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I was diagnosed with RA about 18 months ago. It is very active, but most of

the time I can function pretty well, even though it is painful to do so at

times. We all learn to adjust and stay within our new limits...

Anyway, my question is " When do you call the doctor? " I have rarely called

between visits even when in a flare, because I know he will just tell me to

increase the Predisone for a short time. (The only time I called is when my

big toe got so inflamed it required a shot to get it calmed down.) Usually,

I just put up with flares, increase the pred, get more rest and adjust my

activities. I wonder, though, if this is the right approach. Do the

doctors judge the severity of our disease by how much we complain between

visits - like the squeeky wheel? I would be interested to know your

experiences...

Right now I am on MTX (17.5mg), Arava(20mg) and Predisone (5mg daily - can

increase up to 20mg during a bad flare, then taper back down to 5mg). I

also take Skelaxin occasionally for that killer neck pain, lots of vitamins

to help my immune system, and I couldn't sleep at all without my Elavil. I

had to buy a weekly pill sorter to keep them all straight! However, after

8 months of haggling with my insurance company, I'm finally going on

Remicade next week. The meds I'm on just aren't cutting it. I still have

lots of pain and fatigue. I'm looking forward to being " normal " again.

Although I don't post very often, I'm VERY appreciative of the knowledge and

support this group gives. Your courage in the face of adversity is

inspiring and helps me not to whine too much! Thank you SOOOO much!

Vikki

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<< Anyway, my question is " When do you call the doctor? " I have rarely

called

between visits even when in a flare, because I know he will just tell me to

increase the Predisone for a short time. >>

Hi Vickki,

My Rheumatologist's office is really kind when I do call, but he's told me I

can increase the prednisone during a flare and that's what I do now as well.

If I got really bad and couldn't control it with prednisone and the pain

meds I have I would certainly call. I was thinking of writing a list about

the problems I've had during the month (very brief, of course) so I remember

to tell the doctor. Also, I am going to start making a list of refills I

need because they ask me what I need refilled and I forget then have to have

them call it in.

Hopefully the Remicade will make a big difference and you won't need to

worry about flares! :-)

Hugs,

Carol

[ ] When to call

I was diagnosed with RA about 18 months ago. It is very active, but most of

the time I can function pretty well, even though it is painful to do so at

times. We all learn to adjust and stay within our new limits...

Anyway, my question is " When do you call the doctor? " I have rarely called

between visits even when in a flare, because I know he will just tell me to

increase the Predisone for a short time. (The only time I called is when my

big toe got so inflamed it required a shot to get it calmed down.) Usually,

I just put up with flares, increase the pred, get more rest and adjust my

activities. I wonder, though, if this is the right approach. Do the

doctors judge the severity of our disease by how much we complain between

visits - like the squeeky wheel? I would be interested to know your

experiences...

Right now I am on MTX (17.5mg), Arava(20mg) and Predisone (5mg daily - can

increase up to 20mg during a bad flare, then taper back down to 5mg). I

also take Skelaxin occasionally for that killer neck pain, lots of vitamins

to help my immune system, and I couldn't sleep at all without my Elavil. I

had to buy a weekly pill sorter to keep them all straight! However, after

8 months of haggling with my insurance company, I'm finally going on

Remicade next week. The meds I'm on just aren't cutting it. I still have

lots of pain and fatigue. I'm looking forward to being " normal " again.

Although I don't post very often, I'm VERY appreciative of the knowledge and

support this group gives. Your courage in the face of adversity is

inspiring and helps me not to whine too much! Thank you SOOOO much!

Vikki

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Hi from my point of view i think that bone scans and blood tests are done

twice a year..unless something forutitous happens as you mentioned...

i manage it ...the only reason i am seeing a new doctor is because the last

doctor screwed up so much and this doctor is in charge of putting me on

other meds if necessary...it is a hierarchy thing here in canada..

otherwsie my family doctor simply gives me my Rx every three months..i think

it is all indivudualized

sam

[ ] When to call

> I was diagnosed with RA about 18 months ago. It is very active, but most

of

> the time I can function pretty well, even though it is painful to do so at

> times. We all learn to adjust and stay within our new limits...

>

> Anyway, my question is " When do you call the doctor? " I have rarely

called

> between visits even when in a flare, because I know he will just tell me

to

> increase the Predisone for a short time. (The only time I called is when

my

> big toe got so inflamed it required a shot to get it calmed down.)

Usually,

> I just put up with flares, increase the pred, get more rest and adjust my

> activities. I wonder, though, if this is the right approach. Do the

> doctors judge the severity of our disease by how much we complain between

> visits - like the squeeky wheel? I would be interested to know your

> experiences...

>

> Right now I am on MTX (17.5mg), Arava(20mg) and Predisone (5mg daily - can

> increase up to 20mg during a bad flare, then taper back down to 5mg). I

> also take Skelaxin occasionally for that killer neck pain, lots of

vitamins

> to help my immune system, and I couldn't sleep at all without my Elavil.

I

> had to buy a weekly pill sorter to keep them all straight! However,

after

> 8 months of haggling with my insurance company, I'm finally going on

> Remicade next week. The meds I'm on just aren't cutting it. I still have

> lots of pain and fatigue. I'm looking forward to being " normal " again.

>

> Although I don't post very often, I'm VERY appreciative of the knowledge

and

> support this group gives. Your courage in the face of adversity is

> inspiring and helps me not to whine too much! Thank you SOOOO much!

>

> Vikki

>

>

>

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Vikki, this would be a good question to ask your doctor directly. In

some ways, I think you have already answered this yourself. If you know

that if you call you will be advised to take more prednisone and so you

don't call and take more and that does the trick, then possibly the call

wasn't really necessary. On the other hand, if something more

distressing happens and can't be remedied by what you normally do, for

example, the instance you describe about your big toe, then you should

definitely call. It's really a matter of what you want your physician to

do when you call. Do you not want to rely on the prednisone? Or is the

prednisone really not completely effective? Do you want to decrease the

frequency of the flares? How do you want the physician to respond when

you call? If you believe the physician could or should be doing

something different for you, please convey that to him.

I believe that you should voice any concerns to your physician. The

doctor cannot read your mind or feel your pain. If you do not reveal

what is troubling you, you may be suffering needlessly. Sometimes it is

not that your physician doesn't care, it can be that he truly does not

realize how much you are enduring. Describe in detail how you are

feeling, how many times you have flared and for how long since the last

visit, what sort of pain you experience, and how your daily activities

are affected. Try to give your physician a very accurate picture of how

you are functioning.

In general, if you still have " lots of pain and fatigue " and you believe

your current meds " just aren't cutting it, " or if you are finding

yourself flaring more and more often, then you should discuss your

treatment plan with your physician and, perhaps, revise it. Sounds like

you have already done that if you are about to try Remicade. Good luck

with it!

And by all means, if your doctor isn't open to discussion or dismisses

your concerns, please find someone else.

[ ] When to call

> I was diagnosed with RA about 18 months ago. It is very active, but

most of

> the time I can function pretty well, even though it is painful to do

so at

> times. We all learn to adjust and stay within our new limits...

>

> Anyway, my question is " When do you call the doctor? " I have rarely

called

> between visits even when in a flare, because I know he will just tell

me to

> increase the Predisone for a short time. (The only time I called is

when my

> big toe got so inflamed it required a shot to get it calmed down.)

Usually,

> I just put up with flares, increase the pred, get more rest and adjust

my

> activities. I wonder, though, if this is the right approach. Do the

> doctors judge the severity of our disease by how much we complain

between

> visits - like the squeeky wheel? I would be interested to know your

> experiences...

>

> Right now I am on MTX (17.5mg), Arava(20mg) and Predisone (5mg daily -

can

> increase up to 20mg during a bad flare, then taper back down to 5mg).

I

> also take Skelaxin occasionally for that killer neck pain, lots of

vitamins

> to help my immune system, and I couldn't sleep at all without my

Elavil. I

> had to buy a weekly pill sorter to keep them all straight! However,

after

> 8 months of haggling with my insurance company, I'm finally going on

> Remicade next week. The meds I'm on just aren't cutting it. I still

have

> lots of pain and fatigue. I'm looking forward to being " normal "

again.

>

> Although I don't post very often, I'm VERY appreciative of the

knowledge and

> support this group gives. Your courage in the face of adversity is

> inspiring and helps me not to whine too much! Thank you SOOOO much!

>

> Vikki

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