Learning To Live With A Chronic Condition

The Kubler-Ross model, commonly referred to as the "five stages of grief", is a hypothesis introduced by Elisabeth Kubler-Ross, that says that when a person is faced with the reality of an awful fate, he or she will experience a series of emotional stages of grief.  It was introduced in her 1969 book On Death and Dying. 
Kubler-Ross originally applied these stages to people suffering from terminal illness, but later expanded it to apply to any form of catastrophic personal loss, including the onset of a disease or chronic illness.  Thus, it is applicable to conditions such as multiple sclerosis, lupus, and fibromyalgia, and many others.

• Denial: "I feel fine.  This isn't happening."  Denial is a defense mechanism--to dispute the diagnosis, to try to maintain your lifestyle, to pretend the condition will not affect you.
• Anger: "Why me?  This isn't fair."  You can be angry at your doctor, yourself, your body or your surroundings.
• Bargaining: "I'll do anything for... What if I become a better person?"  This is an attempt to cure yourself, or negotiate away the situation for more freedom from the condition and avoiding treatment by doing good things.
• Depression: "I'm sad, so why bother with anything?  I don't care anymore."  When the illness or condition is a certainty, you may withdraw or lose interest in outside activities.
• Acceptance: "I will move forward."  The goal is to come to terms with the reality of the condition and learn to live with it.

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

Hearing Loss Linked to Other Problems?

The Better Hearing Institute maintains that hearing loss isn't a harmless condition to be ignored, because it often coexists with other serious health problems, and a growing body of research indicates that there may be a link.  Studies show that people with heart disease, diabetes, chronic kidney disease, Alzheimer's disease and depression may have an increased risk of hearing loss.

When left untreated, hearing loss alone can lead to a wide range of physical and emotional conditions.  Impaired memory and the impaired ability to learn new tasks, reduced alertness, increased risk to personal safety, irritability, negativism, anger, fatigue, tension and stress are among its more common side effects. When untreated hearing loss coexists with chronic illness, quality of life is diminished.  Dr. Sergei Kochkin, executive director of the BHI, says: "Hearing aids help most people hear better and improve their quality of life."






Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

Children+Secondhand Smoke=More Illness

Children exposed to secondhand smoke who are hospitalized with influenza have more severe illness.

The Journal of Pediatrics compared children (exposed vs. not exposed) hospitalized between 2002 and 2009. Using intensive care, intubation and length of stay in the hospital as severity indicators, researchers found children with chronic conditions and secondhand smoke exposure required more intensive care and had a longer length of stay (10.0 vs. 3.5 hays) than children not exposed.

In addition, children with SHS exposure were 4.7 times more likely to be admitted to intensive care and had a 70% longer length of stay, even when factors including demographics and the presence of Asthma and Tooth Decay asthma or chronic conditions were eliminated as factors.

Source:  jpeds.com/article/S0022-3476(12)00731-7

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

What Is "Lupus Fog?"

As many as half of all people with lupus describe feelings of confusion, fatigue, memory loss, and difficulty expressing their thoughts.  This collection of symptoms is termed cognitive dysfunction, although many people call it "lupus fog."  It is associated with problems with memory, concentration, speech and logical reasoning.  Currently, it is not understood whether these problems are medication related or a reaction to a chronic illness.

Research is being done to determine the causes of cognitive impairment with lupus.  Staying physically fit and keeping a healthy diet are critically important to good cognitive health.  This means avoidance of nicotine, excessive caffeine, and alcohol, and, equally importantly, it means regular exercise.  Improved organization can also help overcome the difficulties and frustrations associated with worsening memory and concentration.  In addition, separate from lupus fog, people with lupus may be twice as likely to experience migraine-like lupus headaches.  This problem is usually treated by a neurologist, because different types of headaches respond to different types of treatment.

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

Take Control of Lupus with Exercise

Exercise can help lupus patients

Lupus, a connective tissue disorder, is a chronic illness.  It is something that you can't control, is extremely frustrating.  It can make you feel like your life is over.  Exercise can give lupus patients the chance to work out some of those frustrations, and give you the feeling that you have some control over your body instead of it controlling you.
  

The benefit of exercise

Exercise doesn't just improve your overall fitness, it can also help relieve many of the symptoms of lupus, by fighting fatigue, relieving stiff and painful joints and releasing chemicals that improve your mood.  Consult with your physician regarding an exercise program that can be integrated into your daily life.  It will usually involve aerobic conditioning at a moderate intensity and will be balanced with appropriate rest.  Because getting moving replenishes your energy supplies, it directly combats fatigue.  Even a daily short period of time can make you feel better.  Moving your joints facilitates their natural lubrication.  Exercise also strengthens the muscles around joints to take pressure off joints.  Flexible, strong muscles help protect joints.  

Exercise is good for your heart

Since exercise is good for your heart and fights obesity, it lowers the levels of inflammatory proteins.  Since lupus is an inflammatory disease, exercise eases inflammation.  When you're in pain all the time, you feel miserable.  Tied into the fatigue are stress, anxiety, depression and poor sleep.  Exercise lifts your mood by triggering the release of endorphins, the feel-good chemicals of the brain, that stimulate feelings of greater comfort, pleasure and confidence.  If you have lupus, just think about what better muscle tone, more joint stability, increased mobility and less fatigue could mean in your life.  

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

Compliance In Taking Medication Is A Problem

The statistics are alarming:

• one-quarter of all patients never fill prescriptions at all
• 10% decide not to fill them because the doctor hasn't explained how the drug will help
• of those who fill prescriptions, 50% do not take the medications correctly because they misunderstood the instructions
• of patients with chronic illness, 30% to 85% decide not to refill their prescriptions because they don't know how the drug is helping them, or don't know how to manage a side effect
• patients usually do not tell their doctors they are not taking their medication

If you are concerned that your medications no longer seem to be effective, ask your doctor if there are new medications that can help, or of the dosage needs to be changed.

Source: www.lupus.org


Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

The Lupus Implications of Staph Infections

Chronic exposure to even small amounts of staph bacteria could be a risk factor for the chronic inflammatory disease lupus, Mayo Clinic research shows.  Staph, short for Staphyloccus aureus, is a germ commonly found on the skin or in the nose, sometimes causing infections.  In the Mayo study, mice were exposed to low doses of a protein found in staph and developed a lupus-like disease, with kidney disease and autoantibodies like those found in the blood of lupus patients.  The findings are published online this month in the Journal of Immunology.

Research on Lupus  

The next step is to study lupus patients to see if the staph protein in question plays a similar role in humans. "We think this protein could be an important clue to what may cause or exacerbate lupus in certain genetically predisposed patients," Dr. Vaidehi Chowdhary, co-author, says.  "Our hope is to confirm these findings in lupus patients and hopefully prevent flares."  In the mice studied, a staph protein activated white blood cells, leading to an inflammatory illness mirroring lupus.

Research on people has shown that carrying staph bacteria is linked to autoimmune diseases such as psoriasis, Kawasaki disease and granulomatosis with polyangilitis.  Since the cause of lupus is still unknown, the discovery of the staph protein's role is exciting, Dr. Chowdhary says.

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

Children and Second-hand Smoke

Children Exposed to Smoke

Children exposed to secondhand smoke who are hospitalized with influenza have more severe illness.

compared children (exposed vs. not exposed) hospitalized between 2002 and 2009. Using intensive care, intubation and length of stay in the hospital as severity indicators, researchers found children with chronic conditions and secondhand smoke exposure required more intensive care and had a longer length of stay (10.0 vs. 3.5 hays) than children not exposed.

In addition, children with SHS exposure were 4.7 times more likely to be admitted to intensive care and had a 70% longer length of stay, even when factors including demographics and the presence of or chronic conditions were eliminated as factors. 

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

Find out how Secondhand Smoke Plays into Children's Health! [influenza]

Secondhand Smoke Statistics

Children exposed to secondhand smoke who are hospitalized with influenza have more severe illness. compared children (exposed vs. not exposed) hospitalized between 2002 and 2009. Using intensive care, intubation and length of stay in the hospital as severity indicators, researchers found children with chronic conditions and secondhand smoke exposure required more intensive care and had a longer length of stay (10.0 vs. 3.5 hays) than children not exposed.

In addition, children with SHS exposure were 4.7 times more likely to be admitted to intensive care and had a 70% longer length of stay, even when factors including demographics and the presence of or chronic conditions were eliminated as factors. 

Read more here - http://www.ncbi.nlm.nih.gov/pubmed/22863259

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

Lupus and Joint Pain

More that 90% of people with lupus experience joint and/or muscle pain at some time during the course of their illness.  More than half of the people who develop lupus mention pain in their joints as their first symptom.

Symptoms of Lupus 

Inflammation  is the most common reason for muscle pain and aches.  When major inflammation exists (i.e. lupus is a chronic inflammatory disease), the aches, pains and weakness are signs of your body's inability to cope with whatever process has overwhelmed it, especially during periods of increased disease activity (flare).  Lupus arthritis causes pain, stiffness, tenderness and warmth in your joints.  The joints most often affected are the ones farthest from the middle of the body, such as fingers, wrists, elbows, knees, ankles and toes.  General stiffness upon waking in the morning, which gradually improves as the day goes on, is a key feature.  Sometimes joint pain may develop later in the day, and involve several joints, with similar joints on both sides of the body.  Compared to rheumatoid arthritis, lupus arthritis is less disabling and less likely to cause destruction of the joints.  Fewer than 10% of people with lupus arthritis will develop deformities of their hands and feet associated with weakening of cartilage and bone.  


Source:  Lupus Foundation of America    


Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309