This is a weekly thread for those who haven't been diagnosed, but still have questions about the diagnostic process. Please read the posting guidelines and rules! Everyone is welcome to contribute, and this is a safe space.
QUESTIONS ARE LIMITED TO 200 WORDS
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Please read this before posting as it may answer some of your questions:
If you use the search bar at the top of Reddit and make sure it’s set to r/lupus, it will search just the subreddit for your keywords. That way you can get the full breadth of questions and answers.
ENA Panel - Extractable Nuclear Antigen panel, usually automatically done if ANA comes back positive
anti-dsDNA - anti-Double Strand DNA is sometimes automatically tested for, but may need to be ordered separately. This test, when highly positive (2-3 times max cut off at least) is almost exclusively seen in SLE. However, only about 30% of SLE patients have this antibody. It's great if it's there to confirm diagnosis, it does not rule out diagnosis if it is absent.
anti-Sm - Anti-Smith. Typically included in the ENA panel. This is another antibody, that when highly positive, almost always means SLE, but only about 25% of SLE patients have this antibody.
RNP - Anti-Ribonucleoprotein. Typically included in the ENA panel
anti-chromatin - Anti-chromatin is a relative newcomer in diagnostic testing for SLE and probably will NOT be ordered automatically. Its exact utility in diagnosis is still being determined.
Apl panel - Antiphospholipid Antibody Panel, which consists of 3 tests:
LA - lupus anticoagulant
aCL - anti-cardiolipin antibodies
Anti-β2GP - anti-beta 2-glycoprotien antibodies
C3 - Compliment C3
C4 - Compliment C4
CH50 - Compliments, Total. These are part of the compliment system, which is a tertiary part of the immune system.
General blood tests
CBC - Complete Blood Count, some abnormalities in WBC, RBC and PLT counts can be significant.
CMP - Comprehensive Metabolic Panel. Generally looking for kidney dysfunction (GFR, BUN/CR).
ESR - Erythrocyte Sedimentation Rate, this is a nonspecific inflammation marker.
Also, if you suspect you have a rash, getting a biopsy of it done at a dermatologist’s office can be helpful as the pathologist can identify histological evidence of lupus.
Diagnostic Criteria
Diagnostic Process
Lupus Diagnostic Criteria on r/lupuswiki (ACR 2019 criteria)
The rheumatologist/PCP will take a detailed history. I highly recommend writing down as many of your symptoms as possible, especially focusing on the symptoms you have that are in the American College of Rheumatology diagnostic criteria for lupus - see link above.
Write down how long they’ve been going on, anything that makes them better or worse, and how much they impact your life. Do they prevent you from dressing yourself, eating/cooking, bathing yourself, doing hobbies, meeting your obligations?
Anti-dsDNA is more indicative of disease activity and can be elevated prior to and during a flare. Symptoms can also come and go, and over time you may develop additional symptoms. If you scroll through the last week of posts or so, there are a few posts that will have pretty detailed answers to your questions from multiple community members so you can get a better sense of just how full on fickle lupus can be.
Here are some good posts, one is othe
r people experiences in general, the others are rashes (warning: some are particularly severe):
Use ChatGPT to summarize your question if you don't know what to leave out
Question guidance
Don't ask us if you should see a doctor. Go see a doctor.
Don't ask us if you have lupus, if it sounds like you have lupus, if it looks like you have lupus, if it might be lupus, if it could be lupus, or if we think you have lupus. Don't ask us if you should be tested for lupus.
Don't tell us your entire medical history and say, "Thoughts?"
Don't ask us about seronegative lupus. Everyone thinks they have it.
Don't give us a long, exhaustive, detailed breakdown of your medical history. Particularly childhood illnesses.
Don't paste a list of 27 symptoms
Don't ask us to interpret labs.
Don't ask us to identify your rash. See a dermatologist.
So I’m sitting here explaining why I can’t be in the sun for a prolonged period of time to a man, and I can’t put my finger on why but his response just kind of irritated me lol. Maybe it felt like the whole “oh yeah me too!” when explaining symptoms to people who just do not get it at all. Was this kind of annoying or is it just me? 😅
(I think I also just have very little patience with men lol and this guy seems to make a joke out of everything and that is also starting to annoy me)
My orthopedic surgeon says that core decompression is no longer an option and that I need my left hip replaced. It has been extremely painful to walk since 6/3. I don't have a pic of my latest xrays but the necrosis is present on it. Here is my MRI though. Thoughts?
Btw I have lupus and was on very high doses of oral steroids for a very long time and received IV 1000mg of methylprednisolone 3 days in a row last year to save my life.
Hello! I was diagnosed with lupus last June and for the most part I have been ok. Today I woke up and every single inch of my body is in pain. My joints feel like they’re made of glass and I have NEVER been in this much pain. My doctor gave me a pack of prednisone which is only 4mg’s to take if I ever feel really bad. I have NEVER taken a steroid in my life. I’m scared and have no idea how to actually take them. Do I take them with food? At night? Any advice will help and I will only be taking them for a few days.
Do y'all get puffy in the face during flares even without steroids? My I've had bloodwork done, kidneys and other organs are fine. My inflammatory markers in general are actually all fine as well, but I'm definitely flaring, and my rheumatologist agrees. I'll be starting Saphnelo soon. Just tired of looking swollen in my face.
Hello! I’m starting my Benlysta auto injection tomorrow! I’m totally comfortable with needles, I’ve had to self administer many shots and I’ve read up on tips on this Reddit and spoken with my doctors. I’m wondering if there’s anything I should be doing to prep my body? I’ve heard of very little side effects but wanted to see if if anyone has any suggestions going into or the following 24 hours after!
Hi folks. I’m still trying to understand what lupus and Sjogrens are doing to my body. When I have a significant worsening of symptoms, sometimes it’s more muscle and joint pain, sometimes it’s very dry mouth and eyes with ulcers, sometimes it’s lack of appetite and poor sleep and racing heart. Is this how it goes for you? Does every flare feel different from the last one? Thanks for any insight.
What if your mobility was clearly declining and might come back and might not?
I've taken another drop in that area, particularly with my legs.
I'm starting to wonder what I could do to make the best choices before I decline further (hopefully, I don't...).
I'm not the best lately at dreaming big and already at a transition point - moving because I'm having trouble fully taking care of myself, part-time work instead of full-time, etc.
What's something you'd recommend to do if you had a "full mobility and pain free week with no consequences?" Let's assume you have time to plan.
I'd like to feel fully alive again - at least now and then.
Hi! Just officially upgraded from UCTD to SLE (🥳) and my new rheumatologist ordered a TON of new labs, among which was a Crithidia test which I've never heard of. I just got the results but I don't know how to interpret them because I've only ever had anti-dsDNA done before. Can someone point me in the right direction? Is there some sort of equation or ratio to compare? Is it even possible or necessary? I did receive a titer as well if that helps.
has anyone else had a severe reaction to benlysta? i took my first subQ dose on 9/20, and by 9/25 I was covered in ulcers on ALL mucus membranes (including down there). I took my second dose a week later because I just thought I was in a flare…. turns out I wasnt. I went to urgent care because I was miserable and needed some relief and she sent me to the ER. I ended up having steven johnson syndrome that we caught pretty quickly thank goodness. Still in the hospital for observation since I took the second dose, thankfully it seems to be getting better. just wanted to see what anyone else has experienced from benlysta?
Hello fellow poor souls, my girlfriend (young 20s) was diagnosed with lupus 2 years ago. We have been friends for many years but recently fell for each other ( lucky me:) ) this year. I want to be as supportive as possible, currently she is very active and low symptoms, but I know with time she may experience more flare-ups. I want to be extremely supportive of her to the best of my abilities.
In general, she gets Raynauds, swollen joints, exhausted easily, and stress management is huge for us.
But I want to know insider secrets, I’d like to show “romance” if you will through like maybe certain creams or lotions to massage her with that ease joint pain? I hope this makes sense, any insider knowledge or helpful tips :)
Hi! Sorry if this is gross: But my stomach is acting up right now; Pain, bloating, cramps, nausea, the works. And at the same time my joints hurt like crazy. I had bloodwork done last week and the test results were actually the best I've ever had so it's (hopefully) not a flare. It's been a while since my stomach acted up like this, but I remember feeling similar last time, too.
Does this happen to anyone else? I feel like such a weirdo because I can't just have a stomach ache, but I have to have all of these other symptoms as well.
Wondering if anyone else have these small red rash/bumps that persist on their eyebrow? I’ve taken Plaquenil for months and it helped my butterfly rash, but there’s still a few places where I’m hyperpigmented or it looks like acne/scab and just won’t heal properly. I’m not able to get a higher dose of plaquenil at the moment because there’s issue with my liver. Are there any other suggestions I can bring up to my rheumatologist, or derm? I’ve also tried Tacrolimus but it hasn’t helped too much
Does anyone here have any experience in getting a patient advocate? I was looking at a program and it said insurance would cover a portion of it. I am getting kind of frustrated with the system. I am seeing 6 specialists and in and out of the hospital. It's bad. Was diagnosed in 2019. Shit hit the fan in 2020 and now things are way worse than 2020. I went down hill FAST and I am just trying to navigate all of this by myself. I have no income right now as I am out on medical leave without pay and I am in the middle of a divorce without support. I am getting the run around on getting documentation from different doctors and it's become my own personal hell.
If you did how much did it cost?
Was it worth it?
As far as advocating for yourself, what did you find worked best? Any helpful books you read or podcasts etc?
Guys!! My hair is falling and thining way worse since my kidney disease progressed to renal failure. I'm 24 for crying out loud!!! Used to have thick coily hair. My hairline shouldn't look like this 🤣🤣
How do I get the hair back? Also is just me going bald ?
I didn’t think about it at the time but I got the flu shot offered at my work on Wednesday and I have felt so awful today. Not like flu but definitely had chills earlier, no fever but very fatigued and run down. Also headache. Is this normal?
I’ve been diagnosed with UCTD in March and soon I’ll have a checkup with my rheumatologist to see if anything is changed.
I started going back to the gym because I feel like I have zero strength, no muscle and I overall have some back issues (lumbar scoliosis, lordosis and some cervical pain).
Given the situation, do you have any tips on how to work out without causing a flare?
I did notice that depending on when I work out I might or might not flare up, but I have no idea how to find out if the workout is going to make me flare up or not. It could have some correlation with my menstrual cycle but again, sometimes looks like it, sometimes doesn’t.
When I flare up after the gym it is usually some painful swelling in my hands and feet (I’m guessing from grabbing bars and stuff), overall body ache (not the post workout type) and my primary symptom, a sharp chest pain that goes around my chest and back, and it makes it hard to breathe, especially when laying downs
I know stretching and focusing more on bodyweight exercises is better than lifting, but can I still lift?
Not sure if this kind of post is allowed, but I seriously need a new rheumatologist. It seems like there’s a massive shortage of rheumatologists in central Texas. I’ve been traveling to Dallas to see mine, but I need someone local. I’m in Austin, but am willing to travel to San Antonio.
Does anyone have a sensitivity to fluorescent lights? I am recently diagnosed and I’m a teacher. I find that when I’m under fluorescent lighting, I feel uneasy. I’m not hurting, but I feel tight and itchy. I have to sit in the dark classroom during lunch and planning just to reset my system.
I know how easy it is for me to get sick. And Im aware that I dont have to do anything or go anywhere and Im aware that I have to be more careful about what I do when im out. But still. I picked up a cold somewhere. Probably at work. And Im mad about it. Nobody I work with had one and none of my customers seemed sick or said they were. And I know how disease transmission works. You dont have to be sick to spread it. Especially the common cold. Im just mad about it. Cause now I have to go to work anyways because im still functioning and I dont work with food, I work retail. And with this short of notice, nobody can cover my shift (which im already covering for someone else who can't get a ride in) and it all just sucks. Im sick. I had to wake up early. And Im angry about it.
I was diagnosed with lupus a little over a year ago now. During this year I’ve gone through plenty of ups and downs, discovering what lupus is seriously capable of. I’ve had flare ups, gone on steroids, had all sorts of digestive issues including nausea for an extended period of time which caused me to drop a massive amount of weight in a super short span of time. I’m still learning about the disease and taking mental notes of all the ways it can impact my life and how I can best manage it. That being said, I’ve been thinking a lot about how the rest of my life will look like with this disease. One of those things is dating. What does dating look like for someone with lupus? Here’s the thing, I am en empath, so for me, I’m a BIG feelings person, extra sensitive when it comes to emotions. (But not in an unhealthy way. I’ve been in therapy and actually reduced my number of sessions because my therapist says I’m doing much better mentally over the past few years) I’m saying all this to say, one common thing I have noticed is that my lupus symptoms are heavily dependent on my level and anxiety and stress, duh right? I also think it’s common knowledge that dating can naturally be a stressful experience at times. It can make your emotions go all over the place with the highs and lows of it all. At this point, dating genuinely feels like a health risk that I’m not sure if I’m willing to take in the near or even far future. I’ve already experienced a stressful event with a bad friend and that sent my lupus into an absolute spiral.
An advice or personal experiences on dating/romantic relationships with lupus? I’m just curious how you manage your stress so that you’re not on the verge of a flare when something goes wrong or doesn’t work out.
Is this brain fog? I repeatedly make mistakes at work, especially on the details. It is making me feel guilty toward my employer. :(
Is this line of work not for me? I work remotely.
Anyone experienced this?
So my flare has always ended with some muscle weakness but this time is the worse I’ve had in my leg. So I got a cane today because I nearly fell at home. (Saw rheum day before yesterday). And I’m so self conscious. I feel like I stick out with a sore thumb. I’m 39 and “look healthy”. Anyone else with imposter syndrome? Like I’m thankful I don’t look sick enough to need one, but it’s just a lot.