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Hey Peanut, Definitely the autoimmune party going on with you! I was seeing an orthopedic doctor initially when I developed bilateral (both hands) carpal tunnel. Nerve conduction studies confirmed the diagnosis and he was encouraging me to have surgery. I elected to try treatment with steroids to decrease the inflammation instead. A 7 day dose pack was successful in quieting the inflammation for a few months at a time. I was reluctant to have surgery as I was suspicious that something systemic was going on with my body. I elected to see a rheumatologist like you have done which I think is an excellent decision on your part. By the time I saw a rheumatologist, I was having pain in my elbows and my shoulders. I was experiencing extreme fatigue, feeling like I had the flu and spending about 2-3 days a week out of 7 in bed sleeping. I have a strong family history of Lupus (mother, aunt, cousins) and had a positive ANA about 6 years ago after some minor joint pain in my hands that was present during the summer months for a couple of years but always went away in the fall. I did not have the characteristic butterfly rash common with lupus. My family doc at that time suspected Lupus but an occasional advil and limited time in the sun worked to control my symptoms, so I didn't think much about it until the carpal tunnel and other joint symptoms emerged with a vengeance 2 years ago. My rheumatologist surprisingly diagnosed me with RA instead of Lupus due to the severity of my joint pain and lack of other organ involvement. My lab work has been inconsistent in confirming or ruling out either diagnosis. I have had positive and negative ANA tests, RA factor etc. My doctor has explained to me that at this stage of the game that Lupus and RA are treated very similarly so we don't argue over labels. The bottom line is thank goodness I did not let the ortho doc do surgery on me. He was not wrong in his diagnosis, he just wasn't looking at the big picture and he was suggesting treatment that is his specialty .... orthopedic surgery. Now that my underlying autoimmune disorder is being treated, I rarely have problems with carpel tunnel and surgery was avoided! So, kudos to you for getting a second opinion! Good luck in getting an accurate diagnosis so you can continue your journey to recovery. Shelly