My hair is falling out

 

Ack! My hair has been falling out at an alarming rate. I get a handful from the tub drain each time I take a shower. When I brush my hair, or run my hand through my hair, it comes right off at the roots. This has happened to me several times over the years. It means my lupus is flaring.

Next week I see a surgeon about getting my gallbladder removed. In the past, surgeries have made the flare-ups even worse. And…to top that off, something is wrong with my female parts. This is week three of my period. I have real bad endometriosis and that is going nuts, too

I feel really yucky. There is soooooo much I want to do and just sitting upright is tough. Here’s some lupus info…

Fatigue

This is one of the most common and certainly one of the most prominent features of lupus. Patients often describe it as an unnatural fatigue. Its causes are not well understood. Often it precedes the diagnosis by months or years and only when treatment has been successfully started does the patient realise how major a feature it had been.

Aches and pains

The majority of lupus patients suffer at some stage from joint and muscle pains. In many patients this presents as ‘pain all over’. In acute flares of lupus the symptoms are often described as being ‘flu-like’. Unlike other rheumatic diseases such as rheumatoid arthritis, there is often very little to see in the way of joint swelling. It is not just the joints that are affected but the tendons and muscles as well. In the majority of cases the joint inflammation does not progress to permanent damage.

Fevers

Fever is usually a feature of a flare of the disease. Fever is unusual when the disease is in a quiet phase: thus in an adult or a child known to have lupus who develops fever the possibility that a separate diagnosis – infection – might be present always needs consideration.

Rashes

A wide variety of skin rashes occur in lupus. Traditionally these are sun-sensitive (photosensitive) but this is not always the case. The commonest rashes are on the cheeks (the butterfly rash across the nose and cheeks), on the elbows, on the palms and soles and on the V-neck area. The rashes vary from pinkish discolouration through to blisters and small pinpoint ‘blood spots’ (purpura). Most rashes in lupus have a tendency to come and go.

Hair loss

Hair loss is one of the most important features of active lupus. It may be the first manifestation of the disease and is often first noticed by the patient as hair on the pillow. In some cases hair loss is patchy and even extreme. Fortunately, in the vast majority of patients the hair re-grows after successful treatment, though hair regeneration is often notoriously slow.

Headaches

Headaches are a major feature of lupus. In some patients a history of headaches or a typical migraine go back to the patient’s teens and pre-date the diagnosis by many, many years. There is almost certainly a variety of causes of headaches in systemic lupus. One specific and important cause is ’sticky blood’ caused by the presence of antiphospholipid antibodies.

Depression

Depression is an important feature of lupus. It is sometimes simply attributed to ‘being unwell’ or having tiredness and pain. However, in many patients it is far more important than this and is a primary feature of the disease. It sometimes responds well to management of the lupus itself and is clearly a central feature of the lupus process. In some patients the return of depression is a tell-tale sign that the lupus is flaring.

General symptoms

As almost every organ in the body may be affected at some time, the symptoms and signs are legion and can include irritation of the eyes (sometimes associated with dry eyes), mouth ulcers, chest pain (pleurisy is, for example, important in active lupus), weight loss and ankle swelling.

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