Rules for my doctors

Somewhere in the depths of my blog (if you blog for over five years I think it has depths) I have written about this before that I have rules for my doctors.

Yesterday I saw my  rheumatologist, Dr. P. She was recommended to me by Dr G, my pain management doctor. It is my three month follow up (which will be the story of the rest of my life with RA) to see how treatment is progressing. I have been a bit stressed about this RA stuff and came prepared with list of questions to help me destress and further my coping with this new ailment.

We discussed RA and fibromyalgia and pain management and what I need to cover with Dr G next week. She was concerned about my fatigue levels and wanted to run some more blood tests. I was surprised to find out which pains are not RA and which are probably fibro - tips of fingers are fibro not RA. Foot pain is probably fibro. Hip pain on the outer hip is probably fibro. I have lots of notes to talk to Dr G about.

Dr P answered all my questions. She is happy with the progress of treatment but says its still active so we need to up my dose of methatrexate to get it under control.

She asked me my opinion of self injection. I said my husband (the saint) had agreed to give me my injections if we get to that. I was very pleased to hear there are non injection forms of medications available. And she said she would make a note in my file about me and needles.

We did discuss long term prognosis and she assured me that with new treatments the goal is to get the disease into remission so that I can live pain free for life and not end up with crippling disfigurement. This is the current treatment expectation. This made me MUCH happier.

I was beginning to think that this could be manageable and I could see working with her in the long term. I was feeling more relaxed about this whole thing. She dropped her bombshell. She is leaving the hospital at the end of March. WHAT!!!!!!!!!!!!!

That is not allowed in the rules for my doctors. Doctors that I like I never allowed to leave or retire. One of the reasons I liked her so much is she is  younger than me so chances were that she would be with me for decades. Dr G is much older and I hope he will never retire.

Its completely understandable as she has two small children and traffic in the evenings can make her homeward commute to take 90 minutes.

The hospital expects to hire someone in the spring. Normally I would alternate a visit with nurse practitioners with the doctor every three months. The plan is I will see her nurse practitioner in three months. Then three months after that I will see the new doctor.

But I have a plan. When I see Dr G, who sent me to Dr P in the first place, I will ask him his opinion of who to see in rheumatology or if I should wait to see who the new hire is. I can be sneaky when my health is on the line - especially when my doctor breaks the rules.