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Welcome to www.LupusMCTD.com
This forum is for folks who have an autoimmune disease (Lupus, Mixed Connective Tissue Disorders, etc.) and for their loved ones. It is a place to share experiences and information with each other.

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a)As with any public forum, be considerate of others.

b)This is a place for SECURITY and & UNDERSTANDING of a serious medical matter we live with.

c)"PLAYING GAMES" is on an actual link we have here, not through private messages.
The arcade game link your'e more than free to go play with.

These boards has always been a friendly place to meet other Lupus sufferers, Mixed Connective Tissue Disorders .
Not limited to but to include Fibro, Raynauds, Sjogren's Syndrome, Arthritis of all forms, Polymyositis, Dermatomyositis, Thyroid Diease, Vasculitis, Fibro, etc

This is a friendly place to share advice and offer support. I fully intend them to stay that way.

A reminder-
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This is not allowed and members who do so, lose their privelages to post.
4)Any previous banned members who come in here useing another members screen name and password, both of you will be banned.

Any action I decide is necessary to take is final and shall not be put into question. Anyone found to be abusive to me or other members, either on the boards, by PM or email, will be banned from the boards.

Please work with me to help keep these boards the special place I have all worked hard for them to become.


~Multiple Sclerosis, Fibromyalgia and Lupus -
How Do You Know Which One You Have?

Many people who are eventually diagnosed with Multiple Sclerosis (MS) often spend years misdiagnosed with other diseases and conditions. (We have concentrated on 3 main ones, although there are also other conditions with similar symptoms.) Even worse, some patients who present doctors with a bewildering variety of complaints may be written off as having psychosomatic symptoms - basically being told that it's "all in your head"! So how do you avoid this problem? How do you find out what is really going on with you?

Write a complete symptom history for your doctor or neurologist. Too often, doctors are only told about symptoms that are occurring right now, and only getting part of the picture.
To help you accomplish this, www.LupusMCTD.com will give you a brief description of MS, Fibromyalgia and Lupus, their symptoms, and tests for each.

~ What Is It? ~
Multiple Sclerosis 
MS is an autoimmune disease of the central nervous system (CNS). The nerve cells in the brain and spinal cord, which make up the CNS, are connected to each other by long fibers called axons which are covered with a protective myelin sheath. The body's own immune system attacks the myelin sheaths and axons, causing inflammation and scarring (thus multiple sclerosis - multiple scars). When enough axons and nerves are damaged, the messages carried by the nervous system are disrupted, causing the symptoms of MS. The symptoms of any one individual with MS are dependent on what areas of the CNS have been damaged. For this reason, symptoms differ from one person to another, and can be temporary, recurring or permanent. Symptoms also come and go depending on whether a person is having an exacerbation (attack) or a remission.

~ Who Gets It? ~
Who Gets Multiple Sclerosis? 
Multiple sclerosis usually affects people between the ages of 20-50 with most people experiencing their first symptoms in their 20's or 30's.There are higher numbers of cases in certain northern latitudes, including Washington. Approximately two thirds more women than men have MS, and more Caucasian people are affected than other ethnic populations. Studies indicate that genetic factors may make certain individuals more susceptible to MS, but no evidence exists that it is directly inherited.

~ What are the Symptoms? ~
Symptoms of Multiple Sclerosis include, but are not limited to: 
Blurred or double visionBladder or bowel problemsCoordination and balance difficultiesMuscle spasticity, or stiffnessTremors  ParalysisSlowing or slurring of speechMemory problemsDepression and/or mood swingsHeat sensitivityOverwhelming or unusual fatigueDiminished sexual sensationNumbness and/or tingling sensationsConfusion, difficulty focusing, organizing or planningWeakness in the arms or legsHeadaches

~ How Do You Test For It? ~
Testing for Multiple Sclerosis 
For a clear diagnosis of MS, the doctor has to find evidence that multiple distinct parts of the central nervous system are affected. The neurologist will first take the patient's medical history of what the symptoms are; when the first symptoms occurred, how long they lasted, whether they cause any pain, and a variety of other physical health questions
Once these tests are performed, the neurologist may order an MRI (Magnetic Resonance Image). MRIs look for plaques, or lesions, in the brain and spine. A gadolinium-enhanced MRI reviewed by an MS specialist neurologist will provide your best chance at accurate diagnosis via this method. 
While MRIs are the most useful testing device doctors have for finding MS, they do not uncover every case of MS. At least 10% require further testing and a complete symptom history to facilitate diagnosis. Many times evoked potential tests (EP) are used to measure the impulses along neural pathways running throughout the body that may be damaged. In addition, a lumbar puncture (LP) may be done to look for abnormalities in the Cerebral Spinal Fluid (CSF) and blood tests may be ordered to exclude other diseases that mimic MS symptoms. With all this information gathered during the examination and testing, a diagnosis of multiple sclerosis can usually be determined.

~Lupus ~
Lupus is a widespread and chronic autoimmune disease that causes the immune system to attack the body's own tissue and organs, including the joints, kidneys, heart, lungs, brain, blood or skin. In lupus the immune system, for unknown reasons, loses the ability to tell the difference between foreign cells and the body's own cells and tissue. Once this happens, the antibodies attack different areas of the body. Symptoms can range from mild to life-threatening and can vary greatly from person to person. Approximately one third of patients with lupus also develop fibromyalgia. Lupus can also have periods of flares (attacks) and remission. 

~Who Gets Lupus? 
Lupus develops most often between the ages of 15 and 44. It occurs 10-15 times more frequently among adult females than adult males. It is also 2-3 times more common among African Americans, Hispanics, Asians and Native Americans*. 10% of people with lupus have a parent or sibling with lupus and 5% of children born to someone with lupus will develop the disease. Both genetic predisposition and environmental factors play a role in triggering the disease. Triggering factors include infections, antibiotics, ultraviolet light, extreme stress, and hormones. Hormonal factors may explain why lupus occurs more frequently in women than men.(*Statistics taken from Lupus Foundation of America).

~Symptoms of lupus include, but are not limited to: 
Achy jointsPhotosensitivityFevers (over 100F)Hair loss ArthritisAbnormal blood clotting problemsOverwhelming or unusual fatigueCold sensitivity (Raynaud's phenomenon) Skin rashesSeizures AnemiaMouth or nose ulcers Kidney involvementDepression Pleurisy (pain in chest while breathing)Cognitive dysfunctionGI problems  Headaches
~Testing for Lupus~
To help distinguish Lupus from other diseases, the American Rheumatism Association established a list of 11 abnormalities which help distinguish lupus from other diseases. To make a diagnosis of Lupus the patient must have had at least 4 of these, though they do not all have to occur at the same time.
Malarrash (rash over the cheeks) or Discoid rash (raised red patches)
Photosensitivity (reaction to sunlight - rash)
Oral Ulcers (sores in nose or mouth)
Arthritis (pain in joints)
Serositis (inflammation of organ tissue and abdominal pain)
Pleuritis (inflammation of lining of lung) or Pericarditis (inflammation of lining of the heart)
Renal disorder (excessive protein or cells in urine)
Neurological disorder (seizures or psychosis)
Hematological disorder (low red blood count, low white blood count, low lymphocyte count, low platelet count)
Immunologic disorder (positive LE cell, anti-DNA or anti-SM antibodies tests or positive syphilis (VDRL) test)
Anti-Nuclear Antibodies (positive ANA test)
In addition to these tests your doctor will take a complete symptom history, so having a list of your symptoms, when they started, and how long they have been manifesting, is an important first step.

~Fibromyalgia ~
Fibromyalgia syndrome (FMS) is characterized by widespread pain and fatigue. Fibromyalgia means pain in the muscles, ligaments and tendons - the fibrous tissues in the body. There is also a substantial symptom overlap between fibromyalgia and chronic fatigue syndrome (CFS). Some experts even believe that fibromyalgia syndrome and chronic fatigue syndrome are one and the same. If you can remember what it felt like the last time you had the flu - exhaustion, every muscle feeling pulled and overworked, hypersensitive skin, etc. - then you have an idea of what fibromyalgia entails. As with MS however, FMS presents a wide range of symptoms which can wax and wane, and can differ from person to person.

~Who Gets Fibromyalgia? 
Approximately 20 out of every 1000 people get this condition. Over 85% of these are women. Viral or bacterial infections, automobile accidents, or development of another disorder, such as rheumatoid arthritis, lupus or hyperthyroidism can bring about the onset of fibromyalgia. There is a genetic component to this disease and a genetic predisposition, combined with a triggering event, may cause disease onset.

~Symptoms of fibromyalgia include, but are not limited to: 
 Pain - muscular aching, burning throbbing, shooting, stabbing pain
  Irritable Bladder Syndrome
 Stiffness & pain - especially in morning  Dysmenorrhea (painful menstrual periods)
 Overwhelming or unusual fatigue 
Cognitive or memory problems
 Sleep disorder 
Cold sensitivity (Raynaud's phenomenon)
Numbness and/or tingling sensations
 Irritable Bowel Syndrome
 Impaired coordination
 Chronic headaches  Dizziness
 Temporomandibular Joint Dysfunction Syndrome (TMJD) - face & jaw pain  Multiple Chemical Sensitivity Syndrome - odors, noise, bright lights, medications, various foods, etc.
 Muscle twitching 
Dry eyes and mouth

~Testing for Fibromyalgia 
Because fibromyalgia is not considered a disease but rather a clinical invention to describe a chronic pain syndrome, there are no blood tests or x-rays which reliably diagnose fibromyalgia. In order to diagnose fibromyalgia, a physician must take a careful history and perform an examination which focuses on specific local areas of tenderness. These locations are called tender points. There are 18 specified tender points, and the patient must have a finding of pain (not just tenderness) in at least 11 of the 18 points, together with a history of widespread pain in all 4 quadrants of the body for 3 months or more. The doctor will also look at symptom history to determine whether the symptoms reported match the symptoms for FMS.


Systemic Lupus Erythematosus

Systemic lupus erythematosus (lupus) is a chronic inflammatory connective tissue disorder that can involve joints, kidneys, mucous membranes, and blood vessel walls.
About 90% of people who have lupus are young women in their late teens to 30s, but children (mostly girls) and older men and women can also be affected. Lupus occurs in all parts of the world but may be more common in blacks and in Asians.

The cause of lupus is usually not known. Occasionally, the use of certain drugs (such as hydralazine and procainamide, which are used to treat heart conditions, and isoniazid, which is used to treat tuberculosis) can cause lupus. Drug-induced lupus usually disappears after the drug is discontinued.

The number and variety of antibodies that can appear in lupus are greater than those in any other disorder. These antibodies, which are the underlying physiologic problem in lupus, along with other unknown factors, determine which symptoms develop. However, the levels of these antibodies may not always be proportional to the person's symptoms.

Discoid lupus erythematosus is a form of lupus that affects only the skin. In this condition, raised round bumps occur, with scaling and sometimes with scarring and hair loss in affected areas. In 10% of people, manifestations of lupus—for example, those affecting the joints, kidneys, and brain—may occur but are generally mild.

Symptoms vary greatly from person to person. Symptoms may begin suddenly with fever, resembling an acute infection, or may develop gradually over months or years with episodes (called flare-ups) of fever, feeling unwell, or any of the symptoms discussed below alternating with periods when symptoms are absent or minimal.
 For many women, lupus flare-ups occur during the second half of the menstrual cycle, with symptoms disappearing when menstruation starts.

Migraine-type headaches, epilepsy, or severe mental disorders (psychoses) may be the first abnormalities that are noticed. Eventually, however, symptoms may affect any organ system.

Joint symptoms, ranging from intermittent joint pains (arthralgias) to sudden inflammation of multiple joints (acute polyarthritis), occur in about 90% of people and may exist for years before other symptoms appear. In long-standing disease, marked joint deformity may occur (Jaccoud's arthropathy). However, joint inflammation is generally intermittent and usually does not damage the joints.

Skin rashes include a butterfly-like redness across the nose and cheeks (malar butterfly erythema); raised bumps or patches of thin skin; and red, flat or raised areas on the face and sun-exposed areas of the neck, upper chest, and elbows.

 Blisters and skin ulcers are rare, although ulcers do commonly occur on mucous membranes, particularly on the roof of the mouth, on the inside of the cheeks, on the gums, and inside the nose.

Generalized or patchy loss of hair (alopecia) is common during flare-ups. Mottled red areas on the sides of the palms and up the fingers, redness and swelling around the nails, and flat, reddish-purple blotches between the knuckles on the inner surfaces of the fingers also may occur.

Purplish spots (petechiae) may occur because of bleeding in the skin as a result of low platelet levels in the blood. Sensitivity to sunlight (photosensitivity) occurs in 40% of people, particularly in whites.
Systemic Lupus Erythematosus

It is common for the person to feel pain when breathing deeply. The pain is due to recurring inflammation of the sac around the lungs (pleurisy), with or without fluid (effusion) inside this sac. Inflammation of the lungs (lupus pneumonitis), resulting in breathlessness, is rare, although minor abnormalities in lung function are common. Life-threatening bleeding into the lungs may rarely occur.

Chest pain due to inflammation of the sac around the heart (pericarditis) is often present. More serious but rare effects on the heart are inflammation of the walls of the coronary arteries (coronary artery vasculitis), which can lead to angina  or inflammation of the heart muscle with scarring (fibrosing myocarditis), which can lead to heart failure

Widespread enlargement of the lymph nodes is common, particularly in children, young adults, and in blacks of all ages. Enlargement of the spleen (splenomegaly) occurs in about 10% of people. The person may experience nausea, diarrhea, and vague abdominal discomfort. The occurrence of these symptoms may be the forewarning of a flare-up.

Involvement of the brain (neuropsychiatric lupus) can cause headaches, mild impairment of thinking, personality changes, stroke, epilepsy, severe mental disorders (psychoses), or a condition in which a number of physical changes may occur in the brain, resulting in disorders such as dementia.

Blockage of arteries in the brain or lung due to thrombosis or embolism can also occur.

Kidney involvement may be minor and without symptoms or relentlessly progressive and fatal. The most common result of this impairment is protein in the urine.

Rarely, the blood vessels at the back of the eye become inflamed (retinitis). Blindness can develop over a few days.

Characteristics of Lupus
At least four of the following symptoms are generally present for a diagnosis to be made:
Red, butterfly-shaped rash on the face, affecting the cheeks
Typical skin rash on other parts of the body
Sensitivity to sunlight
Mouth sores
Joint inflammation (arthritis)
Fluid around the lungs, heart, or other organs (serositis)
Kidney dysfunction
Low white blood cell count, low red blood cell count due to hemolytic anemia, or low platelet count
Nerve or brain dysfunction
Positive results of a blood test for antinuclear antibodies
Positive results of a blood test for antibodies to double-stranded DNA

Doctors suspect lupus mainly on the basis of its symptoms and findings on a careful physical examination, particularly if they occur in a young woman. Nonetheless, because of the wide range of symptoms, distinguishing lupus from similar diseases can be difficult for a doctor at first.

Laboratory tests can help doctors confirm the diagnosis. A blood test can detect antinuclear antibodies, which are present in almost all people who have lupus. However, these antibodies also occur in other diseases. Therefore, if antinuclear antibodies are detected, a test for antibodies to double-stranded DNA is also performed. A high level of these antibodies almost definitely means the person has lupus, but not all people who have lupus have these antibodies. Other blood tests may be performed to predict the activity and course of the disease. A blood test to detect antibodies to phospholipids can help identify people at risk for thrombosis. Blood tests can also indicate anemia, a low white blood cell count, or a low platelet count.
Laboratory tests can detect the presence of protein or red blood cells in the urine or an elevation of creatinine in the blood; these findings indicate kidney damage caused by glomerulonephritis. Sometimes a biopsy of kidney tissue must be performed to help the doctor plan treatment.

Prognosis and Treatment
Lupus tends to be chronic and relapsing, often with symptom-free periods that can last for years. Flare-ups occur less often after menopause. Because many people are being diagnosed earlier than in the past and because better treatment is available, the prognosis has improved markedly over the last two decades.
 However, because the course of lupus is unpredictable, the prognosis varies widely. Usually, if the initial inflammation is controlled, the long-term prognosis is good.

 Early detection and treatment of kidney damage reduces the incidence of severe kidney disease.

Treatment depends on which organs are affected and whether the lupus is mild or severe.

Mild lupus may require little or no treatment. Aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) (see Pain: Nonsteroidal Anti-Inflammatory Drugs) often can relieve joint pain. Aspirin is used in low doses if the person's blood has a tendency to clot, as happens in some people with lupus (aspirin reduces the tendency of blood to clot by reducing the tendency of blood platelets to stick together); aspirin or NSAID doses that are too high can harm the liver and kidney.

Hydroxychloroquine, chloroquine, or quinacrine, sometimes taken in combination, helps relieve joint and skin symptoms. Sunscreen lotions (with a sun protection factor of at least 30) should be used, especially by people who have skin rashes.

Severe lupus is treated immediately with a corticosteroid such as prednisone  The dose and duration of treatment depend on which organs are affected.
 Sometimes an immunosuppressive drug such as azathioprine or cyclophosphamide is given to suppress the body's autoimmune attack.

Mycophenylate mofetil is another new alternative immunosuppressive drug. The combination of a corticosteroid and an immunosuppressive drug is most often used for severe kidney disease or nervous system disease and for vasculitis.

Once the initial inflammation is controlled, a doctor determines the dose that most effectively suppresses inflammation over the long term. Usually, the dose of prednisone is gradually decreased when symptoms are controlled and laboratory test results improve. Relapses or flare-ups can occur during this process. For most people who have lupus, the dose of prednisone can eventually be decreased or occasionally discontinued.

Surgical procedures and pregnancy are more complicated for people who have lupus, and they require close medical supervision. Miscarriages and flare-ups after childbirth are common, but pregnancy need not be avoided if conception is delayed until after flare-ups subside.

If inflammation of the blood vessels at the back of the eye occurs, doctors give prompt treatment with an immunosuppressive drug because of the high risk of blindness.


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Doctor/Patient Communications

Many people come from a generation that did not ask questions of a doctor. They expected doctors to figure out what was wrong and have all the answers. Others feel they want to ask questions. But they don't feel comfortable doing it when the doctor is rushed - or when the doctor doesn't encourage them to ask question. However, doctors aren't mindreaders. The doctor-patient relationship is a two-way street. The patient needs a doctor for care, and the doctors need feedback in order to provide the best care. Good doctor/patient communication requires a relationship that goes two ways.

People become doctors because they want to care for people, and most hoped largely to cure. But doctors working with patients who have chronic illnesses have to shift their mind-set - to caring for people over time rather than curing. It can be difficult for doctors to know if they are meeting the needs of patients with chronic illnesses. So feedback is very important.

Feedback can be:

*~information about how your illness affects you,
*~honesty about other care you may be receiving, or
*~feelings about the doctor's care.
*~Some people provide feedback by writing letters to make their needs clear. They may also write thank you notes when they feel they receive good care.

Patients are consumers. You or your insurance is paying for a service. You are entitled to good service. It can be frustrating if you feel doctors are doing you a favor by seeing you - but that can happen if the doctor is very busy. You may be reluctant to ask questions. But if you don't, then you may not get all the information you need. It is up to you to ask for good service. But that may take some assertiveness. If you are not satisfied with your care - after trying to improve communications over several visits - it may be time to find a new doctor.

To start a relationship with a doctor, treat it like any other relationship. You want to find out what the other person is like, and you want him or her to know you.

You need to think about how to let the doctor know:

*~who you are as a person,
*~what your values are in relation to health care,
*~how the disease has affected your life and changed you, and
*~how your needs are different from other people with the same disease.
*~Workshop participants presented problems they have had communicating with their doctors. *~Then the speakers and participants brainstormed ways to build a relationship with a doctor.

The first theme that emerged was that patients want doctors to listen to their concerns or ideas. You need to have an open discussion in which you feel heard and proceed from there. One group member said that she talked about why she might be having muscle weakness, and her doctor listened to her. Sometimes you know your body best - and that can help a doctor plan treatment.

Another theme was how to get the doctor to know you as a person. One member said that it seemed as though doctors do not have enough time. By the time you report your symptoms, they test your muscle strength, and you discuss medications, there is no time left for personal discussion. But patients are not asking too much by wanting their doctors to know more about the effects of the illness on their daily lives.

One possibility is asking your doctor for extra time at the next appointment to discuss things that are affecting your personal life or business activities. Then, make sure it's scheduled. It can be valuable to add a positive comment - tell the doctor what aspects of care you are happy with.

Another participant discussed problems in "the system" that are frustrating. For example, she had specifically scheduled the first appointment of the morning so that she wouldn't have to wait long. But another patient was seen before her, and she had to wait a long time for her turn. The result: she was feeling stiff from waiting. Another problem: appointments are sometimes mixed up, and the staff double books appointments. Make sure to tell these problems to your doctor, who may not know all of what goes on in the "outer office."

Some members felt frustrated with doctors' explanations of technical information. One said that the doctor gave her a diagnosis and sent her to a physical therapist, but she didn't understand what she had until the physical therapist explained it. You need to be educated about what is going on and not just given a diagnosis - that's part of your doctor's job.

 One participant started bringing a tape recorder to her appointments - because her doctor sometimes talks fast. She wants to make sure that she remembers what the doctor tells her. When patients explain that stress makes it difficult to "hear" during a visit, doctors may not be intimidated by a request to tape the visit. Tell the doctor that you understand that a particular diagnosis may be common for them, but it's new to you -- and stressful. So you need to go over new information several times to understand.

Many people are uneasy when their doctors don't look at them. It's normal to need eye contact - which helps create trust. To ask a doctor to look at you while speaking, try using humor and practice asking questions. Some doctors may not be comfortable with the emotional part of the doctor/patient relationship. They may be afraid of getting too involved.

Although doctors are taught that they should look at people, sometimes an emotional topic makes it difficult. Telling your doctor that you need eye contact can improve your relationship. It can also help the doctor develop a skill that will benefit other patients. But remember, like any other relationship, the doctor/patient relationship depends on chemistry. If you and your doctor just don't click, you are wrong for each other.

Other group members said that their doctors always seem very busy and rush through appointments. You can find ways to approach busy doctors. Acknowledge how busy the doctor is and let him or her know that you care about them too. But also let the doctor know what you need. It helps the doctor provide better service and teaches the doctor what patients' want and need.

One group member shared how she developed a relationship with her doctor. At first, she felt that she was getting good medical care. But it was difficult because she felt like a number - like any patient rather than an individual. There was no emotional link. She was determined to find ways to communicate with the doctor on a more personal level. She learned what her doctor likes and now bonds with him over basketball and coffee. Finding ways to relate to your doctor - making a connection - is important.

One participant was concerned about telling her doctor when she feels depressed. The doctor tells her that maybe she should see a psychologist, but she just wants him to listen and show compassion. You should be able to tell your doctor when you are upset about something. It's important for your doctor to know when your mood is changing over time. Many people get depressed - aside from chronic illness. Sometimes it just takes five minutes of listening to help, but sometimes treatment with medication or therapy may be needed. By telling your doctor how illness affects your life on an ongoing basis, your doctor can better understand symptoms of depression.

Patients are entitled to

*~good medical care,
*~education about their illness, its treatment, and how it can affect their lives,
*~getting questions answered,
*~respect for their individuality,
*~honesty about the details of diagnosis, prognosis (outlook), and treatment.

Reviewing a list of items to think about before appointments can help organize your thoughts and needs before appointments. This will help both you and your doctor. Think about what you want to get out of the visit and mention it to your doctor at the start of your visit. Make sure you get answers to your questions during the visit.

If you forget a question or one is not answered, call soon after so that you aren't waiting anxiously until the next visit. Remember, the only way to have a two-way relationship is to give feedback and to let your doctor know what you need.



Some other features of our board !

"Search Messages" is a favorite tool for most of us here at www.LupusMCTD.com.
We are able to input any subject and it will bring up all the posts made with that word/words in it. You can also input a members name and bring up their previous posts.

"Replying or posting": To make a new post, simply click on: Post Topic. A title is required.

When replying, click on reply. We ask that, as often as possible, you always keep your replies to a message on that same post or often called a thread.

The Library
 It has become a favorite for all of us. It contains many articles of great information on all of the illnesses listed on this site. (Lupus, MCTD, Fibro, Arthritis & Ortho ,  Fibro, Dermatology, Cardiology, Renal, Chronic Fatigue Syndrome, Irritable Bowel Syndrome, Nuerology, Gastro,etc) Everything that effects us living with Lupus and Mixed Connective Tissue Disorders.

I add to the library every couple days. Presenting the very best & recent information from researchers, pharmachuetical companies, science researchers, medical labs, Universities, etc.  from around the world.

There are so many wonderful features of this site, but these few tips will make your visit with us more productive an hopefully more enjoyable.

We are here to uplift you and support you while you find the best quality of life available to you while living with chronic illnesses.
W*E*L*C*M*E to www.LupusMCTD.com "where we understand what you are going through".
Admin/Site Owner
http://www.LupusMCTD.com  ;)


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