Quick questions (promise :O)

[PennyPru]

1. Who would be better to see: a urologist or nephrologist? Do most urologists know a lot about kidney problems and SLE, or is it alike the rheumo practice, where only 4% seem to have a clue?

2. Do all people with SLE who are sun sensitive get a rash? I sometimes get the rash on my nose and cheeks, but have never found a causative effect after being in the sun. I do, however, get crazy thoughts and notice personality changes, and feel awful after being in the sun. How does one know for sure if they are sunsensitive? If one is sunsensitive, does that mean direct sunlight only, or even indirect sunlight like thru windows.

style_emoticons/<#EMO_DIR#>/Thanx.gif in advance for your replies.
>|< Penny

[rwb200]

As afr as the doctors go we have always used a Neph but it would depend alot on the doctor and how good they are.
In some areas some may find one better while in another the other would be better.
Very dificult to answer because it largely depends on your area and the Doctors there.

One of the best ideas is to ask your rheumy or family doctor who they would recommend. If you have good luck with that doctor and like them chances are good you will be happy with who they recommend.
If they list several ask them who they would recommend you use or who they would use if they needed to.
If that don't work ask them who they feel they could work with the best and who would keep them informed of what was going on and being done.

As far as sun sensetivity and the effects it will differ from person to person. As Lupus does not effect each person the same the effects are not the same.
One will get very red, another may have swelling, confusion or other cognitive problems, lessions.
As far as the amount it takes this also changes from person to person and the degree of sensitivity that they have.
If you visit the site very often you will notice that some people talk about being able to use a sunscreen and it helps them alot. My wife could use a sun screen and be covered like a mummy and she would have trouble with being in the sun for over a couple of minutes.
Some only have problems with direct sun light when it is very intence others have problems with some types of lights in buildings because of the effect it has on them.

For the most part if you think you are sensitive to the sun then chances are that you are.
If you notice rashes after being in the sun this is a indication of sun sensitivity. If you notice swelling and pain and hard to move after being in the sun this is a indication of sensitivity.
If you notice and inability to think clear or mood swings after being in the sun it is ether sun sensitivity or you have been in the sun to long and the heat is getting to you.

Lupus and medicine have very few clear cut answers. No two people are effected the same or have the same reactions.
They may share some points with each other from time to time but each one here has had there own list of problems, there own list of what works and how to deal with it.
Some have very few and very mild symptoms while others are plagued with problems.
Many probelms that some have mimic or can be attributed to other problems or deseases as well or could be a result of Lupus. One time when my wife had a problem she went to her doctor. he said he thought it was probably the Lupus doing it. I responded I did not know that Lupus could effect that.
He stopped and set down and looked at me and told me you have to understand Lupus has no bounds.
It effects every part of the body and nothing is off limits for it. It effects every body diferently and frequently shows new signs or problems with the people who have it. Some of these problems seem to come and go, some only happen once and some seem to happen all the time.

Your question was a short easy question. Sorry my answer was not but Lupus has no short easy answers.

[lisade]

Hi Penny,

I agree with RWB he gave you good advice. Ask your rheumy for a referral to a physician he would reccomend. I would think you would need a nephrologist for kidney involvement rather than a urologist.

rwb answered the sun questions I really can't add alot more to that. I am sun sensative, but not to the point that his wife is. I do not go out in the sun, If for some reason I do go I have to wear sun screen and then sometimes I do have systemic effects fromt the exposure. I limit my sun exposure and have managed to work around it most of the time.

Good luck on getting some answers.

[PennyPru]

style_emoticons/<#EMO_DIR#>/Thanx.gif RWB and Lisa. The thing about uro vs. nephro is my sister in law's uncle is well respected urologist here where I live. We know each other and see each other at family functions about once a year. He may take me more seriously than seeing a doctor cold. I can probabaly get a referral to see him, but I may be able to talk with him offline out of office to get his opinion. Just wondered if I should try that route before the nephro. I think I'll get in touch with him ... can't hurt. He's a super nice fella and I'm sure he could get me into see a good nephro who perhaps has experience with SLE.

Thanks for the sun info. I just wasn't sure if there was any definitive correlatation e.g. if you have sunsensitivity you will get rashes. I am learning all the things we have YET to learn about SLE. Wow, this is not easy. Blessings upon all of us. style_emoticons/<#EMO_DIR#>/thumbs-up.gif

>|< Penny

[rwb200]

By all means if you know this Doctor like and respect him and his ability go and see him.
If nothing else he may be able to point you to a good Doctor.

We had a Doctor that looked after my wife for awhile not because Lupus was his speciality but because he was well trained. A Doctor and a Oral Surgeon/Dentist and he was working in a Lab working on Immune Problems.
He was present the day that my wife was diagnosed and he did alot to help her get the treatment that she needed.
He followed my wifes case for some time and she could just stop in and see him at anytime she wanted and he would look over what was being done for her treatment and would make recommendations or answer anything we wanted.
More then once when she went for an apointment the Clinic Records department would not have the records but a quick check in his office turned them up.

We concidered his adivice and his care as very valuable to us and we kept in touch for sometime. If nothing else he helped us to have a good feeling about the care she was getting and educated us on what was going on and what could happen down the road.

If nothing else this Doctor could be the same way for you. Give him a try.