When to take the next step | Arthritis Information

 

When do you know when it is time to start looking at surgeons as opposed to sticking to the script as far as your Rheumy and meds go.

My meds are Celebrex, Methotrexate, Plaquenil, and a whole bunch of other unrelated stuff as well as Panedeine Forte for pain.  I was diagnosed about 20 months ago and have been trying to get a med combo that works for that length of time.  In 2001 and 2002 I had total knee replacements done.  I knew it was time for them because my knees were contracted at 30 degrees and couldn't stand or walk for more than about 5 minutes.  It was also WAY before I was diagnosed. 

My problem now is mainly my left wrist.  If I miss one day of my Celebrex I'm in agony and can't use my hand.  I know the base of my thumb needs looking at and I also know that the eight wrist bones are quite eroded and  are causing problems.  My fingers and knuckles are actually in pretty good shape.  I know that the meds are working and I'm sure it has slowed the progress of the disease in other joints, I'm just starting to think that the damage has been done in this wrist and its not going to get any better so  maybe I need to bite the bullet and fix what can be fixed.

I guess what I want to know is,  is it disloyal to move on from Rheumy to Surgeon.  I know we will continue our 'special' relationship for years to come, but I know she can't help me with the damage that is done.  Maybe a surgeon can.

What do you think.

pammy41639266.2322916667Absolutely, I would consult a good hand surgeon.  I've never had anything done to my hands and they are in pretty bad shape due to deformities from RA.  My RD has told me that even though my hands are still quite usable to me, a well qualified hand surgeon might be able to help me a little more.  I'm assuming the surgery is pretty complicated because I've been told to weigh all the issues before having any hand procedure done.  Of course this should be done with any procedure but I think the hands are a little more delicate.  Anyway, I think I'm going to visit a well recommended hand surgeon pretty soon just to see how or if I can be helped.  Good Luck to you.

I would totally go se a hand surgeon.  It is no way disloyal to your rheumatologist.  he can't fix the damage, a surgeon can.  

It is never disloyal to a doctor to consult with another.  If your doctor thinks so then you really need to get another. 

Have your primary care doctor refer you to an orthopedic doctor.  If your RD gets angry then you have a problem and it should be addressed with the RD.  Lindy

Thanks guys.  I think I am at the stage where I will go ahead and ask for a hand/orthopedic surgeon to assess what might be done.

yay!!  more surgery (maybe).  My doctor list is getting longer and longer... I have lots of special-IST'S on my list now.
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