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Filtering by Tag: arthritis

Invisible Disability Awareness Week

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Yesterday marked the first day of Invisible Disabilities Awareness Week!

Each year, people with invisible disabilities and their loved ones come together for Invisible Disabilities Week, a time to educate the general population about the challenges they face and the progress society still needs to make towards acceptance.

It’s a time to break down the belief that people with invisible disabilities are “exaggerating” or “faking” their symptoms, and start a discussion about what inclusion really means. So this week, the community works to raise awareness of their invisible conditions and how their conditions affect their lives, as well as offer their recommendations for how to make the world a more inclusive place.

(Content: Erin Migdol via Image:

#invisibleillness #invisibledisability #invisibledisabilities #invisibledisabilitiesawarenessweek #spoonies #arthritis #fibro #fibromyalgia #mentalillness #depression #anxiety #pots #autoimmune #crohns #deaf #hearingimpaired #spectrumdisorder #autism #learningdisabilities #diabetes #diabetic

Juvenile Arthritis Awareness Month

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July is Juvenile Arthritis Awareness Month!

It’s that time again! Welcome back, friends, thanks for joining me today for another awareness blog entry. I hope you’ve all had a wonderful week since our last post. This week’s topic is Juvenile Arthritis, in honor of Juvenile Arthritis Awareness Month. I’m sure you’ve all heard of arthritis. At some point, we all develop a little arthritis in our joints as we age from use. But, there are many different types of arthritis, and most of them have nothing to do with aging. Juvenile arthritis, in particular, affects children under the age of 16, which clearly isn’t related to again at all. So, today we’re going to discuss juvenile arthritis, and the numerous different types of arthritis under that umbrella. All aboard the juvenile arthritis information express, we’re leaving the station.

Juvenile arthritis is an autoimmune disease that affects children under the age of 16. Juvenile arthritis occurs in the joints, more specifically it affects the synovium in the joints. Synovium is the tissue within the joints. Autoimmune disease cause inflammation. With juvenile arthritis, the inflammation occurs in the synovium. Autoimmune diseases are a classification of diseases in which the body’s immune system begins to malfunction and attack itself. Each autoimmune disease acts differently, the the one thing they all have in common is that the body has mistakenly begun to attack itself, which leads to inflammation. Consistent inflammation can cause serious damage to the area it occurs in. If inflammation is not treated, the area it occurs in will slowly become more and more damaged and may eventually lose function all together. In a healthy body, the immune system is responsible for fighting off anything that may harm the body, such as bacteria or viruses, or other kinds of illnesses. With autoimmune diseases, the body gets it’s signals crossed and begins to fight off it’s own healthy cells. Like most other autoimmune diseases, juvenile arthritis is idiopathic. Idiopathic means that there is no precise cause. Even though there is no apparent cause for most autoimmune diseases, it is pretty much accepted that it may have something to do with genetics, environmental triggers, or specific infections/illnesses.

There are quite a few different types of juvenile arthritis, five types to be exact. Each type affects the body differently. The five different types of juvenile arthritis are called systemic juvenile arthritis (also referred to as Still’s disease), oligoarthritis (also referred to as pauciarticular juvenile rheumatoid arthritis), polyarthritis (also referred to as polyarticular juvenile idiopathic arthritis or pJIA), psoriatic arthritis, and enthesitis-related arthritis. Let’s talk about each one in a little detail.

Systemic arthritis, also known as Still’s disease, affects the whole body. Each different kind of juvenile arthritis affects the body differently. With systemic arthritis, the entire body may be involved, and may also involve internal organs. Systemic juvenile arthritis is usually accompanied by two seemingly ordinary symptoms, which are a high fever and a rash. This rash usually appears on the legs, arms, or trunk of the body (basically anywhere from the neck down). Typically, when there is internal organ involvement, it affects the lymph nodes, spleen, liver or heart. Unlike other forms of juvenile arthritis, this type does not affect the eyes, usually.

Oligoarthritis, also referred to as pauciaticular juvenile rheumatoid arthritis, is unique in the sense that children usually outgrow this disease. With this form of juvenile arthritis, diagnosis requires counting how many joints are affected in the first six months of disease activity. If less than five joints are affected, along with other diagnosis factors, then it’s oligoarthritis. The joints that are most frequently affected are the knee, wrist or ankle. It can also affect the eyes, usually the iris. For some reason, this type of juvenile arthritis occurs in girls more than boys.

Polyarthritis, also referred to as polyarticular juvenile idiopathic arthritis, is most like the kind of rheumatoid arthritis that adults experience. This type of juvenile arthritis is kind of the more advanced version of oligoarthritis. With polyarthritis, more than five joints are affected in the first six months of disease activity, along with other diagnosis factors. Polyarthritis tends to have an element of symmetry to it, meaning that if a joint on one side is affected, then usually it’s corresponding joint on the other side of the body is also affected. Often, the neck, jaw, hands, and feet are affected. This form is also more common in girls than boys.

Psoriatic arthritis is associated with the skin disorder psoriasis. Either psoriasis or arthritis may occur before one another. Sometimes, it may not appear until years after the first diagnosis of either psoriasis or arthritis. Pitted fingernails are associated with psoriatic arthritis.

Enthesitis-related arthritis is the last of the five types of juvenile arthritis. Enthesitis-related arthritis affects the entheses. Entheses are the parts of the body where the tendons attach to the bone, for example the hips. The parts of the body that are frequently affected are the spine, hips, and eyes. This type of juvenile arthritis is more common in boys, especially boys with male relatives who suffer from ankylosing spondylitis. Enthesitis-related arthritis is typically diagnosed in boys over eight years old.

Now that we’ve done a quick rundown of the five different types of juvenile arthritis, let’s talk about the symptoms that may indicate the disease. It’s important to note that in some cases, a child may not experience any symptoms at all, but can still have juvenile arthritis. So, obviously, the big symptom is joint involvement. Joints may be stiff, particularly right after waking up. Joints may be painful, tender or swollen. Sometimes, the younger children will appear to have difficulty with recently learned motor skills such as walking, but it may actually be a limp due to the joints being affected. Some forms of juvenile arthritis are accompanied by a high fever and rash, as discussed above in the corresponding type of juvenile arthritis. Fatigue is also a common symptom amongst children with juvenile arthritis. Fatigue is often accompanied by irritability, not surprisingly. Sometimes, weight loss can occur. There can also be eye involvement, such as blurry vision, pain in the eyes, or red eyes. Juvenile arthritis can be tricky to diagnose at times because many symptoms mimic other diseases, and sometimes children do not show any symptoms at all. There is no specific test that can confirm whether a child has juvenile arthritis or not, and so diagnosis can sometimes take a very long time. With juvenile arthritis, diagnosis is basically a process of elimination. Eliminating all other possible causes can be time consuming and may involve many trips to the hospital and many blood tests. Doctors will want to rule out cancer, fibromyalgia, lupus, Lyme disease, infections, viruses, and other causes that have similar symptoms.

Treatment for juvenile arthritis varies depending on the type. Medications and exercise are typically used to treat all forms. The kind of exercise may depend on the severity of symptoms, or the type of juvenile arthritis. Polyarticular juvenile arthritis carries a higher risk of joint damage, and so water based exercises and physical therapy may be used. Medications for juvenile arthritis have four objectives. Those objectives are to reduce inflammation, ease and prevent pain, prevent joint damage, and maintain or increase strength and flexibility. Some cases may require more aggressive treatments.

If you’re new to our awareness blog, welcome! I’m so glad you found us. This awareness blog is run by Personalized Cause. Personalized Cause is an awareness accessory company that specializes is custom awareness ribbons. Our custom awareness ribbons can be engraved with any name, date, message, or phrase that you’d like, on any of our custom awareness ribbon colors. We carry just about every awareness ribbon under the sun. In addition to our custom awareness ribbons, we also carry classic awareness ribbons, fabric awareness ribbons, and silicone awareness wristbands. Basically, whatever your awareness accessory needs are, we’ve got you covered.

Personalized Cause decided to start this awareness blog because we believe in raising awareness. We decided to practice what we preach by raising awareness for as many causes as we can. We can’t expect our customers to be passionate about raising awareness if we’re not, and raising awareness is crucial for understanding, fundraising, and research. We hope to educate everyone on different causes so that progress is made in our communities. Compassion and understanding are the key to every cause. Personalized Cause believes in the power of awareness, which is why we’ve started this awareness blog. Our mission is to help you raise awareness for causes close to your heart with our line of awareness products, but also to raise awareness for as many causes as possible on our own. We strive to create a community of educated and compassionate people, while also calling attention to causes that may be unknown or misunderstood. So, I hope you’ll join us next week, and every week after, for our latest awareness blog installment.

Blue awareness ribbons are used to raise awareness for juvenile arthritis. To order a custom blue awareness ribbon for juvenile arthritis, visit:

#juvenilearthritis #arthritis #juvenile #lupus #fibromyalgia #scleroderma #awareness #awarenessblog #cancerribbons #awarenessribbons #jia #chronicillness #autoimmune

Arthritis Awareness Month

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May is Arthritis Awareness Month!

Hey you guys! Thanks for stopping by! I hope that everyone out there is pumped to have a little knowledge dropped on their… face, or whatever. Hopefully last week’s post full of poop puns didn’t scare too many of you off. I’m sorry, you just can’t write an awareness blog post about Irritable Bowel Disease without a few jokes. Honestly, I think a little humor can make a world of difference when it comes to shitty health conditions. (LOL, sorry. I’m done, I swear!)

Today’s topic for the awareness blog is way harder to make puns about, so you’re all safe for now. Today, were gonna talk about one of the most common health issues out there. Drumroll, please… Arthritis! This month is Arthritis awareness month, and considering how many people are affected by it, I think it’s about damn time we get around to discussing it.

So, I’m guessing that everyone knows someone with arthritis. What you may not know is that there are different types of arthritis, and the effects of each kind can vary greatly. So, let’s break it down, shall we?

Arthritis is divided into three groups: osteoarthritis, rheumatoid arthritis and psoriatic arthritis. Within those three types of Arthritis, there are subsets of the condition, or diseases that cause the condition. There are more than 100 specific kinds, so I won’t bother listing them.

Osteoarthritis is typically an age-related issue that occurs over time as wear and tear begins to damage the joints and surrounding tissue. Osteoarthritis commonly affects the joints that get the most use, meaning hands, feet, and weight bearing areas like spine, hips or knees. As we age, our cartilage gets worn out, which leaves us with less and less cushion to absorb the shock of everyday physical activity. As you can imagine, given what we’ve just learned about wear and tear, obesity is a major cause of osteoarthritis in those younger than the average osteoarthritis patients. Because there is so much extra pressure on the joints, the cartilage gets worn down more quickly. Osteoarthritis causes the joints to become painful. Over time, function of the specific joints affected may decrease.

Depending on the joint, there may be surgical options available, when medication no longer helps or function is too poor. Some joints can be completely replaced with new artificial joints so that the patient can get back to their normal physical activities. Hip replacements have come a long way from what they used to be, might I add. Other types of joint replacements include knee replacement, shoulder replacement, and even finger joint replacement (called PIP). Of course, joint replacements aren’t right for everyone, and some may not be healthy enough to undergo the surgery. Osteoarthritis is kind of one of those unavoidable health issues, it’s just a matter of what age it will begin and what joints it will affect. It usually begins in the joints that get the most use.

Osteoarthritis is usually managed with NSAIDs (anti-inflammatory medications that are not a steroid), over the counter pain relievers, analgesics (to numb the affected area), dietary supplements for joint health, and even with narcotics, as a last resort. Surgery is also an option for some. There are many self-care options, too, like icing the joint (which is a good idea because it reduces inflammation), products like Bengay or IcyHot, weight loss to reduce pressure on the joints, and exercise (even though it sounds counterintuitive, it keep the synovial fluid moving which helps).

Rheumatoid arthritis is different from osteoarthritis in pretty much every way except for the painful joints. Rheumatoid arthritis, also called RA, is an autoimmune disease, which means that the body’s immune system mistakenly attacks it’s own healthy cells instead of invaders such as a virus or bacteria. With RA, the immune system attacks the joints in particular. Over time, the immune system attacking healthy cells leads to inflammation, and inflammation can lead to permanent damage. This is why treatment and early diagnosis is crucial to preventing long-term damage, which can be potentially debilitating in some cases. RA can appear at any age, even children, which is it’s own classification of the disease, called juvenile rheumatoid arthritis. RA is not caused by normal wear and tear, but by the immune system, so age doesn’t discriminate either for or against it. RA can appear out of the blue, suddenly, or gradually over a long period of time.

Symptoms of RA are different than osteoarthritis. Typically, the pain in the joints is worse than that of osteoarthritis, and is accompanied by a deep, aching pain. Joints can become stiff, especially noticeable first thing in the morning, easing as the morning goes on. It can cause the joints to look red and swollen, even warm to the touch. These are all indications of the damaging inflammation. It may also affect range of motion, limiting the joints function. One of the less common symptoms is something called rheumatoid nodules, affecting around one in five RA patients. Rheumatoid nodules are bumps that occur over the joints that are under the most pressure. You’ve most likely seen images of them affecting the knuckles. They can be red and just appear as if the joint itself was very swollen, or they can also present as smaller bumps along the joint. Either way, they are a telltale symptom of RA. Another characteristic of RA is that there tends to be symmetry to the affected joints, meaning that if a patient has it in one knee, they likely have it in the other knee as well. Over time, if the disease is not managed or isn’t well controlled other joints will become affected by the disease because RA can be progressive in nature. People with RA can experience chronic fatigue, loss of appetite, and fibromyalgia. As if all of this weren’t enough, RA can also involve other organs, such as eyes, lungs, or even heart.

Last, but not least, we have psoriatic arthritis. Psoriatic arthritis, like rheumatoid arthritis, is also an autoimmune disorder. Generally, people who suffer from Psoriasis are the ones that develop Psoriatic arthritis. Psoriasis is an autoimmune skin condition that commonly presents over joints, like the elbows. Psoriasis has a red, scaly, patchy appearance, often accompanied by white spots that can flake off. Having psoriasis does not necessarily mean that one will develop Psoriatic arthritis, though. About one third of psoriasis patients end up developing psoriatic arthritis. And, generally, people develop the skin condition before psoriatic arthritis, rather than the other way around. Of course, there are exceptions to that, and some will develop psoriatic arthritis before psoriasis.

Psoriatic arthritis can sometimes be misdiagnosed, particularly because it can look similar to the symptoms of rheumatoid arthritis or gout. It also seems to run in families, like many of the autoimmune diseases. In fact, up to 40 percent of those with psoriatic arthritis have blood relatives with a skin or joint condition. Patients are usually diagnosed between the ages of 30 to 50, but it can occur in children and young adults.

Treatment for both RA and psoriatic arthritis are similar because they are both autoimmune diseases. With autoimmune diseases, treating the disease usually means trying to get the immune system to stop attacking itself, and that is done using the same pool of medications for many of the diseases. The first line of defense is usually NSAIDs and over the counter pain medicines (for inflammatory issues, ibuprofen is best). Steroids can be very effective in reducing inflammation, but they come with a lot of side effects. Biologics and DMARDs (disease-modifying antirheumatic drugs), and even some forms of chemotherapy (usually methotrexate) are used to threat them as well. The treatment depends on severity, which is why it is so important to get it under control early on, so that you can avoid the drugs with more serious side effects. Some people also find improvement with natural supplements. One supplement people with autoimmune diseases find particularly helpful is tumeric. Tumeric supplememnts work on a multitude of health issues, which you can learn about here.

That’s the deal, folks. This was just a brief overview, and each type of arthritis could easily be a separate post. I’m sure I’ll get to do that at some point, too. I hope this was an easy to digest run-down of the differences and basics of each kind of arthritis. People tend to find there is more to it than they thought.

To wrap things up, I’d like to very quickly explain a little bit about our awareness blog. This awareness blog is dedicated to raising awareness about many different kinds of illnesses and causes. We tend to choose our post topics based on current awareness observances, like awareness months or awareness days recognized in the U.S. or worldwide. The awareness blog is run on behalf of Personalized Cause, who also hosts the awareness blog on their website.

Personalized Cause is an awareness apparel company that specialized in custom awareness pins. Personalized Cause is the only U.S. company to offer their customers low volume personalized awareness ribbons. Customers can choose any name, date, phrase, or message they want to be engraved on a cloisonné awareness ribbon pin. The pins are beautiful quality, and very affordable. Custom awareness ribbon pins are a powerful way to support someone going through a health crisis, or lifelong health journey.

Arthritis is represented by a blue awareness ribbon, but there are special ribbons to signify rheumatoid arthritis or psoriatic arthritis. RA is represented by a purple and blue awareness ribbon. Psoriatic arthritis is represented by an orange and lavender awareness ribbon.

To order a blue awareness ribbon, click here:

To order a purple and blue awareness ribbon, click here:

To order an orange and lavender awareness ribbon, click here:

#arthritis #pain #inflammation #jointpain #chronicpain #chronicillness #fatigue #invisibleillness #seearthritis #arthritis #RA #rheumatoidarthritis #psoriaticarthritis #psoriasis #auntoimmunedisease #osteoarthritis #awareness #awarenessribbon #cancerribbon

World Lupus Day

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Today is World Lupus Day!

Looks like it’s time for another installment of your very favorite awareness raising blog! How exciting! And let me tell you, this is going to be a good one!

But first, lets take a second to answer a few questions from my last blog. I got quite a few questions about why we started this awareness blog, and I would be thrilled to reiterate our story for newcomers.

Personalized Cause is an awareness accessory company based in California (we do ship international). Personalized Cause specializes in personalized awareness ribbons, also referred to as custom awareness ribbons, where you can add a name, date or message to whatever ribbon you choose. Our custom awareness ribbons are engraved with your choice of text. We also carry the original awareness ribbon pins, without customization, as well as wristbands and fabric ribbons (which can also be customized) for bulk orders. We are the #1 custom awareness ribbon source for personal orders (meaning not bulk order) in the United States. There are not currently any other companies that offer the type of product we do at the quality we do. That’s our deal. We’re awareness ribbon people. We’re very proud of that.

At Personalized Cause, we know that awareness ribbons have the ability to raise awareness, educate others, represent hope and inspire others. Awareness ribbons can signify to others your support for a cause or illness, or demonstrate your support for someone who is struggling. Awareness ribbons can also be a powerful way to take ownership of your health, rather than letting your health take ownership of you. Yes, this is a sales pitch, and yes, I truly believe everything I’m writing because of my own experience (which is exactly why I got involved with this company. So, while this awareness blog is sponsored by an awareness ribbon company, it is ultimately about raising awareness for as many causes as possible in order to eliminate stigma, misconceptions, misinformation, and ignorance. We truly have the very best intentions in our endeavor. Not to mention that I, personally, put my heart and soul into writing these in hopes that it may help someone out there.

Without further delay, lets get to it, shall we?

Today we’re going to be looking at a disease called Lupus. Yes, the disease that Selena Gomez has. Gotta love the awareness that one celebrity can bring to a disease. Purple awareness ribbons are the most popular choice to represent Lupus, although some organizations and countries prefer to use orange. Both are correct. It’s really just a matter of preference or affiliation.

Lupus is an autoimmune disease, which means that the body’s immune system attacks itself mistakenly. Lupus is a chronic condition, meaning that it is ongoing without a cure, although the disease activity and symptoms tend to wax and wane throughout a patient’s life. These phases of disease activity are called “flares.” Flares can be triggered by any number of things, for example, overexposure to the sun, other illnesses like a cold or flu, or overexertion (aka pushing yourself and doing too much). Flares can also arise with no apparent cause. Flares can last anywhere from a couple days to weeks or months. They can subside over time on their own, or require medication to control disease activity.

Lupus is an inflammatory disease, meaning that it causes the body to produce inflammation without any reason (like an acute injury, or problem with the function of an organ, or infection). Over time, if left untreated, inflammation can cause permanent damage and lead to other health issues. The inflammation can affect pretty much any organ in the body, such as the joints, skin, heart, liver, kidneys, muscles, blood cells, lungs, brain… pretty much everything is on the table with Lupus. If you’re one of those people who thrives in chaos, loves surprises, and is great at hitting a constantly moving target… Lupus is the disease for you! (I hope that doesn’t offend anyone, I know that the disease can be very serious and even deadly.)

Lupus can be a real pain in the ass to diagnose. Diagnosis can often take years because the signs and symptoms of Lupus tend to come and go (in flares), and the symptoms also resemble the symptoms of many other health problems. Autoimmune diseases tend to share many of the same characteristics that make it difficult to narrow down, at times. As a beloved doctor once told me, autoimmune diseases are all the same ice cream, they’re just different flavors. That saying has stuck with me for over 15 years. It’s a great little metaphor, so I thought I’d share it with you all. One symptom that leads doctors straight to the Lupus diagnosis is the telltale butterfly rash that appears on the face, though not all patients experience the butterfly rash. It is called the butterfly rash because the rash covers the bridge of the nose and spreads out onto the cheeks, resembling a butterfly.

The butterfly rash is also the source of the unofficial Lupus mascot… the butterfly. I know you’re thinking, “Wait, doesn’t Lupus mean wolf? Why isn’t the mascot a wolf?” Good question, and the answer is: who knows! Maybe butterflies are just a little cuter and friendlier. Personally, I think the wolf is more appropriate considering that your body is now basically hunting itself, but whatever. I get it, though, butterflies are beautiful, and wolves are scary.

Lupus is not necessarily heredity, although your chances of developing the disease are higher if a parent has it. It’s also more common in women than men. The disease can be triggered by external factors, for example, sunlight, infections, medications, or foreign bodies that are implanted (looking at you breast implants).

Each case of Lupus is unique, and each patient’s experience of its symptoms is different. The disease process unfolds in it’s own way, and there is no road map to predict how or where it may lead. Some patients get better on their own and require no ongoing treatment, while others will depend on treatment for their entire lives. I want to make this point because while I know how scary and bleak this sounds, you have to realize that none of the symptoms are guaranteed to affect you at all. You may have a very mild case. Just because its worst-case scenario can be pretty bad, doesn’t mean it will be.

Get to the symptoms already, right?! Here we go.

Lupus tends to affect particular systems in each person, for example, the nervous system, circulatory system, tissues, cells, etc. Symptoms are generally specific to how and where the disease affects a person. The following are the symptoms most experienced by those who suffer from the disease.

  • Joint and muscle pain, joint stiffness, and swelling.
  • Fatigue, aka being fricken exhausted 24/7.
  • Fever, particularly ongoing.
  • Butterfly rash on the face.
  • Sensitivity to sunlight, possibly resulting in skin lesions.
  • Dry eyes.
  • Raynaud’s phenomenon/syndrome: your fingers and toes turn blue or white and feel cold.
  • Shortness of breath.
  • Chest pain (always see a doctor ASAP if you experience chest pain).
  • Headaches.
  • Confusion, aka brain fog.
  • Memory loss.

If you experience more than one of these symptoms persistently, see your primary care physician and talk to them about a referral to a rheumatologist. Don’t rely on your doctor to bring it up. Even though doctors hate it when people think they’ve diagnosed themselves with something using the Internet, you are responsible for your health. It is essential that patients advocate for themselves, educate themselves, and listen to their gut if something doesn’t feel right. You have the right to get a second opinion, and you should not feel bad or worry about offending the current doctor. In the end, you are the one that pays the price if they are wrong, not them. So, speak up, and don’t let anyone talk you out of your symptoms, or talk you into a treatment.

There is no definitive blood test for Lupus, but blood labs are very important in assessing whether or not you have it. Certain blood tests, like the Antinuclear Antibody test, or Sed rate (short for sedimentation rate, measuring the amount of inflammation in the body) are crucial.

Lupus has quite a few medicines in its arsenal. Unfortunately, there haven’t been many new drugs developed specifically for Lupus in a very long time. Lupus is treated with four categories of medications. The first category is NSAIDs, which stands for non-steroidal anti-inflammatory drugs. These include over the counter medications like ibuprofen, but there are also special prescription NSAIDs, which are better to take for long periods of time. NSAIDs are used to treat pain, swelling and inflammation caused by the disease. Plaquenil is a popular medication for Lupus, which is actually in the antimalarial category of drugs. The third category of drugs is corticosteroids. These are everybody’s most and least favorite because they work very well but they have some terrible side effects. The most hated side effect is insatiable hunger, and the resulting weight gain. If you need them, they can totally change the game for you. Last but not least are immunosuppressant’s. These are the heavy hitters. These drugs suppress the immune system, and therefore, hopefully, they suppress your immune system from attacking itself. These drugs tend to have more dangerous side effects and increase your risk of infection.

That’s all, folks! Thanks so much for reading; I hope that you learned something that helps you or someone you care about.

If you would like to purchase a purple personalized awareness ribbon, visit:

#worldlupusday #autoimmune #autoimmunedisease #butterflyrash #jointpain #chemo #steroids #lhandsign #lupusawarenessmonth #lupussucks #chronicillness #chronicpain #invisibleillness #invisibledisability #awareness #awarenessribbons #advocacy #cancerribbons #lupus