As physicians, we’re accustomed to a certain amount of variety in treating different patients with the same illness.
After all, we’re treating individuals.
But when you take on lupus patients, you’re taking the concept of variety in symptoms and outcomes to a whole new level.
Granted, there are specific symptoms to the various types of lupus, but no two lupus patients are the same.
Lupus is an ever changing illness with periods of activity and rest that are as different as the patients they affect.
Those differences can make developing a treatment plan difficult to say the least.
And when you add peripheral neuropathy caused by lupus to the mix of symptoms[1], you have an even more complex set of issues to treat and, hopefully, stay ahead of.
If you have any hope of preventing serious neuropathy complications in your lupus patients, you have to be diligent in monitoring your patients’ symptoms and, even more importantly, your patients have to be very conscious of their symptoms and keep you advised of any changes as soon as they happen.
That means you need to educate your lupus patients on their illness and peripheral neuropathy.
Helping Patients Lupus and Peripheral Neuropathy
Because the peripheral nervous system can be affected by lupus, every system of the body that is regulated by the peripheral nervous system can be damaged[2].
That means the nerves that control involuntary body functions like heart rate, blood pressure, digestion and perspiration.  Your patients need to understand that their body many not be able to regulate their heart rate or blood pressure, they might not be able to properly digest food,  their  kidneys can be damaged and they could develop urinary problems.
And even worse, lupus can cause serious problems with inflammation.  That can lead to:
–          Inflammation of the sac around the heart
–          Diseases of the heart valves
–          Inflammation of the actual heart muscle
–          Inflammation of the tissue around the lungs or pleurisy
Now, imagine having any of these issues and having peripheral neuropathy, too…
The peripheral nervous system isn’t functioning properly and can’t send the proper signals to the brain to let them know they have a problem.
It’s easy to see why this could be serious.  By educating your patients on these possible problems and the symptoms they present early on, they can keep a watchful eye out for any symptoms and get in to you see you before they have a potentially deadly problem.
Treating Lupus Patients with Peripheral Neuropathy
Once you take a very thorough history and physical (preferably one following the NeuropathyDR® protocol for lupus patients), you’ll have a better handle on your patient’s condition.  Pay particular attention to their symptoms, when they began, the severity of the discomfort, and any and all medications they currently take (including over the counter medications, herbal supplements or vitamins).
Once you’ve complete the history and physical, the next step in the NeuropathyDR® protocol will be to order some tests. Depending upon your patient’s actual symptoms and which systems seem to be affected, these tests might include:
∙           Neurological exam
∙           Electromyography
∙           Nerve conduction velocity test
∙           Antinuclear antibody test
∙           Blood tests
∙           Urine test
∙           Skin biopsy
Once the tests are completed and you determine your patient has peripheral neuropathy associated with lupus, you can design a specific treatment program based on your patients’ specific symptoms and adjust it as they enter periods of remission or as their symptoms change.
Lupus is not curable and your patient should understand this from the outset.  Your NeuropathyDR® treatment protocol should focus on relieving pain by reducing inflammation, repairing any nerve damage with nerve stimulation, slowing joint and bone damage and improving your patients’ ability to function with their disease.
Focus on:
∙           Rest and stress management.
∙           Exercise programs designed specifically for your individual patient based on their physical limitations.
∙           Pain medication as needed.
∙           Drug therapy as needed.
∙           Safety precautions to deal with the possible loss of sensation, especially in the hands and feet, due to peripheral neuropathy.
The NeuropathyDR® protocol is ideally suited to treating lupus and the peripheral neuropathy it can cause.
Early intervention with a physician well versed in treating lupus and peripheral neuropathy, like a NeuropathyDR® clinician, is their best course of action.  While you can’t cure them, you can help them achieve a better quality of life and lessen the chance of severe and possibly fatal complications.
When you’re trained and ready to work with them, let them know you’re there.
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