What is Lupus

If you watch house,you will probably have heard about lupus.This is a chance to find out a bit about it.

I hope you guys don't mind. I am a med student so things could get a bit sciencey.

What Is Lupus?

Lupus is a chronic autoimmune disease where the body's immune system becomes hyperactive ³and attacks normal, healthy tissue. This results in symptoms such as inflammation, swelling, and damage to joints, skin, kidneys, blood, the heart, and lungs.³

Systemic Lupus Erythematosus(SLE) affects about 5 in 10000⁴ people in the UK.

What Causes Systemic Lupus Erythematosus?

At present the cause of lupus is unknown.Researchers have identified a number of  mutations⁶ in the genes

The immune system defends the body against infection. Viruses and bacteria trigger an immune response.

In people with lupus, B cells stay in the body longer than normal. This is thought to be the result  excessive amounts of B-lymphocyte stimulator present in the body. These are called autoreactive B cells, autoreactive B cells react against the body . The autoreactive B cells produce autoantibodies. Unlike normal antibodies, which react against foreign invaders, the autoantibodies attack the body. This results in inflammation of body tissue.( red box figure 2)

Figure2: Top Left - Antibodies in a  normal person. Bottom right-Antibodies in a lupus sufferer.

 Risk Factors

 A persons chance of developing lupus are increased by certain factors.

Estrogen levels: Lupus is more common in female(figure3) than males. In addition to this almost all women

develop lupus whilst they are childbearing age³

Race-lupus is more common in Black and Asian people

Family history: Approximately 10% of people with lupus have a family member with lupus

Major stress or infection: In people who are  genetically  predisposed to get lupus, extreme stress or an infection may trigger onset of the disease

These risk factors are out of peoples control, and it is not possible to reduce the risk of getting lupus.

 Symptoms

How is Lupus Diagnosed

Systemic Lupus Erythematous is difficult to diagnose. This is because symptoms of SLE are sometimes similar to several other conditions, most of which are more common than SLE. Lupus patients often suffer unpredictable bouts of the disease (flares) followed by periods of 

remission ,further complicating diagnoses.

If SLE is suspected, a doctor will run the following blood tests

· Anti-nuclear antibody test

· Anti-DNA antibody test

· Complement level test

Prognosis

SLE is incurable, but available treatments enable sufferers to lead a high quality life⁷

In the 1950s, most people diagnosed with SLE lived less than 5 years.¹² Death within 5 years, of diagnosis is due to organ failure or overwhelming infections.⁷

Now over 90% now survive for more than 10 years after diagnosis.¹² Many  sufferers live relatively asymptomaticly.³  and 60-75% can expect to live a normal lifespan.

Prognosis is worse for men and children than for women.³ If symptoms first present  after  60, the disease runs a more benign course.

While there are no known root causes or cure, the 

progress of recent discoveries and treatments in development is encouraging. Scientists hope that with this 

information effective treatments can be made to prevent the disease.

 References

1  

1.       Lupus Foundation USA.Malar Rash.Lupus Foundation 2009
http://www.howdoyougetlupus.com/lupus-malar-rash-symptoms

2.       GlaxoSmithKline.Lupus Facts.GSK 20012
http://www.benlysta.com/benlysta-information/lupus-facts.html

3.       Lahita RG.Systemic lupus erythematosus. London : Elsevier, 2004

4.       NHS.Lupus.NHS,2012
http://www.nhs.uk/Conditions/Lupus/Pages/Causes.aspx

5.       Lupus UK.Image of Lupus Symptoms.Lupus Uk,2009
http://www.lupusuk.org.uk/

6.       Kamboh MI, Wang X, Kao AH, Barmada MM, Clarke A, Ramsey-Goldman R, Manzi S, Demirci FY. Genome-wide association study of antiphospholipid antibodies.Autoimmune Dis. 2013;2013:76

7.       Wallace DJ. The lupus book : a guide for patients and their families. Oxford : Oxford University Press, 2009.

8.       Frieri M. Mechanisms of disease for the clinician: systemic lupus erythematosus. Ann Allergy Asthma Immunol. 2013 Apr;110(4):228-32

9.       Tortora GJ, Derrickson B. Essentials of anatomy and physiology. 13th ed., Asia. John Wiley & Sons, c2011

10.   Al Arfaj AS, Khalil N.Clinical and immunological manifestations in 624 SLE patients in Saudi Arabia Lupus . 2009 18: 465-473

11.   Kan HJ, Song X, Johnson BH, Bechtel B, O'Sullivan D, Molta CT. Healthcare utilization and costs of systemic lupus erythematosus in Medicaid. Biomed Res Int. 2013;. Epub ahead of print  

12.   Arthritis UK.What is Lupus. Arthritis UK.2010
http://www.arthritisresearchuk.org/arthritis-information/conditions/lupus/what-is-lupus.aspx

Rosario C, Seguro L, Vasconcelos C, Shoenfeld Y. Is there a cure for systemic lupus erythematosus? Lupus. 2013;22:417-21. 

Study Tips

University not only about parties,there is that other thing called studying. Medical School is intense,there is a lot of work required,therefore its important to stay on top of it all.

There is no magic set of instructions to ensure perfect grades.Each person is unique and some things may not work for everyone.

Here is a list of my top 10 study tips.

10. Set mini deadlines or use a to do list.
Break each task into small achievable chunks.Its easier to accomplish lots of small tasks compared to a single big one. With small goals you can also ensure you are on track to achieve the bigger goals
A list reduce the chances of you forgetting to do something.Crossing things of to-do lists is soooo satisfying.


9. Draw mind maps and diagrams
Mind maps are the marmite of studying,you either love them or hate them
I personally only use them during revision time.Mind Maps help me see how various concepts and ideas relate to each other.I found that my course was delivered in such a way that the information given seemed really out of context,so there was no way I could have used mind maps in the beginning. Diagrams are great at all times, they are certainly a nice change from reading text. Print out diagram stick them on doors mirrors,draw your own,or try labeling a blank diagram.


8.Aim to Study a little bit everyday

Every little bit helps.I know from experience that there will be some days when you can not be bothered to study or 101 things are happening at once and you just don't have time to study. Do something,even if its just going over that mornings notes, or making a vocab list.


7.Coloured pens or highlighters
Studies have shown that use of colour can improve memories.I personally love my colored pens and highlighters. Write your notes in colour or highlight key ideas.


6.Be prepared when attending lectures
Doing this will dramaticaly reduce your work load.Before going to a lecture ensure you are ready to learn, try not to be hungry or thirsty.In the lecture listen to whats going on,and do not be distracted by friends. If you are going to drag yourself out of bed for that 8am lecture,you may as well get the most out of it.
Repeat after me: Lectures are for learning, revision is for recapping stuff you have already learnt.


5.Post-it notes
Use post-it notes to summarise things.They are tiny so you can not get too wordy. If have lots of ideas stick to one key idea per post-it note.
Post-it notes are great for revision games
Example:   1.Copy facts onto one color
                 2.Stick these onto a wall.
                 3. Using a different colour try and re-create as many post-it notes as possible,and keep                                    trying to beat your personal best

4.Frequent breaks

As you study your attention span decreases meaning you will become less productive.This means it will take much longer to do every thing.Take breaks after 40 min of studying, go for a walk,stretch, have a snack or tidy your room.
Warning: Don't spend more time having a break than you do studying

3.Periodically review what you have learnt
This is especially important if you are studying a degree like medicine.The sheer volume of information means it will be difficult to rely on cramming for exams alone.
I choose to go over my notes quickly at the end of each week before filing them.Its fairly simple, the more often you review stuff the more you remember.


2.If stuck go find an expert
There is no shame is asking your lecturers for clarification.Send them and email or ask them after class.If you are shy ask your friends if they can explain it for you.
When it comes to essay writing read a book about how to correctly write an essay

1.Stay motivated.
Above all other things keep your eye on your goal.Think of all the great rewards studying will bring.
When desperate:

New Flatmates and Chronic Illness

Freshers week is almost upon us.Many people like with long term conditions such as epilepsy,allergies,diabetes, etc.I personally have lupus, and several food allergies resulting in anaphylaxis.

If you decide to live away from home its highly likely that you will have flatmates, deciding what to tell them about your health can be difficult for some. Medical conditions are a highly personal thing, that you wouldn't want to share with just anybody.

I personally tell my flatmates exactly what I am allergic to ,this is important for my safety and it just makes things simpler later on. I didn't tell them the first time I met them but they definitely knew I had food allergies after a week.

It was not a formal chat,it just randomly came up in conversation,and my flatmates didn't find it weird at all.If you have a medical condition that could result in you requiring assistance in an emergency( diabetes,allergies etc) you should definitely let your flatmates know.

This brings us onto emergency contact details, who to phone if you get ill. My G.P said that this would be a good idea, because if you get ill you don't have to worry about contacting your parents.

 I did not because:
1.lived and will live on campus, assuming I got ill enough to be incapable of phoning my parents, I would be in hospital or on my way to hospital. There is no way this can happen without the accommodation staff getting involved, the accommodation staff have my parents contact details.
2.I have a medic alert bracelet that has all my incase of emergency contact details, if i am ill in the presence of my flatmates they will have access to my wrists
3. Uni students are notorious for their juvenile pranks, the last thing I need is my flatmates ringing my parents in the middle of the night as a joke.

Long term conditions and Mental Health

There is less of a need to tell others about these,but bear in mind that you will be living with the same people for at least a year, they will notice stuff.

If you tell them from the beginning it will get rid of any awkward moments before they happen. Your flatmates can also be more accommodating and helpful if they know.

If you say nothing they could wonder what's wrong with you but be too shy to ask ,resulting in them reaching misinformed decisions.

I chose not to tell my flatmates,because I did not want to be treated differently.When they asked questions I answered them honestly and it all worked out well.

Please post about your experiences or thoughts in the comments bellow.I would love to hear from you

Introduction

Hey Guys

I am a medical student and this is my blog.
At this point I am not exactly sure what I will talk about,but it is most likely to be about

1.Medical School-Studying medicine is all consuming, unsurprisingly it takes up ALOT of my time. I love is and this is what I have always wanted to do.Hopefully my account won't be boring or scare you away from studying medicine.

2.Arts and crafts- I knit, sew,and create jewelry. When I was much much younger I used to blog about this,so  my creations might make an appearance on this blog.

3.My life-Lets not forget that other thing called life. I have a family,friends, no pets. You will find out a bit more about my life as this blog progresses.