Rheumys

[Guest guest]

Hi guys, I have a very good question.

I notice almsot ALL of you have a Rheumy. My personal care doc (a gp), felt that

I did not need to have a full time rheumy, just sent me ONCE for a referral and

recommendations visit. I have NEVER had a regular rheumy.

I am now thinking that I need one, as doctors in Houston were asking my mother

if I had one.

I would like us to discuss this--the pros and cons of having a Rheumy as well,

and do you need to see that doctor ALL THE TIME or only here and there for

follow ups if your dermo has you on Enbrel and the other GP Dr has you on

Hydocodone and Baclofen?

Advice badly needed. I am in Oklahoma City area, and all my doctors are with OU.

LeAnn Cayer & Furbrats Blossom & Meriko

Heart Bandits American Eskimo Dog Rescue

Oklahoma Referral Chapter

Railroad Coordinator

www.heartbandits.com

[Guest guest]

Hi LeeAnn,

You're right - your question IS an excellent one. I look at it this way:

Although my GP appears to be a good and understanding physician, I would not

want her performing open heart surgery on me or even be the only doctor I would

see if I had a heart attack. Instead of a heart attack, my body is under

attack from PA. Just as I would demand to see a cardiologist for a heart

attack, I

feel I must see a rheumy for PA attacks. Rheumys (only see one that is Board

Certified rather than a GP that has a lot of " little old ladies " as patients)

are required to spend extra years specializing in arthritic diseases. My

rheumy doesn't just see 2-3 patients a week with arthritis, he sees dozens. My

rheumy hasn't seen 3 other people with PA, over the years he has seen scores.

The difference between his knowledge and experience in treating PA and that of

my wonderful GP are night and day.

Because PA is a chronic disease, you do not just see a rheumy once - you

should see a rheumy with great regularity. In my case, because I am on Humira

and

Arava, my rheumy sees me every other month in order to review my current

status and to go over my blood tests. We discuss changes in my ability to

function, pro and con. We discuss my pain levels and the things I can now do

with

greater ease vs. the things that remain a major challenge. We discuss questions

I may have about my current meds as well as other meds that I may be curious

about. We have become real partners in my battle against PA and that is due

to the quality of his care as well as the frequency of my visits. I personally

don't think anyone should battle PA without being under the regular care of a

rheumy. I don't even think you should accept a diagnosis of PA unless it has

been confirmed by a rheumy who has seen many PA patients. A cardiologist

treats the heart and a gynecologist treats women. A dermy ONLY treats the P and

a rheumy only treats the PA. Seeing a dermy is NOT a proxy for seeing a

rheumy for your PA and vice versa. I only think there are pros in being under a

rheumy's regular care (if you find a good one) - I know of no cons.

Best of luck to you,

Kathy F.

<< Hi guys, I have a very good question.

I notice almsot ALL of you have a Rheumy. My personal care doc (a gp), felt

that I did not need to have a full time rheumy, just sent me ONCE for a

referral and recommendations visit. I have NEVER had a regular rheumy.

I am now thinking that I need one, as doctors in Houston were asking my

mother if I had one.

I would like us to discuss this--the pros and cons of having a Rheumy as

well, and do you need to see that doctor ALL THE TIME or only here and there for

follow ups if your dermo has you on Enbrel and the other GP Dr has you on

Hydocodone and Baclofen?

Advice badly needed. I am in Oklahoma City area, and all my doctors are with

OU.

LeAnn Cayer & Furbrats Blossom & Meriko

Heart Bandits American Eskimo Dog Rescue

Oklahoma Referral Chapter

Railroad Coordinator

www.heartbandits.com

>>

[Guest guest]

Hi Leann,

I guess the answer is " It Depends " .

If you are being happily and EFFECTIVELY by your gp, then you

probably do not need to see a rheumy. If your treatment is not

satisfactorily relieving pain,swelling, etc, then you probably should

switch to a rheumy. Theory on this being that a rheumy is a

specialist, well informed about PA and up on the recent data,drugs

and treatment. That said, there seems to be a good number of rheumys

who are poorly informed, rather lackluster in their treatment and

sometimes rude.

A GP, usually needs to to be much more well rounded and has a little

info on a large number of health issues.

A good rheumy should be your advocate. Presenting you with all of

your options,advising of the pros & cons, and allowing you to make

choices you are comfortable with, while listening and treating your

immediate as well as long term needs.

Stay Well,

[Guest guest]

I have a Rheumy that I see only when my PCP suggests maybe she needs to see how

I'm doing. When my PCP diagnosed me and referred me to the Rheumy, she set up

the dosage of meds and the standing order for lab work and sent me back to my

PCP. In the six years I've been diagnosed, I've seen her on average every 12 to

15 months. She is copied on all blood work and my pcp reports to her quarterly.

It's working great for me. BTW me Rheumy taught my PCP.

Sandy swOHIO

[Guest guest]

Hi LeAnn,

It must work differently in the US (At least some parts) Over here in the UK

most GP's, if they suspect Arthritis would automatically refer you to a

Rheumy (Specialist) When I tell my GP about any new meds nowadays I usually get

sort of a blank look (You see the eyes glazing over. Lol) So I have to explain

it to him rather than the other way round. He is great otherwise but it is

just that this is not his area of expertise. If you feel you need more help,

maybe you should ask your Doc to refer you to one.

Good luck,

[Editor's Note: Hi, . Actually, a good GP here will always refer their

patients to a rheumy as soon as they suspect arthritis. GPs here are afraid of

getting sued, so they are often ultra conservative about referrals. However,

there are plenty of doctors here who are afraid they will lose $$$ if their

patients get plugged into a rheumy instead of relying on them. Some GPs also

actually believe that they are masters of the universe and are capable of

treating everything. I view GPs as ticket takers who assess the location of

your seats and direct you to the proper usher. So, just as is true everywhere,

there are good GPs here, mediocre GPs and dollar-hungry selfish GPs. This is

why the patient must take the ultimate responsibility for their treatment and

not treat doctors as anything other than paid help. Kathy F.]

[Guest guest]

I went without a rheumy for about 2 years.Quess what? I am now in bad

shape.I prayed and prayed and I now have what must be the most

wonderful educated Dr. She immediately had blood drawn and then put

me on Methatrexate and Enbrel.But I keep getting infections and have

to stop. Meanwhile the RA invaders are attacking the planet called

Skye. They battle with my knees they do alot of warring with my

hands .They must not know how I love my music.I wish I would have

taken it more seriously. This Is a serious illness. Youo can get

vasculitis,glacoma,lymphoma (Cancer of the Immune system) It can

attack your heart,lungs,central nervous system and your brain. By all

means .no matter how far you have to drive..Find a Rheumatologist and

a damn good one. I have found that the Universitys' have the best Drs.

I saw one at UofM michigan..UofA Never a problem. Please please do

not think for 1 second that it is not SERIOUS.Just worried..Skye

[Guest guest]

I am afraid to go to a rheumy for fear he will think I should take all the

meds. Do you think that's usually the case? I react to meds due to chemical

sensitivities and allergies and resist them like crazy. But I do need a good

firm dx.

Thanks,

In a message dated 2/12/2006 11:22:18 A.M. Eastern Standard Time,

writes:

Message: 7

Date: Sat, 11 Feb 2006 13:27:45 -0800 (PST)

From: " C. Y. " <cjmy3454@...>

Subject: Re: Rheumy

Yes, you will still need your family doctor for whatever else will ail you.

The Rheumatolgist will only take care of your RA. It's important that both

your physicians are aware of all your illnesses and test results.

Cheers

[Guest guest]

Rheumatologists are not known for their bed side manner. But

remember this. You are paying them for their advice. Be persistent,

keep asking questions, they have to answer you. I probably drive my

rheumy crazy and he's usually trying to push me out the door, but my

persistence pays off. I get my answers maybe in short quick answers

that are not at all warm and fuzzy, but I get the information. There

are just not enough rheumatologists for all the patients they need to

see. Their schedule is very full and probably only schedule 15-20

minute visits per patient. Don't tell stories or beat around the

bush. Walk in with your questions planned and while they are moving

your joints around ask those questions. It is their job.

" Sheridan " <sksherid@...>

[Guest guest]

I feel the need to stick up for our rheumy. He is very good. He

spends at least 45 minutes with us each appointment. He completely

understands PsA and is very knowledgeable in the medications that work

and don't.... There are good ones out there, you just have to keep

looking. I wouldn't stand for a rheumy that treats me like you have

mentioned.

[Guest guest]

This post is right on. Keep looking for the right rheumy! I found a wonderful

rheumy on my second try. Takes all the time I need, returns phone calls

personally, even sent letters on my behalf to the state attorney generals office

when I had insurance problems. They are out there, you just have to keep looking

and asking questions.

Good luck,

Job in CT