Hi Zymae
Welcome to the Forum

You ask a pertinent question about secrets to handling the fatigue.
Fatigue has got to be one of the most troublesome symptoms cited by people with Lupus. I know it is for me. Other symptoms come and go but for many the fatigue is always there.
I dont know if there are any secrets but there are some common sense approaches to managing it. You mentioned in your introduction post that you have been on Plaquenil since 2007 so you will have reached maximum benefit of this drug at this stage. Let me tell you how I try to manage the fatigue.
Firstly I used to work full time but over the past couple of years I have had to reduce this to working half time only. I just couldnt manage a full week's work without crashing completely - usually midweek. If you are working and can manage to reduce your hours it can be a good idea to take a midweek day off (say Wednesday) and just use this to sleep and rest your body.
Secondly I got someone in to help me with housework and ironing. Its only once a fortnight but it has been a godsend as I cant hold the weight of the iron for too long and I just dont have the energy for washing floors, etc.
Thirdly, when I can, I sleep. If Im tired when I come in from work I lie down for an hour on the sofa. There is no point in fighting it because my body wont let me do anything else but lie down.
Lastly there are medications that can help the fatigue - provigil for example. But you need to talk this through carefully with your Rheumy as it might be better for your body to slow things down rather than artificially creating energy. Having said that, sometimes we just need that extra energy in order to function. I guess it all depends on our lifestyle and commitments, etc. Not everyone can afford to just rest up when they can.
Do mention the fatigue to your Rheumy. Keep a record of how it feels, how often you feel fatigued, what it prevents you from doing, how it is impacting on your life, etc. These are important considerations for your doctor and very good for you to get an idea of how your Lupus is affecting you.
The very best of luck and let us know how you are doing
Joan:rose: