Hi Donna
It was nice to catch you in chat last night and Im glad you are feeling a bit calmer today. If I can offer you some advice for your Rheumy visit...when you go into the consultation the usual 'greeting' is something like 'well, how are you'. Instead of saying 'grand', terrible, crap, etc or whatever the first thing that usually comes to ones lips

, take a deep breath and say something like: 'Im really glad to be here today because I have a few very important questions to ask and I want to hear from you what are my best treatment options'.
The other option is to say 'I hope you dont mind but I have taken the liberty of preparing as well as I could for this consultation and I have a few questions/issues written down here which I hope we can get through'
It doesnt have to be exactly those kind of words but the point I am trying to make is that its important that you take control of the conversation from the get go. Otherwise you may find yourself on the back foot, not explaining yourself well and worse still, come out feeling that you were but not getting heard. There is nothing more frustrating than that.
Before you leave, check that you have all your questions answered. If you are suffering from bad pain then explain how the pain is affecting you. Dont say 'Im in terrible pain all over'. That doesnt really mean much and is hard to know how to treat. If its joint pain, then tell him which joints are worse, how bad they are on a scale of 1-10, how often you are in pain, etc. Also ask him directly if your episodes of pleurisy could be Lupus related and if so what is the best treatment for that.
Im just trying to give you a few tips to prepare for the Rheumy visit and make the most of it. It takes a lot of practice to get it right. Im attending my Rheumy now since early 2005 and I still come out saying 'drat' I should have said this or that! But I am getting better at it
Dont forget to tell him about your on call doctor prescribing you doxycycline and the effect it had on you. Ask him if there is anything else you should know about your condition to help you avoid flare ups, etc. Try and get as much conversation going between the two of you. It will help develop the kind of relationship you need with your Rheumy.
If, at the end of all that, he is still being uncommunicative then I think its time to seek another referral.
Best of luck!
Joan:rose: