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Anon, I hope you see a rheumatologist, because good rheumies know a lot about a lot, as the systemic diseases they handle so often cross over into other specialties.

Have you read the "sticky post" about APS, antiphospholipid syndrome? It's a blood clotting disorder in which migraines are common, and other problems too.

When you review your recent blood results with your primary, you could ask if ANA and ESR vacillate. For me, the autoantibody they finally caught, anti-Ro, rises & falls as flares come & go. Meaning, for some things, timing of bloodwork can be crucial.

What kind of rashes did you have as a kid & teen? I'm curious because I had various rashes & skin problems over time. Itchy scratchy things, probably ordinary dermatitis. More interesting, raised watery itchy blisters, maybe bulllous lupus (too late to know now for sure). Always HUGE swelling from bee, wasp, and yellow jacket stings. Last, the lupus rashes Dx'ed as SCLE.

Another thought. The most meaningful thing I was ever asked to do was to write up my medical history *in my own words*, then fax to new rheumie, before my first appt. As he read, I believe he was contemplating the "alternative criteria" you cited. WOW. No dr. I'd seen locally had queried about, or reacted to, those "fine points" that lie underneath the standard lupus diagnostic criteria. WORSE, in retrospect, my local drs. didn't even understand the standard "4 of 11" lupus criteria.

You sound wise & determined, so I know you'll keep pressing. Post when you have time, OK? All my best, Vee





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