first, It's important to not go off your medication without consulting a doctor first. However, I understand that it can be difficult to find another doctor - try looking at the website of the American College of Rheumatologists to find one in your area. I would also recommend that you go to the nearest teaching hospital, as they usually have a good Department of Rheumatology.  The doctors that treat your other conditions may also be able to refer you to a rheumatologist - if you have lupus, it is essential that you have a doctor. Luckily, it sounds as if your medical condition is generally fairly good, but should you someday have a flare, you need to have somebody you can call.

It's quite likely that the pain in your back was caused partly by the problem that was solved by surgery and partly by inflammation that the Paquinil was getting under control. The first thing you need to do is to go back on Paquinil to protect your body and then go out there and advocate for yourself to find a rheumatologist. Talk to your primary care physician, talk to any other specialists who you have about a referral and you may also want to check out Arthritis Introspective, which is an organization of people who have RA offering support groups in different areas. If there is one near you, you may find a rheumatologist through one of the other members.