Beth Gottlieb MD Ped Rheumatology wwwDrMDK.com
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Interviewer: How do you treat lupus? Interviewee: Lupus is treated by suppressing the immune system and one of the things that we have learn that is very important is that we treat the symptoms. So, there is no lupus patient that gets exactly the same medicine as these other lupus patient does. Since it is such a variable disease, we treat exactly the symptoms that we see. So if somebody has joint pains, we treat the arthritis and we do not have to use very, very potent medication for that, but sometimes in the course of lupus in the patient, we often do need to use steroids because they work very quickly and they suppress the disease quickly but then will also try to get rid of that medicine as fast as we can because of the side effects. So everybody is different and has to be followed very carefully and very closely so that we can adjust the medicines for them. Interviewer: The goal that therapist to give the best quality life with the least part of symptoms? Interviewee: Absolutely, lupus is controllable. It is unfortunately a chronic disease which means it is a lifeline disease but it is controllable in most cases. And so, we want our patients especially children who want to live in normal teenage life and adult life, we try to make sure that their doing as well as possible, and usually that means taking some medicine to keep them feeling well, to keep the disease quiet and might be a minimal amount of medicine but they hardly notice so they do not think it is very important. But if it is enough to keep the disease suppress, they can do everything that their friends do and that is our goal. Interviewer: The like expectancy of someone going for rheumatologist is it shortened or what? Interviewee: Realistically, it maybe shortened. Interviewer: By what or little bit? Interviewee: Depending on -- usually by a little bit but it is again because lupus is so variable, that is a really difficult question to answer because some people and I treat many, many lupus patients who are hardly on medicine at all. They have had arthritis and pain and swelling in their joints, they had skin rashes or sores in their mouth, that does not require a lot of medication and it also is not life threatening. On the other hand, there are patients who have effects of lupus in their kidneys, their heart, their lungs, and those patients were much more concerned about and again those are patients that I would be worried about in the long run. So it is very, very important that we follow them very closely to try to give them really optimum care. Interviewer: So there is a mild form, it could be moderate form; it could be a severe form? Interviewee: Right, there is a tremendous spectrum of what lupus can do. Interviewer: And if you get good follow up, and you attend all the complications, you are probably are enhancing the life expectancy? Interviewee: Absolutely, it is extremely important to have a good follow up from a rheumatologist.