I have been a little concerned as of late about the swelling that I've been experiencing. I dont know how to take it for sure because I've had bladder surgery and it may or may not have changed the way or frequency of urination. Also, I am just so darn swollen in the morning that some days I can't even open my eyes! It's pretty bad. I itch a lot on the neck and jaw line to the point I could literally rip it off! This morning I couldn't open my eyes and my skin felt tight and full and I had some mild chest pain. So I took my blood pressure. It was 116 over 80 with a pulse rate of 69. An hour later, after the swelling subsided a bit and the chest pain stopped, I took it again and it was my typical 107 over 67 with a pulse rate of 69. That's pretty significant if you consider that its 10 points + above the norm for me. I have also been experiencing some serious fatigue and right flank pain. Not sure what to make of that either, but I'm hoping that by keeping this blog, eventually we will find the significance. I will be discontinuing salt use for a while to see how it effects me. In the meantime, I have included images of the swelling I had this morning. The right side was more severe today than the left.
Blurred vision in both eyes. Unable to open fully
Couln't see from Right eye at all yet
Also developing red rash on face
Notice severity of Right side
Forcing eyes open
Forcing eyes WIDE open
I started looking up causes for swelling/edema in Lupus. All I could find had to do with the kidneys. Scary stuff!
Kidney Disease
Treatment and Therapy
Treatment for lupus nephritis must be individualized to the needs of the specific person. All of the following must be taken into consideration:
- the amount of edema (swelling)
- urine abnormalities
- amount of protein in the urine
- reduction of kidney function
- findings of the kidney biopsy.
Diuretic agents may be used to help eliminate excess fluid. Anti-hypertensive drugs can control increased blood pressure. Anticoagulation drugs are used in case of complications arising from blood clots. Changes in the diet can be made to control the intake of salt, proteins, and calories.
There are two major forms of drug therapy used for lupus nephritis: corticosteroids to control inflammation, and cytotoxic or immunosuppressive drugs to suppress the activity of the immune system.
Corticosteroids
Corticosteroids have been used to manage lupus nephritis for nearly forty years. Still, there are many unanswered questions as to exactly how they work and how they may be most effectively used.
High doses of corticosteroids, or even corticosteroids given for extended periods of time, may cause a number of side effects (some side effects can be lessened by a low calorie and low salt diet):
- increased appetite
- fluid retention with weight gain
- puffy face
- easy bruising
- moodiness
- loss of mineral from the bones
- cataracts
- thinning hair
- an increased risk of infection and diabetes.
- High doses of corticosteroids (taken orally or intravenously) are given until the lupus nephritis improves.
- The dose of corticosteroids is then slowly reduced under close watch of a physician to make certain that the nephritis doesn't worsen.
Cytotoxic or immunosuppressive drugs are generally regarded as standard treatment for people with serious lupus nephritis. These drugs block the function of the immune system, which in turn prevents further damage to the kidneys.
The most commonly used is cyclophosphamide (Cytoxan).
Immunosuppressives that are used less frequently include: azathioprine (Imuran), chlorambucil (Leukeran), and cyclosporine (Sandimmune or Neoral).
