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I’ve probably mentioned more than once how much I like my rheumatologist. She is intelligent, caring, compassionate, and passionate about rheumatology. I don’t think I’ve ever had an appointment with her when I didn’t learn something interesting on top of taking care of my own medical needs.

This past visit, I came away with two pieces of information.

The first is that my rheumy has been speaking to other doctors’ practices about rheumatology (and presumably what to look for, when to refer, etc.). She said that she most recently had addressed one of the larger, more well-known orthopedic practices in Dallas, located in the same hospital/professional building complex where she and 90% of my other doctors are located. She said that she found it pretty astounding that these orthopedic surgeons regarded RA as “an injectable” disease. That is, inject the swollen joint with steroids and/or prescribe a round of steroids for the swelling and be done with it — perhaps with a note back to the primary physician, but not a referral to a rheumatologist or other follow-up.

I will tell you that one of the earliest “weird things” (a badly swollen elbow), which eventually led to my RA diagnosis, was treated by this practice and that’s pretty much what they did — except that they also immobilized my arm in a removable cast.

To their defense, my rheumatologist pointed out that she doesn’t have the knowledge to practice orthopedic surgery, so she shouldn’t have been surprised to learn they knew so little about her specialty.

The bad news is this gives us some additional insight as to why it can take so long to get an RA diagnosis. The good news is there are people like my rheumatologist who are sharing information, not only in the rheumatology field, but throughout the various medical specialties — all for the good of the patients.

The second thing I learned was how much new information there is on rheumatology and immunology. My rheumatologist said it was time to retake her boards and, in studying for the exams, she learned a great deal of new information on treatment and symptoms of the disease. My rheumatologist is fairly young, so it hasn’t been that long ago since she was board certified. She also subsequently taught rheumatology at one of the leading medical schools before going into private practice — so it’s not like she’s been slacking in her education. It’s just that advancements are being made every day.

My take-away from this second piece of information is to try to find the best rheumatologist you can — particularly one that is board certified. I know that many of us count ourselves lucky to have even one rheumatologist available, much less the ability to pick and choose. There are also financial considerations when it comes to which doctors are covered by our insurance. Put into the mix numerous other important factors such as accessibility (geographic, office hours, etc.) and the comfort level of the doctor-patient relationship, and it’s a wonder that any of us have a decent shot of connecting with a good doctor. But having a good, knowledgeable doctor who actually listens is, IMHO, probably the most critical factor in a treatment plan that meets your goals. I haven’t changed rheumatologists quite as often as I have husbands (heaven forbid), but it didn’t take me long to switch from my first doctor to the one that I have now when I decided I couldn’t stand the way my first doctor ran his practice. (Twice I had 11:00 am appointments and wasn’t seen until after 4:00 pm.)

In other news, this week I have my annual “well woman” checkup (we ladies know what “that” means) as well as my evaluation with the cataract surgeon. I’m not expecting anything that I don’t already know from either of them, and that would be a good thing.

I hope that your life is going well. I appreciate you checking in.