The “Most Wonderful Time of the Year” – for some but not all

Every year right around the time of tree decorating, cookie baking and the mad-dash to complete holiday shopping, germs seem to find their way into my life.  Whether it’s the increased susceptibility to infection, the stress of the holidays, increased allergens, or just the weather, telling my uncooperative immune system it is in for a beating, this time of year isn’t always the most wonderful.

 Germs & Lupus

Specifically people with lupus, (SLE), are more vulnerable to infection.1 The killing ability, and process, of white blood cells, and other immune system components in SLE patients is severely altered. What this means to people with lupus is that a cold isn’t just a cold that lasts a few days, it’s an infection that can take 2-4 weeks (or longer) to clear up, with additional antibiotics, and medications, such as prednisone and other corticosteroids. Lupus patients have been found to more frequently develop respiratory infections (colds, flu, sore throats, sinusitis, bronchitis), as well as urinary tract infections. Of course, some lupus patients are additionally compromised due to corticosteroid and immunosuppressant use for treatment of lupus symptoms.

Why don’t they understand?

Friends have wondered, out loud to me – as I have been plagued with chronic sinus issues in addition to lupus – why I need to take antibiotics so frequently and need to visit the doctor each time my sinus infections occur? The answer is because what might have started in them as a sniffle and a little runny nose, has spread to me and quickly progressed into a bacterial infection. Inflammation closes my passageways and they are blocked. The blockage creates a nice environment for a bacterial infection. Due to the decreased killing ability, and chronic inflammation, it’s impossible to move the germs out. I need something to go in and kill them for me – and those are antibiotics. Not only that, but the use of a corticosteroid is typically necessary to get rid of the inflammation.

A perfect example of this happened to me this month. I developed my annual infection, received a start of 14 days of antibiotics, and a corticosteroid shot, plus a week of follow up corticosteroids. My son, 11 months old, was exposed to my stuffiness, and cough, and also developed a runny nose. However, he did not need medical treatment and within one week has nearly kicked the entire infection.  I am on day 14 of antibiotics, last day of 5 days of corticosteroids, after an injection, and still battling. I fear I am going to need an additional week of antibiotics. That is what autoimmunity does with something as “simple” as a cold.

How can you reduce your risk of developing infections?

• Politely minimize your contact with people with colds, flu and other infections. Sometimes it might mean putting the word out there that if a future guest is sick, to please skip out on the event. I have put it out there several times, that sick people should not come to events we are having.  A polite way to put it is to ask that they take the time to themselves and get some rest. No need for them to feel they have to make an event feeling under the weather.

• Get a flu shot. Although there are multiple viewpoints on being vaccinated with an autoimmune disease, the Lupus Foundation and other lupus experts recommend a shot to decrease your chances at developing the flu viruses that are considered in season for that year. The flu mist is not recommended, only the shot. The mist contains partially live virus, which is not considered safe for lupus patients who take immunosuppressive drugs.

• Wash your hands frequently, and avoid touching your mouth and eyes. Hand washing is a safe and effective way of reducing your risk of infection. 2 After washing your hands, opt to use a paper towel to dry your hands, rather than a towel. Avoid sharing towels, especially in a public environment, as the germs can live in the used towel and transfer to your clean hands upon drying. 3

• Avoid allergens and other irritants. An allergic reaction causes inflammation, and inflammation can lead to blockages and damage. Allergic reactions can also trigger flares in lupus patients. If you know you are sensitive to certain allergens, avoid them.

Sources:
1 – The Lupus Book by Daniel J. Wallace, M.D. – http://www.amazon.com/Lupus-Book-Guide-Patients-Families/dp/0195132815
2- The Lupus Foundation of America. http://www.lupus.org/webmodules/webarticlesnet/templates/new_learnliving.aspx?articleid=2254&zoneid=527
3- Lupus Handbook for Women by Robin Dibner, M.D. and Carol Colman.
http://www.amazon.com/Lupus-Handbook-Women–Date-Understanding/dp/B002HJ3EYQ/ref=sr_1_1?s=books&ie=UTF8&qid=1324325026&sr=1-1