knowledge.Today was my first apt with him, and I don't care for him too much. He's much like dr.spock(well i did get him to smile once) He did not like the fact that I've been taking natural supplements for the past 3WKS. He said two of the sups I'm taking (gluco and MSM) were for osteo, even though that has not been what I've read, and gleaned from other RA sufferers. He asked me why was I even taking them, and tried to sway me to stop taking them(even tho they aren't causing me probs)
He also got an attitude with me when I explained joint damage could be seen upon xray and not w/ the human eye. When he was putting in more bloodwork orders and I mentioned wanting to get an xray of my hand, he said well they look fine to me and you've never had swelling so there is NO joint damage. I kinda shook my head no, as in saying that just b/c you can't see it, doesn't mean it's not there. He challenged me and said how?
I went in there without my medical records and gave him my last 3 numbers(from 92,98,two weeks ago) based on memory alone and the name of the tests. He didn't seem to impressed that i came in there with the info he needed.
He alluded that I'm reading too much, and if I'm not careful I can take on some symptoms that aren't there. He said that nothing I've told him sounds like ra and he would be really suprised if it was. I asked him what he thought it would be if all other tests(butt-load) came back normal, and he said then it would most likely be Mild RA. He said the fact that i was dx 15yrs ago, and that he can manipulate my joints and do all these test exercise with comfort, leads him to believe it's just aches and pains or some other underlying non arthritis condition. Anyway I'm to see him in 6wks. YAY
Well at least i get to see what the ccp reveals, then again, if my other numbers(sed, crp,rf) came back normal, why wouldn't that? Oh well, we shall see.
Btw-before anybody says it,yes I am happy and grateful but at the same time..I JUST WANT TO KNOW!
Doctor sounds like a jerk in my opinion. I can't stand a know it all! Mild RA untreated turns into severe RA with irreversible joint damage. "Mild RA" isn't exactly a dx'ed. That sounds pretty stupid in my opinion. RA is a progressive disease. What's considered mild today may not be 10 to 20 years from now.
I'm a little lost on your story. You were dx'ed 15 years ago and now you're seeing a new doctor? Sorry....can't remember if you've told us.
lovie,
I was dx'd by a GP 15 yrs ago,(MY SED RATE AND RF was elevated) had the same bloodwork drawn 6yrs later,same outcome and was told to see a rheumy but never did b/c it wasn't really a bother. Then recently I had about two weeks of on again off again intermittent pain so i decided to follow up. Yes most get progressively worse, but there are 20% who never progress and just keep a mild form of ra for the duration of their life. I can go weeks w/out twinges, then i can have them intermittently lasting 3-30minutes for a month, then it can go away for yrs or months. That's pretty much been my pattern
Not smug at all.
You go, girl!
I think the most important aspect in health is a good fit with an MD. If you can find one. :-)
Pip
Hi there
My initial contact with my RD was the same (Apr 07) and I paid for the privilege.
My second contact wasnt much better due to the fact that all the blood tests hadnt come back yet so he really, couldnt make a diagnoses without all the evidence (I even understand that).
The next lot of tests came back, RF at 219 other tests high end of normal. He wanted me to wait 6 months. I rang his office and nicely asked his secretary to tell me who was in charge. She didnt want me to know but after some pressure she gave me the name. Literally in the time it took me to drive home (30 mins), my RD had called my home number, left his mobile number with a request that I call him back. I did, we chatted and I saw him the next day. I came away with a prescription for Sulfa and a sore butt (had a steriod injection). He also mentioned the CCP antibody test, and I had the bloods done for that last week and get the results on Thursday.
I agree whole heartedly with you. My third visit I was well armed. My doctor had run off all my test results etc and I had them in a folder. After being on the site and asking questions it was great to be able to go in and ask intelligent questions which were relevant to me. Any suggestion from him that I'd been reading too much, I'm afraid, he'd have probably got a slap for his impertinence
You will have already become aware from the posts on this site that a 'real diagnosis' is often difficult to come by.... it doesnt mean that everything is all in yur head tho
If it's been 15 years and you've had little change in your condition (With no DMARD Treatment)then I guess you are right that it's "mild" and won't be changing. In my case there has been progressive changes on x-rays but to the naked eye you'd never know it. X-rays are common practice in the dx'ed process with RA and if you saw a RD that saw no need to get even a base line x-ray I'd question his judgement. To say you have no swelling so there could be no damage is absolutely wrong! My ring size is 4 1/2 on my left hand and 5 on my right. That's skinny fingers to say the least but my hand x-rays show changes consistant with RA. I'm what they refer to as seronegative and the only blood indication that I have RA is an occational elevated seds rate. Luckily for me I've had three different RD's over the years that consider all the other criteria when making a dignosis. I hate to think what kind of shape I'd be in today had they not started treatment all those years ago.
Is there another doctor you might could go to for a second opinion? I don't think I'd be happy with what you heard from this doctor.
Well, because I had that happen to me three years ago and just said "screw it the doctor is right." Now we are trying to play catch up on a disease that is rampent. If only I had looked him in the eye and said, "can you LOOK further than the nose on your face?" He told me to come back when I was REALLY SICK. I have to drive aways, but I have a doc. I trust now. We are still finding a combo for me. Newbb...You know, if your rheumy is an a** now, then how will he treat you when you're in agony and you call him for help? Will he dismiss your feelings like he did today? I know its hard to get a rheumy appt. but I was pissed to see he treated you like that. To hell with him. Did he at least give you a prescription or tell you what to do for pain?
I went to a MTF for years and I insisted I see a private Rheumy. My primary doc got sent to Iraq - I was seeing him once a week before his first patient appt. and he did OMT on me. After he left I saw numerous drs and they could never seem to find my chart, etc. I went on the outside and found a private Dr who turned out to be wonderful! He recommended a Rheumy, whom I really like. I also have a private Gyn, ortho dr, gastro, Pt, etc. Leaving the military facility was the best decision for me...
I live in Colorado - only one RA for the Western Slope - treated me like I was an idiot - when I went off my medicine for infection - because he told me told me too- I flared up real bad -BUT to the point I was going to make - I've had RA (in beginning really bad) for 30 years. MY blood tests have always shown up NEGATIVE - many Dr told me it was all in my head - I was a ginny piq for a doctor teaching class - the specialist teaching it - showed all the drs - how bad I was and some people never do show up Positive on testsA single appointment is such a short time to build an effective communication base with a doctor. I truly doubt your rheumatologist was intimidated by you..my guess would be that he was annoyed. I cna just see him thinking "she thinks she knows more than I do, she hasn't seen a specialist in 15 years and now she is trying to tell me how to do my job etc..."
Remember that you always catch more flies with honey than vinegar, There are ways of asking questions or making statements that invite communication not confrontation. For example with the hand x'rays after his initial response saying something like " I understand what you are saying but since I have had these mild attacks on and off for many years I would feel much better if we can officially rule out any potential damage "
If this is your only choice for a rheumatologist you want him to be on your side not dreading your visit.
Let us know how the blood work comes out
My first rhuemy was given to me by the Tricare office too. When I went back this time I asked for a different one in this area. We only have one, and he is a noted horses behind. This is why I travel. Get with the Tricare office and tell them we want to chose someone different. Also, tell them of your experience.
There is a difference between walking in unprepared and accepting everything the doctor says, and being prepared and ignored.
Get a copy of the med records too. This will save time and money. Docs have a way of talking Doc language.
I agree you catch more flies with honey than vinegar. It's just after all else fails it's time to whip out the bug-bomb and get as many flies as you can. My first rheumy was a jerk that though gold was the cats meow. It did nothing for me.He always talked down his nose at me and on several occasions refused to fill my prednisone, saying I used too much. Well, if I don't have it I will go into renal failure, and I used very little more than I was prescribed.I just called my pharmacist friend who happilly refilled my pred. After that I finally switched to a new rheumy who is aggressive with the disease, she immediatly put me on enbrel, and increased my pred from 6mg to 10mg until the enbrel started to work. She told me my old rheumy was known to be "difficult"I chose the fourth RD based on his credentials, schooling, and certifications. My immediate response to him was "he's an arrogant bas##rd and I was ready to cross him off my list. He examined me throughly, had reviewed my history (I hand carried it to the office the week prior to the appt.) prior to my visit, knew what meds I had been on before, told me some things that I didn't want to hear, said that he was going to treat my RA aggressively because it was destroying my hands and knees. No one else had told me this. He said he didn't need to see additional xrays, what he had in hand told him the story. I had additional xrays a year later after I started Remicade and MXT. He's still arrogant, but he really appreciates my input now and we have a wonderful relationship.
I used to go to MTF and my gyn diagnosed RA! I went in for some gyn problems. I was limping, joints inflammed and swollen. Her father had severe RA and she said that I looked exactly like her dad did when he was flaring badly. She did an RA factor and it was over 900 and she referred me to my first RD. I've been very fortunate with Tricare Prime. They've even paid for doctors out of contract because of the problems that I had with the only RD in our area that was contracted. They've never denied a treatment plan. And I will never complain about having to pay .00 for a Remicade infusion that costs ,800.
You might want to give those RD another chance. You never know. Lindy
You might want to check into Palindromic RA. From what you describe, it sounds a little like that. If your opinion about your RD doesn't change after a couple of more visits, then maybe it is time to search for another one.
My rheumy is pretty appreciative that I come in armed with knowledge. To him, that means I am involved in my health and I care about my health.
Yep, I even went to my old RD about half a dozen times before he told me to come back when I was sick. Stick with it. I guess with all of the "drug" seeking and such maybe they have to be a little bit careful, because if anything should go wrong...then they will be seud(sued)??? I can't even spell these days. I need another nap.I never asked my rheumy for any addicting drug. My pain killers are administered by my primary care physician. My rheumy and I just didn't get along. So I got another one. I agree to having patience. I saw this jerk rheumy about 8 times before he failed to fill my prednisone for the 3rd time. Like he was teaching me a lesson or something. I was just done with him. [QUOTE=buckeye]
A single appointment is such a short time to build an effective communication base with a doctor. I truly doubt your rheumatologist was intimidated by you..my guess would be that he was annoyed. I cna just see him thinking "she thinks she knows more than I do, she hasn't seen a specialist in 15 years and now she is trying to tell me how to do my job etc..."
Remember that you always catch more flies with honey than vinegar, There are ways of asking questions or making statements that invite communication not confrontation. For example with the hand x'rays after his initial response saying something like " I understand what you are saying but since I have had these mild attacks on and off for many years I would feel much better if we can officially rule out any potential damage "
If this is your only choice for a rheumatologist you want him to be on your side not dreading your visit.
Let us know how the blood work comes out
[/QUOTE]
I appreciate the constructive criticism but I will say that I remained cordial and did not get confronational or snotty. He was the one to get really defensive when I said that damage can be done,and sometimes only xrays can see this. He acted like he had never heard of such a thing. Coming from a rheumy that concerns me. The good thing about him, is he did take his time with me and wrote pretty much everything I told him down. I understand what ppl are saying about giving him a chance, and since I most likely won't be seeing him that oft, I don't plan on switching, unless it progresses. I want a dr. who is NOT against natural sups, and doesn't think i need to stop reading so much.
As to some other comments from other posters. I mentioned the palindromic, he ruled that out b/c he said it was an inflammatory arthritis(even tho from what i read it states that it usually lacks the swelling that's accompanied by RA)
As for meds, i'm not seeking meds at this point since I'm not in severe or even moderate pain. I was moreso looking for a concrete dx. Also clinically/technically I'm in remission so it's not needed at this point.I got all my bloodwork done today and will get xrayed tommorow, so hopefully I will hear something in less than two weeks.
One final question; will the anti-ccp show positive if you are in remission?
Sorry to hear about your frustrating appointment. I can relate. My rheumy told me during my second visit that if I don't take the drugs he recommends I would regret it. He went as far as to say I had a 2 year window of not return. After which time the meds would no longer work for me.
When I asked him for some PT on my right ankle, he told me that they don't do physical therapy on ankles. This made me feel like he was with holding treatment because I wouldn't take his drugs.
I feel lucky to have surpassed his 2 year window of doom. And I have been thinking about finding another Rheumy who I could work with better.
Hope you find the right fit soon.
Marybeth
Oh, by the way I also bring my own personal "medical chart" of labs and xray results from all my prior visits, when I see a new doctor. I include the course of my symptoms ( including at one point a chart of my blood pressures for a one week period) and a list of my supplements/medications.
Most doctors appreciate this.
Marybeth
I just went through pt for my ankle, so he is wrong on that point