a ball, cry and honestly, disappear. Luckily, I was the only one in the waiting room so my wait was less than 5 minutes. The doctor took my temperature and it was raised, checked my ears and listened to my chest and they were clear. He checked my throat and he said it was red, he had me do a urine sample which was also clear and he checked my stomach which was sore as he pressed down on it. His diagnosis was a virus or the start of laryngitis, since the visit my throat hasn’t got worse so it was a virus all along. He couldn’t prescribe me anything stronger than Tramadol, so he prescribed me more to keep taking. After the checks and prescription were done he had a chat with me, he told me I need to get my Rheumatology appointment brought forward and told me that I really need to go on steroids. As soon as I heard the words “you need steroids but I can’t prescribe you them” I wanted the ground the swallow me. From the start of my diagnosis, I have been dead set against going on steroids unless I’m told I will die without them. I am yet to bring my Rheumatology appointment forward for the fear of being put on steroids.

This week has been rough. I’ve eaten next to nothing, my joints have been so sore and my fatigue just doesn’t seem to be improving – it feels like I’m at a dead end.
I try my very best to stay optimistic but this week has tested me, I’ve found it very difficult to take part in everyday activities and do basic tasks and I’ve felt extremely low in mood. I hate the thought of people thinking I’m snappy or horrible, I try my best to not be and it’s for those people I try my best to keep a smile on my face. My mood is slowly improving but I’m still struggling with a lot of pain, aches, headaches and nausea, but thankfully I haven’t vomited since Friday.

It’s the first viral infection I’ve had since being put on immune suppressants, which is good going as I have been on them since November. I was told I would more than likely constantly catch viruses and bugs. And, because of my lowered immune system it’s taking longer for me to shift it.

I can only hope that I start to properly improve this week. This has probably been my worst flare to date.

Misconceptions about Lupus.

Lupus is a poorly understood illness and when you're on the poorly understood territory, a few misconceptions happen. This is because the people who know about it are a minority compared to those who don't. The main point about this blog is to not only share my journey with Lupus but to also educate people about the illness. I have decided it's time to write a post about these ridiculous misconceptions, so here are 10 cleared!

1. You will NOT catch it.
It's not the common cold. It's impossible to catch it. Lupus is not a special strain of invincible bacteria, it's a majorly confused immune system. So next time you're in the company of a Lupus sufferer, shake their hand, or give them a friendly hug and maybe even share food. I can guarantee you'll leave as healthy as you came.

2. Lupus is NOT cancer.
I can see why people believe this one as chemotherapy is sometimes used to treat Lupus. But, you'll be glad to know, it's definitely not cancer.

3. Only women can get Lupus.
It is more common in women so maybe this is where the confusion has stemmed from but men can also suffer from Lupus.

4. Women with Lupus can't have children.
Although we will be classed as a high risk pregnancy and have an increased risk of miscarriage, women with Lupus can indeed carry to full term and have a healthy baby.

5. Lupus is easily diagnosed.
It's not a case of visiting your doctor and walking out an hour later with the diagnosis. There isn't a singular test to confirm Lupus so testing can go on for months to years with countless blood tests, questioning and physical examinations. It isn't a diagnosis given out easily and it's an extremely exhausting process to have to go through.

6. It's not real.
How could an imagery illness have the power to do so much damage? Everything we feel is real, Lupus is 100% real. Ask the scientists who research it.

7. We will get better.
There is research going on but there's very little funding for Lupus research so unless the scientists have a eureka moment, we will remain incurable.

8. Lupus is uncommon.
The NHS website even states this. Although most of the people you know are probably healthy, Lupus is not as uncommon as you'd think. Don't get me wrong, it's not the most common illness to have but in my opinion it's not as uncommon as they make out.

9. Lupus is deadly.
20 years ago only 40% of Lupus patients were expected to live more than 3 years following a diagnosis. Although we can still experience complications, we now have a normal life expectancy.

10. We brought Lupus on ourselves.
False. Although many believe Lupus is brought on by certain lifestyle choices, this is not true. We haven't brought it on ourselves. If this was the case, don't you think there would be more people with it and better funded research?

I think I can speak on behalf of most Lupus sufferers that if you ever want to know anything, just ask us. We'd rather you get the correct information and who better to ask than someone who lives with the illness?

There’s been better days. Diary entry: Thursday 20th July.

I've been dealing with a headache for around 4 days now. It seems to change in intensity throughout the day, going from what I'd call mild to intense and sometimes it's just a pressure headache – like my brain is expanding or someone has my head in a vice. I've talked about those headaches in past posts, I call them Red Queen headaches because the Red Queen has a massive head and that's what it feels like.

This past week has been a struggle with fatigue. I'm always tired but the last few days I've been asking myself "is 7pm really to early to go to bed?". My evenings have literally been spent clock watching. I mean, I really should just go to bed when I feel I need to. My body clock is already all over the place so I don't want to mess it up more. Either way I can't win, the end result will always be the same: tired.

I woke up today feeling generally okay, well, as best as I could but things went downhill pretty quickly. I'd say within in an hour or two of waking up I started flaring. This is what I dislike the most about this illness – it changes with no warning, you think "today feels like it's going to be alright" then the next thing you know, you're curled up in a ball on the sofa wondering where your 'alright' day went.

It started with a throbbing pain in my right knee, the throb was accompanied with a sharp pain. Then it quickly went to both elbows, the only pain I really get in my elbows is a sharp pain and the pain travels down my forearm like electric shocks. It's very typical of my knees and elbows to hurt, it's the joints my Lupus affects the most. Pain in my shoulders is less common, but today I had the worst pain in my right shoulder. It was a burning sensation mixed with a sharp pain, it started so suddenly and out of nowhere (like nearly everything this illness throws at you). It was the burning sensation that made it unbearable, fortunately the sensation didn't last long but the sharp pain decided to stay for the day. It's also sending a dull ache down my upper arm. So today, my full right arm has been affected – not so helpful when you're right handed!

I was sitting waiting to see if any of the pain would subside but nope. It wasn't letting up and I couldn't sit in pain any longer so today has been a codeine day, which I'm sure my headache will thank me for later. And by that I mean, I'll probably wake up with a blistering headache tomorrow, what's new? I'm due another dose in an hour and a half and it can't come quick enough. It's helping but not fully, it's just taking the edge off it all.

It still mind boggles me how any part of my body will start hurting, it's as quick as turning on a switch. Some parts of my body hurt briefly, like the soles of my feet but then it'll move to my legs or fingers. Although I'm writing about my joints, because those are the areas that have consistently hurt, nearly my whole body has been affected today. It just gets tiresome when there seems to be no break from pain.

I spent the day curled up on the sofa with
a blanket and my dogs in a codeine haze, having little cat naps and drinking tea…all whilst trying to get my head around the new season of Orphan Black…that's not a show you should watch whilst on codeine.

What a day! There's always tomorrow. As always, thank you for reading xo

Does Lupus hang over you like a dark cloud?

People have asked me “do you ever feel depressed?” and I reply “no”. The months that followed my diagnosis, my GP frequently asked “how are your moods?” or “do you feel low?”. Truthfully, in the beginning, I did feel low, but isn’t that expected? I was diagnosed with 5 auto-immune diseases – none curable. I still told him “no”. My low mood was not depression. I used to think to myself are people waiting for me to crack? Now, I realise that people just cannot fathom it happening to them and their first thought is “I’d get depressed”

When I sit back and think about it, there’s absolutely no reason for me to depressed, I can’t think of one thing in my life that would justify me being depressed. You might be thinking “is she serious?!” but, yes I’m serious. I have the most wonderful people around me who catch me when I fall. I have a roof over my head, food, water, clothes and I’m not laid in a hospital bed clinging onto my life. Yes, I have bad days – days I ask a God I don’t believe in “why me? What did I do wrong?” and days where I think “this is it, today is the day it finishes me off”. But, I get through those days with the help of my family and friends and I stand back up, ready to face it again. So, no, there’s no reason for me to depressed. 

People ask me “are you okay?” and I reply “yes” each time I’m asked. Sometimes it’s visibly clear that I’m not okay, but my answer will always be yes. I think that’s due to stubbornness, if I say “no, I’m not”, in my head I’ve let it win for that day. I might not look like I’m winning, but I am. 

Does Lupus hang over me like a dark cloud? No. No it does not. I treat Lupus like a game, hence my ‘winning’ reference above. So far, I’m doing great, I’m in the lead. You have to be one step ahead of it, but every so often it’ll gain a lead and push me off the board completely, but I will always climb back up and laugh at it as I regain my winning position. It’s a tough game but it’s a game I have to play, a game with no end. In my mind, I’ve painted a picture of what Lupus looks like. It’s huge, both by height and width, black and cloudy figure. I guess I did that so I could have a visual of what I was up against. I can safely say, I’m not scared of it or what it’s potential is. 

If I let this horrible black figure hang over me, I’d be screwed. I will never cower behind it, but I’ll always be stood in front of it, waiting for it to make it’s next move on the board.