Welcome to our family! Unfortunately, with Lupus, there really is no normal. Symptoms affect each of us differently and so our treatments are individualized also. Small spontaneous pneumothoraces will usually resolve without treatment and require only monitoring, especially if you have no significant underlying lung disease. SInce your symptoms are continuing, the excess air can be extracted with a syringe or a chest tube connected to a one-way valve system. Sometimes, surgery is required when tube drainage is unsuccessful, or as a preventive measure, if you continue to have peated episodes. The surgical treatments usually involve pleurodesis (in which the layers of pleura are induced to stick together) or pleurectomy (the surgical removal of pleural membranes). Before you consider any of these treatments, perhaps you can ask your doctors to check you for either pleurisy, pericarditis, or pulmonary hypertension.
Pleurisy tends to be sharp (jabbing) pain and worsens with taking deep breaths. The chest pain from coronary heart disease can be described as pressure, squeezing, and heartburn but usually not sharp. You may also experience shortness of breath and get winded easily with Pleurisy. The chest pain from coronary heart disease tends to improve with rest and worsen with physical activity (exertion).
Have your doctors checked you to ensure that you do not have pericarditis or pulmonary hypertension? These conditions can cause the type of pain that you are describing. Pericarditis or inflammation of the lining of the heart from lupus can lead to sharp chest pain and fluid around the heart, often worsened with deep breathing and certain body positions. Rarely, lupus may involve the heart valves and heart muscle (myocardium). More importantly, patients with Lupus are at increased risk for coronary heart disease (resulting in blocked arteries) from increased cardiovascular risk factors including: chronic inflammation and dyslipidemia (high cholesterol).
Pulmonary arterial hypertension (PAH) is a somewhat common complication of systemic lupus. It results in increased blood pressure in the vessels carrying blood flow to the lungs. Causes of PAH include interstitial lung disease (inflammation of the lung tissue) and pulmonary embolism (blood clots in lung blood vessels), which should be investigated. Obstructive sleep apnea (airway obstruction during sleep) can also cause PAH. PAH is not preventable. However, it can be monitored. There are treatments when the PAH becomes more symptomatic.
I would suggest that you ask your doctors to do a more thorough search for the cause of your chest pains as it is important to know exactly what it is, especially since the pains have continued after treatment.
I hope that this has been helpful. Please let us know what your doctors say and how you are feeling.
Peace and Blessings