Terminology Tuesday: fatigue

I put a call out for some terms y’all would like to see defined further and one of the first responses I received was fatigue.

Despite the above, fatigue is hard to define. We might say we’re tired but that doesn’t quite cut it does it? Sometimes I’ll tell T I’m tired and he’ll tell me to lay down. I rebut with some iteration of ‘well, it’s not sleepy tired though.’ I might go on to talk about my lack of spoons.

It can be hard to recognize what is fatigue versus things like drowsiness for some. Personally it isn’t, but it can be hard to distinguish drowsiness for regular sleepy tired.

Monsieur Fat-i-gue doesn’t come to a party alone. He usually brings his pals like muscle soreness or weakness, joint pain, headaches, sore throats, and more. He’s really a popular guy. The fact that he has so many friends makes it hard sometimes to get to the root cause of the issue. Sometimes it’s just that we’ve spent our spoons. Other times it might be a sign of a flare up or worsening disease. For others still, this could mean a new diagnosis is on the way or that medications are having more side effects than they used to.

It can be easier, depending on what’s causing the fatigue, to get help. If it’s a thyroid issue, starting on medication for this will help. Some of us are anemic or vitamin deficient and bumping up those levels can really help. These are all things that need to be discussed with your doctor though, as vitamins and that fun stuff also have interactions, contraindications, and side effects. If it’s a medication issue, you might discuss starting a different medication or changing dosages.

There are a lot of things that can aggravate fatigue, from alcohol to caffeine dependence to weight to inactivity or working out too much to depression and grief to our medical conditions and medications. It’s important to learn how to take a step back and check in with yourself to see if any of the non-medical things could be the cause to your fatigue.

For some, fatigue is its own disease. Chronic Fatigue Syndrome (also known as Myalgic Encephalomyelitis or by the new name, Systemic Exertion Intolerance Disease) can be really devastating.

Generally this is a disease of exclusion where your doctor will make sure things like fibro, lupus, other autoimmune arthritis types, diabetes, and more aren’t the culprits. That said, many with CFS/ME/SEID do have a lot of overlapping conditions like fibro so it’s a hard one to diagnose.

Unfortunately CFS/ME/SEID is like fibro in that there are many doctors out there who don’t believe these are very real and concrete medical conditions. They think, instead, that there is some psychosomatic issue at play. It’s unfortunate because you then wind up with a lot of people who need medical attention and help but aren’t receiving it either because their doctor hasn’t brought up the disease due to their beliefs or because they refuse to treat a patient with anything more than therapy.

If you or someone you love has fatigue, it’s important to fight to find the root cause. If you already have an autoimmune disease, that may be the culprit but isn’t always. Track how you feel, especially if things like weather play into it. Track your medications and physical activity so you can see if you may be overusing your spoons or having a reaction to meds. Most importantly, seek second opinions if you run into a doctor who isn’t listening to you.

As always, you really have to be your own advocate with these things. Know that myself and others are here if you need help.

Terminology Tuesday: cytokines

Cytokines are crazy little buggers.

Basically, cytokines are molecules or proteins that help communication in your immune system. If you scrape a knee, for example, the pro-inflammatory dudes say “HEY YOU GUYS” and get cells moving to help protect and heal the area.

Cytokine is basically the umbrella term, with lymphokines, interleukins, TNF, and chemokines included among others as more defined types.

This could get very technical very quickly, but I want to keep it basic. These terms aren’t easy to understand sometimes and, to be honest, it could take a long time to really learn everything there is to know about cytokines.

These are cells related to an inflammatory response, so if you have certain diseases these guys aren’t always helpful. However, they can and have been manipulated to create some of the medications to treat autoimmune or autoinflammatory diseases. For example, we have TNF alpha inhibitors like Enbrel and Humira that suppress that specific cytokine to help lower inflammation in the body. Actemra similarly suppresses IL-6.

PTSD: what it is, what it feels like, and why I hate it

PTSD (Post-Traumatic Stress Disorder) is something that I’ve been struggling with. It’s something that I try to be pretty open about on here because I know it helps myself process things but it also helps to raise awareness and help others feel as though they’re not so alone.

It’s common in our veterans but also occurs in a wide variety of people depending on their experiences. My comrades in being afraid all the time can include child soldiers, kidnap or assault victims, terrorism, bullying, those who witness death and natural disasters, or other traumatic and stress causing events. It’s actually a lot more common than people think. There is also a genetic component though it needs to be investigated more.

My brain even looks worse hooray!

In very very basic terms, PTSD is essentially where your mind and body are in constant fight-or-flight mode. Sometimes it’s just lurking and subdued, but can be triggered by a number of things. To expand, the trauma affect the levels and productions of certain chemicals in your brain like cortisol, adrenaline/epinephrine, norepinephrine, and dopamine. It can affect your prefrontal cortex and other areas in the brain as well as chemicals that regulate your temperature, growth, and metabolism… and your amygdala, which helps regulate emotions and learning and your memories.

Basically it just messes with your entire body. NBD.

There are a lot of things that happen as a result of this body-wide issue. I used to be very short with everyone and get overly angry at little things. I’m happy to say that I’m over that for the most part, because I’ve learned to communicate what I’m dealing with and express myself.

If you live with other chronic illnesses, you may notice that some of these are things we deal with due to rheumatic disease or other things – difficulty sleeping, irritability, difficulty concentrating, memory issues, etc. I feel like I’ve gone to Culvers and gotten a delicious meal to find it tripled in my bag.

But like with things I don’t like in it instead of delicious custardy goodness.

Anhedonia is when you stop getting pleasure or joy out of things you normally love. That one sucks. I would say for me that it’s the same as feeling flat but eh. There are have been days where I come home and the piggies are so excited to see me and I’m just kinda like…

That breaks my heart because I love them like they were human babies… which can lead into questioning myself on what the fuck is wrong with me and how I thought I could be a parent to animals let alone kids in the future being so fucked up, etc, etc.

That, hypervigilence, flashbacks, and intrusive thoughts are definitely my least favorite.

Hypervigilence is just exhausting honestly. Do you ever have the feeling that something bad is about to happen (like the dude walking behind you creeped you out) so you’re extra aware of your surroundings? Or where you might hold your keys in your hands in a way to fight back just in case you’re mugged or whatever?

That feeling has its place, which is exactly in those situations. It doesn’t need to be in your every day life. It’s exhausting, harms your muscles because they’re often tense, and mentally is hard to process unless you go into the CIA or something.

Sadly, I did not.

Sometimes I like my spy skills but not usually.

Flashbacks are just hard. For me they tend to involve moments where I didn’t protect my sister and instead watched her being beaten. That happens so much so actually that it’s almost refreshing when my flashbacks are of myself being beaten or assaulted or molested.

 

This image takes you through some of the steps that can happen over the course of a single PTSD episode but also of the initial trauma. If we think of it as a guide for being triggered, we can use one of my issues to walk through it (why do I share some of these things?). In case it needs to be said, from now to the next picture is going to contain major triggering talk for child physical abuse.

Right now I’m not able to watch Law & Order SVU which sucks so much because it’s my favorite. Katy and I used to watch it practically whenever we weren’t in class in college, so it also may be part of why some of my energy drink fueled papers sucked.

This is going to be a fictional trigger with a real result, but it’ll help shed some light on these attacks.

I’m watching an SVU episode and it turns out the child’s mother was helping her boyfriend to sexually assault her daughter. I usually can figure these types of twists out easily, but sometimes I miss them and they take me by surprise. When that happens, it’s almost like I can feel myself shutting down or I have to go do everything on my list ever NOW to get away.

I’ll explain.

When I’m initially triggered, I get the chemical fight-or-flight reaction. It makes my hair stand on end and I get a shiver in my back or neck. I may breathe differently – more rapidly and audibly, like I may cry or hyperventilate. My temperature changes. I zone out if I don’t go do other things because that’s a technique that kept me sane and from fighting/talking back. I’ll interact with you intelligently but may not remember our conversation. It feels like everything is still and taking forever because I feel slowed down.

Sometimes this is where it ends. Eventually I watch something funny or go do something and wake up out of this.

Other times I’m not so lucky. Maybe the SVU episode showed some of the interaction or showed a parent beating and degrading a child. I go through the process above, but with some add-ons.

It takes me back to sitting in one of the two rooms that was once part of the garage in the house I grew up in. They turned part of the garage into two rooms before we moved in – one with blue carpeting that was sometimes a kitchenette or pet room depending on the era, and the other with red carpet which was either a bedroom or a movie/hangout room. In the memory I bring up, the blue room was a kitchenette with storage and the red room was a bedroom.

There was one of those white wire shoe rack type things on the back of the door to the red room (which you got to through the blue room) where mom hung her belts in addition to shoes I think. All that ever stands out in my mind are the belts.

My sister is crying and screaming and begging as my mother drags her into the red room and closes the door and locks it. I’ve run after them wanting to know what happens, telling my sick six year old self that I can help my sissy. I know I can pick the lock but I don’t want to leave because what will happen to sissy. I’m presumed that me being near will help things not go too far. I’m scared as hell.

The wire rack hits the door as mom yanks her belt down. You can hear the clinking of the belt buckle, a noise that to this day elicits this memory. If my pants are falling down, please just keep it to yourself because fuck belts man. Fuck belts.

Whatever happened made mom angrier than normal. Normally, Kelsey just got hit with the inserty end of the leather belt. This time she isn’t so lucky. You can hear her still struggling as Michelle tries to get her into a position to whip. Maybe that’s part of why she got so angry? I have no idea. All the while Michelle is hurling horrid horrid insults at my baby sisser. They’re so bad I can’t access them. I know I remember but my brain won’t let me go there.

I move to hiding in a further corner and by this point I’m crying. Things haven’t even fully started yet.

But then they do.

And all I can hear is the snap of the belt, the violent clinking of the buckle, as it hits Kelsey’s skin… and her blood curdling scream. Every lash makes me cry out and by the time it’s almost over I could fill in for Niagara Falls. My throat hurts from holding in as much as I have.

It’s done and mom throws down the belt, which she’ll later ask me to pick up and put away before demanding that I cuddle with her. Touching this weapon and being so close to the woman who just did this makes me want to vomit. For now, Kelsey sits there crying and Michelle yells at her for it before leaving the room. She uses the old parent line about how this hurt her more than it did the child who was just beaten. She walks back to the main part of the house, not seeing me hiding in the corner thank god.

Kelsey has welts and bruises that quickly develop on her back. They really hurt her.

I feel like shit. I didn’t do anything to stand up for her or to wake my mother up to what she was really doing. I didn’t get help from other adults, though we were threatened with the knowledge that we’d be taken away and likely split up because who wants two broken girls. I feel like shit for still not really sharing details of this with anyone (this is the first time even T has heard this story in detail here). I feel awful for treating my sisser so poorly and for not protecting her. That’s what big sisters are supposed to do and I have failed.

I parented my mother enough at times that I feel guilty for not chastising her… until I remember that I was a six year old who everyone thought was literally dying. What could I do?

I feel helpless, hopeless, like shit. I’m worthless because I don’t do anything to stop this. I get angry with my mother, with her parents and grandparents. What did they do to raise this monster that bore me? My grandmother is much the same and has done similar things to my sister. She is, in fact, the one person I’ve ever called 911 on… Well, dialed 91 and threatened to finish.

It was much easier to stand up to her because (remember I’m in my six year old brain here) she is fat and can’t move as fast as mom. She also doesn’t sleep in the same bed with us or do nurturing things that mother does. Mother made me think that she was doing this because Kelsey was bad. Everything turned into her fault somehow.

My sister was treated like shit her entire life. My mother never cared to connect with sis – until I left and lessened contact. Then sis suddenly became this amazing child who could do no wrong, save not sending her poor mother money.

Sometimes this storm of thoughts builds and builds and I think about other events that happened or mistakes that I made. I spiral downwards until I’m numb and seem like a zombie. This happened everywhere – at work, school, lying in bed at 3am not sleeping, even during sex.

If I think about this, I get angry. Fuck you Michelle. Fuck you for all of this. It doesn’t matter how you were raised – you had a responsibility to do better by us, to love us and protect us, and instead you beat us physically and emotionally and allowed us to be sexually abused without doing shit about any of it. How fucking dare you?! And even more, you gaslight us. You try to act like what we remember didn’t happen. Then why the FUCK do we have the same or very similar memories? Why won’t you ever admit fault? That you did even one thing – maybe this particular thing?

Because of my research, my adult brain knows why. It’s because Michelle and Patricia are mentally ill. They need serious help that neither of them will ever get for many reasons, but namely the illness itself. Well, and not believing that they need it.

This all goes through my head in the span of a few seconds. While I’m zoned out, I notice everything. Hooray for special spy skills.

Now I’m just exhausted – physically, emotionally, mentally. I cry, sometimes in front of T or in the bathroom or at my desk at work or driving. My crumpled and angry body is done, spent, completely out of spoons in such a way that that phrase doesn’t do it justice.

It’s interesting to look at this image because so much of it has to do with ableism too, doesn’t it? Dismissing others as unimportant or unworthy? It’s like a family hobby. It gets so bad you think that you really are lying, like that episode of Star Trek.

The hardest thing about PTSD is that it’s a physiological response to an event or a series of events. When those events aren’t around anymore, though, your brain and body don’t know how to adjust. It still is prepared to protect itself. I’m grateful for the thought behind it, but living with the result is really hard.

Working on recovery is hard. It means revisiting a lot of this and allowing myself to feel the emotions and really be there with them. It sucks so many donkey balls.

I think the hardest thing is that sometimes the most innocent things trigger me. Sure, SVU is a perfect example, but sometimes it’s blinking a certain way or hearing a child scream (even happily) or a word or just someone being angry or berating/putting down someone else – even if they think it’s funny.

Of course, there is also the belt sound triggers. I hate public restrooms between this and being beaten during potty training.

I hate having a good memory honestly.

The good thing is that my antidepressant really helps. My therapist and I are working on some coping skills – and really working hard to get to the bottom of some things. I know that if I want to be more normal or have certain hobbies back, I have to get through some of this trauma. It’s not going to be easy and there will be days where I want to stop. I just have to tell myself that I’m different and will always be so, which is totes fine.

But you know what? I’m also unbreakable.

Terminology Tuesday: Kineret

 

I totally stole this pic from Emily @ Chronic Curve

Well, it’s been done.

I went for labs Thursday morning and, despite a pred boost, my sed rate has only gone down ONE FRIGGIN’ POINT and my CRP has actually gone UP.

I cannot right now with this.

Anyway.

Kineret is an IL-1β inhibitor.

Hi IL-1β!

This little guy can be a cause of inflammation and in Still’s/SJIA interleukin (IL) medications tend to work better. The theory is that this is the type of inflammation we deal with more than others (TNF alpha, etc).

K-dawg (my new nickname for it) inhibits IL-1β because it’s IL-1α protein which can block the beta bits from attaching to cells and causing inflammation.

Some of the studies with Still’s show symptom relief within HOURS which is pretty friggin’ baller.

The downside? Well there are a few.

It’s still a biologic and it still inhibits the immune system. I haven’t had as much of a problem catching the ick from people on TNF drugs, but that can be a sign that those drugs aren’t working for you. The nice thing right now is that I share an office with one person AND work with docs, so they’ll totally get my precautions.

K-dawg is injected daily, which is nice if you have to stop it for some reason but annoying because daily shots.

The other big downside? Major injection site reactions. They seem to last for like a month for most people, causing fun painful welts. I’m not excited about this, especially if I do end up starting here before my JA conference trip and my previously planned swimsuit time while there.

Oh well.

I’m trying to look at it in a good light. With my old rheumy, I’d be stuck moving onto another medication that wouldn’t really do much for me. This is why I switched docs. With my current rheumy, who has treated Still’s before and hates step therapy, I’m ready to really deal damage to Arthur.

/nerd

I’m also hopeful. None of the medications I’ve been on would get me to remission. This could. And that’s an awesome notion.

 

Terminology Tuesday: sed rate

Today we’re going to look at what exactly a sed rate is.

The term sed rate is thrown around a lot in autoimmune or autoinflammatory communities, so it’s really an important one to wrap your head around.

You may see sed rate listed one of many ways – sedimentation rate, westergren sed(imentation) rate, erythrocye sed(imentation) rate, or ESR. It’s all the same thing, which is nice. In short, this is one way to monitor the level of inflammation in your body. As you can see in the graphic above, the higher the sed rate, the higher the inflammation.

This isn’t disease specific, which rocks and sucks all at once. It rocks because this test can be used to help monitor and treat SO many people. It sucks because, well, infections and other acute illnesses can cause high inflammation levels too. I got a call from my rheumy in March when I had bronchitis (before it was actually diagnosed) because my levels were crazy high and she was worried. Things like being full o’ babies or female or anemic can affect it too.

The pill can up the levels too. So that’s fun. Remind me to ask about birth control alternatives.

Do you ever wonder how these tests are really done though?

So do I!

Lab peeps stick your blood in these crazy tall tubes. When I was studying chemistry I totally broke one. It’s not easy, but clearly that didn’t stop me!!

Anyway…

Your blood gets placed in these tubes and checked on after an hour. Your red blood cells eventually sink to the bottom, which happens even faster if you have high inflammation levels. Basically the test is like one of those race games at the fair… except not one you want to win.

Hopefully you don’t bust the tube!

The faster your cells hit the bottom of the tube, the higher inflammation you have.

Because the test only takes an hour, it’s a quick one that generally isn’t costly either. If you live with a rheumatic/autoimmune/autoinflammatory disease, you likely have this test monthly. It’s a great way to measure general inflammation but, again, isn’t so great for certain people or for telling you where the inflammation is. My guess is, though, that you can usually figure that one out.

Terminology Tuesday: Hepatosplenomegaly

Hepatosplenomegaly is something that can happen in rheumatic diseases, especially in SJIA or adult onset Still’s which both are more likely to cause systemic/organ issues. However, it can also happen in types of cancers, infections, and other diseases.

I always find it helpful to break down the prefixes and suffixes in medical terms, so let’s do that here.

Hepat- or hepar- has to do with the liver, while splen- has to do with the spleen. The suffix -megaly indicates abnormal enlargement, so hepatosplenomegaly is the abnormal enlargement of the liver and spleen together.

There are not always obvious signs of hepatosplenomegaly. The above are some of the things to look for as a doctor, but what do we look for as patients?

People dealing with this malady can have the following:

  • Jaundice
  • Fever
  • Changes in bowel movements (looser)
  • Nausea and vomiting
  • Gas (belching)
  • Distended abdomen
  • Difficulty eating (loss of appetite, harder to digest food, etc)
  • Abdominal pain
You need to make sure to seek medical care with this. As I talked about earlier, it can be a sign of cancer. It could also be a sign of infection and/or organ failure.
Do you have an idea for a medical term you’d like to see defined? Shoot me a note or comment below!

Terminology Tuesday: TAPVR

While this isn’t necessarily arthritis related, it’s obviously weighing heavily on my mind with my newborn nephew facing open heart surgery.

Total Anomalous Pumonary Venous Return (TAPVR) is a kind of Congenital Heart Defect (CHD) where the heart doesn’t connect to itself correctly. In fact, it’s listed as a Critical CHD, which means extra bad news.

It means he’s special medically just like me and his momma though – one out of 7200 babies every year is born with a CCHD in the US. That’s 1 in 4 of the 1 in 100 born with a CHD, or 1 in 400 children. TAPVR specific rates aren’t available, but would be much smaller due to how many CCHDs there are.

To understand it, we’re gonna need a quick rundown on how the heart works. Heads up for my boss for running through this with me last week (and to the CDC for having the best site). Can I just say again how much I love pediatric docs?

Blood that has run through the body loses oxygen. That’s why our veins are blue instead of red – the blood inside has lost oxygen. That blood has to come back to the heart to get oxygen again, and it does so through the superior and inferior vena cava.

The right atrium, where the blood enters the heart, acts like a mini reservoir in that blood collects there until it is pushed down through the tricuspid valve when the heart beats. It goes into the right ventricle and, when the heart beats, it gets pushed into the lungs via the pulmonary valve and main pulmonary artery.

The blood gets oxygen in the lungs and then comes back into the heart through the left atrium. Just like the right, the left atrium acts as a holding space until the heart beats and blood is pushed through the mitral valve into the left ventricle. The muscle here has to be very strong, because when the heart beats again, the blood has to go through the aortic valve and aorta to go out into the rest of the body.

If that doesn’t help, maybe this video will:


Got it? Kinda? Good!

In someone with TAPVR, the blood going out to the body carrying oxygen isn’t going out the right way.

As we can see in this picture, the blood with and without oxygen is all mixing together. Here’s what’s going on:

The unoxygenated blood comes back to the heart like normal and even goes out the the lungs like normal. However, the oxygen-rich blood coming back from the lungs has a problem.

Sam’s heart isn’t set up like a normal heart. TAPVR means that the pulmonary veins aren’t connected in the right spot. Instead of coming to the left atrium, the oxygenated blood goes back to the right atrium and starts the process again. The only reason Sam is getting any oxygen to his body is because there is also a small hole between both atriums, allowing both oxygen-rich and unoxygenated blood into the left atrium.

The blood going to his body isn’t oxygen rich and that causes problems.

There are a few types of TAPVR. Sam’s is infracardiac, meaning:

the pulmonary veins come together and form abnormal connections below the heart. A mixture of oxygen-poor blood and oxygen-rich blood returns to the right atrium from the veins of the liver and the inferior vena cava, which is the main blood vessel that brings oxygen-poor blood from the lower part of the body to the heart. (what up CDC)

The only way to correct this is to have open heart surgery. If you want to see what the surgery looks like, you can watch the graphic video here. It’s upsetting, so if you’re emotionally invested in this baby boy, stay away from the link or you’ll wind up in a puddle like me.

With it being a CCHD, he may need further care. Some kids need more surgeries. If things go really well, he’ll have to visit numerous specialists often for a long while.

This is not okay. No child should have to go through this.

Terminology Tuesday: NSAID

NSAID is such a common term used in arthritic and rheumatic diseases. NSAIDs are obviously used with other diseases, and in fact in many other ways.

NSAID stands for non-steroidal anti-inflammatory drug, which makes it pretty clear to see what it does on a superficial level. Without using steroids, these drugs help to bring swelling and other issues related to inflammation down. For many with autoinflammatory or autoimmune diseases like autoimmune arthritis types, NSAIDs are the first step in pain relief. If you don’t respond, they may add steroids and/or a DMARD to better control your disease.

Cox-1 and -2 are enzymes that make prostaglandins which are lipid compounds that regulate inflammation among other things. Cox-1 enzymes help support platelets and protect the stomach, which is part of why NSAID users should be on a stomach protector like Prilosec. Cox-2 medications include drugs like Celebrex, which were manufactured in order to help limit the gastrointestinal issues caused by other NSAIDs. However, Cox-2 inhibiting NSAIDs raise your risk of heart attack, stroke, and similar issues.

What other side effects can NSAIDs produce?

There are a number, which is why it is important to not mix NSAIDs and, again, to protect your stomach. NSAIDs can cause high blood pressure in some. Other side effects can include things like headache, decreased appetite, rashes, drowsiness, photosensitivity, higher chance of prolonged bleeding, easy bruising, and allergic reactions. If you have asthma, it’s very important to be careful with what NSAIDs you’re taking. Aspirin based meds can flare up asthma issues.

(Note to self – don’t freak out about my NSAID!)

There are some people who wonder what NSAIDs are really the best for their aches and pains. Some people, like myself, are allergic to Tylenol (which isn’t always referred to as an NSAID btw) and have other medication sensitivities so we don’t get much choice. The rest of you should check out the following picture though:

Make sure that you read the fine print on everything though… Those for OTC arthritis medications often are tested on pains that are more menstrual or achy in nature and NOT on arthritis.

Terminology Tuesday: DMARDs (and a warning about antibiotics and C. diff)

DMARD stands for Disease Modifying Anti-Rheumatic Drugs. These drugs help to slow the effects of rheumatic diseases and are often the first lines of defense against further joint damage, especially in adults.

DMARDs include drugs like methotrexate, plaquenil, minocycline, arava, sulfasalazine, imuran, cyclosporine, xeljanz, and the biologics (Enbrel, Humira, Cimzia, Kineret, Orencia, Rituxan, Remicade, and Simponi).

These are likely drugs that you’re used to hearing about. For children diagnosed with juvenile arthritis, they often try to stick with an NSAID first (check out next week for more information on that term). Steroids can also be used, but should be used more in the short term to limit side effects.

Someone with a rheumatic disease can end up on a combination of several of these medications, all of which impact your immune system. Steroids even do that!

Many of these drugs are used for other diseases as well, from autoinflammatory/autoimmune to cancer to more.

Rituxan, Remicade, and methotrexate are all used as treatments for some types of cancer in higher doses than a rheumatic patient would receive. Minocycline is an antibiotic, but has been used to fight RA and related diseases. Treatment with antibiotics doesn’t work for all and there can be serious risks in that treatment, including C. diff which is horribly painful in addition to easily transmittable and potentially fatal.

I had C. diff in July of 2012. I let it go for nearly two weeks before doing anything because I thought I was just sick to my stomach or had food poisoning. The process to diagnosis involved collecting my own ‘output’ and taking it to the clinic.

So gross.

Honestly, with how long I let it go, I’m lucky that I didn’t end up in the hospital – and that I didn’t give it to my pregnant-at-the-time sister!

Moral of the story? Don’t take antibiotics unless you have to.

Terminology Tuesday: Idiopathic

We’ll start this new series on terminology off with an easy term to define – idiopathic.

Juvenile idiopathic arthritis used to be known (and is still often referred to) as juvenile rheumatoid arthritis. However, this led to many people simply asserting that JA was a childhood version of RA, with basically the same symptoms, complications, and issues.

This isn’t true.

Renaming JRA as JIA both removes the stigma associated with ‘rheumatoid’ and helps to label the disease as one with an unknown origin.

Simply put, idiopathic means that no one knows what causes it.

I never thought to look up the meaning of idiopathic until one day while watching House, MD, when I heard this lovely conversation:

Dr. Allison Cameron: [giving differential diagnosis] Idiopathic T-cell deficiency?
Dr. Gregory House: “Idiopathic”, from the Latin, meaning we’re idiots ’cause we can’t figure out what’s causing it.

The next time someone asks you what ‘idiopathic’ means, just whip out that House quote. It’s the perfect definition.