Category Archives: Issue 74 – Fall 2012

Do you suffer from severe limitations in your dai- ly activities because of your disease? Then you are among the 11% who are able to minimally per- form regular, daily routines. And if you suffer from any limitations in your daily activities as a result of your medication or treatment, you are among the 68% who said they have mild, moderate, or severe limitations. We know because over 700 people told us so! The IPPF Registry ( provides us with a patient’s diagnostic and treat- ment experience information. With more data, the IPPF will be in an influential  position with policy makers and insurance providers. During the 2012 Annual Meeting, IPPF President Dr. David Sirois said, “The thing that empowers an organization is information.” This simple statement captures the IPPF’s goal of advocacy and awareness: providing information to clinicians, researchers, and insurance providers to make more informed de- cisions with regards to pemphigus and pemphigoid patients. Dr. Sirois challenged attendees to join the Regis- try. Now, I am asking you to do the same: JOIN THE REGISTRY. We need your help. “That registry is vital to our organization’s posi- tion, and our next step is to publish these findings in peer-reviewed journals, such as the Journal of In- vestigative Dermatology.” Once we do that, other scientists, researchers, and clinicians can use this important data so we can change perceptions and practice to benefit patients everywhere. Yet we have not reached our magic number of 1,000. We have 721 — out of thousands of patients around the world — who stood up and said, “I want to make a difference!” YOU can change how pemphigus and pemphigoid patients are diagnosed and treated in just 15 min- utes. Remember, your personal information is NEV- ER shared with anyone for any reason. The information we have is great, but without more involvement from pemphigoid patients, IVIg users, and men in general, we are only seeing part of the picture that could change everything.

Here are some Fast Facts from the Registry:

• 73% of all P/P patients are female

• 65% of all P/P patients have PV (11% have BP) • 11% also have thyroid disease (5% have rheu- matoid arthritis)

• 70% see only a dermatologist — even though 41% have current lesions in their throat/mouth.

As you can see, the information is compelling, but if this does not reflect you, then we need your data! The data can be segmented by gender, age, and disease type (see A Look at PV from Inside the Regis- try on the previous page). The goal of 1,000 will make our Registry the largest collection of pemphigus and pemphigoid data available to researchers. Please do your part to help patients everywhere. For more information, or to participate, please visit

I have actively sought out meeting fellow P/P patients in lo- cations I like to travel. By doing so, I have made some great friends around the world. This past summer I wanted to recon- nect with friends in other countries. I had already planned to vis- it my closest friend in the world, Berna, who lives in Belgium. For me, these face-to-face meetings are very important. In fact, the first person I actually met face-to-face was Hermien from The Netherlands, and we found each other on the IPPF’s original dis- cussion group. Our first meeting was in April 2002 and I had just received my diagnosis the previous November. Hermien Konings took a train and met me in Leuven, Belgium. She brought my friend flow- ers and me some cereal, copies of all of the information she had on pemphigus, and a Vivaldi CD for relaxation. This was the first time either of us had met anyone with our disease, and neither of us can now remember how much we hugged one another that first day. As with other people I have met on this journey, you just seem to know that some relationships last forever. We have met on four different occasions over the last 10 years, including one PEM Friends “away weekend” at the beautiful home of Carolyn Blain in the UK. Hermien was instrumental in starting a support group in the Netherlands, and put together a major conference with IPPF Medical Advisory Board member Dr. Marcel Jonkman. In June 2012, I took a train to Amsterdam from Belgium. It felt so good to spend the day together talking, walking, and dining. We visited the new Hermitage Museum (wonderful Impression- ist exhibit) and other sights. We had a terrific day and our face- face together time continues to be incomparable. I returned to Belgium the next day with some photos — and lots of precious memories. Another wonderful person I had met was PV patient Oceane and her mom, Isabelle, at a PEM Friends luncheon in London in 2004. Oceane was then 7 years old, but beautiful and deter- mined. Since then, I had seen photos and stories about her diffi- culties and breakthroughs, but not had any contact.

During that time, Isabelle became active in the French support group. I was determined to reconnect with these special people.

The week after visiting Hermien, Berna and I traveled to Paris and to meet with Isabelle and Oceane. I quickly realized that after 8 years, young children really grow up. When I first met Oceane, she had been diagnosed with PV for two years and her doctors were worried about her being on systemic drugs at such a young age. Oceane had written about the difficulties she en- dured, even having to soak in
a tub at night just to remove her clothes. The good news is Oceane just turned 16 and is doing great! Isabelle shared some literature and material from their support group as we walked around Paris (Oceane and I definitely share a sweet tooth). It was a fun adven- ture where time passed too soon for our liking. Oceane gave my friend and me special cups used for relaxation in a Paris bistro- type of atmosphere. Saying good-bye was difficult
and emotional, but I am grate- ful to have met these wonderful people. The “I” in IPPF stands for International making these face- face meetings truly special times for those of us who are able to connect — and reconnect. These friendships carry the same un- common bond that brought us together. Crossing the “pond” was — and will continue to be — a very important part of my life. How lucky am I? My advice to you is if you have an opportunity, grab it!

With pemphigus and pemphigoid, painful oral lesions frequently occur in the mouth and throat. This causes difficulty when drinking or eat- ing solid foods. Let’s face it — it can be just painful! Assessing your individual tolerance to foods and ad- justing what you are eating will enable you to bet- ter understand which foods to eat and which foods to avoid. For many P/P patients, highly seasoned, acidic, or salty foods are irritating. As are foods that are dry, sticky, or abrasive because they can be difficult to swallow. Extremes in temperatures of liquids or sol- ids, such as ice cream or hot chocolate, may cause pain for some. In the case of severe mouth sores, I recommend using a blender or food processor. Here are a few helpful hints to remember:

  •   Drink liquids through a straw.
  •  Cook coarse or hard foods, such as vegetables, until they are soft and tender.
  •  Soften or moisten foods by dipping them in gravies or cream sauces.
  • Sip a beverage when swallowing solid food.
  •     Eat small meals more often instead of one large meal.
  • Rinse your mouth with water while eating (or use water, peroxide, or Biotene afterwards).

• Remove food and bacteria to promote healing.

Having oral lesions can present many challenges including; pain manage- ment, oral hygiene, nu- tritional intake, and your overall health. Speak with your doctor about ways to help relieve the pain. Also make sure they monitor your blood sugar levels if you are taking systemic steroids. Don’t for- get to inform your dentist of your condition and ask them to use caution when treating you. If you have difficulty swallowing, or find yourself frequently choking on food, talk to your doctor. You may want to ask to be seen by an ENT to help deter- mine the extent of your disease activity. With pemphigus and pemphigoid, the mouth is one of the most difficult areas to treat and requires due diligence. Changing your behavior and habits can be the biggest “pain” but will eventually pay off. If you need help, encouragement, or suggestions… just “Ask a Coach!”

The IPPF is looking for volunteers to help us with many of our education and support projects and programs, including in several newly-created roles. The three main types of positions we are looking to fill are Executive Board (CEO’s senior staff), Special Projects Contributors, and General Volunteers.
The Executive Board heads up a “department” or initiative under the CEO. This could include efforts like managing our patient support programs, planning and running our annual Patient Conference, running fundraising events, volunteer management, and research and development. Other areas include accounting, collaborations, and project management.

  • The commitment would be for one year or the duration of the initiative, whichever is shorter. And we are open to ideas for new “departments” and initiatives, and will even tailor a position to an individual’s talents and interests. This role is ideal for people that are operationally-oriented and want a significant role within the foundation.

Special Projects Contributors (SPC) have special expertise, resources, and access to give the IPPF a short-time commitment revolving around a specific area. This allows individuals to make a substantive contribution that fits their interests and lifestyle. Example projects include:

  • competitive landscape analysis
    review of clinical guidelines
    website and/or graphic design
    exploration of a specific clinical care question
    legal analysis of a specific issue
    accounting and investments
    technical writing and reporting
    building a data management platform for our patient registry
    development strategy
    helping set up and negotiate an external collaboration
    developing a market access/reimbursement advocacy strategy

The SPC role is great for people that have a special expertise they would like to use for a short-term project. Volunteers are encouraged to propose their own projects as well.
And equally important are the General Volunteers. General volunteers contribute across a wide range of initiatives and events. Example include newsletter and website contributions, print and graphic design, Patient Conference preparation and on-site help, event planning, peer support, and community fundraisers (e.g., 5K run, bake sales, wine and cheese tasting, golf outings, etc.). This role provides an opportunity for anyone to contribute with as much or as little time as they can.
We encourage those interested to tell us about their talents and interests, and we are happy to find a way for them to contribute.
These are great opportunities for anyone that feels strongly about our community, wants to give back to the Foundation with their time and expertise, and wants to help grow our organization to deliver greater impact.
All volunteers receive acknowledgment in our newsletters and website, and they can list the experience or project in CVs, resumes, and related documents.
If you or someone you know would like to get involved, please contact me at or by calling the office at 855-4PEMPHIGUS (855.473.6744) extension 103.
Helping the IPPF through volunteering is a great way to help us help others. That’s the Power of Giving Back!

In the days after being told that you have one of the diseases in the Pemphigus/Pemphigoid family, when you’re running around filling prescriptions for your new, huge, seven-day pill container, it’s hard to feel hopeful.

Maybe you’ve been looking for answers for months – and getting the wrong ones. Maybe you’re finding it a challenge to take care of ordinary everyday things, like brushing your teeth because of painful oral lesions. Or you don’t know how to explain to friends that you’re miserable and not feeling up to your usual activities.

That’s how it was for me. By the time I was diagnosed with PV nearly three years ago, I’d consulted five different doctors over five months and had a medicine cabinet filled with failed ointments, pills and rinses.

Because my symptoms were so widespread, and because the doctors I saw were not familiar with Pemphigus, I’d been told I had everything from allergies to cold sores to possibly cancer.

It was weird hearing doctors, whom I instinctively trusted, tell me that this or that was going on with me, and turn out to be wrong, time after time. Each doctor focused on his or her special area of expertise, ignoring the symptoms that didn’t fit.

I remember calling one doctor to complain the medicine she’d prescribed wasn’t working, and she told me I was using it incorrectly.

Another doctor simply increased the dose of what he’d given me, and a third told me that if a certain cream didn’t work in two weeks, I should come back and be biopsied for cancer.


Finally I saw a doctor who said the magic words, “I don’t know what it is,” and referred me to a great dermatologist, who biopsied me and put a name to my condition. Under his care I began the slow uphill journey back to health.

For me, the hardest part was not the discomfort of eating or washing my hair or the harsh side effects from medications, unpleasant as they were. It was the sad sense that I’d lost something precious and my life would never be the same.

As I learned how to cope with PV over time I found out that, like other major life events, this experience offered a unique opportunity to grow and learn more about myself.

Some encouraging words, for those new to this journey:

1. You will feel better, a little at a time. Celebrate the small steps as your health improves each day, each week and each month.
2. Remember P/P is just a small part of who you are. While it may loom large right now, it will command less of your attention as time goes on.
3. Keep a health journal. I found it extremely helpful – especially in those foggy prednisone days when I got lost in the middle of sentences – to record everything health-related in a notebook.
I wrote down the details of every doctor visit, the questions I wanted to remember to ask, the answers I got, symptoms and feelings, medication doses and so on. I’ve now had my notebook for three years, and it’s so handy for keeping track of lab work, bone density scans and other treatments that occur at regular intervals.
Writing things down also keeps them from swirling endlessly around in your mind and is helpful when talking to your doctor.
4. De-stress any way you can. At the 2012 IPPF Patient Meeting in San Francisco, we learned about the chemicals released by stress that aggravate autoimmune disorders.
My favorite way to get rid of excess stress is by doing yoga. I also enjoy walking, and when I don’t have time for either of those, a few long, deep breaths do wonders.
5. Count on your friends at the IPPF. There’s a wealth of help at the IPPF. You can get one-on-one support from a trained Peer Health Coach, ask questions on the discussion forum or join the active email group.
Online resources, dial-in Town Hall meetings with IPPF’s doctor-researchers, and annual Patient Conferences are other options. I made the mistake of waiting too long before getting involved with this fantastic organization.
6. Give back. Share a tip that worked for you or just lend an ear to help someone else who’s newer to P/P than you. See #5 for places you can jump in.

GlassesLiving in the northeast (actually mid-Atlantic), it is still very much summer – with humid heat and lush greenery and flowers surrounding me outside – as I write this. Nature is very much alive and in all its glory. In another month or so, I know that the leaves will be changing colors and dying while retaining their extraordinary seasonal beauty. It is really quite remarkable how beautiful nature is when dying. It doesn’t feel like a death, but more like a segue into a new and different way of being in the geographical areas where we experience the seasons and annual changes. Changes and transitions are always with us; some are just more noticeable and harder hitting. It is a cycle that continues – even with global warming and human intervention. As always, the only constant IS change – and so transitions are part of our lives whether we fight them every step of the way or accept and welcome them, learning from our experiences. Changes of any kind can take us out of our comfort zones, but are necessary for our individual journeys. People are complaining about the very hot and humid summer we are experiencing, but it brings back memories of the old “dog days of summer” which I fondly remember growing up with in the 50’s & early 60’s – without the comfort of air conditioning or even fans. I have no idea how we did it, but we did – and had fun even while sweltering. Running through a “sprinkler” attached to a hose on someone’s grass was like a piece of heaven in those days, but nights were more challenging! This made the season change even more eagerly anticipated; it always felt like summer lingered a bit too long. Of course, with age, the days, weeks, months and seasons seem to go more and more quickly, keeping us on our toes. No two years (or days) are exactly the same, which keep us guessing just as these rare chronic illnesses do. There are less challenging days and more challenging days with tears of both joy and sadness/loss along the way. The days merge into weeks and then months. Seasons change and other transitions – some smooth and expected. A lot of people become conditioned to dealing with crises, and encountering and overcoming problems and difficulties usually leads to more resilience – a very positive quality to possess. Unfortunately, a growing number of people seem very at ease with crises, seeming to live from crisis to crisis while not dealing with everyday life. This is not a natural way to go through life and leads to very real daily difficulties and unhealthy stress levels. The studies on stress continue to highlight the negative aspects of the mind-body connection. No, not every ache, pain or serious illness is caused by stress; but stress-relief strategies that work can make everyday life “easier” (or less difficult) and make crises smoother to navigate. This can be thought of as a navigation system of sorts in our life’s journeys. Unfortunately the navigation system must be learned through training, experiences and successes and failures. Often we do learn the most from our failures. We all go through stages and often with some back-peddling from time to time. These are NOT negative times. Think about an EKG; a flat line is not a good thing. The small ups and downs are totally “normal”, and it is only when there are extreme changes that they are harmful. That is when people need extra help and more and more often seek it out – or go back to a therapist or psychologist (or family member, friend, colleague) for a “tune up”. Sometimes the positive coping tools are misplaced, lost, forgotten, rusty or no longer enough. Frequently, one of the most common initial diagnoses for patients is “Adjustment Disorder”, which usually passes once new tools and strategies have been learned, especially with a mindfulness based cognitive behavioral intervention. Psychotropic medication may or may not be prescribed, and some are short-term, while others may be more long-term in more complicated cases, or when the person has deeper underlying emotional or psychological problems (e.g., bipolar disorder, recurrent depression, a personality or panic or other anxiety disorder). Sometimes previously repressed underlying issues emerge and take longer to resolve. Financial, insurance, work, primary support (or lack thereof), physical illness and other social and environmental concerns can work toward or against the eventual resolution of problems. Being aware of these and of the larger situation always helps. For me, I have spent 10 years on boards devoted to pemphigus and related diseases and have watched and participated in many changes over this decade. It has been an amazing and exciting time. I went from being a healthy and high-energy person with one long-term autoimmune condition that was under control (for decades) to developing new and life-threatening conditions. My previous chronic condition, along with other acute health issues at various times, probably gave me an advantage regarding resilience. I went through the same basic stages as anyone else, but also felt very strongly almost from day one that it was all for a reason – for a purpose. I soon learned that the psychological and emotional components of these orphan diseases were not being addressed. It is, of course, always critical to get the disease itself under control, but I would argue that being as mentally healthy as possible and with a strong support group is nearly equally important. I have not been among the fortunate who have been in remission for any considerable length of time. My one partial remission included symptomatology that was atypical. That diagnosis was made and addressed; monitoring myself daily is routine. After a particularly nasty and stubborn flare this year, I felt the need to make some serious new life decisions. I did use the Cognitive model of decision making, examining all the facts and then carefully weighing options, while taking a few steps back for perspective. I have made some decisive strategic moves, including stepping down from the IPPF Board of Directors. However, I will always remain very involved in the IPPF, especially where patient support is involved. his will allow me to have more time to make necessary decisions regarding my own health, volunteer and professional work and family. It is just one more life transition along the road. The coming years will bring new and different challenges and changes, but these transitions are necessary and very positive. Our IPPF Board of Directors has several new and very capable and passionate people who will continue to lead this Foundation forward in new and important ways. It is a very exciting time for the IPPF and the welfare of all patients, families and friends. My participation with the IPPF remains an integral part of my life, but it is a time to re-prioritize, take the time to smell the roses in the moment, enjoy the beauty of the fall/autumn leaves and then make snowmen or just watch the winter wonderland, before spring and the start of the next season. I look forward to this transition and to the new and interesting places and opportunities which will be part of the next phase of my own personal journey. Not only do I not fear transitions, but I look forward to them and what they will add to my personal human experience. Also, your Annual Meeting Committee is working hard to make the 17th Annual Patient Conference in Chicago, April 25-27, 2014, a fulfilling experience for all who attend. We are looking at trying more changes, based in large part on feedback from patients and their families and friends who’ve attended the conferences. Yes, we are listening and making necessary changes. Please consider what special talents or interests you may have or have access to as we ramp up our volunteer system and add ad hoc members to committees. Those experiences will not only add to your personal journeys, but also the future of the IPPF. And who knows? Maybe it will be a special and transitional time for you!
Summer is drawing to an end, kids are back in school, and the IPPF is preparing for our end-of-year activities. I want to thank everyone help us carry our mission to the four corners of the globe. Volunteers are becoming more and more important in our daily operations, and every bit counts.

Helping us in the office will be not one, but two Cristo Rey High School student interns. For the fourth year in a row, we welcome back Kevin Cruz. Kevin has spent the past few years entering data into our patient database, uploading content to the website and Facebook page (who can forget his Chuck Norris quotes?), and other IT functions. This year he is working on patient and caregiver guides to provide essential information and tools.

And we welcome Freshman Isaac Silva who will help on the administrative side as he learns about our mission, programs, and services. Isaac will also help with the patient and caregiver guides to help him learn more about our community and how the diseases affect patients, caregivers, and families.

Cristo Rey Work Study allows low-income students to gain real-world experience in professional settings while receiving a private education. For more information on Cristo Rey High School Sacramento visit

And while I’m on the subject of helping move the IPPF forward, let’s keep talk volunteering. The IPPF needs people to help us keep overhead low and mission success high. For example, during 2012 there were 64.5 million volunteers in the United States. The United States Red Cross’ workforce is 94% volunteers ( The Pacific Crest Trail Association ( has over 1,600 volunteers along the West Coast. Please consider volunteering with the IPPF (related stories p. 6 and 11).

Pemphigus and pemphigoid awareness has always been an issue, but that is changing. In 2012 we helped introduce a resolution in New Jersey. The Canadian Prime Minister of Finance announced he had pemphigus vulgaris. Marc Yale visited Washington D.C. and spoke with members of the House and Senate. And our Awareness Campaign began to develop.

To help the IPPF with the Awareness Campaign, please join me in welcoming our new Awareness Program Manager, Kathryn Fraser, to our family. Kathryn is working with the Awareness Campaign Committee to develop next steps and prepare for a Best Practices Consensus Conference in Spring 2014. Along the way, Kathryn will provide updates right here in the Quarterly and online.

As our pemphamily grows, we remain close to one another online and in person. Family. That’s what we are.