What do you do when your dr.'s don't agree? | Arthritis Information

 

I know that I can't be the only one with this problem.  Like everyone else, I have gathered a ton of doctors over the years.  How fun.  I do have 3 main ones that tend to disagree with each other.  Pain dr, RD, and my Oral Surgeon.  Let me first say-I have been very lucky-all 3 are great.  They just tend to have different ideas on how to treat things.  Ex: Oral Surgeon is the one who is cleaning out the jaw joint over Thanksgiving.  He had prescribed flexeril to try to loosen the muscles as much as possible.  Sounds good.....RD is concerned about nerve issues due to the damage in my rib cage/sternum.  SO, he says, no Flexeril-we are trying Cymbalta for the nerve stuff.  Um...sure.  Then see pain dr.  He says Cymbalta has caused my problems for his patients than benefits and he wants to try something else.  Ok kids....put your heads together.  All 3 are very professional-it's more like they are thinking outloud.  It just seems they each have a different angle of how to treat things.

Shame on you and this forum!

AchingAudrey2008-11-30 11:06:48I agree with Audrey; they need to have a conference call and sort out their issues.  Since they're all specialists, they get a couple hundred bucks (whether from you or your insurance company) each time you visit their offices - get your money's worth!  Would you accept that crap from a stockbroker?  Housecleaning service (no one makes the bed because they each have their own way to do it)?  Car mechanic?  These docs work for you, hon.

I'm not sure I understand the reason the RD is against flexeril - I've never heard of it being contraindicated in cases of nerve issues.  It's just a tricyclic antidepressant that happens to suck at relieving depression but works well to loosen knotted muscles.
I think it is more the combo of meds.  He was not big on Flexeril, Cymbalta , and Lortab all being prescribed.   I plan on telling the RD that while the Flexeril obviously does nothing for nerve stuff, it did allow me to sleep better.  That of course has its own benefits. [QUOTE=rocckyd]I think it is more the combo of meds.  He was not big on Flexeril, Cymbalta , and Lortab all being prescribed.   I plan on telling the RD that while the Flexeril obviously does nothing for nerve stuff, it did allow me to sleep better.  That of course has its own benefits.[/QUOTE]

Gotcha.  I don't see why you can't hold off on the Cymbalta until after the jaw gets tuned up.I just hate feeling like I am bouncing back and forth.  Also, we all become rather educated ourselves after having this disease for years.  Combine that with a biology degree and I tend to question.  Problem is, I know just enough to question but not enough to totally get it from the drs viewpoint. Sometimes I think it is because "there is no 'I' in team".  Such egos these docs have! I have been there myself, I have a primary care, rheumatologist and a hematologist all telling me different things... I have a nurse advocate that gets all my docs talking and they work out the details and my rheumatologist is the one that generally tells what was agreed and why...  sometimes when there is more than one option she will explain them to me and we make a decision together...  If you do not have a nurse advocate then I highly recommend that all your docs talk so they can come up with a plan that is right for you and your situation.[QUOTE=RAwalker]I have a nurse advocate that gets all my docs talking and they work out the details and my rheumatologist is the one that generally tells what was agreed and why...  [/QUOTE] Wow RAwalker. Sounds great to have a team like that. You are new here. Just joined a few minutes ago? Welcome to the board RAwalker.I like the name RAwalker...my  walking aid is called that and its a great addition to my mobility aids

The advocate sounds like a great idea.  Never even heard of the option.

Ok...saw the big three yesterday.

Dr. K was first (oral surgeron). He was doing a couple of things/measurements before the "Big Day".

Then I saw the RD and the pain dr. RD was first and I told him how I felt like a kid in the middle with all the back and forth med/treatment wise. He apologized for that. He said that he couldn't have picked a better two other docs for me. He promised that he would call the pain. dr. during my infusion so when I saw him in the afternoon, they would have a plan.

So, pain appointment went well. He was not happy at all about the way I looked. I have not been able to sleep due to feeling so uncomfortable. We tweaked some meds. and then he said he and Dr. P have agreed to stop the Cymbalta(which I am happy about) and to go back on the Flexeril. They both agree at this time Dr. K should come first due to the upcoming procedure and he needs the muscle to stay loose before and after to encourage the best result. After the procedure is done, Dr. K will be in a more "maintain" role unless something else jaw wise develops. The other two docs both promised to make contact with the other if there is any change of treatment at all. Especially on the days where they are lined up back to back. This often happens since the pain guy wants to see me monthly and so are my infusions. I know the next debate will be about the Orencia since the pain dr. is not impressed with the results.

Hopefully the communication will improve. All three fax their notes to each other after an appointment, but docs get so many a day, they often aren't read right away. By placing phone calls if I see the other the same day, that should clear up the confusion. If there were all associated with the same hospital, it wouldn't be such an issue. They would be able to pull up all tests, xrays, mri's, and charts on the computer screen. But, two are associated with different hospital systems, and one is independent. They don't have a common system. When my docs do not agree ( mostly they all do) I gather the info myself, make a decision, then go to the one that is most opened minded and say ......"now what!?"Rebecca, I am so glad you finally got them to all work together and make a plan.  I know it was a lot of effort for you, and it shouldn't have to be that way, but you made it work.  And I have to say I am impressed that your RD apologized when you brought it to his attention.  Hopefully now they can get a treatment that really helps.Best of luck to you rocckyd- I got stressed out just reading about what you had to go through and you haven't even had the procedure done yet. I Yi Yi. I say a prayer that all goes smooth!
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