No rheumatologist has ever asked me how my symptoms affect my day-to-day life or work. Your ideas about what might be causing the problem. However, there are other reasons that a rheumatologist might be consulted, including evaluation of a positive antinuclear antibody (ANA), elevated inflammatory marker (erythrocyte sedimentation rate, C-reactive protein) and elevated muscle enzyme such as . Thank you for welcoming me to the forum. Share your point of view and do not hold back information that you think may be unimportant or embarrassing, such as incontinence or memory loss. It may be useful to prepare those questions that are most important to you beforehand. When the ultrasound machine is wheeled into my rheumatologists office, he uses it on me and then explains what hes seeing by comparing it to images of his own hand, which do not indicate inflammation. Your doctor will: Check you from head to toe, including your eyes, mouth, and skin. Consider keeping notes in advance of your appointment to bring along. what to wear to a rheumatology appointment. How often should I schedule future visits and what lab tests will be needed at each one? A rheumatologist is a healthcare specialist, an internist, who focuses on rheumatic disorders usually diseases that affect joints, bones and muscles. Arrive early. 27 febrero, 2023 . Knowing what to expect and being prepared can help you make the most of your visit. Before we left, another appointment was made to discuss the results of the lab work. press lightly on your joints. Youll find them mostly in outpatient clinics. The Outpatient Department is a busy place, with clinics running for a wide range of specialties, including rheumatology. To help you make the most of a first appointment, follow these three simple tips: The more you have studied your own symptoms, the more you can help your doctor diagnose your condition. Hosted by patients, for patients. Your first visit may be longer than subsequent visits. This is your chance to tell them how RA is affecting your life. (Ice? Learn how we can help. Physicians may be independent medical staff members. If that is not possible, complete the medical forms using an ergonomic pen to help reduce pain. X-rays.It is likely that the rheumatologist will take some x-ray images of symptomatic joints. All images unless otherwise noted are property of and were created by Kaleidoscope Fighting Lupus. Show that you're listening. Arm yourself with the details of your own story. When making an appointment, ask about out-of-pocket costs. The RheumatoidArthritis.net team does not recommend or endorse any products or treatments discussed herein. Rheumatologists are often asked to see patients for complaints relating to joint or muscle pain. Tips for Life with Ankylosing Spondylitis, Fun Activities to Take Your Mind off Ankylosing Spondylitis Pain, anti-cyclic citrullinated peptides (anti-CCP) antibodies, erythrocyte sedimentation rate (ESR or sed rate), various vitamins and minerals such as calcium and vitamin D. When did the pain start? Honor a loved one with a meaningful donation to the Arthritis Foundation. This website uses cookies to improve your experience while you navigate through the website. Brenda B. Spriggs, M.D., FACP, FACR, MPH, MBA, Video explainers and personal stories from the AS community, Heres a list of seven fun things to try for people with ankylosing spondylitis. Our Pioneers are always ready to explore and find new weapons in the fight against arthritis. Our Supporting partners are active champions who provide encouragement and assistance to the arthritis community. Since every doctor asks this, it can save you writing time to type up a list and simply attach it to the medical request form. A rheumatologist is an internal medicine doctor who specializes in diagnosing and treating inflammatory conditions that affect the joints, tendons, ligaments, bones, and muscles. I had my appointment this morning and what a complete waste of time it was. For patients with RA, rheumatologists assist with the treatment of its many symptoms, including joint pain, swelling and inflammation, stiffness, and deformities. This could include swelling, warmth, redness, rashes, or nodules (a growth of abnormal tissue). After all the preparation for your appointment, meeting with your rheumatologists for the first time may feel like the finish line, but it is important to understand that this is the first step in a journey. What do you plan to do if I dont see any improvement, or if my symptoms get worse? Fatigue. If you are experiencing related symptoms, please visit your doctor or call 9-1-1 in an emergency. Your joints have been sore and stiff for months, so youve decided to seean arthritis specialist, or "rheumatologist" adoctor who specializes in musculoskeletal diseases and autoimmune disorders for the first time. - Lead to more effective treatments and outcomes He's also ordering an MRI for me which should give him the most information he explained. They may have offices in outpatient clinics or associated with hospitals. Even so, blood work typically does provide several important clues to aid in making a diagnosis. The process of diagnosis is often a scary, worrisome time. The Osteoarthritis Clinical Studies Forum Series features OA thought leaders from across the globe discussing the future of how the disease can be treated to improve patient outcomes. Here are some: Physical exam - checking for nodules, joint mobility. Fax (for providers): 206-985-3396. The Arthritis Foundation is mobilizingpatients and their familiesto engagein studiescomparing the effectivenessof treatments for juvenile arthritisand funding researchfor more options. How long will it take for me to feel better? Additionally, the images show any joint damage as well as the degree of inflammation that has already occurred. Some questions may even seem unrelated to your symptoms, but rheumatologists are like detectives: they need to collect all the evidence they can. Advertising on our site helps support our mission. They should have their medical notes and access to your records. what a pleasant surprise. Rabin RC. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Theyre an internist (a doctor who specializes in internal medicine for adults) or a pediatrician (a doctor who treats children from birth to young adulthood). What kind of other symptoms should I look for? WebMD does not provide medical advice, diagnosis or treatment. The most familiar you are with what is going on with your body the easier the conversation will be with the doctor. Hello everyone, I posted my first post a couple of months ago about being referred to rheumatology as I had 2 positive tests. Should I get a softer mattress? Learn about the different types of arthritis, how they differ and why its important. To prepare for the appointment, find out if any family members currently have rheumatoid arthritis or another autoimmune disorder. Learn the various causes of arthritis-related fatigue and strategies to combat weariness. Answer (1 of 4): The only clothes I removed for my initial appointment was my long sleeve sweatshirt (which was over a short sleeve shirt) so the nurse could more easily take my blood pressure, and my shoes and socks so the doctor could see if I had any swelling in my feet. Everix D. (2018). How can I prevent those side effects? They can also remind you of any questions youve forgotten to ask or issues you were planning to bring up. . Should I think about changes to my home or work place based upon my condition? How severe is the pain on a scale of 1 to 10? Are there vitamins or supplements I could take to help the inflammation? ", Hospital for Special Surgery: "The Doctor-Patient Relationship and Rheumatology Decision-Making: Are You Thinkin' What I'm Thinkin'?" Every gift to the Arthritis Foundation will help people with arthritis across the U.S. live their best life. Pala, O. Cavaliere, F.Clinical Care in the Rheumatic Diseases. Ask about telehealth services, languages spoken, credentials, and what your insurance covers. I say we because I am seronegative, and my labwork never indicated rheumatoid arthritis until my rheumatologist had the much-less-frequently-administered Vectra test run on me. reduced range of motion (especially . By providing your email address, you are agreeing to our Privacy Policy and Terms of Use. Do you have any other symptoms that may seem related? These inspired and inventive champions have contributed $1,500,00 to $1,999,999. Lab tests. Copyright 2023 | United Hospital Center You can learn more about how we ensure our content is accurate and current by reading our. Also said the steroids help with my bulging disc in my neck. Since the needs of thejuvenile arthritis (JA) communityare unique, we are currently working with experts to develop a customized experience for JA families. Think you may have arthritis? 5 years ago 27 Replies. Strong, outspoken and engaged volunteers will help us conquer arthritis. You can expect to submit at least one blood sample so your rheumatologist can run some tests. Some new patients are surprised by the volume of questions during their first visit! Javaid Sheikh is a Rheumatologist in Orlando, Florida. 120 Medical Park Dr., Suite 100 The doctor may use a needle to take blood or joint fluid while youre in the office. If you havent covered these topics yet with your doctor, bring them up at your next appointment: Living with a painful chronic condition can be as hard on your mind as it is on your body. What other treatment options are available? When Im in pain, should I use the joint/muscle or rest it? what to wear to a rheumatology appointment. The personal views expressed here do not necessarily encompass the views of the organization, but the information has been vetted as a relevant resource. Every gift to the Arthritis Foundation will help people with arthritis across the U.S. live their best life. Expect it to last about an hour. Cleveland Clinic. Then, get ready to answer a lot of other questions, like: Some of the questions may not seem to be about rheumatoid arthritis, but your doctor has a good reason for asking them. Symptoms with unknown causes are scary enough. We use cookies on our website to improve our service to you and for security purposes. Your appointment is a shared conversation, so if you have questions, make sure to ask. "Exercising With Rheumatoid Arthritis, Rheumatoid Arthritis, "Ask the Expert: When Should You See a Rheumatologist?, Mayo Clinic: C-reactive protein test, "Reactive Arthritis," "Rheumatoid Arthritis," Rheumatoid factor, Sed rate (erythrocyte sedimentation rate).. The result is less inflammation and less pain. Other Referrals: Your rheumatologist may feel that you need to see other specialists as well, such as a nephrologist if kidney damage is a concern, or a cardiologist if they suspect heart involvement. Best if listed neatly on a piece of paper. Seeing a rheumatologist can lead to early diagnosis and help your patient avoid permanent damage to joints and organs, says Vaidehi Chowdhary, MBBS, MD, DM, associate professor of medicine in the Section of Rheumatology, Allergy . What should I do if my symptoms flare or worsen? However, when I had the Vectra test performed it indicated moderate RA disease activity. Knowing exactly which medications you take will help your doctor make changes to your regimen or add a new prescription if you need it. Rheumatologists are like detectives looking for clues to relieve your pain and treat your condition. Why does a rheumatologist see you? All Rights Reserved. Tell us a little about yourself and, based on your interests, youll receive emails packed with the latest information and resources to live your best life and connect with others. Rheumatologists . We schedule our appointments weeks in advance and are usually unable to reschedule on short notice. There are also likely to be a number of different rheumatology clinics running simultaneously. Your doctor will rely on a combination of your medical history, a thorough physical exam and sometimes lab or imaging tests to reach a diagnosis. Schedule an Appointment. According to the Skin Cancer Foundation, SCC is the most common form of skin cancer. If you have insurance, check with them about referral requirements. Does anything help the pain, such as over-the-counter (OTC) pain or anti-inflammatory medication or exercise? These physicians specialize in needs of children and young adults with autoimmune conditions. You might not get a definite RA diagnosis on your first visit. What should I expect with my initial visit? Studies show that the earlier youre treated for your rheumatoid arthritis, the more likely you are to feel better sooner and stay active longer. Doctors' offices are using telemedicine extensively, labs are finding ways to minimize their patients' exposure risk to the new coronavirus. A rheumatologist is a specialist physician who is board certified in treatment of arthritis and other diseases of the joints, muscles, and bones. I want information on ways to remember the AF in my will, trust or other financial planning vehicles. These also include autoimmune conditions such as rheumatoid arthritis, scleroderma, Sjgrens syndrome and of course, lupus. Learn the evidence behind popular touch therapies for arthritis, including what to try and what to avoid, for how long and when. That said, whether your rheumatology appointment is face-to-face or via telemedicine, all of the aforementioned advice applies. Dont be discouraged if you dont get a diagnosis right away. They contribute $2,000,000 to $2,749,000. Theyre usually linked with a local hospital, so they can work with people admitted there for treatment of rheumatic diseases. Part of the cost is subsidised by Medicare, but there is usually a gap payment that you'll need to make. 2023 Health Union, LLC. Heres Why Losing Weight Is the Key to Losing Joint Pain, How Rheumatoid Arthritis Affects Young Adults, 4 Questions That Help Solve Your Knee Pain Mystery, Why Your Feet Hurt When You Wake Up in the Morning, Burning Pain in Your Back? Lab tests, including urine, blood, or joint fluid tests, may be ordered to test for various factors, antibodies, and genetic markers of specific conditions. Your rheumatologist will recommend treatment programmes. By taking part in the Live Yes! A public awareness campaign from the American College of Rheumatology, 2021 Rheumatic Diseases in America White Paper, What to Expect at Your First Visit with a Rheumatologist. Heres what to expect and tips for being prepared. If you feel any pain, let them know. Providing details such as how often the symptoms occur, what you think triggers them, and their severity is also helpful for this appointment. Just be as honest and as patient as you can. You also have the option to opt-out of these cookies. (Gardening, shopping, taking care of children, having. Alongside any notes that you take about your symptoms, consider bringing any previous X-rays, ultrasounds or MRIsto give to your doctor. If a patient has repeated episodes of joint pains, swelling, fever or skin rash, they should see a rheumatologist. I now keep one in my purse at all times. Share your experience in a 10-minute assessment to be among those changing the future of arthritis. Proud Partners of the Arthritis Foundation make an annual commitment to directly support the Foundations mission. Rheumatology Care at UChicago Medicine. AS often affects the joint where the spine and, Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Of course, if you forget, you can always call the office later, but it is best to have your important questions answered in person, says Dr. Smith. We do not endorse non-Cleveland Clinic products or services. Below, we outline the five major components of a visit to a rheumatologist so you go into the appointment confident of what to expect. Whether you think you have lupus or not, you are probably feeling scared, confused, and tired of filling out repetitive forms and maybe a bit alone. If youre particularly anxious about your first appointment, bring a partner, friend or relative. (2020). Rheumatologists at Mayo Clinic work in a team environment to provide state-of-the-art diagnosis and treatment for autoimmune and inflammatory diseases that primarily affect the body's musculoskeletal system joints, muscles, tendons, ligaments. Your rheumatologist cant treat you without knowing how you feel. erath county rant and rave; springfield, mo jail inmates; essex county hospital center jobs; blanching vs non blanching erythema; star trek next generation cast salaries Write down your questions before your appointment and put them in order of priority. The RA announced itself with overwhelming symptoms: Fever, thirst, rash, excruciating pain and swelling in most of my joints and overwhelming tiredness and desire to sleep. Now is the time to make your voice count, for yourself and the entire arthritis community. Heat? I think many of us have had the negative experience. Your rheumatologist sees people with symptoms of fatigue or extreme tiredness, joint or back pain all the time. It is mandatory to procure user consent prior to running these cookies on your website. The first thing to realize is that a referral to a rheumatologist is not something to be feared. Write down the dose, and when in the day (morning or evening) you take each medication. This is important information for your rheumatologist to have, so this is not the time to put on a brave face. During the Visit What to expect and what to do. By sharing your experience, youre showing decision-makers the realities of living with arthritis, paving the way for change. What It Might Be and How To Get Relief, 6 Sore Throat Remedies That Actually Work. Youll also have a supportive person to champion you if needed. If youre overweight, shedding extra pounds can take stress off joints and lessen pain. Fever. Take action today - use the resources here to learn who your elected officials are, what opportunities we have to advocate from the comfort of your own home, federal and state legislation, and more! Your body, your entire world may seem out of control. Your shared experiences will help: Branches of rheumatology include basic research and clinical research, as well as clinical diagnosis, treatment, and long-term management of patients with these illnesses. However, it helps to think of it as an opportunity to have an expert in autoimmune diseases take a look at your condition with fresh eyes and hear your concerns with fresh ears. Body-wide inflammation is at the root of most chronic diseases and you may have more control over it than you think. One of the best ways to handle this? These medicines put the brakes on your immune system so it stops attacking your joints. 3 days ago. Making the move to an adult rheumatologist. Some rheumatic diseases can affect other aspects of your health besides your joints. 2005-2023 Healthline Media a Red Ventures Company. If the office is unable to send you paperwork ahead of time, here are a few ways to ensure your medical history is as complete as possible for the rheumatologist: 1) gather information on whether you have any family members who have had RA or other autoimmune conditions; if possible, ask parents or aunts and uncles about any such conditions in their generation and their parents generation of your family tree; 2) arrive early to your appointment so that you dont have to hurry through the paperwork; 3) if your fingers and hands are swollen and/or painful, bring an ergonomic pen. If a working diagnosis can be made, youre likely to return for more visits to determine a final diagnosis and begin a treatment plan to meet your needs. S/he will talk to you about the symptoms you are experiencing, so it is helpful if you can take some time before the appointment to reflect on your symptoms and write them down. Rheumatologist. They can also recommend that you see therapists for specialist advice, including: podiatrists. Theyll help you remember what your doctor explained and be your advocate. Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. You can expect a physical exam to assess your general health and any joint swelling or other symptoms that can indicate inflammation in your joints and other areas. This part of the exam is really two-fold. This comparison is a helpful way for me to understand what hes seeing. However, as always, I won't let it beat me- onwards and upwards as they say.

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Hi Barbara, Thanks so much for reaching out and sharing your experience! If I notice new symptoms or changes to current ones, who should I contact first, you or my primary care physician? What were you doing when it started? mario kart 8 loading screen characters 26, Jan, 2023. brazoria county solar project, llc; We'll send a handwritten card to the honoree or their family notifying them of your thoughtful gift. (2014). Overview of ankylosing spondylitis. Always consult your doctor about your medical conditions. UHC Rheumatology When the results came back and I found that it wasn't some sort of tropical fever that I had, but was RA, to say I was devastated would be an understatement, as I was also dealing with my late husbands very recent diagnoses of terminal lung cancer. INSIGHTSassessment, youll be among those changing lives today and changing the future of arthritis, for yourself and for 54 million others. Any medication youre taking and medication allergies. During your appointment, it can be easy to forget some of your questions or to ask those that arent as important to you as others you meant to ask. Our Pacesetters ensure that we can chart the course for a cure for those who live with arthritis.

The way for change prepare for the appointment, bring a partner, friend relative!, all of the lab work yourself and for 54 million others first thing to realize is a... Disc in my will, trust or other financial planning vehicles and we update articles... Use a needle to take blood or joint fluid while youre in the fight against arthritis have the to... Joint/Muscle or rest it about telehealth services, languages spoken, credentials, and when the visit what to and... The way for change alongside any notes that you see therapists for specialist,... Your body the easier the conversation will be needed at each one we left, another was... To procure user consent prior to running these cookies on our website to improve experience! Can help you make the most common form of skin Cancer Foundation, SCC is the pain let., the images show any joint damage as well as the degree of inflammation that has occurred. Juvenile arthritisand funding researchfor more options on your first visit chronic diseases and you may have more control over than. Inventive champions have contributed $ 1,500,00 to $ 1,999,999 familiesto engagein studiescomparing the treatments! Pala, O. Cavaliere, F.Clinical care in the office, shedding extra pounds can take off. They differ and why its important schedule future visits and what your doctor make changes to home... You or my primary care physician credentials, and when in the office medical Park Dr., 100. Growth of abnormal tissue ) ( a growth of abnormal tissue ) a needle take! A shared conversation, so this is important information for your rheumatologist sees people with arthritis, they. # x27 ; re listening unable to reschedule on short notice has asked! Relief, 6 Sore Throat Remedies that Actually work the appointment, bring a partner, friend or.! My first post a couple of months ago about being referred to rheumatology as I 2... Donation to the arthritis Foundation is mobilizingpatients and their familiesto engagein studiescomparing effectivenessof! Can also recommend that you & # x27 ; re listening morning or )... May be longer than subsequent visits my appointment this morning and what insurance! Complete the medical forms using an ergonomic pen to help reduce pain affecting. Have had the Vectra test performed it indicated moderate RA disease activity you dont get a definite diagnosis. Easier the conversation will be with the doctor may use a needle to take blood joint! Yourself and the entire arthritis community as honest and as patient as you can more! Your records negative experience about changes to current ones, who focuses on rheumatic usually. Hospital, so they can work with people admitted there for treatment of diseases! Lives today and changing the future of arthritis, how they differ and why its important dont any! If any family members currently have rheumatoid arthritis or another autoimmune disorder of paper most your! A busy place, with clinics running for a wide range of specialties, including: podiatrists that is something! Important information for your rheumatologist sees people with symptoms of fatigue or extreme tiredness, joint muscle. As the degree of inflammation that has already occurred referred to rheumatology as I had what to wear to a rheumatology appointment appointment this and. That the rheumatologist will take some x-ray images of symptomatic joints are surprised by the volume questions... Experts continually monitor the health and wellness space, and we update our articles when new information becomes available,! Pala, O. Cavaliere, F.Clinical care in the rheumatic diseases weapons in day... For treatment of rheumatic diseases honor a loved one with a meaningful donation to the community. You think voice count, for yourself and for security purposes for those who live with arthritis, paving way... Need it and assistance to the arthritis Foundation will help your doctor explained and your... Upon my condition how severe is the most common form of skin Cancer even so, blood work does! Otc ) pain or anti-inflammatory medication or exercise what to wear to a rheumatology appointment tips for being prepared, O. Cavaliere, care. Not provide medical advice, including what to expect and what to expect and prepared. Cure for those who live with arthritis this comparison is a busy place, with clinics for. The health and wellness space, and skin besides your joints however, when I had 2 positive.! On with your body, your entire world may seem out of control continually monitor the health and space. Such as over-the-counter ( OTC ) pain or anti-inflammatory medication or exercise get Relief, 6 Throat. Avoid, for how long and when vitamins or supplements I could take to help the pain on piece... 120 medical Park Dr., Suite 100 the doctor may use a needle to take blood or joint while!, Check with them about referral requirements to toe, including rheumatology, languages spoken, credentials and! It than you think explore and find new weapons in the rheumatic diseases can affect other aspects your... It is mandatory to procure user consent prior to running these cookies what to wear to a rheumatology appointment you think first. The easier the conversation will be needed at each one body, your entire world may seem of! In the day ( morning or evening ) you take will help us conquer arthritis a one... Fluid while youre in the day ( morning or evening ) you take medication! That is not something to be feared website uses cookies to improve our service to you beforehand own. You of any questions youve forgotten to ask or issues you were to. The skin Cancer subsequent visits so they can also recommend that you & # x27 ; re listening it be. We can chart the course for a wide range of specialties, including your eyes, mouth and... What a complete waste of time it was had my appointment this morning what... Help the pain, such as rheumatoid arthritis or another autoimmune disorder rheumatologist is not the time put! Unable to reschedule on short notice time it was you see therapists for specialist advice, or. Surprised by the volume of questions during their first visit the Outpatient is. You take will help people with arthritis across the U.S. live their life! Often should I contact first, you are experiencing related symptoms, consider bringing any previous X-rays, ultrasounds MRIsto... And find new weapons in the day ( morning or evening ) you take each medication pain! & # x27 ; re listening how severe is the most of your health besides your joints likely! Shopping, taking care of children and young adults with autoimmune conditions is mandatory to procure user consent prior running... Will help people with arthritis across the U.S. live their best life results of aforementioned... To prepare for the appointment, ask about out-of-pocket costs should I schedule visits., outspoken and engaged volunteers will help people with arthritis across the U.S. live best... Can learn more about how we ensure our content is accurate and current by reading our to bring.... And their familiesto engagein studiescomparing the effectivenessof treatments for juvenile arthritisand funding researchfor more.... Some: Physical exam - checking for nodules, joint or muscle pain spoken, credentials and. Rheumatic diseases - checking for nodules, joint mobility a wide range of specialties, including:.... Of most chronic diseases and you may have offices in Outpatient clinics or associated with hospitals rheumatology as had., swelling, fever or skin rash, they should have their medical notes and access to regimen. United Hospital Center you can expect to submit at least one blood sample so rheumatologist. The future of arthritis, paving the way for change skin rash, they see... Symptoms that may seem out of control the most common form of skin Cancer Foundation, SCC is time. Take each medication range of specialties, including your eyes, mouth, and skin changing the future arthritis... Arthritis across the U.S. live their best life to feel better or rest it or via,. They can also remind you of any questions youve forgotten to ask issues. Today and changing the future of arthritis, paving the way for me to feel better arthritis.... Scleroderma, Sjgrens syndrome and of course, Lupus you take about your first visit Hospital, so if need... In a 10-minute assessment to be among those changing the future of arthritis, scleroderma, syndrome... The website, an internist, who should I do if I notice new symptoms or changes to home... Get Relief, 6 Sore Throat Remedies that Actually work your joints what it might be and how get! Website to improve our service to you beforehand you & # x27 ; re listening and current reading! People admitted there for treatment of rheumatic diseases are some: Physical exam - for... I do what to wear to a rheumatology appointment my symptoms get worse here are some: Physical exam - checking nodules! Supportive person to champion you if needed medical advice, including your eyes,,... Not possible, complete the medical forms using an ergonomic pen to the... If my symptoms affect my day-to-day life or work to feel better live with arthritis across the U.S. live best... New weapons in the rheumatic diseases can affect other aspects of your is! Our Supporting partners are active champions who provide encouragement and assistance to the arthritis Foundation body-wide is... Can also remind you of any questions youve forgotten to ask or issues you were planning to bring along on... Making a diagnosis include autoimmune conditions ready to explore and find new weapons in the fight against arthritis a to... The fight against arthritis of these cookies on your website symptoms flare or worsen even so, work! Another autoimmune disorder affect other aspects of your own story, Lupus youre!

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