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Shelley Ensz

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About Shelley Ensz

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  1. Scleroderma and Sjogrens

    Hi Luwana, Welcome to Sclero Forums! As it happens, quite a few of us have both Sjogren's and scleroderma. They figure about 20% of people with scleroderma also have Sjogren's. It's also not unusual to be diagnosed with Sjogren's first, for any number of reasons. One reason might be because Sjogren's, and Hashimoto's (autoimmune thyroid disease), are thought to be "gateway" diseases to autoimmunity. But part of that might be because those diseases are more common and much easier to suspect and diagnose than many of the rarer and more unusual autoimmune diseases, such as scleroderma. Also, Sjogren's can "go systemic", imitating or overlapping with many symptoms of scleroderma. I don't know your particular situation, but many of us with overlaps tend to get delayed diagnosis, since things get so confusing.
  2. Help with ANA

    Hi Lynn, Welcome to Sclero Forums. You pose an interesting question, and Dr. Thomas Lehman of the Hospital for Special Surgery in New York has posted an article about this issue, entitled ANA titers, what to do? Here's an excerpt: "General guidelines I use. 1) If the patient has symptoms of rheumatic disease they should be evaluated no matter what the ANA result. 2) If the patient has an ANA of 1:40 or less and no one knows why the test was done there is a good chance it means nothing – but you can’t be sure. If the ANA is 1:80 you are in ‘no man’s land.’ If the ANA is 1:160 or higher, a pediatric rheumatologist should take a look – not all of them will have something, but some will." So, the question to go back to your doctor with is, do you have symptoms of rheumatic disease? Migraines and anxiety are very common conditions; and people with anxiety are much more prone to migraines; and I must add, migraines can also cause anxiety, it is a two-way street. As you've noted, neither migraines nor anxiety are listed symptoms for the diagnosis of scleroderma. I'm sure it's very uncomfortable to have health anxiety plus an ANA test that lands you in this "no man's land". To reduce it a bit, perhaps you could discuss with your doctor making a plan to only have your ANA tested again if you develop significant symptoms of autoimmune disease in general. As Jo mentioned, anxiety has adverse effects on health and the enjoyment of life, so tackle the issue in every healthy way you can find. It might be that your anxiety is subtly pressuring your doctor to search for more "causes" and that can increase your anxiety, and stimulate more searches, etc. I often push back on medical tests, asking my doctor, so if I flunk the test, then what happens? Sometimes we are healthy enough, or otherwise sick enough, or old enough, that the tests are just not really necessary. I don't suffer from anxiety, although of course I'm only human, so I certainly experience it from time to time. You'll encounter many people who think they understand what you are going through, but who, like me, really don't understand because isolated experiences of lesser intensity are not at all the same as continual or more severe suffering. That's why I concur with Jo to be sure to also seek counseling (if you haven't already), so that you have someone who truly understands and can give you very practical steps to cope for the time being, in hopes of eventual recovery. We've recently added a topic, the Endocannabinoid System. You might find that research interesting, since disruption of the endocannabinoid system might be relevant to many disease states, including anxiety and migraines, and some autoimmune diseases like multiple sclerosis and scleroderma, as well. Here are some warm hugs, just for you, and in hopes you feel a bit better soon.
  3. This is a gentle reminder to forum members, especially new ones, to make an effort to avoid excess drama in posts -- because forum trolls delight in over-the-top expressions. And we ban forum trolls. For life. It is especially tricky to avoid drama when we are dealing with the effects of serious illness, such as scleroderma, and when we are used to letting it all hang out on social media. Our moderators look for "drama signs" such as exaggerations: horrible heartburn, extreme pain, insinuated suicide threats, CAPITAL LETTERS (WHICH IS SHOUTING ON THE INTERNET), or a general tone of being more emotional than logical. Clearly, there are times when illness is disturbing, to say the least, and times when we feel unable to cope. Those times, we need to call our primary doctor or mental health professional right away. We shouldn't be posting on social media then, because social media is not able to provide the counseling or medication that we may need. Our forums aren't suited for every trouble that arises with chronic illness (or its diagnosis). Many of us, including me, have turned to local counselors to help us adjust to the many dismaying demands of chronic illness. If you tend to be verbally overly-expressive, rather than risk being wrongly pegged as "just another hysterical troll", we recommend composing a forum post offline and saving it. Reread it a bit later. Look for words like "horrible", "worst", "PAIN", "unbelievable PAIN", etc. Can you tone it down a bit yet still get your message across? Maybe you have "very bad heartburn" instead of the "worst heartburn ever". Or you have "chronic joint pain". If you don't self-edit, our moderators may freely edit the drama out of your message -- and they also have the power to ban forever, based on just too much hype. Real patients tend to be factual, precise, and don't need to exaggerate anything. Our community -- and your care providers -- are far more likely to take your issues a lot more seriously if you try to stick to the unembroidered, unexaggerated facts of the matter. And please ask your primary care doctor for a referral for counseling if you find that you are over-reacting emotionally to illness issues. Not being able to tone down a forums post would be a symptom of that. It's perfectly normal for us to experience depression and anxiety along with illness, and the sooner we deal with those issues, the better. Thank you for being part of our community, and for doing your best to understand and follow our guidelines. We greatly appreciate it!
  4. No answers yet.

    Hi Liz, Welcome to Sclero Forums! I'm sorry you have worrisome symptoms and a concern about possible scleroderma. Although many things can disrupt the gastrointestinal system, scleroderma is a possible cause of issues from stem to stern. I would just caution you to keep a very open mind, because there are so many similar diseases, and it is equally possible to have dozens of symptoms that turn out to be unrelated, or perhaps even caused by a combination of diseases and not scleroderma per se. This part is not aimed at you, as I'm sure you know this already, but rather at other people searching for a diagnosis who land on this thread. It's a reminder that when dealing with doctors, it's also helpful to say that you have reason to "suspect scleroderma or similar autoimmune issues", because when people announce they are "sure" they have scleroderma (for whatever reason) perhaps 9 times out of 10 the doctor is going to be "sure" they have hyponchondria instead and diagnostic progress is cut off at the pass. Bear in mind that nothing is very certain when it comes to autoimmunity and diagnosis is a thing that is approached very cautiously, even by top experts in the field. I hope you at least begin getting some answers at National Jewish. Just please go into the appointment knowing that you might have more questions than answers after just one appointment, since quick diagnoses of systemic scleroderma and related illnesses seem to be very few and far between, even at expert centers. Often it requires extensive history collection, more tests, and observation over a period of time.
  5. Newly diagnosed and overwhelmed

    Welcome to Sclero Forums. I'm sorry that you have symptoms and concerns about a scleroderma diagnosis. Usually scleroderma diagnosis is not very fast or easy (often it takes years), so try not to get either your hopes or fears too high while waiting for your rheumatology appointment. In the initial stages, many of us had a lot more questions than we had (specific) answers. Just remember, we'll be here for you, whether your appointment is enlightening or disappointing. Since many rheumatologists seldom encounter scleroderma (it's so rare, they may only see one or two cases in their entire career, and may be very hard put to recognize it even then), most people find consulting a listed scleroderma expert to be helpful, sooner or later.
  6. Recent diagnosed

    Hi Jeannie, I just want to welcome you to Sclero Forums. Hopefully you can consult a listed scleroderma expert. I know that's not easy, especially when it requires an out of state consult. Sometimes doctors seem to bend over backwards to not appear concerned, lest we catch their anxiety. I actually feel more comforted when they allow themselves to show a bit of kindness and compassion. It's like then, I can let them worry about it, so that I don't have to! Give your doctor the benefit of the doubt. They are likely more concerned than they are letting on. And see if you can get an expert on your medical team, too.
  7. Greetings!

    Jeannie, it is absolutely delightful to hear your update, and your ever-sparkling example of living life to the fullest with scleroderma, with courage and compassion, come what may. Congrats on the big 7-0!!! We are all grateful for the enormous contribution of time and caring and expertise that you have given our scleroderma community through the years. Thank you for being a beacon of light for us all...and also for your honesty in saying that some days it's just plain hard. I know some newbies, especially, tend to think they are doing something wrong as they find many things to be disturbing and not exactly a tiptoe through the tulips experience, learning about scleroderma and learning how to live with it. Just knowing that we all find it hard sometimes is actually quite reassuring, when we are caught up in the middle of another adjustment.
  8. Gluten free diet

    Hi Kamlesh, As Dimarzio pointed out, gluten free can be quite expensive, if you aim to replace processed foods right away. If you want to try it to see if you notice any changes, you could simply try eating only "real" food for awhile. It's easier to simply cut out all processed foods than to read a million labels and angst over whether everything has gluten or not. Even frozen strawberries can contain gluten, if they use flour on the assembly line. I mean, who'd think?! So eating any real, unprocessed foods is usually a lot safer and a better trial. Such as any real fruit, vegetable or protein in its original form (not canned or frozen or processed in any way). Even spices can contain gluten (is that crazy, or what?), so using the simplest spices and fresh herbs can help. Gluten can also show up in drinks, making pure water an easy choice during the trial period. If you begin noticing any improvements, then it's time for a medical consultation. You might need to be tested for Celiac disease before going gluten-free any longer. It's important to know whether it is Celiac or "plain" gluten sensitivity, because Celiac disease also confers other risks for continuing gluten consumption of any sort, such as lymphoma. I noticed some health improvements with a gluten free diet. My mother had Celiac disease, so I'm very fortunate I didn't get the full-blown version of it. I went strictly gluten, casein and soy free for over 5 years. Now 2/3 of my diet is gluten free and I'm thinking about whether I want to go all-in again. Or not. Sometimes its a balance of quality-of-life issues versus an expected pay off in symptom reduction. Eliminating any food or food group can pose a challenge for the patient, add stress to caregivers (especially any that do shopping or cooking), and can also pose social issues with restaurants, ordering, etc. As you may know (but casual readers may not), being sensitive is not the same as being either allergic having Celiac (either of which means you must eliminate gluten entirely). And, being gluten sensitive does not necessarily mean that it is the be-all and end-all cure for whatever ails you now. Odds are, that ship has already sailed, quite awhile ago, and blaring the fog horn at this late date probably won't bring the ship all the way back to shore. Some of us may enjoy more impressive results than others. Some of us may choose to overlook the issue as being entirely too much work for possibly too little pay. And then there are fence sitters, like me at present, who still stand to be swayed once more into the straight and narrow, if strong enough research on the subject comes to our attention.
  9. Gluten free diet

    Hi Kamlesh, In some people, there may be a connection between gluten and scleroderma or other autoimmune conditions. We have a section of our main site on it. It might reduce some inflammation to avoid all gluten (which is a mighty endeavor in itself) but only if you happen to be sensitive to it. See Celiac Disease and Gluten Sensitivity at https://www.sclero.org/scleroderma/autoimmune/celiac-disease/a-to-z.html .
  10. Issues with password

    Hi Kamlesh, I'm sorry you're having login issues. Usually that is caused by corrupted cookies. Could you please try deleting your browser cookies, then re-enable cookies (which is necessary for the forum to work properly) and try again?
  11. Social Security Disability for Scleroderma

    Hi Jean, Then call another disability attorney. If you quit your job, they are just going to complain that you should have called them first. So, keep calling until you find someone who actually cares and isn't just out to make a fast buck. You are right to wonder how much longer you can hold out, and you really need to know all of your rights and responsibilities before that day arrives.
  12. Tony and Mariah

    Hi Quiltfairy, I want to apologize for my very belated reply. I'm sorry that you lost your dog, Tony. Is Mariaha feeling any better yet? I'm so happy for pets. I think of them as a secret weapon for chronic illness, just as good if not better than most medications!
  13. Social Security Disability for Scleroderma

    Hi Jean, Anyone who is thinking they may not be able to continue working full time should consult a disability lawyer immediately, before letting their employer know or making any other work arrangements (like working fewer hours, working from home, taking a less demanding job, etc.) Initial consultation with a social security disability lawyer is always free. If they take your case on, they take a percentage of your first Social Security disability check (and none after that. The percentage is set by law.) Systemic scleroderma is a listed disabling condition, however, the applicant must prove that they meet the medical requirements (as well as having enough current credits in the Social Security system). See Scleroderma and Social Security for more info. Please make an appointment with a disability lawyer right away. Many people make the mistake of worrying that they might be jumping the gun, or just hope that things will somehow magically improve. But people facing possible disability are at a tremendous disadvantage in every way, and it is impossible to plan too soon, or too well, for such an eventuality. For example, it can take months -- and even years in some jurisdictions -- to receive claim approval (or denial). And even after approval of disability, it is still nearly a two year wait (from time of initial disability, as established by Social Security) for Medicare benefits to kick in. Also, many people wish they had never let their employer get a whiff of their illness beforehand. Although there are some protections under the Americans with Disabilities Act, there are a great many exceptions which can work to the detriment of a sick employee.
  14. Is this Scleroderma?

    Hi Worried, Welcome to Sclero Forums. Please keep in mind that I'm not a doctor, and have no medical training at all. Perhaps you could make some progress by asking your primary doctor for a referral to a rheumatologist. Then they could perhaps run some tests or monitor you to see if any other symptoms develop. Then, if it looks like scleroderma, which it may, they could refer you to an expert center for further evaluation. Bear in mind, like Jo mentioned, that a scleroderma diagnosis is very often a long and difficult process, often years, unfortunately. There is an effort afoot to get it diagnosed in the earlier stages by scleroderma experts, however that has not yet seemed to have caught on very well among rheumatologists, in general. So if you have tests done that seem to support the diagnosis, you may then need to push for the expert consult.
  15. All started with a blood clot.

    Hi Firefly, Welcome to Sclero Forums. I'm sorry that you have worrisome symptoms and blood tests. Please keep in mind that I'm not a doctor, and have no medical training at all. As it happens, it will take an expert to sort your case out. The first test you flunked, "dRVVT 47.4 HIGH" is what is known as the lupus anticoagulant. And SCL-70 antibodies also occur in people who have lupus. Research shows that people who have lupus with the SCL-70 antibody are at greater risk for pulmonary hypertension and kidney involvement. In a 2001 study, none of the lupus patients who had a positive SCL-70 also had scleroderma; I mention that because it is possible to have the two diseases in overlap, but it seems it is more likely that with these results, you would likely have either lupus or scleroderma (but it would seem that in this instance, the odds are, not both at once.) While the doctors sort things out, I'd suggest you seek support from both the lupus and scleroderma communities. Since your inquiry just doesn't sound like the usual scleroderma onset story, which is quite varied in itself, you might want to read up more about both illnesses while you wait for your rheumatology appointment. This sort of thing requires many years of medical training and experience to properly sort out!
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