Todavía disfruto una vida activa y plena con lupus


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Tal como se relató a Marnie Goodfriend

Siempre me han gustado las cosas emocionantes. Cuando tenía 22 años, quería disfrutar la vida al máximo y me encantaban las tablas sobre nieve, viajar e incluso el puentismo. Era saludable y nunca me había dado nada más grave que un resfriado hasta que empecé a experimentar fatiga extrema, dolor de las articulaciones e hinchazón en mis piernas, pies, manos y brazos. Caminar, descansar o mantenerme de pie era difícil y ya no podía sujetar objetos. Después de unas semanas, el dolor se volvió insoportable, así que fui al consultorio de mi doctor para saber que estaba sucediendo.

El médico apenas revisó mi cuerpo y no solicitó ninguna prueba. Me dio ibuprofeno y me dijo que regrese si seguía teniendo dolor. Perder días de trabajo me estaba causando dificultades financieras y el dolor solo seguía empeorando. El doctor con quien tuve la consulta no investigó lo que estaba causando mi condición. En vez de eso, me recetó analgésicos más potentes. Dos meses después, no tuve ningún alivio y me obligaba a misma a ir a trabajar a pesar del dolor.

Un día, el dolor se volvió insoportable. Me desmayé y me caí de una silla en el trabajo. En la sala de emergencias, ni siquiera imaginaba que mi cuerpo estaba colapsando. Querían darme de alta, pero mi madre y mi abuela exigieron que me hospitalicen hasta el día siguiente y se hagan pruebas. Tenía escalofríos, una fiebre de 104 grados y dificultad para respirar. Finalmente me hospitalizaron y me diagnosticaron pericarditis (inflamación de la membrana alrededor del corazón) y neumonía. También hicieron una prueba ANA, que sirve para detectar trastornos autoinmunitarios. En mi cumpleaños 23, me enteré que la prueba ANA tuvo resultados positivos. En función de esa información y de mis síntomas, me diagnosticaron lupus.

Me mantuvieron aislada en el hospital por más de un mes con dosis altas de esteroides mientras trataba de procesar la idea de tener un trastorno debilitante que puede ser mortal. Una amiga del colegio tenía lupus y había visto cuan horrible fue para ella. Me preocupaba morir. Fue difícil asimilar que debía adaptarme a un nuevo estándar de normalidad, que tenía que hacer cambios en mi vida que nunca había siquiera considerado y lamentaba todo lo que no podría hacer. Fue una bendición haber trabajado en la misma compañía durante años porque me dieron permiso para ausentarme. Mis amigos y colegas me apoyaron enormemente, pero mi madre fue y sigue siendo mi pilar principal. En ese entonces nació mi primer sobrino, quien me dio fortaleza para seguir adelante.

Una vez que me dieron de alta, me mudé a la casa de mi mamá y entré en un estado de depresión. Todos los medicamentos, el dolor, las consultas médicas y las terapias físicas eran una carga enorme que debía asimilar. Al ver que estaba experimentando emociones intensas, mi reumatólogo recomendó que tenga una consulta con un terapeuta y me dio la información de contacto de un grupo de apoyo para pacientes con lupus. Ahí es donde encontré a mi gente y aprendí de sus experiencias con la enfermedad, lo cual cambió mi perspectiva por completo. Mi mamá empezó a cuidarme a tiempo completo sin dudarlo. Sé que eso no ha sido fácil para ella y siento un poco de culpa y tristeza de que tenga que cuidarme incluso en mi adultez cuando se supone que yo debería cuidar de ella.

Seguí trabajando durante dos años pero pedía permisos para ausentarme cuando mis síntomas empeoraban. Fue entonces cuando mi amiga del colegio murió por complicaciones de su lupus y yo desarrollé nefritis lúpica (lupus renal). Sin mi sistema de apoyo, hubiese pensado que pasaría lo mismo conmigo. En vez de eso, invite a algunos amigos a participar en la caminata contra el lupus de Lupus Foundation of America’s (LFA) en San Francisco. Estar en un lugar en el que miles de personas saben lo que estás experimentando y contar con el apoyo de familiares, amigos, colegas, patrocinadores y voluntarios fue motivador. Me inspiró para decir, “no voy a dejar que el lupus me venza”, así que empecé a trabajar voluntariamente para la organización, lo cual fue útil para convertir mi dolor en un propósito.

Tracy en la Walk to End Lupus Now de Lupus Foundation of America, San FranciscoTracy en la Walk to End Lupus Now de Lupus Foundation of America, San Francisco, octubre de 2023

El lupus es una enfermedad impredecible e incurable, y cuando me diagnosticaron, no habían medicamentos desarrollados específicamente para tratarla. Logré tener acceso a un equipo de proveedores de atención médica (HCP, por sus siglas en inglés), que incluía nefrólogos, nutricionistas y terapeutas, para controlar los síntomas. También aprendí a defender mis derechos y a encontrar proveedores de atención médica nuevos si otros no me atendían adecuadamente. Durante esta época, seguí trabajando a tiempo completo pero me despidieron y me convertí en trabajadora independiente unos años después de mi 30º cumpleaños. Perder el seguro médico de mi trabajo me afectó mucho porque eso implicaba que debía pagar la mayoría de mis cuentas médicas. En esa misma época, tuve un brote de lupus, que es cuando la enfermedad ataca un órgano o sistema de tu cuerpo. En esa ocasión, fue mi sistema gastrointestinal y perdí 100 libras de peso en menos de seis meses. Sobreviví comiendo solo arroz, agua y avena. La repentina disminución de peso causó atrofia muscular y debilidad extrema.

Tuve otro brote terrible durante la pandemia. Tenía un nuevo trabajo permanente que me encantaba cuando empecé a sentir fatiga. No pude caminar desde mi escritorio al baño y siempre tenía frío. A veces apenas podía levantar mi cabeza y caminar, sentarme o cualquier otra cosa me daba dolor de cabeza. Una persona del consultorio de mi proveedor de atención médica me dijo que debía asistir inmediatamente a una consulta porque mis pruebas semanales de laboratorio mostraban que estaba en peligro. No quería salir del trabajo, pero también se comunicaron con mi padre, quien me llevó rápidamente al hospital. Tenía anemia grave. Consecuentemente, recibí dos transfusiones de sangre y me hospitalizaron de nuevo por más de una semana. Mientras me recuperaba en mi hogar, empecé a perder mi capacidad para moverme y ya no podía cuidarme por mí misma. Estaba peleando para sobrevivir: No podía bañarme sin asistencia. Necesitaba ayuda para ir al baño. Perdí mi capacidad para caminar y tuve que volver a aprender a hacerlo con terapia física intensa. No he podido volver a trabajar y he estado discapacitada desde entonces.

El lupus puede ser una enfermedad muy solitaria. No quieres que la gente sienta pena de ti. Recuerdo que me preguntaban, “¿vas a morir? ¿Es contagioso el lupus? ¿Es como el SIDA?” Entonces, tratas de minimizar la enfermedad porque las palabras de la gente pueden herir y no quieres ser una carga para tu sistema de apoyo. Puedes sentir un dolor insoportable, pero empiezas a decir a la gente que el dolor no es muy grave. Podrías necesitar ayuda para caminar, pero no quieres pedirla. Puesto que el lupus es principalmente una enfermedad invisible, las personas dicen que no te ves enferma, incluso cuando sientes que te quemas por dentro. Este aislamiento es la razón por la cual tengo el compromiso de hacer que el lupus sea más visible trabajando como embajadora, concientizando y hablando con compañías farmacéuticas y legisladores acerca de financiamiento y apoyo. Uno de mis logros más importantes fue convertirme en coordinadora del grupo de apoyo para pacientes de lupus del área de la bahía de San Francisco de LFA, estableciendo un espacio seguro para pacientes con lupus para que reciban información del lupus, para que compartan información y recursos y para que los escuchen porque eso cambió mi vida, especialmente cuando recién recibí mi diagnóstico.

Actualmente, sé que puedo disfrutar una vida integral con lupus y quiero que otras personas también lo sepan. Todavía puedes florecer y tener alegría de vivir. Me apasionan actividades tales como mi club de lectura, conciertos musicales y tours gastronómicos. Si bien me dolió no poder ser madre, mis sobrinos son una luz muy brillante en mi vida y puedo darles mucho amor. Pasar tiempo con mi familia y ser su tía son las mayores alegrías de mi vida. Esto fue una prueba para mi fe, pero sigo rezando y confiando en Dios. Es lo más importante en mi vida y me ha dado fortaleza durante mi vida con lupus.

Este recurso educativo se preparó con el apoyo de GlaxoSmithKline, Merck and Novartis.

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What Is Sjögren’s Disease? – HealthyWomen



Sjögren’s (pronounced show-grins) disease is an autoimmune condition that affects the moisture-making glands in the body. The disease can affect the eyes, mouth, nasal passages — even the
vagina — and cause extreme dryness and chronic pain among other life-altering symptoms.

Unfortunately, it can take years to get a diagnosis for Sjögren’s in part because symptoms like dryness can be dismissed by healthcare providers as eye allergies or
menopause or just no big deal. But Sjögren’s is a serious, systemic disease.

Recently, the international Sjögren’s community officially changed the name from “Sjögren’s syndrome” to “Sjögren’s disease” to more accurately reflect how complex and serious the condition is. And the term “secondary Sjögren’s” is no longer used because it implied that Sjögren’s was less important when diagnosed along with other
autoimmune diseases.

Read: Autoimmune Diseases 101 >>

The shift in language is a step in the right direction in raising awareness about the disease. Today, about 4 million people in the U.S. are living with Sjögren’s and most of them are women or people assigned female at birth (AFAB).

Here’s more on what you need to know about Sjögren’s disease symptoms, risk factors and treatments.

What is Sjögren’s disease?

Sjögren’s is an autoimmune disease that occurs when the body’s immune system mistakenly attacks glands that make moisture in the mouth, eyes and other parts of the body. The limited production of fluid leads to dryness and irritation, among other symptoms.

Sjögren’s can also cause damage to the lungs, kidneys and nervous system. And people with Sjögren’s may be diagnosed with additional autoimmune diseases, such as rheumatoid arthritis and lupus.

Read: FAQs About Lupus >>

What are the symptoms of Sjögren’s disease?

The most common symptoms of Sjögren’s are dry eyes and dry mouth. Your eyes may feel grainy — like there’s sand in them — and you may experience blurry vision, sensitivity to light and itchy eyelids.

Dry mouth can cause problems with swallowing, tasting and speaking, and the lack of saliva can lead to dental problems, such as cavities and mouth infections.

In addition to dry eyes and dry mouth, the disease can also affect other tissues and organs and show up in different ways.

Other symptoms can include:

  • Dry skin
  • Dry nasal passages
  • Swelling in the glands in the face and neck
  • Fatigue
  • Joint pain
  • Muscle aches and weakness
  • Memory problems
  • Numbness and tingling in arms and legs
  • Shortness of breath
  • Skin rash

What are the risk factors for Sjögren’s disease?

The exact cause of Sjögren’s disease is unknown, but researchers think a combination of environmental factors, genes and illness play a part.

You may have an increased risk for Sjögren’s if you:

  • Are a woman or person AFAB
  • Are over the age of 40
  • Are in perimenopause or menopause
  • Have/had certain viral or bacterial infections that may trigger Sjögren’s
  • Have an immediate family history of autoimmune diseases

How is Sjögren’s disease diagnosed?

There’s no one test that can diagnose Sjögren’s disease. And a diagnosis can be complicated by the fact that multiple healthcare providers are usually involved in the diagnosis, including rheumatologists, dentists and ophthalmologists.

Typically, a physical exam starts the process followed by blood tests and tests to check tear and saliva levels. These tests can include:

  • Blood tests for antibodies SS-A and SS-B
  • Schirmer test for tear production
  • Rose bengal and lissamine green dye tests for signs of dry eye
  • Saliva test
  • Salivary gland biopsy

Women and Sjögren’s disease

Nine out of 10 people with Sjögren’s disease are women and people AFAB. Research is ongoing as to why more women are affected than men, but some research suggests that estrogen — or the lack of estrogen — may contribute to the disease since most women are diagnosed around the time of perimenopause and menopause when estrogen levels go down.

Due to the lack of moisture in the body, women living with Sjögren’s can also experience more extreme vaginal dryness and genitourinary syndrome of menopause (GSM), as well as other gynecological problems, than women without Sjögren’s.

What are the treatment options for Sjögren’s disease?

Treatment plans for Sjögren’s vary from person to person and no two treatment plans are the same. This is why it’s important to be involved in making decisions regarding your treatment options.

Read: How Shared Decision-Making Can Lead to Better Healthcare >>

Most people with Sjögren’s use a combination of over-the-counter products and prescription drugs.

Treatment options can include:

  • Corticosteroids
  • Disease-modifying anti-rheumatic drugs (DMARDs)
  • Biologics and small molecule therapies
  • Prescription dry eye drops and inserts
  • Prescription oral medications for dry mouth

Lifestyle factors such as good dental hygiene and staying hydrated throughout the day may help with symptoms for some people.

There’s no cure for Sjögren’s, but an individualized treatment plan can help manage symptoms and reduce the risk for complications. As always, talk to your healthcare provider right away if you have symptoms or think you may be living with Sjögren’s disease. The average diagnosis takes three years — there’s no time to waste.

This educational resource was created with support from Amgen, a HealthyWomen Corporate Advisory Council member.

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The High Cost of Living with Lupus



Niranjana Parthasarathi, M.D., started experiencing extreme fatigue and joint pain in her 20s. Within months, she was diagnosed with lupus. “As a medical student, I knew how serious it could be,” she said, recalling how one of her peers had tragically passed away from complications of the autoimmune disease during her internship.

Parthasarathi went on to graduate medical school, and was able to take time off during her residency when she had a flare, which is a period when the disease becomes more active. She became a well-respected internist and worked full time as an associate professor of internal medicine. But at 50 years old, she experienced a flare that led to severe acute kidney failure and left her disabled.

“I’ve unfortunately not been able to resume full-time work or even consistent part-time work,” she said.

Despite this devastating turn, Parthasarathi, now 62, still considers herself fortunate, She had the network and access to care to get quickly diagnosed, and she continues to have health insurance that covers her ongoing medical care, which has included chemotherapy, blood transfusions and immunosuppressants. For those who don’t have access to resources, the costs related to lupus can be devastating.

How the costs of living with lupus add up

“If you have to get admitted to the hospital, go to the emergency room, get all of the testing that you need to have done when you have lupus — because you’re really supposed to be getting your blood and urine tested every three to six months — those costs add up over time,” said Jessica Williams, M.D., MPH, assistant professor of medicine in the Division of Rheumatology at the Emory University School of Medicine in Atlanta, Georgia.

The financial burden of managing lupus can be very different based on how severe your disease is, according to a study published in The Journal of Rheumatology. Researchers found that patients with severe lupus faced healthcare costs of $52,951 annually — while mild cases cost an average of $21,052. These expenses also include indirect costs, such as lost wages. A 2021 study published in Lupus Science & Medicine had similar findings, putting the costs at $68,260 for severe cases and $13,415 for mild cases

The study also revealed that even before diagnosis, patients who would eventually develop severe lupus already had significantly higher healthcare costs.

“Lupus is an autoimmune condition that can impact any part of the body, so patients can have symptoms involving many different organ systems,” Williams explained. On average, it takes five or six years for most patients to receive a correct diagnosis, partly because symptoms can come and go in periods of flares and remission and also because symptoms can be mistaken for those of other chronic conditions. This delay can lead to additional medical expenses while patients see multiple healthcare providers looking for answers.

The economic costs and disparities of lupus

The financial strain is particularly tough for women, who account for 9 out of 10 lupus cases. Many women with lupus are in their reproductive years, a time when flares from the disease can interfere with their career and financial stability. One study found that being a female with lupus was associated with unfavorable work outcomes, which include lost days of work and quitting work for health-related reasons. Symptoms like extreme fatigue, pain and brain fog can affect patients’ ability to do their jobs well, and more severe flares can lead them to reduce their working hours, switch to less demanding roles or even leave the workforce entirely.

“Women with lupus are often just financially devastated, and with our healthcare system being tied to employment the way it is, it can be impoverishing,” said Parthasarathi, whose book, “Lupus: In the Jaws of the Wolf,” is a personal guide to living with the disease and navigating the healthcare system.

Lupus also worsens economic inequalities for women of color. “We know that lupus is more common in racial and ethnic minority patients of all backgrounds,” said Williams, who was the lead researcher on a 2023 study published in Rheumatology that looked at demographic disparities in health outcomes for lupus patients.

Black and Hispanic women, in particular, are more likely to develop lupus and experience more severe forms of the disease, including complications like lupus nephritis, which can lead to kidney failure and the need for dialysis — a potentially huge expense. Williams highlights that these groups are not only at higher risk for developing lupus but are also more likely to face poor outcomes due to factors such as limited access to healthcare, being underinsured and environmental exposures.

These groups are also more likely to have public forms of insurance, and Williams’ study revealed that patients on Medicare or Medicaid have higher rates of 30-day hospital readmissions and preventable lupus hospitalizations compared to privately insured patients. Additionally, lower income levels are associated with increased disease activity, organ damage, depression, work disability and mortality. Patients living in poverty often report only being able to manage their lupus during disease flares and not being able to take care of themselves while in remission because of competing demands like food and housing insecurity.

Tips and resources

“Many of the manufacturers of drugs for lupus have patient assistance programs,” Williams said. She recommended checking with healthcare institutions about financial assistance programs and contacting local chapters of the Lupus Foundation of America, which may offer support for housing and food insecurity.

In Parthasarathi’s book, the proceeds of which are donated to the Lupus Foundation of America and Lupus Research Alliance, she emphasizes the importance of lifestyle measures that can help control the disease, particularly for those who may not have access to all available treatments. Some tips include eating more whole plant-based foods, getting extra rest, reducing stress and walking for 30 minutes per day, if possible.

For women who may be struggling to get a diagnosis, both Williams and Parthasarathi encourage advocating for oneself. Williams suggests taking photos and videos and journaling about symptoms during flares so doctors’ visits during remissions are more valuable.

To those who are diagnosed with lupus, Parthasarathi said, “I would want people to feel very empowered that they can take control of their lives. Not only are there lifestyle measures that they can take to keep themselves healthier, but they will also find that they’re more resilient than they think.”

This educational resource was created with support from Novartis.

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