Hi, again, jdeet! I am 46 now and, by the time I had made it to the level of symptoms when I received a diagnosis and, then, treatment, my ankles were quite swollen. In looking back, my symptoms started at about
age 17 and I was 40 when it became apparent that I actually had something more serious. I suspect that I had many remissions in that time period and this is typical of lupus. There is not really anything preventative your brother can take to prevent full-fledged lupus - at least not anything I am aware of at this time. Like Rosie says, we all fight this until the last moment and try to maintain as normal a pace as possible. It took three years (age 43) for me to receive a diagnosis and treatment.
Currently, with the help of medications, I can keep a full-time career and enjoy some personal fun. I am vey careful to pace myself but, if I push too hard, I really pay for it in pain and extreme fatigue. My husband is very supportive and my children are both in college now so this is all a possibility for me. I can tell that I cannot keep up even this pace for too much longer. I hope that I can make it four more years so that I can retire with my full 30 years in education.
As for your brother, I cannot tell from your descript
ion if he has lupus. If he does have the start of lupus, he needs to keep a journal of his symptoms and keep at least a yearly appointment with a rhuemetologist to keep on eye on the progression. Every lupus patient is very different. A rhuemy will appreciate detailed notes from him to help in the detective work necessary for a diagnosis.
Lupus and RA and LOTS of Medications!