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Re: Digest Number 1953

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Dear Moonsung

I was sorry to read about your daughter. Life is tough and very unfair.

Connie's suggestions seem very sensible and helpful.

Some other comments :-

My wife has had rp for several years and now has significant damage to her

trachea and nose. She has had eye problems but only temporarily ( no real

ear problems apart from tinnitus ). I am not a doctor ; these are my

comments based on observing my wife's condition and reading medical

articles and this group's emails. No one knows what causes rp and no one

has a guaranteed method of control. Why the disease fluctuates is not

obvious . In my wife's case no one ruled out stress as an initial trigger

but since then there is no obvious pattern. We think there are seasonal

variations ( pollen, air quality ? ) but by the nature of the disease you

just can not see when real damage is occurring until too late ( e.g.

cartilage collapse in the nose ) I don't think you can tell whether '

stress' precedes a ' bad fluctuation ' or is merely a symptom of it .The

most common treatment is steroids plus one or more immuno suppressants and

it is clear from this group that individuals vary in their reaction /

toleration. The most common is methotrexate and in my wife's case this

seems to be working better than any of the others although the build up did

seem to take a long time ( over 6 months ) She tried others ( cellcept,

azothiaprine, cyclosporin ) but either could not tolerate them or they did

not seem to be working.

Apart from the antibiotic angle I think all you can do is quiz the

specialist as to which immuno suppressants he thinks are really working (

the azothiaprine or the metho or both ? ) and whether others might be more

effective. Like you I asked about more radical treatments but got the same

answer that they carry real and significant risks ( e.g. immuno ablation

and stem cell replacement has a 20 -40 % risk of death )

Chester, England

IMPORTANT NOTICE:

This email is confidential, may be legally privileged, and is for the

intended recipient only. Access, disclosure, copying, distribution, or

reliance on any of it by anyone else is prohibited and may be a criminal

offence. Please delete if obtained in error and email confirmation to the

sender.

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Dear Moonsung

I was sorry to read about your daughter. Life is tough and very unfair.

Connie's suggestions seem very sensible and helpful.

Some other comments :-

My wife has had rp for several years and now has significant damage to her

trachea and nose. She has had eye problems but only temporarily ( no real

ear problems apart from tinnitus ). I am not a doctor ; these are my

comments based on observing my wife's condition and reading medical

articles and this group's emails. No one knows what causes rp and no one

has a guaranteed method of control. Why the disease fluctuates is not

obvious . In my wife's case no one ruled out stress as an initial trigger

but since then there is no obvious pattern. We think there are seasonal

variations ( pollen, air quality ? ) but by the nature of the disease you

just can not see when real damage is occurring until too late ( e.g.

cartilage collapse in the nose ) I don't think you can tell whether '

stress' precedes a ' bad fluctuation ' or is merely a symptom of it .The

most common treatment is steroids plus one or more immuno suppressants and

it is clear from this group that individuals vary in their reaction /

toleration. The most common is methotrexate and in my wife's case this

seems to be working better than any of the others although the build up did

seem to take a long time ( over 6 months ) She tried others ( cellcept,

azothiaprine, cyclosporin ) but either could not tolerate them or they did

not seem to be working.

Apart from the antibiotic angle I think all you can do is quiz the

specialist as to which immuno suppressants he thinks are really working (

the azothiaprine or the metho or both ? ) and whether others might be more

effective. Like you I asked about more radical treatments but got the same

answer that they carry real and significant risks ( e.g. immuno ablation

and stem cell replacement has a 20 -40 % risk of death )

Chester, England

IMPORTANT NOTICE:

This email is confidential, may be legally privileged, and is for the

intended recipient only. Access, disclosure, copying, distribution, or

reliance on any of it by anyone else is prohibited and may be a criminal

offence. Please delete if obtained in error and email confirmation to the

sender.

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In a message dated 08/27/2001 11:12:14 PM Central Daylight Time,

Rpolychondritis writes:

<< I don't know I remember

being scare at first but it was nothing to it. Hey I have found the IRS are

pretty easy to work with, at least so far. >>

Lu,

Bless you for passing that along. I'm terrified about this, so can probably

expect a flare real soon. ; (

Love,

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In a message dated 08/27/2001 11:12:14 PM Central Daylight Time,

Rpolychondritis writes:

<< I don't know I remember

being scare at first but it was nothing to it. Hey I have found the IRS are

pretty easy to work with, at least so far. >>

Lu,

Bless you for passing that along. I'm terrified about this, so can probably

expect a flare real soon. ; (

Love,

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" These symptoms are severe in every morning then

improved at daytime. "

Dear Moonsung Jun,

I want to let you know that the mornings are

always the most painful for me when I'm having my

flares. I've always attributed it to the medicine

wearing itself out (prednisone and

ibuprofen/vioxx) at the 24th hour. I'm usually

okay after I've had my morning dose.

Like your daughter, I have tracheal involvement.

My windpipe is half the size it used to be. I'm

sorry to hear that your daughter has already had

a tracheostomy as any type of surgery is

stressful and should be a last resort. I have

" episodes " of great difficulty in breathing.

These episodes come on during times of exertion,

so I've learned to walk slowly, take slow and

concentrated breaths and to take elevators or

escalators rather than stairs. I can see how your

daughter's condition gets worse when you leave.

Aside from exertion, my " episodes " appear when I

am anxious or stressed, so I try to keep events

that might cause anxiety and stress at a minimum.

It's difficult to do. One thing that I'm looking

into is taking classes like yoga, meditation, tai

chi as these are all slow moving and breathing

exercises.

I wish you good luck with your daughter and hope

that she is getting the best medical help

possible.

__________________________________________________

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" These symptoms are severe in every morning then

improved at daytime. "

Dear Moonsung Jun,

I want to let you know that the mornings are

always the most painful for me when I'm having my

flares. I've always attributed it to the medicine

wearing itself out (prednisone and

ibuprofen/vioxx) at the 24th hour. I'm usually

okay after I've had my morning dose.

Like your daughter, I have tracheal involvement.

My windpipe is half the size it used to be. I'm

sorry to hear that your daughter has already had

a tracheostomy as any type of surgery is

stressful and should be a last resort. I have

" episodes " of great difficulty in breathing.

These episodes come on during times of exertion,

so I've learned to walk slowly, take slow and

concentrated breaths and to take elevators or

escalators rather than stairs. I can see how your

daughter's condition gets worse when you leave.

Aside from exertion, my " episodes " appear when I

am anxious or stressed, so I try to keep events

that might cause anxiety and stress at a minimum.

It's difficult to do. One thing that I'm looking

into is taking classes like yoga, meditation, tai

chi as these are all slow moving and breathing

exercises.

I wish you good luck with your daughter and hope

that she is getting the best medical help

possible.

__________________________________________________

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