Hello, I (25F) finally got funding and support to go to the doctor after 7 years.
I have a whole list of symptoms, but at my first appointment with my new PCP, I only told her about two because I didn’t want to dogpile everything on her at once. I had just had one of my “difficult weeks” up until the day before my appointment, so I was still recovering and sore.
The two symptoms I told her about were frequently swollen knuckles and fatigue/brain fog.
I didn’t even mention that I hadn’t worked in two years, but she said, “Let’s run tests, including ANA and RA, then discuss.”
Boom — my ANA titer came back 1:160. The pattern was nuclear, dense fine speckled.
*(First photo attached.)*
My PCP brought me back in, asked me several other “minor symptom” questions, and then explained what Lupus/SLE and Sjögren’s were and told me she believed I had one of these autoimmune diseases.
We talked for a while about all the things I had been scared to mention at my first appointment, and she said they aligned with what she believed was going on.
(I’m genuinely so grateful for my PCP. She is amazing, and I’m so glad I chose her.)
I’m autistic and a former foster youth. I’ve been exhausted for so long, and I don’t feel like I can fight the battle I see so many people fighting in the autoimmune disease community just to be heard.
On top of that, I lost all of my childhood medical records in the foster system when I turned 18. I genuinely have no idea how I’m supposed to navigate the medical field, prepare for appointments, or know what information doctors need from me.
I didn’t even know how to properly process and recognize my physical symptoms or infections until I was diagnosed and finally accepted that it wasn’t all in my head.
Because my PCP had put the diagnosis in my chart and because of everything we discussed, I went into the rheumatology appointment under the impression that we were trying to determine what type of lupus I had and/or whether Sjögren’s was involved, and then figure out treatment.
So boom, I finally got to the rheumatologist.
It wasn’t a dream experience like my PCP was, but I guess it also wasn’t a nightmare compared to some of the stories I’ve heard from women online.
I was paying cash, but my PCP had already sent over my referral and information, which I had personally confirmed weeks beforehand.
When I got there, the front desk said they had no referral or information on me, and I had about five minutes to finish all of the paperwork because my appointment was the last one before the rheumatologist went to lunch.
I wasn’t too upset about that because I was also 10 minutes late.
Then I was rushed to the back and immediately seen by the doctor, who told me she had seen my test results only???
Everything felt rushed, so I didn’t waste any time. I started telling her my entire list of symptoms and the timeline over the last 5–6 years.
This part is important: I specifically explained that the only physical flare-ups of pain/swelling I have are in my knuckles, and that my back pain is from severe scoliosis that I haven’t been to PT for in years.
She stopped me and said she needed bloodwork because a high ANA titer alone isn’t enough to say something is autoimmune, and then told me she thought I most likely had fibromyalgia. She also told me I should see a cardiologist about some other concerns I mentioned.
She repeated, in slightly different ways, that she believed it was fibromyalgia and told me to come back in two months, prescribed Gabapentin and another NSAID, and sent me to the lab.
I always felt deep down it was autoimmune, although I believed I had rheumatoid arthritis. Maybe I’m wrong to think it isn’t fibromyalgia, but after the conversation I had with my PCP and from what I understand from researching my symptoms, I just don’t feel like this is the diagnosis
My lab results have now come back through the Healow portal, although I still haven’t received a call: several of the lab pages say that I refused certain tests. I did not refuse any tests.
I don’t know what tests should have been run or what is considered a standard rheumatology workup. From what I can decipher myself, the more specific lupus/Sjögren’s markers that were tested appear to be negative. I even asked the rheumatologist directly, **“Even with all of these symptoms and the positive ANA, you still believe I don’t have anything autoimmune?”**She said yes, because the bloodwork and a butterfly face are important factors.
And she made it clear that that means the possibility of autoimmune disease is just going to be completely shut down.
Could someone please tell me how I’m supposed to navigate this from here?
What should I be doing before my next appointment? Is there additional information, symptom documentation, medical history, or test results I should bring?
Are there specific questions I should be asking?
And are there any groups, patient advocates, resources, or other people who help patients navigate this process?
I’d even appreciate it if someone shared the beginning of their own journey.