How to deal with a lupus comeback – An experiment

After being quiet for almost 2 years, my lupus friend has made a comeback.

I had my quarterly checkup last week and my urine protein creatinine ratio has increased beyond the normal range. For the past two weeks I have also been feeling mild joint pain at the fingers, wrist, abdomen, arms, neck, ankle and sole. Not all parts painful at the same time, but an indication of lupus activity. My immune system is starting to act up again! 

Time to press the panic button?

My specialist increased my medication, and asked me to see him in one months’ time instead of three. He also said if I had fever, I should see him immediately instead of waiting for the appointment in one months’ time. He mentioned that my kidney function is still normal, but we must treat the attack at an earlier stage so that my immune system does not get agitated further.

A lot of thoughts go through my mind when I hear from him what I would consider a relapse diagnosis.

(1) Anger / frustration / Worry

After taking for granted the good life and health that I enjoyed for close to two years, lupus has came back to warn me not to take things too far again.

What if the increased medication does not work out? What if it really aggravates to become what some people who will finally consider it to be ‘quite serious’, and land me in hospital again?

All of a sudden I remember of a certain person who cursed that my lupus made a comeback and it reminded me momentarily of that unpleasant incident again. Could it be that their ill wishes caused the comeback?

What’s going to happen to my job, and the new projects that I take on? Those that I did not manage to handover since one month ago after I changed department? Is my full time job under threat?

(2) Reflection and acceptance

This is the part where like in the movies, there was a flashback on my life in the past three months, and think hard what has caused this attack. Actually I did not have to think too hard. The few key factors why lupus was possibly triggered are because of the follows:

• Job stress
• Physical activities
• Eating less discreetly

If I had to rank the factors, job stress plays a big role in causing anxiety and depression in the past two months, ever since I was transferred to another department, and yet still handling a number of work from the previous department. There were also numerous stress factors within the job, such as having no resources, an extremely tight deadline, and some super micromanage colleague whom asked a thousand and one things despite the fact that handover information was already given to him in a pack. There were several courses that I had to instruct which landed me tonnes of stress because I am not one who loves to prepare on the details upfront.

Physical activities was more of a complementary factor. There is no doubt that I loved rock climbing, hiking and strength training. These activities on their own did not cause flare-ups for the past two years. I did Mount Rinjani in Indonesia last year, and I did Mount Kinabalu this year. They did not cause lupus joint pains to me, only regular muscle strain from increased activities, and it subsided after three days.

In terms of diet, I believe that I was still eating pretty discreetly, cooking my own food 3 days out of a week, and eating less salt and oil etc. Maybe I did let it slip by eating a lot more out, and eating the famous sin – Durian! Oh well. It could be the triggering factor for my lupus activity. I have not eaten durian and drank minimal alcohol for almost two years. Probably should have kept it the way it is considering that I am already under attack.

(3) Action plan

So I have done an analysis in length, and it is time to conclude on what can I do moving forward to hopefully see improvement during my next visit to the doctor’s.

• Get some medical leave from the doctor. Since we only have another week until the holiday season, and I never really utilised my medical leave before, I have a legitimate reason to utilise my remaining medical leave.
• Immediately handover my work, and for those which cannot be completed before the holiday season, to defer and inform the stakeholders. (Actually, no one is bothered since they are already away as well, so why stress over it?)
• To stop all climbing and hiking for now.
• Continue eating clean and exercise more discretion when comes to eating out.
• Rest well and sleep early.

One thing that I do notice after going through the thought process on how to go about with this, is that I take full responsibility of what happened to me. Whilst it is an attractive option to think that the world is not fair, and some people just have a twisted mind, I think my usual don’t-give-a-damn self has too much ego to actually let others be the reason why I thrive or die. In fact, the biggest part why I could go into remission in the first place, was to focus on health and getting support from great friends and family. I could negotiate with lupus previously, then I could manage them this time as well.

Let this be a life experiment, and we shall see how this turns out in one months’ time. Wish me luck!