Q. Is lupus causing all my symptoms?

Hi doctor,

I am a 44-year-old female, and I have been diagnosed with rheumatoid arthritis, systemic lupus, and Sjogren's syndrome, with symptoms dating back to as young as six years old. I have also been diagnosed with pulmonary hypertension, thyroiditis, Raynaud disease, right-sided heart enlargement, bronchiectasis, and a history of pneumonia. For about twelve years, I have had kidney pain that was mistaken for gallbladder disease, gastritis, etc., this past year, protein was found in my urine twice. Recently, I have been experiencing shortness of breath and wheezing. For most of my life, I was told that I had asthma and was treated accordingly. Now, however, the asthma medications (Dulera and Ventolin) are not working. I also have a nebulizer, which is of little help, as well. I am under the care of a pulmonologist who is reticent to believe that I am indeed an asthmatic; so, now I am confused, breathless, and a little scared. Is this lupus doing this? I have been experiencing widespread inflammation, malar rashes, and a weight gain of approximately fifteen pounds over the past week. I have some personal problems, and the stress and fear just sank into me like poison. I could feel myself grow weak in the hours that followed. Before this, I was feeling pretty good. I am taking Enbrel and Plaquenil, both of which have been about as effective as sugar pills lately (although the Enbrel does give me a little bit more energy). My vision has also been worsening. My rheumatologist is almost a hundred miles away and nearly impossible to get an appointment. My primary care doctor is telling me to try harder to see the specialists. I am lost, and I do not know what to do. Any advice would be appreciated.