New member. Lupus for a year now

I first went to my dr for joint pain and my ANA test was 320. I then was sent to a rhuematalogist and she did more testing and ANA was at 640 then at me 6 month appointment in July it was at 1280 and now my latest last week was at 2560 so it keeps going up but all the other tests are normal. I am taking plaquenil and it does significantly help the pain and fatigue. I am however dizzy and very nauseous and not sure if it is meds or just part of lupus. My pain although significantly reduced with the Lupus is still debilitating at times.
My latest symptoms seem to be severe memory issues and just foggy brain. It is making it very difficult to do my job which is very focused on attention to detail. I have been making a lot of mistakes and hoping I don't get fired for that.
I am also having a hard time finding words, remembering names and just saying the wrong words and writing things down wrong. So frustrating.

I have a referral to have a barium swallow study because I have been aspirating and chocking a lot. Has anyone else had this issue? What do you do about it?

Thanks