Home' Trinidad and Tobago Guardian : April 26th 2015 Contents 6 | WOW MAGAZINE
Sunday Guardian www.guardian.co.tt April 26, 2015
| HEALTH |
By Dr Makini McGuire
PHILOSOPHY STATES that "You are your own worst
enemy". Women's groups focus on empowering women, ad-
vising them to stop being their own stumbling blocks. One
of the greatest songs of the late Whitney Houston says that
"Learning to love yourself, is the greatest love of all". To sum-
marise, then, the consensus is that if we don't stop battling
ourselves, if we don't stop being our worst enemy, if we don't
find love for ourselves, true progression and success are un-
likely to occur.
In the words of another great woman, Maya Angelou, "Noth-
ing will work unless you do". Good words to live by in the
philosophical sense, but let's come back into the physical
world of medicine. How do you not fight, and not be your
worst enemy, when your own body is fighting and battling
you? The answer is, you fight your body like you've never
fought before. Welcome to the world of autoimmune dis-
eases, where the battle against self is real.
The immune system, when working correctly, is the body's
defence force. It battles viruses, bacteria and any other for-
eign material that tries to cause harm to us, its leader. It is a
truly amazing militia that fights for us every day with its own
version of AK-47, M16, APC or whatever latest, most spe-
cialised war equipment exists. What happens in autoim-
mune diseases really, then, is treason and betrayal; a coup.
Autoimmune disorders occur when the body's immune sys-
tem inappropriately attacks the body's own healthy tissues.
The defence force no longer recognises the leader as friend,
but foreigner and enemy, and turns all of that specialised war
equipment against its leader. Many different autoimmune
conditions exist, but today we will focus on Systemic Lupus
Erythematosus (SLE), more commonly known as Lupus.
Ninety percent of SLE cases occur in women, and new cases
of SLE are four times more likely to occur in a black woman
than a white woman. It is considered a multi-systemic dis-
order, meaning that it affects multiple organ systems in the
human body. The symptoms and signs of this disease are so
numerous that the medical community needed a 3-word, 11-
letter long mnemonic to remember them.
The usual onset of symptoms is in the early twenties but
can begin as early as childhood years. There is no fixed order
in which symptoms arise, and so we will discuss them from
head to toe. The hair starts to thin and bald patches begin
to appear; this can remain permanently if not treated in a
timely fashion. The skin becomes very sensitive to sunlight
and a red rash appears on the cheeks. Several other types
of rashes and scarring can also occur along the rest of the
body. At its worst, SLE can also cause seizures and psy-
chosis, leading to irrational and uncharacteristic behaviour or
what would be colloquially called 'madness'. Ulcers in the
mouth are another feature of the head and face findings.
Moving on from the head, SLE affects the lungs, heart, in-
testines, kidneys, and blood cells. Autoimmune antibodies,
the leaders of the coup, are often found in the blood of these
patients and also contribute to the infertility found in SLE.
Patients will often have recurrent miscarriages, sometimes
even as the presenting symptom. The commonest present-
ing symptom, however, is joint pain, sometimes accompa-
nied by joint swelling and/or muscle pain. Fever, fatigue and
weight changes can also be present. Specific criteria exists
for the diagnosis of SLE, and it is inadvisable to self-diag-
nose. The condition can range from skin rashes and joint pain
to frank psychosis and kidney failure in varying people or any
one individual at any point in time.
Treatment involves the use of immunosuppressant drugs,
that is, drugs that dampen the immune system, fight the
militia. Treatment should be directed by a Rheumatologist
as aggressive treatment is sometimes needed to prevent
permanent damage. SLE cannot be cured as the propensity
for the self to battle the self will always be there, but it can
be controlled, and patient education goes a long way in the
treatment of this disease. Treatment in itself has its own
side effects and can be expensive; thus, the battle against
self is constant. The psychological battle with hair loss and
scarred skin as well as infertility can be difficult. The strength
and fortitude of someone that battles SLE is undeniable.
The Voices of Lupus Foundation is a non-profit organisation
in Trinidad and Tobago that gives support to patients with
SLE and their relatives and aims to keep awareness high;
please share your support with them.
In the end, the philosophical cliché can be applied to the phys-
ical; we, or our bodies to be specific, can be our worst enemy.
Autoimmune disorders occur
when the body's immune
system inappropriately at-
tacks the body's own healthy
tissues. The defence force no
longer recognises the leader
as friend, but foreigner and
enemy, and turns all of that
specialised war equipment
against its leader.
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