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There is the old joke about the girl who said to her date, “Don’t … Stop”, so he didn’t.

I have to admit that I’m not usually surprised during doctor’s visits. I’ve been going to most of my doctors for a number of years now and we’ve come to know each other and our routines pretty well. However, I was surprised during my visit to my orthopedic surgeon last week.

I like my orthopedic surgeon. Actually, I like both of my orthopedic surgeons. This one happens to work primarily on the hips to the feet while the other one specializes in shoulders.

My knee had been bothering me for a while and I was in for a consult and hopefully a steroid injection to see if that would help. All that went swimmingly.

And even though he’s into orthopedics, my doctor also treats me as a whole person/patient and has a particular interest in my RA — since RA damages my joints and may involve him in future surgical work. He asked what medications I was on for the RA and, after I’d given him the litany, he nodded approvingly and said, “Well, it sounds like you’re on the big guns.” He went on to comment that as much as my knee was hurting now, he couldn’t imagine what my joints would be like if I quit the medication and cautioned me not to stop.

That gave me pause.

If you’ve been following my blog, you know that I’ve posted a couple of times about how much medication I take and expressed concern about the long-term effects of the drugs. I’ve also wondered if the drugs might be losing their effectiveness as my RA symptoms seem to have been getting worse lately. I guess I never thought about the fact that the drugs might be doing their job as much as they can, but that the RA might be increasing. And while I had fleeting fantasies of taking a drug vacation, my doctor made me realize that I very probably would be asking for serious consequences by doing so.

(You’d think I’d learn. In 2008, after my hip replacement surgery, I went off the drugs and less than six months later had to have my shoulder replaced.)

My doctor went on to comment that medically he wouldn’t offer any suggestions for changes, that he was satisfied that my rheumy had me on a good treatment program. I know him well enough that if he did have a suggestion, he would discuss it with me — including his reasons for suggesting it — and then send a note directly to my rheumatologist with his recommendations for her consideration. (Although he cares enough about me as a patient to take an active interest in my overall care, he wouldn’t cross the boundaries of directly altering another doctor’s prescribed course.)

Take lawyers. You send them something to review, they’re going to make changes, if nothing else, simply to justify their hourly charges. I think that some doctors are like that. You go see them with a problem and they feel obligated to prescribe something. I like it that my orthopedic guy cares enough to consider the situation and give his opinion, but doesn’t order drugs or treatments just because.

So, as much as I fantasize about telling my rheumatologist that I want off the drugs when I see her in a few weeks, I’m going to take my orthopedic surgeon’s advice and don’t stop.

Thanks for checking in.