My Lupus Buffalo Hump

Things I Hide about My Invisible Disease - Part 2 - The Buffalo Hump

Buffalo Gals, won't you come out tonight,
Come out tonight, Come out tonight,
Buffalo Gals, won't you come out tonight,
And dance by the light of the moon.

I don't think that song was about women with Lupus, but now that I've read all the lyrics I'm more inclined to think that it might have been. In any case, it's the tune that inevitably starts playing in my head when I think about this one particular aspect of having Lupus that I hide. Whereas you may have heard about the "butterfly" rash associated with Lupus, I bet you haven't heard about the Buffalo Hump! Doesn't that just sound beautiful and feminine?

I guess technically it's not a symptom of Lupus itself but it is a side-effect of the treatment. In particular steroids. Now when I talk about steroids, I'm not talking about anabolic steroids...the kind that "pump you up" and give you big muscles, and get you kicked out of baseball (usually after you've retired). The steroids I'm talking about are corticosteroids. Corticosteroids have an interesting history:

Corticosteroids: Once a Miracle "Cure"?

Corticosteroids or glucocorticoids, often just called "steroids", where once thought to be almost miraculous. In 1948, at the Mayo Clinic in Rochester, Minnesota a group of arthritis patients were given daily injections of a corticosteroid. The results were so striking and the improvement so dramatic that it was thought that the "cure" for arthritis had been discovered. However, as the use of corticosteroids expanded over the years, side effects emerged and it was realized that high doses given over prolonged periods of time turned steroids into "scare-oids". Patients were warned of the potential problems, the use of corticosteroids became more conservative, and some patients were so frightened of them they even declined treatment."

 Corticosteroids are used in Lupus patients to suppress the immune system (which has gone all wonky is attacking the bodies healthy cells and tissues) and to reduce inflammation. When the immune system is suppressed, surprise surprise you are more likely to get infections, all kinds of infections. Add a 4 year old in pre-school with 100 other little germ contaminated monsters running around her, breathing on her, playing with her, and then she comes home and jumps on Mommy and gives me a big slobbery kiss and hug with all those lovely kid germs...and me with no immune system. But I digress.

When I first took Prednisone (the most common steroid prescribed) I though it was a WONDER DRUG. I had been in bed for months, was horribly sick, anemic, basically having my initial flare of my diseases triggered by my pregnancy and child birth. This little white pill made it possible for me to actually get out of bed. It even gave me a little bit of energy, where I hadn't had enough to even take a shower. I had started reading the message boards about Lupus and read all of these horrible things about Prednisone and I couldn't understand what these people were talking about. I even posted about how helpful it had been and asked why was it so awful. I received a rush of responses regarding the side effects especially the long-term effects of steroid use and the list of side-effects is long everything from cataracts, diabetes, thinning of the skin, glaucoma, increased blood pressure, mood swings, edema (swelling due to water retention), suppressed adrenal gland hormone production, increased risk of infections, etc. etc.

The biggest short-term side-effect is weight gain and not just a few pounds. We are talking about people putting on 100 lbs. in 3 months (I didn't even believe that was possible, but some had pictures). Also, this weight gain is accompanied by a redistribution of fat. People develop what is called "moon face" because the fat settles in a circle around the face. You may have seen someone with this look because in some cases it is hard to miss, a HUGE ROUND face usually with round double chins. I thought this lady's diagram was helpful although honestly her moon face is not particularly bad.

So I was absolutely TERRIFIED when I started taking Prednisone that although I finally felt a little better, I was going to get incredibly FAT. I have never really been a thin person. I come from the hourglass figure kind of stock, lots of curves. That's the nice way of saying I can gain 10 lbs. by watching someone else eat something that looks tasty. I have always had to watch my weight and I've watched it go up & down & up & down & up & down. So naturally, I expected to be posting my own story of gaining 100 lbs. in 3 months and wondered to myself if my husband would divorce me if I got really fat (come on we all have these fears). He's from that naturally tall and thin stock who can eat the whole pie and not gain weight, who complains that he can't keep weight on, and has actually had those weight gainer shakes that add 2000 calories to your protein drink. It's completely mind boggling to me that these people exist & I'm married to one.

Anyway, by the grace of God I did not gain 100 lbs., I didn't have any major speedy weight gain. It is easier to gain weight, but when I'm sick I tend to stay in bed and not eat so it kind of evened itself out. I had put on weight slowly over the last few years but I attribute that more to being completely sedentary and not being able to exercise. I did however have a "redistribution of fat". So to continue with the things I hide about my invisible disease. I have a "buffalo hump".

What is a Buffalo Hump?

"Buffalo hump refers to a lump of fat that develops at the top of the back between the shoulders. It can arise from a variety of conditions that are characterized by an increase in cortisol or glucocorticoid (hormones produced by the adrenal gland) levels in the bloodstream. The most common cause of elevated cortisol levels is the use of oral corticosteroid drugs, which are prescribed to treat different conditions, including inflammatory diseases."
 Here is what my buffalo hump looks like currently:

The Buffalo Hump is the rounded area at the top of my back

The redistribution of fat also causes it to somewhat wrap around the the front sides, like a collar, leaving pads above my clavicle bones. I actually didn't know this until I was searching the web for this post and read up on it, so I don't have a good picture of myself. You can somewhat see the side pads rising up next to my bra strap, but here is a better example of what I'm talking about:

 Again, my buffalo hump is actually much improved. I am on the lowest dose of steroids that I've ever been on. I actually currently take 10mgs per day & previously have taken 70mgs (7x more & a VERY high dose). The buffalo hump is easily hidden with high back neck lines & long hair. This condition can be much worse, for example:

I don't think I could hide this one.
The buffalo hump should go away if I stop taking Prednisone, which is possible but unlikely, as that's what keeps my Lupus under some control. There is a possibility that the buffalo hump will never go away even if I stop taking steroids. I suppose I could have liposuction treatment, but I'll have to start a fund for that, it is difficult enough keeping up with the medical bills for my necessary treatment. Getting rid of the buffalo hump would really be treatment for my vanity at this point.

I know today is the last day of May and thus the last day of Lupus Awareness Month, but I have more things to post and pictures to show & I've decided I'm not going to stop just because I couldn't get it all in this one month. That is why I have started this in blog form.

If you didn't know, you are linked to my new blog Princess Lupus at  www.princesslupus.blogspot.com. I am by no means a blog wiz, so please bear with me as I try to get this blog going. Let me know if there are any problems that I need to fix.

I hope to see you for my next installment: Red, White, & Blue & Black.

The Things I Hide About my "Invisible" Disease Lupus - Part 1

Lupus and other auto-immune diseases are often called "invisible" diseases because for the most part you can't look at someone and see that they have Lupus. In fact I actually just call my list of conditions "Lupus" because that's the only disease most people have heard of, even if they aren't sure what it is. I'll save my list of conditions for another time.

I was thinking about the whole idea of an "invisible" disease and realized that actually there are a lot of things that are invisible because I intentionally hide them. Since this is Lupus Awareness Month, I've decided to "show" some of the things I hide about my "invisible" disease and provide some information no what I'm showing you via information from & links to The Lupus Foundation website. I'm doing this in parts...so I can change my mind about what pictures I want to post...LOL. Okay so here I go.

The Beautiful Butterfly
Usually the one thing people have heard about Lupus is something about a "butterfly" rash on the face. It's not quite as pretty as a butterfly, believe me. I thank God for MAC & the invention of concealer. What the heck does a butterfly rash look like? Well one looks like this.

I look like I'm blushing all the time. You may notice the weird thing I'm doing
with my mouth & the dark circles under my eyes, those are a topic for another post.

Right Side Close-Up

Left Side Close-Up. Lovely broken blood vessels that look like red strings.

Up My Nose Close-Up

Okay, so that's a start. It really doesn't look like a butterfly to me, mine is kind of more all over. This is actually my "rash" at it's best as it's been improved by steroids and I haven't seen the sun in a few years now. What's the big deal with a red face?

This is actually Acute Cutaneous Lupus Lesions:
"Acute cutaneous lupus lesions occur when your systemic lupus is active. The most typical form of acute cutaneous lupus is a malar rash -- flattened areas of red skin on your face that resemble a sunburn. When the rash appears on both cheeks and across the bridge of the nose in the shape of a butterfly, it is known as the "butterfly rash." However, the rash can also appear on your arms, legs, and body. These lesions tend to be very photosensitive. They typically do not produce scarring, although changes in skin color may occur."

Okay, so I started with something simple, easy to hide too. A little make-up and concealer and the red is gone, but this means that I have to wear make-up all the time if I don't want to look perpetually sunburned, blushing, like I'm having a hot-flash, or a number of other things that people have asked me if I am suffering from when they see this, particularly when it's more "active".

Psychologically for me this one is difficult. This is my face. Aside from make-up you can't really hide your face. I actually tried to have laser treatment on my face in hopes of lessening the redness. I went to a very well known dermatologist in Pasadena and explained all of my medical conditions and medications as I was afraid that certain medications that thin my skin and make me sensitive may preclude having laser treatment. I was assured that it was fine and so started the zapping.

They used this square thing and went portion by portion. I was told by the woman actually doing the zapping that it was not supposed to hurt really and it didn't at first. She moved from the left side of my face up and around my forehead. It started to sting. She then started down the right side of my face and it started to really sting. I saw the lady's face who was giving me the treatment, she looked concerned. One more zap and I screamed in pain, her expression turned to fear, & she ran out of the room to get the doctor. I sat up and looked in the mirror, my face was red of course, but within a minute blisters started forming on the right side of my jaw.

There was chaos in the office as everyone came in to see "the girl with blisters on her face". I was told this had never happened in 15 or 20 years and blah, blah, blah. Ice packs were brought out and salves and other stuff I'm not even sure what it was. The lady who had been doing the zapping was clearly holding back tears and looking to the doctor for some explanation. As usual with any and all odd reactions, symptoms, test results, etc. the doctor came up with the grand explanation..."It must be the Lupus" (umm...hello, I told you about the Lupus BEFORE...so this wouldn't happen). I was sent home with a grocery bag full of stuff to put on the blisters which had gotten even bigger in the chaos. The doctor bandaged up my face & off I went with my grocery bag. The lady who zapped me called twice a day for about a week to "check" on me (make sure I wasn't going to sue her) and told me over and over again how this had never happened before and she just couldn't understand it.

The truth was, I COULD understand it, because it probably was the Lupus.

So, I ended up with 2 rectangular (the zapper thingy) shaped scars on my face, the are very light and relatively unnoticeable (so I'm told). Of course, I can see them just fine and to me they are these huge, glaring, reminders of my disease, my vanity, that I'm not as pretty as I used to be, that I can't fix this problem, that some doctors are idiots, that you should trust your gut (I had a feeling it might not work, that's why I asked so many questions, told him about every condition, & every medication), and that I am Living With Lupus (and a bunch of other stuff). 

This show and tell is tame. So my next installment should be something more interesting...how about "The Buffalo Hump"? See you for Part 2.

Musings From the Past-6/2009

6/2009 update - Up & Down, Up & Down...that's the best way to describe my medical conditions...it's annoying. I never know if it's going to be a good day or not...my calendar revolves around doctor's appointments, my daughter is getting (if not already) too heavy for me to pick up), a simple trip to the Renaissance Faire (for which I rested up for for days, even spending the day before in bed) resulted in a tiring but fun day followed by a horrible reaction to the sun which went systemic. I was threatened with IV Infusion and spending time in the hospital. And now I'm NEVER allowed any prolonged or really ANY sun exposure :-(

Whine, Whine, Whine! LOL

This is me and my manservant/husband. My dress without the petticoat underneath. It looks so much better with the petticoat (by the way, I made that dress & my husband's shirt myself), my face looks so "moon faced" (aka: round/fat) here, a side effect of large doses of Prednisone. 24 hours after this picture was taken, I'd be flat on my back in bed with giant blisters all over my shoulders (the one place I forgot to put sunscreen and wasn't covered up). The sun caused a flare which went wildly systemic and I was down for about 3 weeks to a month...just from the darn sun...for gosh sakes, I live in California! I can't get away from the sun. The Faire was fun. I haven't been since, I'm too scared to go. My dress is somewhat on display on a dressmakers figure (a mannequin who's dimensions you can change). I think next to my wedding dress, I loved wearing this dress second, but with the huge petticoat to make the skirt fill out like a true Princess's should.