Systemic lupus
erythematosus is an autoimmune disease that causes your immune system to
be almost over-active and start attacking your own body. This disease
affects mostly women of childbearing age (doctors think female hormones
may have something to do with it) and is more common in minorities. We
say lupus patients are like snowflakes--no two are alike. Most of us
have joint pain that can be debilitating at times and most of us
experience extreme fatigue. A lot of people have a rash across the
bridge of their nose, sometimes called a "butterfly rash" and sun
sensitivity. A lot of times it can just be a general feeling of
"unwellness", like the flu, even with a fever. It can affect almost any
system of your body. My lupus affects my kidneys.
I was diagnosed the summer after my freshman year in college and it only took a couple months after the first suspicious medical test to be diagnosed. Unfortunately, because I didn't realize what was happening, I lived with the symptoms for about two years. Because the symptoms of lupus can be vague if it does not affect a major body system, diagnosis is very difficult. There is no specific test for general lupus. I was diagnosed because of my kidney symptoms through a biopsy. Many people don't realize what is happening to them or doctors can't make sense of their symptoms. You might just sound whiny.
When I was in college, I realized that the group of people most likely to have lupus was the least likely to know anything about it. Practically no one I knew at school knew what lupus was or anyone else who had it. That's why I participate in lupus awareness events. I didn't stop to think that something could be wrong with me when I was feeling lousy and it was just lucky I had a urine test that uncovered some strange results. Since mine was in my kidneys, not doing anything and allowing that damage to occur would have resulted in some serious issues. There are many people who don't realize that lupus is very treatable, but untreated it is life-threatening.
I have been in remission now for over 4 years and there's really nothing I can't do now. The reason I am well is because I take all of my medications and I get plenty of rest. (And lots of prayers from my mom and her friends!) I know of people with lupus who don't want to have to take medications all the time or miss out on things so they don't take care of themselves. It's really important and I'm proof that just maintenance of your disease can afford you the chance to live normally.
May is Lupus Awareness month and many local chapters of the Lupus Foundation have walks in the first weeks of May. If you're interested in more information about walks in your area or your local chapter or just more about lupus, visit www.lupus.org
I realize that there may be women reading this who don't have lupus, but may have MS, RA, or fibromyalgia, or another similar disease. I'd like to also refer you to the website butyoudontlooksick.com. There's a great essay there I'll go ahead and post here. I'll preface this by saying that this is not at all the type of life I have now, but this is what I experienced for a couple years. Simple tasks can be really difficult and the energy isn't always present. Thanks for reading:

As I went to take some of my medicine with a snack as I usually did, she watched me with an awkward kind of stare, instead of continuing the conversation. She then asked me out of the blue what it felt like to have Lupus and be sick. I was shocked not only because she asked the random question, but also because I assumed she knew all there was to know about Lupus. She came to doctors with me, she saw me walk with a cane, and throw up in the bathroom. She had seen me cry in pain, what else was there to know?
I was diagnosed the summer after my freshman year in college and it only took a couple months after the first suspicious medical test to be diagnosed. Unfortunately, because I didn't realize what was happening, I lived with the symptoms for about two years. Because the symptoms of lupus can be vague if it does not affect a major body system, diagnosis is very difficult. There is no specific test for general lupus. I was diagnosed because of my kidney symptoms through a biopsy. Many people don't realize what is happening to them or doctors can't make sense of their symptoms. You might just sound whiny.
When I was in college, I realized that the group of people most likely to have lupus was the least likely to know anything about it. Practically no one I knew at school knew what lupus was or anyone else who had it. That's why I participate in lupus awareness events. I didn't stop to think that something could be wrong with me when I was feeling lousy and it was just lucky I had a urine test that uncovered some strange results. Since mine was in my kidneys, not doing anything and allowing that damage to occur would have resulted in some serious issues. There are many people who don't realize that lupus is very treatable, but untreated it is life-threatening.
I have been in remission now for over 4 years and there's really nothing I can't do now. The reason I am well is because I take all of my medications and I get plenty of rest. (And lots of prayers from my mom and her friends!) I know of people with lupus who don't want to have to take medications all the time or miss out on things so they don't take care of themselves. It's really important and I'm proof that just maintenance of your disease can afford you the chance to live normally.
May is Lupus Awareness month and many local chapters of the Lupus Foundation have walks in the first weeks of May. If you're interested in more information about walks in your area or your local chapter or just more about lupus, visit www.lupus.org
I realize that there may be women reading this who don't have lupus, but may have MS, RA, or fibromyalgia, or another similar disease. I'd like to also refer you to the website butyoudontlooksick.com. There's a great essay there I'll go ahead and post here. I'll preface this by saying that this is not at all the type of life I have now, but this is what I experienced for a couple years. Simple tasks can be really difficult and the energy isn't always present. Thanks for reading:
The Spoon Theory
by Christine Miserandino www.butyoudontlooksick.com
My
best friend and I were in the diner, talking. As usual, it was very
late and we were eating French fries with gravy. Like normal girls our
age, we spent a lot of time in the diner while in college, and most of
the time we spent talking about boys, music or trivial things, that
seemed very important at the time. We never got serious about anything
in particular and spent most of our time laughing.

As I went to take some of my medicine with a snack as I usually did, she watched me with an awkward kind of stare, instead of continuing the conversation. She then asked me out of the blue what it felt like to have Lupus and be sick. I was shocked not only because she asked the random question, but also because I assumed she knew all there was to know about Lupus. She came to doctors with me, she saw me walk with a cane, and throw up in the bathroom. She had seen me cry in pain, what else was there to know?
I
started to ramble on about pills, and aches and pains, but she kept
pursuing, and didn’t seem satisfied with my answers. I was a little
surprised as being my roommate in college and friend for years; I
thought she already knew the medical definition of Lupus. Then she
looked at me with a face every sick person knows well, the face of pure
curiosity about something no one healthy can truly understand. She
asked what it felt like, not physically, but what it felt like to be
me, to be sick.
As
I tried to gain my composure, I glanced around the table for help or
guidance, or at least stall for time to think. I was trying to find the
right words. How do I answer a question I never was able to answer for
myself? How do I explain every detail of every day being effected, and
give the emotions a sick person goes through with clarity. I could
have given up, cracked a joke like I usually do, and changed the
subject, but I remember thinking if I don’t try to explain this, how
could I ever expect her to understand. If I can’t explain this to my
best friend, how could I explain my world to anyone else? I had to at
least try.
At
that moment, the spoon theory was born. I quickly grabbed every spoon
on the table; hell I grabbed spoons off of the other tables. I looked
at her in the eyes and said “Here you go, you have Lupus”. She looked
at me slightly confused, as anyone would when they are being handed a
bouquet of spoons. The cold metal spoons clanked in my hands, as I
grouped them together and shoved them into her hands.
I
explained that the difference in being sick and being healthy is
having to make choices or to consciously think about things when the
rest of the world doesn’t have to. The healthy have the luxury of a life
without choices, a gift most people take for granted.
Most
people start the day with unlimited amount of possibilities, and
energy to do whatever they desire, especially young people. For the
most part, they do not need to worry about the effects of their actions.
So for my explanation, I used spoons to convey this point. I wanted
something for her to actually hold, for me to then take away, since most
people who get sick feel a “loss” of a life they once knew. If I was
in control of taking away the spoons, then she would know what it feels
like to have someone or something else, in this case Lupus, being in
control.
She
grabbed the spoons with excitement. She didn’t understand what I was
doing, but she is always up for a good time, so I guess she thought I
was cracking a joke of some kind like I usually do when talking about
touchy topics. Little did she know how serious I would become?
I
asked her to count her spoons. She asked why, and I explained that
when you are healthy you expect to have a never-ending supply of
“spoons”. But when you have to now plan your day, you need to know
exactly how many “spoons” you are starting with. It doesn’t guarantee
that you might not lose some along the way, but at least it helps to
know where you are starting. She counted out 12 spoons. She laughed and
said she wanted more. I said no, and I knew right away that this little
game would work, when she looked disappointed, and we hadn’t even
started yet. I’ve wanted more “spoons” for years and haven’t found a way
yet to get more, why should she? I also told her to always be
conscious of how many she had, and not to drop them because she can
never forget she has Lupus.
I
asked her to list off the tasks of her day, including the most simple.
As, she rattled off daily chores, or just fun things to do; I
explained how each one would cost her a spoon. When she jumped right
into getting ready for work as her first task of the morning, I cut her
off and took away a spoon. I practically jumped down her throat. I said
” No! You don’t just get up. You have to crack open your eyes, and
then realize you are late. You didn’t sleep well the night before. You
have to crawl out of bed, and then you have to make your self something
to eat before you can do anything else, because if you don’t, you
can’t take your medicine, and if you don’t take your medicine you might
as well give up all your spoons for today and tomorrow too.” I quickly
took away a spoon and she realized she hasn’t even gotten dressed yet.
Showering cost her spoon, just for washing her hair and shaving her
legs. Reaching high and low that early in the morning could actually
cost more than one spoon, but I figured I would give her a break; I
didn’t want to scare her right away. Getting dressed was worth another
spoon. I stopped her and broke down every task to show her how every
little detail needs to be thought about. You cannot simply just throw
clothes on when you are sick. I explained that I have to see what
clothes I can physically put on, if my hands hurt that day buttons are
out of the question. If I have bruises that day, I need to wear long
sleeves, and if I have a fever I need a sweater to stay warm and so on.
If my hair is falling out I need to spend more time to look
presentable, and then you need to factor in another 5 minutes for
feeling badly that it took you 2 hours to do all this.
I
think she was starting to understand when she theoretically didn’t
even get to work, and she was left with 6 spoons. I then explained to
her that she needed to choose the rest of her day wisely, since when
your “spoons” are gone, they are gone. Sometimes you can borrow against
tomorrow’s “spoons”, but just think how hard tomorrow will be with less
“spoons”. I also needed to explain that a person who is sick always
lives with the looming thought that tomorrow may be the day that a cold
comes, or an infection, or any number of things that could be very
dangerous. So you do not want to run low on “spoons”, because you never
know when you truly will need them. I didn’t want to depress her, but I
needed to be realistic, and unfortunately being prepared for the worst
is part of a real day for me.
We
went through the rest of the day, and she slowly learned that skipping
lunch would cost her a spoon, as well as standing on a train, or even
typing at her computer too long. She was forced to make choices and
think about things differently. Hypothetically, she had to choose not
to run errands, so that she could eat dinner that night.
When
we got to the end of her pretend day, she said she was hungry. I
summarized that she had to eat dinner but she only had one spoon left.
If she cooked, she wouldn’t have enough energy to clean the pots. If she
went out for dinner, she might be too tired to drive home safely. Then
I also explained, that I didn’t even bother to add into this game,
that she was so nauseous, that cooking was probably out of the question
anyway. So she decided to make soup, it was easy. I then said it is
only 7pm, you have the rest of the night but maybe end up with one
spoon, so you can do something fun, or clean your apartment, or do
chores, but you can’t do it all.
I
rarely see her emotional, so when I saw her upset I knew maybe I was
getting through to her. I didn’t want my friend to be upset, but at the
same time I was happy to think finally maybe someone understood me a
little bit. She had tears in her eyes and asked quietly “Christine, How
do you do it? Do you really do this everyday?” I explained that some
days were worse then others; some days I have more spoons then most. But
I can never make it go away and I can’t forget about it, I always have
to think about it. I handed her a spoon I had been holding in reserve.
I said simply, “I have learned to live life with an extra spoon in my
pocket, in reserve. You need to always be prepared.”
Its
hard, the hardest thing I ever had to learn is to slow down, and not
do everything. I fight this to this day. I hate feeling left out,
having to choose to stay home, or to not get things done that I want to.
I wanted her to feel that frustration. I wanted her to understand,
that everything everyone else does comes so easy, but for me it is one
hundred little jobs in one. I need to think about the weather, my
temperature that day, and the whole day’s plans before I can attack any
one given thing. When other people can simply do things, I have to
attack it and make a plan like I am strategizing a war. It is in that
lifestyle, the difference between being sick and healthy. It is the
beautiful ability to not think and just do. I miss that freedom. I miss
never having to count “spoons”.
After
we were emotional and talked about this for a little while longer, I
sensed she was sad. Maybe she finally understood. Maybe she realized
that she never could truly and honestly say she understands. But at
least now she might not complain so much when I can’t go out for dinner
some nights, or when I never seem to make it to her house and she
always has to drive to mine. I gave her a hug when we walked out of the
diner. I had the one spoon in my hand and I said “Don’t worry. I see
this as a blessing. I have been forced to think about everything I do.
Do you know how many spoons people waste everyday? I don’t have room for
wasted time, or wasted “spoons” and I chose to spend this time with
you.”
Ever
since this night, I have used the spoon theory to explain my life to
many people. In fact, my family and friends refer to spoons all the
time. It has been a code word for what I can and cannot do. Once people
understand the spoon theory they seem to understand me better, but I
also think they live their life a little differently too. I think it
isn’t just good for understanding Lupus, but anyone dealing with any
disability or illness. Hopefully, they don’t take so much for granted or
their life in general. I give a piece of myself, in every sense of the
word when I do anything. It has become an inside joke. I have become
famous for saying to people jokingly that they should feel special when I
spend time with them, because they have one of my “spoons”.
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