Hello and welcome to our family. May I commend you for wanting to help your fiance and for taking the time to learn about Lupus in order to help her.
You are correct, relapse is as different as the individual with the disease. There is no way of knowing when one will occur, how long it will last or how often they will occur. A flare can be anywhere from several hours to several months, depending upon its cause and its severity!
Many of us with Lupus also suffer from Fibromyalgia. For me, the burning sensation is a result of the fibromyalgia. For instant relief, I often use cold, damp cloths on the area. However, only complete rest has ever given me results that last for several days. When I am fatigued and/or stressed, the burning sensation returns. So, I find that it is important for me to just STOP, lie down and let my body rest and/or find a way to eliminate my stress!
The general rules of thumb suggested by doctors to avoid flare-ups are as follows:
*Always take all medications as prescribed.
*Keep all doctor's appointments, even when she is feeling well.
*Keep a journal of symptoms, when they occur-how they feel etc.
*Avoid taking sulfa drugs (sulfonomides) that are used to treat infections such as bronchitis and urinary tract infections.
*Limit ALL exposure to sunlight; apply sunscreen before going outside during the day, and wear sun-protective clothing and a wide-brimmed hats. Also, avoid all ultra-violet light.
*Reduce risks of infections.
*Get plenty of rest.
*Do not smoke.
We cannot give you an idea of what a rheumatologist might charge. These vary so widely that it is almost impossible to predict. I am sorry that I cannot help you in this area.
The standard first line of treatment in Lupus is usually Plaquenil, Prednisone and NSAIDs.
Plaquenil - This is an anti-malarial drug. These drugs are particularly effective in treating skin and joint symptoms that may occur in Lupus. They have been demonstrated to improve:
muscle and joint pain
inflammation of the lining of the heart (pericarditis)
inflammation of the lining of the lung (pleuritis)
other symptoms of lupus such as fatigue and fever.
Prednisone - This is a is a synthetic hormone commonly referred to as a "cortisteroid." Prednisone acts as an immunosuppressant. The immune system protects against foreign bacteria and viruses. In some illnesses like Lupus, the immune system produces antibodies, which become overactive and cause undesirable effects. These illnesses are referred to as "autoimmune diseases". Prednisone suppresses the production of these antibodies. This suppression can make it slightly harder for you to fight off infection but also stabilizes the immune system if it is overactive with an autoimmune disease (such as Lupus).
NSAIDs - Pain and inflammation are common in people with systemic lupus erythematosus (SLE). anti-inflammatory and analgesic drugs are often used to help with the pain and inflammation, especially a group of drugs called the non-steroidal anti-inflammatory drugs (NSAIDs). There are many different types of NSAIDs, available either by prescription or over the counter. Traditional NSAIDs-ibuprofen (Motrin, Advil), naproxen (Naprosyn, Alleve), and piroxicam (Feldene), to name a few-inhibit both cox-1 and cox-2 prostaglandins. Many of the undesirable side effects of using these non-selective NSAIDs result from inhibiting the cox-1 "maintenance" prostaglandins.
The beneficial effects of the newer NSAIDs result from inhibiting, or limiting, only the cox-2 "inflammatory " prostaglandins. These specific NSAIDs are effective for treatment of musculoskeletal pain and are without many of the side effects associated with the traditional agents.
I hope that I've answered your questions. Please let us know if you need anything further. We are here to help you in any way that we can!
Peace and Blessings
Look For The Good and Praise It!