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Lupus Coping Corner

Valentine’s Day – This Year, Consider Your Relationship with Your Doctor

Jessica Rowshandel, M.S.W.
Amy Caron
Project Director
Lupus Research Institute

Valentine’s Day is here.  It’s a day to pause and reflect on relationships of all kinds, including those with our doctors.

Earlier this year, author and blogger, Sara Gorman was kind enough to host a webinar for the S.L.E. Lupus Foundation entitled, Living Well Despite Lupus: Listen Up Doc! If you haven’t had a chance to listen to it, I highly recommend that you do. As someone who has lupus and a popular member of the national lupus community, Sara pulls from her personal experiences to offer effective strategies for making the most of a medical appointment, which we know is critical to managing lupus.

Sara provided answers to the following questions from listeners, most of which have to do with the ever-popular topic of lupus and relationships.

Question #1:

How do you suggest engaging a significant other who is unwilling to talk about her lupus to the point where she becomes angry - literally - with me? The standard response I get is "I'm fine! I don't want to talk about that! Stop asking me about that!” When I ask about going to the doctor's office with her, I get the response of "I don't like anyone to go to the doctor's office with me! I've never liked anyone to go to the doctor's office with me! I've always gone alone so it doesn't matter!" I just give up at that point and don't bother continuing the discussion. Thanks for your feedback.

It’s always tough to extend a helping hand to a lupus patient who is trying so hard to be independently strong and capable, in the face of her disease. I can tell you first hand, asking for help and accepting it were major obstacles for me to overcome! Perhaps asking your significant other to specify in what areas she feels you could help would put it back in her court.  I always appreciated when my family would ask how they could help, rather than assuming that it was “x” or “y” that I needed help with. That way, I could help direct them to areas of my life with lupus where I was willing to open up and ready to accept help, rather than their inserting themselves in areas (or activities) where I wasn’t prepared to share the burden. Going to the doctor was one of the latecomers for me, too. (In fact, I’ve done another talk on this very subject – giving yourself permission to ask for help and accepting it…and one of my examples is allowing someone to accompany you to a doctor’s appointment!) 

Question #2:

My doc is generally great, but sometimes he is so pressed for time, that I'm sort of rushed out of the office after getting out one little question. How do you make time to talk to your doc about everything you need to?

Several tactics come to mind, all of which I’ve employed in the past.  I’m sure you go in with a list of questions – one option is to ask him directly how much time he has for questions.

Show him the list, and see what he thinks. (He may be able to eye-ball it and knock a couple off the list right then, or direct you to other resources immediately.)

You can also take the approach that you know you’re only going to be able to get through a couple of your items, so ask him how you can get those other questions answered after the appointment (acknowledging that you don’t want to take up too much of his time right then). Suggest asking a nurse, using email, or setting up a follow-up phone call.

Another strategy is to take in your list, pick the most important questions on the list to ask, and then prep your doctor that at the next appointment, you’re going to need some extra time because of the leftover questions. He might be more willing to cooperate if he knows that list isn’t going away!

Question #3:

Can you speak about Lupus Limbo (i.e., your doc *thinks* Lupus but won't actually diagnose)?

I understand that Lupus limbo can be a very frustrating experience – and although I’ve never been through it myself, I’ve talked with many friends and family members who have waited way too long for an official diagnosis. My suggestions to those I’ve spoken to in this situation are the same that I would give a fellow patient that has been diagnosed:

Ask as many pertinent questions as you can. If there’s something you don’t understand or are wondering about, bring it up. If there’s something that you think might be relevant, but aren’t sure, ask about it. Whether or not you have an official diagnosis doesn’t change the fact that you should have a complete understanding of what your body is going through.

Push for a plan – try to get an idea of where you and your doctor are headed. Is he okay treating you without a diagnosis? What does he plan to do differently? What is he looking for that would prompt a diagnosis? Maybe the lack of diagnosis, in your case, doesn’t change anything for him. Maybe it changes everything. Whatever his answers, you need to know what they are, so that, together, you can continue to work toward wellness, diagnosis or not.

Don’t let the lack of a diagnosis stop you from taking the steps you need to start living well. If you suffer fatigue, take a nap.  If you have joint pain, minimize it the best you can. You don’t need a label to acknowledge that your symptoms are real and debilitating. Take care of yourself first, get the diagnosis second.

Question #4:

I'm newly diagnosed and am having a hard time sharing my illness with people. Is this normal? I don't want people to treat me differently.

It’s absolutely normal! It can be so challenging to introduce the concept of you with a chronic illness to others – it’s hard enough to wrap your head around it yourself. I remember very specifically struggling to figure out who I was, now that I had lupus. I didn’t look different, and, like you, I didn’t want others to act differently around me, but everything was different – from the way I felt the moment I woke up to the moment I went to sleep. And in my experience, the sooner you can acknowledge the change, and begin to embrace it rather than fight so hard against it, the sooner you can start feeling better. The more comfortable you become personally dealing with lupus on a daily basis, the easier it will be to broach the subject with others. From there, you can begin to re-establish your identity with this new illness in tow.

Question #5:

In my case, no effects from 22 years taking Plaquenil and had been evident up to last year, 2011. All of a sudden I am experiencing sight loss. Who should I contact with this problem? Is it the optometrist or the internist, and what would I ask?

Sorry to hear about the late onset of vision trouble! I would mention it, at your earliest convenience, to your primary lupus doctor, or to the doctor who prescribes your Plaquenil®, if it’s another doctor. This doctor needs to be aware of what is going on with your eyes, and will likely then send you to see an eye doctor. If not, take it upon yourself to ask for a referral to see an ophthalmologist. It is important to address any changes in vision, as they relate to Plaquenil and/or lupus.

 

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Lupus Coping Corner

Disclaimer: The information provided by the S.L.E Lupus Foundation is for educational purposes only and should not be used for diagnosing or treating a medical or mental illness, nor be a substitute for professional care. Consult your healthcare provider if you have or suspect you may have a medical or mental health problem.

Amy Caron, MPH is a lupus patient and Project Director of the Lupus Research Institute provider education initiative.  She is not a physician or counselor.  The suggestions shared in this column are strictly opinions from the perspective of a lay person with lupus. Lupus is a very individualized illness; consult a healthcare professional before making any decisions about your care.

The S.L.E. Lupus Foundation does not provide any direct medical or psychological services nor recommend or endorse any particular treatment or therapy. The S.L.E. Lupus Foundation employees, consultants, and agents shall not be liable for any claims or damages, and expressly disclaim all liability of any nature for any action or non-action taken as a result of the information generated by the S.L.E. Lupus Foundation programs and its website, as well as the S.L.E. Lupus Foundation Facebook and Twitter pages.