Questions about PAH/PH (LFT, ECHO, ICD and rheumatology) in UK Scleroderma Posted December 14, 2015 Hi Amanda, Wow, you are being put through the mill! I'm sorry you have so many complications, and all at once, no less. I don't know the answer to most of your questions. PH can be very hard to diagnose. And it can be misleading, because some tests can appear to indicate PH, others can appear to be perfectly normal, but only the right heart cath can sort everything out properly. And, that is quite a procedure to undergo. When is your next cardiology appointment? Be sure to read up on Nissen fundoplication before you visit gastroenterology, in case they suggest that surgery to fix it. For hydroxychloroquine, my rheumatologist had me take my entire dose at bedtime, so that I would sleep through any side effects. That worked like a charm and I never had had any bothersome side effects, except for the good ones like a very noticeable and welcome reduction in pain and fatigue, and fewer flares of all sorts of things. Keep us posted as things develop. It's certainly going to be a cute balancing act to manage all of this at once!