Hello my fellow Lupus friends. I'm way over in USA across the pond. I am so thankful for this site. I've had Lupus for 15 years and this site has been so helpful. We don't have this support here. I have a question. Right now it's very hot - 93 and humid. Not normal for us in my area. My symptoms have become unbearable. Pain, swelling, fog, fever in the am, major fatigue. Pain in my back, chest and swollen in my tissue in arm pits and sides, headaches and rashes, wah wah right? I don't like to complain but I hurt. My question and thoughts are what do you warrant a trip to the emergency? I haven't called my rheumy yet but I've wondered what happens when you go to emergency? Can they do anything? What symptoms require emergency and what treatment do they offer to help you? Does it require a hospital stay? Sorry to be stupid here but I've never been so bad that my normal meds and steroids don't help. I'm not currently on steroids so maybe that is all that is needed. I'm on plaquinel, methotrexate, levoxyl for low thyroid, naproxin which is an anti inflammatory. Any thoughts?