That may be easier said than done, especially for those who are experiencing the depression that can accompany lupus. It often helps to think of yourself as a model for others, and let your behavior show them the way to handle a challenging situation. Everyone in your family and work circle is influenced by your diagnosis. Sensitivity to the changes the disease brings to their lives may assist in balancing your new situation.

Private counseling and support groups can be sources comfort and practical support. Although your future is less certain, do not be afraid to plan ahead, while taking into consideration your new reality. Remember that a person with lupus can live a normal life span, but it is up to the individual to charge that life span with its meaning and vitality.

Management of lupus is a team effort and the patient is an important part of that team. Your healthcare team will customize your medications to minimize symptoms, prevent flare-ups and minimize long-term damage to your body. Your role is to give clear, accurate feedback about your body and its response to medication, to take responsible precautions against flare-ups, to educate yourself about lupus and its treatment, and to keep your mind and body in optimum condition. Because lupus flares and subsides and appears in different organ systems, and because the medications can affect your body in unpredictable ways, your treatment plan may change many times. A person with lupus must develop patience with the unexpected and understand that the medications may need frequent adjustment.

Medications

Always take your medication as prescribed. Never modify it without consulting your healthcare team. For many of the drugs you may be taking, the smallest modification can result in negative side effects.

Tell your healthcare team if you are taking vitamin or herbal supplements. Many of them can interact with medications.

Exercise
Your body will tell you how much exercise it can tolerate. Joint pain and fatigue may make exercise difficult, but people with lupus should stay as fit as possible. Moderate exercise is safe, but those with lupus should not expect it to ease their joint pain or fatigue. Daily exercise is important to avoid stiffness and muscle weakness, even during flare-ups.

Thanks again for the feedback. This week was good, although I have felt a little under the weather the last few days — a little sluggish. I didn’t really bring the same level of energy to my exercise session yesterday, and my appetite has definitely fallen off. My work schedule has been a little erratic this week, so I’m hoping to catch up on my sleep this weekend. Maybe that will help.

Armand, I’m slowly improving with the new exercises, though it was a bit of a struggle yesterday. I added a little more distance to my walk, but not quite as much as I hoped. Still, I feel good about any progress. I walked at work one night this week when I was staying late. The building I work in is almost half a mile long, so I just walked a few laps up and down the main corridor.

Sharon, the answer to your question is, “yes!” I have definitely been passing up some tempting foods. Among my friends at work, I’ve been known as the guy who always gets dessert. So while nobody’s noticed my weight loss, there have been one or two comments about the change in my eating habits. As yet, I can’t see much visual difference myself. My sweet tooth is definitely still there, but I’m just not giving in quite as easily as before. The fruits have helped in that regard, too.

Sharon’s Reply
David,

You eat a lot of meals in restaurants — 12 times this week! Do you ever cook at home? Restaurants serve very large portions, so be careful that you stop eating when your hunger has been satisfied, not just when the plate is empty. It is also hard to find out if the cook adds butter to the vegetables or oil to the recipes. You are doing a good job at selecting the lower-fat food, but it could be that the portion is still too big.

Your average fat gram intake was 30, which is great. You are still eating something light in the evening. You are putting an emphasis on getting fruits and vegetables in your diet — you have not really had any sweets for the past month! And, you have lost 11 pounds! You are doing fine. I hope you can soon be able to see a change in your clothing or find bending over or climbing stairs a little easier.

Keep up the good work!

Sharon

Armand’s Reply

David,

It looks like it was another good week for you — congratulations! Sorry to hear you were a little sluggish though; hopefully, resting over the weekend will help you out, as you said.

You are continuing to do a good job with your walking, attempting to walk a little farther in the same amount of time. By constantly trying to do a little more, you are challenging your body. In so doing, you will see an increase in your fitness level and, eventually, see more results! This way, you can help avoid hitting those annoying plateaus where nothing you do seems to make you lose weight.

I am glad to see you getting creative with your workouts by taking advantage of your work setting. Walking the corridors of your office building is a great example of how people can integrate activity into their normal routine. Other examples of this are parking farther away from the building, taking stairs instead of elevators, and using the last 15 minutes of your lunch hour to walk. Take a look at my Deskworkitis article for more tips.

I am glad to see you progressing nicely with your toning exercises. I want you to keep trying to add repetitions every week on both the abdominal curls and the pushups. Just make sure you stay with strict form; perform each exercise in a slow and controlled manner.

Keep it up, David! Continued success awaits you.

Armand

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Unlike many weight-management programs, L.E.A.N., which was implemented by the corporate fitness center last spring, was marketed to fit and deconditioned clients, emphasizing healthy habits for a lifetime. “Traditionally, weight-loss programs are catered to an overweight population and can become dangerous when individuals of normal body weight pledge to lose weight,” says program manager Sherry Faucher. “With L.E.A.N., anyone interested in improving their daily nutritional intake and learning the roles that both exercise and nutrition play in weight management can participate.”

Participants were organized into teams and “competed” on both an individual and team basis. Points were awarded for completing three exercise sessions a week, completing bi-weekly food diaries and for participating in special weekly activities.

According to Faucher, the pressure of competition was eliminated by allowing all who participated a chance to earn a winning score. “When weight management is made into a ‘game,’ the barriers of frustration and intimidation are broken down,” Faucher says, adding that one of the best outcomes of the program was the connection between staff and members.

“Members loved the individualized attention, and the feedback provided by the staff was the most appreciated component of the entire program,” she says.

Twenty-five percent of the facility’s membership participated in L.E.A.N., making it Paine Webber’s most popular incentive program to date. In addition to an increase in regular exercise, the facility has enjoyed an 8-percent increase in membership adherence.