Breathe Easy – not for some with lupus

Breathing. It’s something that most of us never ever think about. It occurs “naturally.” When is the last time you ever really thought about your breathing? At the doctor’s office perhaps, during an exam, or maybe the last time you had a cold with a cough. Most of the time, however, it never occurs to us.

One of my worst symptoms, to this point in my disease is pleurisy. It is how I was diagnosed, and is one of the most painful things I experience throughout my disease. Usually, it just seems to occur. There is no leading up to it; there is no warning. I wake up and it hurts to breathe, or I am sitting in a chair and suddenly the pain is there. Sometimes it does get worse in a gradual pattern, but the pain is nearly always in the same location and there is nothing else like it. Every breath is shear-stabbing pain. You can’t move away from it, you can’t get it to stop; it is there every breath I take, all day long. I had it on and off for several years, back at the diagnosis phase, and since I had my son, I have had it on and off yet again.

One of the manifestations of lupus, in a person’s lungs, is pleuritis (pleurisy).  The pleura covers the outside of the lung and inside of the chest cavity, basically keeping your lungs safe.1 There is a small amount of fluid generated by the pleura to keep the lungs moving smoothly, like a lubricant. Lupus can create inflammation in this membrane. Pleurisy is seen in approximately 40-60 percent of lupus patients, but only 2-3 percent of them have shown symptoms of pleurisy at diagnosis.2

What Happens When You Have Pleuritis?

• Severe, sharp, stabbing pains – often pinpointed to a specific area(s) of the chest surrounding the lungs.

• Sometimes deep breathing, sneezing, laughing, or coughing increases the pain.

Unfortunately, excessive amounts of fluid can buildup in this membrane, and it causes pleural effusion. There are other causes of pleural effusion itself, so doctors will check to be sure it is actually lupus causing the effusion. Effusion is less common than pleurisy itself.

Excess fluid can show up on an X-ray, and pleurisy itself can sometimes be heard through the physician’s stethoscope. The pleura rubs against the lung, due to the inflammation, causing a squeaking sound inside the stethoscope as the patient breathes.

How is Pleurisy, or Pleural Effusion, treated?

Corticosteroids are quick and effective in the treatment of both of these conditions, as well as the NSAIDs and analgesics.  Both of these conditions may clear without treatment, but often they are so painful, the individual wants treatment.

I just hope my next breath is easier than the last! Here’s to easy breathing today!

1-    Lupus Foundation –
2-    The Lupus Book – Dr. Daniel J. Wallace