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Does My RA Doctor REALLY Hear Me?

When we moved 4 years ago, one of the most difficult challenges was establishing a new relationship with a rheumatologist here. In my previous community, I had a very successful and satisfying relationship with my doctor of 23 years who diagnosed me and supported me through every trial and tribulation of RA, including surgeries and multiple treatments.

Establishing new relationships with a rheumatologist

Finding someone who might be a good fit was challenging enough. I had high expectations. It is complicated, to say the least, to transfer all of the medical records, let alone schedule a visit as a "new" patient. The day arrived, and I was nervous yet eager to meet my new physician. I brought along my usual list of questions and my own personal "short history" so I could efficiently go through the appointment and help her get to know me.

As we chatted, I felt like she was listening and kind, but it seemed difficult to convey all the points I wanted to ensure she knew about me. Suffice it to say, I left with a wait-and-see approach. The best part of the visit was the news that I could continue my treatment even though I was now transitioning to Medicare.

The lack of engagement and dissatisfaction

Fast forward to today, 4 years later. I don't feel any particular attachment to this physician. I doubt she would remember my circumstances if not for the file she glances at before entering the exam room. I have stayed with this practice mainly because I receive my infusions at the office, and I am very happy with the technician who performs the procedure. Additionally, the treatment is: 1) still effective, 2) covered by my Medicare insurance, and 3) convenient.

So what is the problem? When things aren't copacetic, I don't feel like she really hears me. For example, two years ago, I started experiencing unrelenting knee pain and instability when climbing stairs. When I discussed it with her, she immediately said it was likely osteoarthritis and suggested a series of 3-week injections, which I underwent every 6 months for 2 years. However, they did nothing to alleviate my issues. No X-rays were performed to confirm OA versus RA. Nevertheless, despite my reservations, I continued with the injections. Did I mention the shots were very painful? Each series involved 2 shots in each knee, totaling 6 injections per knee over 3 weeks.

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Exploring alternative options

Finally, I decided to see the orthopedist my husband was seeing, and I was very satisfied with the care I received. I had met him several times and felt confident in his approach. During my visit, he listened attentively, conducted X-rays, which he reviewed with me, and determined that it was RA erosion, not OA, causing my problems.

We discussed the treatment options and agreed on an approach that has been working well for me. During my next visit with my rheumatologist, I informed her about my visit to the orthopedist and the outcome. She was fine with it and simply said, "I will see you in a few months." Done. Now, if I were in her position, I would have wondered why my patient felt the need to see a different doctor, especially regarding RA! However, she never asked. I felt that she really didn't care to know. Should I have mentioned why I went to him? Perhaps. But I didn't want to rock the boat.

Coping with change and the fear of disrupting treatment

So what should I do? I tend to dislike change since it is disruptive and mentally challenging, stressful, and often triggers a flare. I have even searched for other potential doctors who could treat me here, but I haven't found anyone who seems particularly appealing.

Above all, I don't want to do anything that could jeopardize my treatment, as it is currently effective. So, as we often do with RA, I will continue with this less-than-satisfying situation until something happens to force me to confront it yet again.

Nan

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