Meeting My New Rheumatologist
In 2021, my rheumatologist, Dr. N, told me he was about to retire. Oh, I knew it was coming, but it was a difficult message to hear. Dr. N and I had a few rough days throughout the 15 years we fought rheumatoid arthritis (RA). You can read all about how he broke the news to me and about my criteria and selection of my new rheumatologist in this post.
Now, if you are all caught up (even if you are not), I am here to tell you about my new rheumatologist and how we are getting along. I selected Dr. E; she is excellent, but it did not exactly work out perfectly.
Meeting my new rheumatologist for the first time
Like 2 people who were skeptical of each other, I had my first official doctor-patient meeting in March. Immediately, she wondered if I was being over-medicated. She was also concerned that Rituxan might not be the correct medication for me. I took a giant gulp and thought, oh, for heaven’s sake, here we go. But she also put my mind at ease. She said those magic words- "what do you think?"
I told her I felt good about things, especially since I was due for an infusion in a few weeks and thought I needed it. She advised that she knew Dr. N had already processed the orders and was following treatment approval, so she felt she should stay out of it. That was nice and gave me some comfort.
Pleasantly surprised by my doctor
Then she ordered a battery of tests. She ordered X-rays of all my joints, blood work, and a chest X-ray (I had not had one for a few years). Then with the results, she referred me to others for a consult.
She found, for instance, that my foot had a significant issue. The surgeon and I knew it well beforehand, but she wanted him to look at it again. He did and passed on fixing it. She wanted me to visit with a nephrologist and, in the process, I found out I have what he called stage 3a chronic kidney disease (that is about par for the course for a person who has had diabetes for 48 years). As my new kidney doctor put it, there is no need to panic, but reduce salt intake and watch this closely. Even perfect diabetes control may not be enough with one kidney, so I agreed to see him on a 3-month rotation with detailed labs. Better to catch a problem early rather than later.
Would this result in a new treatment?
Then came the big test- my second infusion. What would be the protocol? Would I need to argue to get it? Would she keep things the same? I was worried. Then the time finally came, and she did end up keeping things just the same. There you go. My initial skepticism was overblown. As she said, let us go awhile until I see how things are going. I appreciated not overturning the system without first watching at least 2 cycles.
As I write this, I am in the middle of the 2 infusions and set, and I continue to be so happy. The infusion protocol did not change. The pre-medical students were ordered to do the same as Dr. N. did, and the result was about the same.
Feeling supported and grateful
These past few months, I have been forced to interact with her on other matters. The first was a letter from her in support of a poster I entered for the American College of Rheumatology (ACR) patient perspective selection. She was glad to do it and was fully supportive. (My poster will be displayed digitally during the conference). I also served on 2 ACR committees that needed her consent. She was thrilled to do so.
Then, unexpectedly, Dr. E called and said she could get me approved for Evusheld injections to protect me from COVID. I have been trying to get those approved for several months, and frankly, Dr. N felt it was unnecessary. I did not even have to ask Dr. E. for the injections. She called me spontaneously and said I could get them in short order.
Knowing I made the right decision
So, as I sit here almost 1 year later, I feel terrific about my selection. Dr. E is not perfect, and there are some issues we will have to overcome in the future. Whether I am on the right medication will be a sticky problem, but one I have wanted to address for several months. Best of all, she is willing to laugh in my presence. That is something a young physician sometimes finds difficult to do in front of a new patient. Thank goodness we broke that barrier, and here we are. I am pressing forward.
What strategy to fight fatigue is most effective for you?