What is Lupus?

Lupus is a chronic (it lasts a long time) disease where the body’s immune system doesn’t function properly and begins to attack healthy cells, tissues and organs.

There are four types of lupus. The most common type of lupus is systemic lupus erythematosus (SLE); it can affect many parts of the body such as the heart, kidney, brain and lungs. The second type of lupus is called discoid lupus erythematosus (DLE) and this affects the skin causing rashes and a change in the colour of the skin. Drug-induced lupus is caused by certain types of medication (for example hydralazine and procainamide which are used to treat heart conditions). It tends to be a mild form of lupus and goes away when the medication is stopped. Finally, neonatal lupus is a very rare type of lupus that affects newborn babies.

It is not contagious, the severity of the disease varies from person to person – it can be mild or severe – and today, patients rarely die from lupus as an improved understanding of the disease and advances in healthcare has meant that patients can successfully manage their condition.

What  Are the Causes?

The exact cause is unknown but it is thought to occur due to a combination of genetic and environmental factors. There are certain triggers that cause someone’s immune system to become activated inappropriately and attack the body. These triggers include infections, drugs, sunlight and hormonal changes. These triggers as well as a genetic predisposition are thought to lead to lupus.

Researchers have found that there are a number of different genes that together dictate whether a person will develop lupus, what type of lupus they will develop and how severe it is.

What are the Symptoms?

Because lupus can affect a number of different organs and tissues, it can cause a variety of symptoms. The most common symptoms are:

• Joint pain
• Swelling of the joints
• Muscle pain
• Fever
• Rashes, mostly on the face
• Chest pain
• Hair loss
• Pale or purple fingers or toes
• Sensitivity to the sun
• Swelling in legs or around eyes
• Mouth ulcers
• Swollen glands
• Fatigue

Less common symptoms include anaemia, headaches, dizzy spells, depression, confusion and seizures.

The symptoms and the severity of symptoms vary between people. Some sufferers will have episodes where they experience symptoms followed by periods where they have no symptoms whilst others will have symptoms all the time.

Diagnosis and Treatment

Diagnosing lupus is very challenging because recognising the symptoms can be difficult. This is because the symptoms can seem quite vague, are similar to those of a number of other conditions and they may come and go; this makes it hard to pin down what may be causing the symptoms. Furthermore, there is no specific test for lupus and this all means that it can take years for a patient to receive a confirmed diagnosis.

To make a diagnosis doctors have to carry out several tests and they’ll also have to look at the person’s medical history. The American College of Rheumatology has developed the ‘Eleven Criteria of Lupus’ to help doctors diagnose lupus. A person must have four or more of these criteria for a diagnosis of lupus to be made.

Lupus is incurable so when it comes to its treatment patients are typically given medication to help manage their symptoms and are also given advice on lifestyle changes such as avoiding triggers.

Who is at Risk?

Lupus is a fairly rare disease and in the UK it affects just 5 in 10,000 people. It is more common in women with 90% of suffers being women and most of these women are aged between 15 and 44.

Black women and Hispanic women are at a higher risk of developing lupus as are people who have family members with lupus, have taken certain medications and have been affected by specific infections such as Epstein-Barr virus and cytomegalovirus (CMV).

This means that the key risk factors for lupus are:
1. Age
2. Gender
3. Ethnicity
4. Family history
5. Taking certain medications
6. Certain infections

Black Women

Black women are three to four times more likely to develop lupus than their white counterparts and results from the Lupus in Minorities study has shown that black women develop this condition at a younger age, experience more severe symptoms and overall develop more complications. When looking closely at these complications, black women with lupus tend to develop more neurological complications (such as seizures and strokes) and are more likely to develop lupus-related kidney disease.

Researchers are trying to understand why it is more common in black women and why it is more severe. It is thought to be due to a combination of genetic and environmental differences.

The Black Women’s Health Study identified four specific genetic differences that are associated with a higher risk and these were seen in black women with lupus.

As work continues in this area we can begin to gain a better understanding of why lupus is more common in black women and hopefully this will provide information that can help in the development of effective treatments.

For more information about lupus please visit Lupus UK’s website and if you are concerned about any symptoms you may have, visit your GP.

Today is the final day of Breast Cancer Awareness Month and in this week’s blog, we want to end the month by highlighting the key things that women should know about this disease, which are: the signs and symptoms, risk factors, prevention and the screening process.

The Signs and Symptoms

The symptoms of breast cancer can be identified by carrying out regular breast self-examinations. These should be done at least once a month. The aim of the self-examination is to do a visual and physical inspection of your breasts. You can do the visual part in front of a mirror and you should look out for changes in the size, shape and texture of your breasts as well as changes to your nipples (inverted nipple or a discharge).

Once you’ve carried out a visual examination, the next step is to do a physical one where you use the palm of your hands to feel both breasts and your armpit area for any lumps.

If you notice any of the symptoms of breast cancer visit your GP or doctor as soon as possible. It may not be breast cancer but it is best to rule it out.

You can find out more about how to do a breast self-examination in the video below.

The Risk Factors

The two main factors that increase a person’s risk of developing breast cancer are age and family history.

Age: As we get older our risk of developing breast cancer increases. The majority of breast cancers (80%) occur in women who are aged 50 and over.

Family History/Genetics: 5-10% of breast cancers are hereditary. If you have one first-degree relative with breast cancer, this doubles your risk of developing breast cancer, and if you have two first-degree relatives with breast cancer, this triples your risk.

If you have a family history of breast cancer, visit your doctor to discuss your risk and for more information about hereditary cancer please read our recent blog post.

Other factors that have been shown to increase a person’s risk of developing breast cancer include: being overweight or obese; alcohol consumption, hormone replacement therapy; smoking; and oestrogen and progesterone contraceptives.

Breast Cancer Prevention

To reduce your risk of developing breast cancer you should adopt a healthy lifestyle. In particular, you should: limit your alcohol intake, stop smoking, maintain a healthy weight, exercise regularly, eat a diet rich in fruits and vegetables but low in animal fat; and if you have the choice, breastfeed.

Breast Cancer Screening

In the UK all women between the ages of 50 and 70 are invited for breast screening every 3 years as part of the national breast screening programme. Women over the age of 70 can still be screened, you’ll have to contact your local breast screening unit to organise this. In England, the breast screening age is being extended to all women between the ages of 47 and 73.

Breast screening involves having an x-ray of each breast (this is a mammogram) which allows a clear image of the inside of the breast to be developed. This technique is capable of detecting breast cancer at an early stage, much earlier than a breast self-examination.

To find out more about the NHS Breast Screening Programme please visit their website

Now that Breast Cancer Awareness Month has come to an end, remember to remain breast aware throughout the year.

Sadly, our final cycling session of the season took place today. We had a great time with Brian from Cycling Instructor leading the more experienced members of the group on a 9 mile ride along Route 21 from Croydon to Catford. This was, once again, a lovely experience. The weather was great, sunny and mild, and the beauty of route was really impressive. Locations such as South Norwood Country Party, the Riverpool Linear Park and Cator Park were some of the highlights of the route and we recommend this route to anyone who is new to cycling. It is mostly off-road, very safe and picturesque.

Whilst the majority of the group cycled along Route 21, the less experienced cyclists stayed at Croydon Arena with Helen from Cycling Instructor to go over the basics of cycling. They had a nice session on maintaining balance, the correct way to get on and off a bike, pedalling and riding independently.

We had a great final session and have thoroughly enjoyed this season which began in August. Sessions were both informative and fun with attendees now more confident with cycling and keen to take up cycling as a hobby. We would like to say a big thank you to the Cycling Instructor and Croydon Council for giving us the opportunity to offer this activity to our community and we hope to hold more sessions in the Spring.

We get a lot of questions from women about what they can do prevent fibroids. In this week’s blog, we’ll look at the effect of exercise on the development fibroids.

Fibroids are non-cancerous tumours that develop in or around a woman’s womb. They can cause a number of symptoms including pelvic (tummy) pain, infertility, heavy and/or painful periods, back pain, anaemia, constipation, frequent urination and pain during sexual intercourse.

The exact cause of fibroids is unknown but research does suggest that fibroids are caused by a combination of genetic, lifestyle and hormonal factors. Those most at risk of developing fibroids are black women, those who are overweight, women of childbearing age (particularly women who are 25-45 years old), those with a family history of fibroids and women who haven’t given birth.

Exercise and Risk Reduction

When looking at these factors and trying to understand what preventative steps women can take, exercise seems like a logical factor to explore for two main reasons. Firstly, being overweight increases risk of developing fibroids so a woman can reduce her risk by maintaining a healthy weight through exercise. Secondly, fibroids are a hormonal condition with oestrogen and progesterone playing a role in their development. When we look at similar hormonal conditions that have been widely studied, such as breast and endometrial cancer, exercise has been shown to be beneficial in reducing risk. This is thought to be because exercise has a number of effects on our hormones which ultimately can lead to a reduction in the level of hormones circulating in our body and balancing of our hormones.

What Research Tells Us

A recent small study published in 2013 by Peking University in China looked into the association between physical activity and fibroids. They found that women who participated in moderately intense occupational activity (physical activity at work) had a significantly lower risk of developing fibroids.

In 2006, The National Institute of Environmental Sciences in Washington DC published the results of their research study exploring the effect of exercise on the development of fibroids. This study included 1189 women (734 black women, 455 Whites) aged 35-49. Whilst their study did have some limitations they found that women who did the most physical activity (more than 7 hours a week) were significantly less likely to develop fibroids than those who did the least amount of exercise (less than 2 hours a week). They also found that the association between exercise and fibroids was similar for both black and white women.

Finally, in 1986, the Harvard School of Public Health published their study which compared the prevalence of fibroids in former college athletes (2,622 women) to non-athletes (2,776 women). They found that the non-athletes were at a 40% greater risk of developing fibroids than their athletic counterparts.

Conclusion

Research and theory demonstrate that regular exercise is an effective way to reduce your risk of developing fibroids. By introducing as much exercise as you can into your weekly routine you can make a significant difference to your risk.

The UK’s Department of Health recommends that we do a minimum of 150 minutes of exercise per week; this is a good target to aim for.

If you have friends and family in the Caribbean you have probably been hearing the word “chikungunya” a lot lately and might even know someone who has had this disease. You may be wondering: ‘what exactly is chikungunya?’ and ‘where did it suddenly come from?’  In this week’s blog, we’ll tell you everything you need to know about this disease.

What is Chikungunya?

Chikungunya is an illness that is caused by a virus and it is spread through the bite of an infected female mosquito. It causes fever, joint pain, headaches and muscle pain. It is not usually a deadly disease with most patients recovering within a week but some people may develop long-term joint pain.

The History of Chikungunya

The Chikungunya VirusThe chikungunya virus is thought to have originated in central or east Africa where scientists believe it circulated in forest-dwelling mosquitos and non-human primates. The disease first appeared in humans in 1952 in the Makonde Plateau which is the border area between Mozambique and Tanzania. The name chikungunya is a Makonde word that means “that which bends up” and refers to the posture of those who develop the symptoms of this illness.

Since making its debut in 1952 there have been regular small outbreaks of chikungunya in Africa, but between 1999 and 2000 there was a large outbreak in the Democratic Republic of Congo and another one in Gabon in 2007.

In 2005, a chikungunya outbreak was reported in the Reunion Islands in the Indian Ocean where it affected over 200,000 people. It soon moved to India and several South-East Asian countries over the next two years affecting Indonesia, Thailand, Maldives and Myanmar, and then appeared for the first time in Europe in a small outbreak in northeastern Italy in 2007.

The Current Chikungunya Outbreak

The current outbreak of chikungunya, which is affecting the Caribbean, began in December 2013 with the first case detected in St Martin. As of 10^th October 2014 34 countries in the Caribbean and Central, South and North America have been affected; a total of 748,403 suspected cases have been reported.

How Does Chikungunya Spread?

Chikungunya is transmitted from human to human via the bites of infected female mosquitoes. Firstly a mosquito feeds on the blood of an infected person and acquires the virus. The virus then incubates inside the mosquito for 10 days before it can be transmitted to another human via the bite of the mosquito.

The species of mosquito that can transmit chikungunya are the Aedes aegypti and Aedes albopictus mosquitoes. They tend to bite during the day time, mostly in the early morning and late afternoon.

Chikungunya is rarely transmitted from mother to new-born child and it could be transmitted through a blood transfusion but there has been no evidence of this happening.

Symptoms 

The symptoms of chikungunya appear 3-7 days after a person has been bitten by an infected mosquito.  The most common symptoms are fever and severe joint pain. Other symptoms include headache, muscle pain, swelling of the joints, nausea, fatigue and a rash. Most patients recover fully within a few weeks but in some patients, joint pain may last for months or years.

How Can I Protect Myself?

If you live in or are visiting a country affected by chikungunya the only way to protect yourself is to avoid being bitten by mosquitoes and the best way to do this is to:

1. Wear long sleeves, trousers and hats (if needed) to protect unexposed skin especially during the day when mosquitoes are most likely to bite

2. Use appropriate insect repellent. It is recommended that you use insect repellents that contain DEET, Picardin, oil of lemon eucalyptus (OLE), PMD or IR3535. Follow the directions on the repellent packaging, reapply as directed and make sure you exercise care when applying on children.

3.When using sunscreen, apply your sunscreen first then the insect repellent

4. Clear your  home and office of mosquitoes by spraying with a bug spray, close all doors and windows and then use air-conditioning, or install mosquito nets on doors and windows to prevent mosquitoes coming indoors

5. Empty standing water from outdoor containers as these breed mosquitoes

If you think you might have been infected with chikungunya, keep an eye on your health and if you develop any symptoms please do visit your doctor.

Treatment

Currently, there is no treatment or vaccination for chikungunya, doctors simply treat the symptoms and may give patients ibuprofen or paracetamol to combat fever and pain. It is advised that you get plenty of rest and drink lots of fluids to prevent dehydration.

If you’ve recently been to the Caribbean follow the advice given in the infographic below.

That, in a nutshell, is what you need to know about chikungunya. For more information, you can visit the CDC’s website.

Last week, I had an interesting conversation with my fellow commuter, who looked terribly drained and in need of a break.

I thought her look of exhaustion was simply due to the oh-so- lovely London commute which drains everyone – packed trains, no seats, standing up for an hour, delays…it would drain even the sturdiest of people.

As our conversation developed it turned out that my fellow commuter had not had a proper break from work for three years. I was shocked. No wonder why she looked so exhausted! My jaw dropped in disbelief as I tried to diplomatically work out if she was exaggerating or not.

As her story unfolded I could see how she found herself in this predicament. Over the past three years she’d taken a long weekend here and the odd day off there, but had not taken a proper holiday. The days she did take off from work were spent not relaxing and enjoying the fruits of her labour but taking care of what she described as “life admin” – taking the kids to various activities, looking after an unwell member of the family, buying a house etc. etc.

Sadly, the demands of being a professional woman, mother and wife means there was no time for her to sit back, relax and take a break. I was truly amazed at her resilience; this is what we call the modern day superwoman -the woman many of us aspire to be because she has everything. But, when I looked at her there was a hint of sadness in every word and a lot of frustration.

As we parted company I was troubled. Is this what life has become for many of us? Yes, it has. Research has shown that my fellow commuter is not alone. A survey conducted by the Travel Supermarket in 2012 found that 25% of people in the UK do not take their full annual leave entitlement. Furthermore, the UK has the third highest working time in the EU with 11% of employees working more than 48 hours a week.

In this 24 hour, fast paced world that we now live in we are constantly on the go and never switch off. We move from meeting to meeting, stressful situation to stressful situation, project to project and work admin to life admin without pausing to take a break to recharge our battery and this constant state of agitation is not good for our physical and mental health.

In a study conducted by the European Working Conditions Observatory, sixty-nine percent of employees who work more than 48 hours a week stated that they felt tense and 55% said they felt worried or stressed by work. If we combine this with the pressures that may exist at home there will be a significant number of people who are under an enormous and constant amount of pressure with no outlet to relieve it.

We need to remember that stress is not just a feeling but a biological response that is supposed to help us cope with immediate danger. This response includes the release of hormones (cortisol and adrenaline) and an increase in blood pressure and pulse rate. When people are constantly under pressure these stress-induced biological changes can have a negative affect on their health and may increase their risk of, or worsen, a number of health conditions such as heart disease, obesity, diabetes, depression and asthma.

It is important that we minimise the amount of pressure we are under to make sure we aren’t forever running on adrenaline and jeopardising our health. We need to make a concerted effort to have some “me” time. If it’s not practical to have a one or two week break from work then there are a number of techniques that can be utilised to combat the stress that comes with a busy life style; running, walking, other forms of exercise, yoga and Thai Chi are great ways to deal with stress.

Ultimately, it all boils down to balance. Employers and employees need to work together to get the work/life balance right and when we are at home we have to get the life-admin/relaxation balance right too.

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If you’d like more information on managing stress please visit the Stress Management Association’s website.

And, let us know what you think. Are you running on adrenaline? When was the last time you had a proper break? Talk to us in the comments section below.

This week’s blog is a guest post from Ishea Muhammad, the founder and editor of Black to My Roots.

Black to My Roots is an uplifting space and resource with blogs and videos on health and wellbeing, motherhood, parenting, relationships and more. In today’s blog, Ishea discusses keeping healthy and active through walking.

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Our health often suffers from us having a busy schedule and as a result the need for us to do some type of regular exercise can go out the window. In falling victim to this we have to be creative in how we can get that workout in and keep fit.

In recently having my second child and initiating my mission to get back to my pre-pregnancy weight and get fit I’ve taken it to the street…. well OK the park to walk off the excess pounds. I have seen great improvement in my energy levels and weight loss and have met other Mum’s and made a friend or two!

Whatever your circumstances so long as you are mobile, young or old you can walk your way to fitness and reap all the benefits that it brings whilst aiding your time management as you make walking a multi-tasking activity. You are in control as you choose to walk slowly or at a faster pace depending on your level of fitness, ease your way in and take it from there.

If like me you are a busy mum with young children you can have great fun with your little ones helping them to build stamina and get a daily workout whilst getting in some rare me time for yourself as they run around.

Being outdoors in beautiful surrounding takes your attention off the stresses of life and opens you up to be creative as you remember that the gift of life is awesome and you can bring into reality anything you visualize if you just believe in yourself, with God’s backing everything is possible.

On the social side of things a walk in the park can open up some great networking opportunities as you meet other parents and exchange all the parental knowledge and share what you have in common. Your children will grow their circle of little friends to hook up with every now and then too so it’s a win-win situation!

If you have a dog you can take him or her along whilst you walk with the children, I’ve witnessed a mum running with her baby in the pram whilst the dog ran alongside them, how’s that for multi-tasking!

The first step is to think of how you can increase your opportunity to walk as a regular form of exercise such as getting off a few stops before your destination when taking the bus to get that power walk in. You can leave the car at home for short trips especially whilst the weather is warm.

The benefits of walking are numerous:

Watch the video below and click the description box for references to learn more about the health benefits listed above.

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The Lake Foundation would like to thank Ishea Muhammad for her guest blog post which was first published on 26th September 2014 here. Visit Black to My Roots for more information and you can stay connected with Ishea through the social media platforms below:

Twitter: @blacktomyroots
Facebook: https://www.facebook.com/blacktomyroots
Instagram: http://instagram.com/blacktomyroots
YouTube: http://www.youtube.com/user/blacktomyroots1

On Tuesday, we attended an event hosted by King’s College London and Ipsos MORI entitled “Public health: an individual’s or the government’s responsibility?”. This was a really interesting event that featured:

• Duncan Selbie, Chief Executive of Public Health England
• Ben Page, Chief Executive of Ipsos MORI
• Janet Atherton, President of the Association of Directors for Public Health
• Louise Park, Head of Public Health Research at Ipsos MORI
• Dr James Rubin, Senior Lecturer at King’s College London

The speakers explored the range of approaches that the government use to encourage the public to adopt a healthy lifestyle (education, incentives, taxation, bans and innovative behavioural science techniques) and the public’s reaction to these. The key questions this event aimed to answer were: Does the public welcome such approaches and where do they draw the line between individual and state responsibility?

These questions were answered by Louise Park, Head of Public Health Research at Ipsos MORI, who presented data from a recent study. This study showed that the public were evenly split about their feelings about government involvement in influencing an individual’s behaviour to encourage a healthy lifestyle with 39% saying the government should intervene and 32% saying the government should not intervene.

In terms of where the public begins to draw the line between individual and state responsibility for health, predictably the public starts to draw the line as they begin to feel their freedom of choice is being compromised.

The findings from the Ipsos MORI study opened up a discussion on the role the government should play. Generally it was felt that the government should be an information provider who gently nudges the public into rethinking their behaviour but there was concern from attendees that the government does give mixed messages which can be confusing and this is further compounded by media misrepresentation of the facts. In response to this Public Health England stressed that the government follows the most reliable evidence when providing information and will continue to stand by that approach.

The event ended with agreement that improving the public’s health requires everyone to take some responsibility, this includes members of the public, the government, food manufacturers, restaurants, schools and many more.

This was a good debate to have and we recognise the role that charities like ourselves can play in developing healthy lifestyle programmes for communities that the government does not reach.

On 27th March, we attended the 100 Black Men of London’s event “Keep calm and let’s talk about prostate cancer”. This was a very interesting event that highlighted the many challenges faced by black men when it comes to prostate cancer.

The event started with a presentation by Dr Kingsley Osayi, a Consultant Pathologist at Basildon and Thurrock Hospital. Dr Osayi gave an overview of the role of the prostate, common prostate conditions, the symptoms of prostate cancer, risk factors and treatment.

The most startling statistic from Dr Osayi’s presentation was just how common prostate cancer is in black men with 1 in 4 black men expected to develop prostate cancer compared to 1 in 8 white men. It was unsettling to learn that there still isn’t a clear understanding of why prostate cancer is more common in black men, but the prevailing view is that there is a genetic reason for this rather than it being lifestyle related.

After Dr Osayi set the scene it was time for the debate, which was chaired by Kola Sonaike, President of 100 Black Men of London and featured the following panellists:
· Elijah Ashanti Israel– a prostate cancer survivor
· Rose Thompson – Director, BME Cancer Communities
· Ann Smart – Clinical Nurse Specialist, Prostate Cancer UK
· Dr Kingsley Osayi – Consultant Pathologist, Basildon and Thurrock Hospital

We learnt from the debate that:

1. Black men suffer from a more aggressive type of prostate cancer that develops at a younger age than the less aggressive forms that affect the general population. NHS guidelines recommend PSA testing should be made available, if requested, to men from the age of 50, but this is not helpful for black men and may need to be readjusted to allow black men to easily request a PSA test at a younger age.

2. Black men with a family history of prostate and breast cancer are not being dealt with appropriately by their doctors. Anyone with a strong family history of cancer should be provided with sound advice from their doctor; given the opportunity to discuss regular PSA testing; and also be offered a referral to a genetic counsellor for a discussion about what their family history might mean about their risk of developing prostate cancer and what options are available to reduce their risk or to ensure early diagnosis.

3. There is a low level of awareness of prostate cancer in the black community and a lack of willingness to discuss this issue.This means that black men don’t realise the seriousness of urinary symptoms and don’t visit their doctors soon enough. Furthermore there is an unwillingness to discuss cancer in the black community which means the challenges experienced by black men are not identified so key issues are not addressed at a political level.

The debate ended with agreement that these issues need to be dealt with on two levels. Firstly, GPs need to be made aware of how prostate cancer affects black men and guidelines need to be developed on how GPs should manage black men especially those with a family history of prostate, breast and ovarian cancer. Secondly, the black community needs to be more informed about prostate cancer to ensure we are more proactive on this issue so that more men are diagnosed early.

A lot of the issues raised at the event have been analysed and presented in a report entitled ‘Hear me Now’ written by Rose Thompson. You can read the report here and a follow-up report will be launched in a of couple weeks’ time.

We thoroughly enjoyed this most informative event and The Lake Foundation will continue to raise awareness of prostate cancer and will work with other organisations to address the issues raised.