Summertime Sjogren's

Image by zenner

Here in the Pacific Northwest, we have been blessed with a few days of warm temperatures and glorious sunshine. I know that this delightful weather is just a tease - typically our winter rains hang around until June - but it is a good reminder for me that summertime brings challenges as well as good times. 

Early on in the summertime, my initial response is to rush headlong into the sunshine sans sunblock, wide brimmed hat, or common sense. And always, always, I regret my impulsive choices as I retreat indoors to deal with the inevitable discomforts that follow. 

Everyone who deals with autoimmune disease in some form has their own unique mix of symptoms, kind of like those bins of coffee in the grocery store. Some have caffeine, some have chocolate or cinnamon flavors added, some are whole bean, and some are ground. But all are coffee, as all of us have underlying autoimmune disease. 

My special blend of Sjogren's syndrome "coffee" symptoms include sensitivity to sunshine, as do those dealing with lupus, scleroderma, and rheumatoid arthritis, among others. This sensitivity for me manifests as a painful red rash. Others may also experience a flare of their disease. Why? This very good article from the Arthritis Today online magazine describes the mechanism: 

 .

..it turns out the sun’s dangers are more than skin deep. The sun’s rays – particularly deep-penetrating ultraviolet-A (UVA) rays – can damage the DNA within the nuclei of the body’s cells, inhibiting their ability to control how and when cells grow and divide....Problems can range from an immediate redness, burning and stinging of the skin to a systemic flare of the disease, characterized by inflammation of the joints, blood vessels and internal organs.

Sometimes the medications used in treatment of Sjogren's and other autoimmune disorders can also be the culprit in causing sun-related problems:

Several medications that people take for those and other inflammatory diseases, including rheumatoid arthritis (RA), can also cause sun sensitivity and lead to problems such as skin rash or rapid burning. Some of the most common culprits are nonsteroidal anti-inflammatory drugs (NSAIDs) and some disease-modifying antirheumatic drugs (DMARDs), including hydroxychloroquine (Plaquenil), methotrexate and sulfasalazine (Azulfidine). Tetracycline antibiotics, some antidepressants and diuretics can cause sun sensitivity too. 

Protect yourself from these UVA rays by using sunblock, wearing protective clothing, such as a hat with wide brim, and light-colored long sleeve blouses, and carefully monitoring the amount of time spent outdoors. 

"But Julia," you may ask. "What about the enormous benefits that you get from the sunshine vitamin - D?" Good question. There's no doubt that vitamin D is beneficial in several ways. I get my D from a supplement. You can read my previous post about vitamin D, it's benefits, and suggested supplement amounts here. 

Another summertime related symptom that is problematic for me is in dealing with the rise in temperatures that come with the summer season. Our bodies regulate our internal body temperatures with a complex homeostasis mechanism:

image found here. 

When my body reacts to warm outdoor temperatures, I feel nauseous and generally unwell, which could indicate problems with the autonomic nervous system sometimes experienced by those with autoimmune disease. Careful attention to symptoms and length of time in warm temperatures as may be found in hot tubs and direct hot sunlight may head off these symptoms. When the symptoms do present themselves, it is helpful to reduce body temperature by heading indoors or into the shade to cooler air temperatures, drinking cool liquids, using a fan, or if all else fails, a cool shower or bath. Plunging oneself into a frigid tub or any other source of ice-cold water will only make the body try to heat itself even more by promoting a shiver response. Gradual decrease in body temperature is the safest and most effective response. 

Rarely, symptoms are extreme, such as a rapid heartbeat, the absence of sweating, and a change in consciousness levels. These symptoms may indicate that heat stroke may be present, which requires emergency response.

For some, increasing the time spent outdoors can also result in increased tear evaporation. Wearing protective eyewear helps, as does increasing the use of preservative-free eye drops. You may also need to increase the use of skin moisturizers to keep dry skin under control. 

If reading the above makes you want to hibernate inside an air conditioned cocoon for the summer, don't despair! Using common sense, sun protection, a keen awareness of your body's symptoms, and a tall glass of something cool and tasty will keep all you Sjogren's summertime babes rockin' all summer long. 

Bring on the slush.