@windyshores - since all rheumatologist do not have the same level of experience or education we are all left to the practice of medicine with every clinic visit. In my experience, most doctors do not listen to their patients. Every patient will not present like text. Autoimmune conditions are often misdiagnosed because one should not solely depend on labs but look at the big picture and take into consideration clinical symptoms. When I think about all of this, I am being sent back to ENT by rheumatologist for what exactly? I am so desperate for help that I am willing to go but all I see is lots of wasted money along the way. So frustrating