When to Call the Doctor

As a person who has lived with rheumatoid arthritis since I was a very young child and who has been independent and stubborn that entire time as well, I haven’t always followed the rule book on when to call the doctor. But I feel like I now have good guidelines for myself that have been developed in advance with the guidance of my doctors.

Work with your doctors to make a plan

First, I think it is important to have a few healthcare professionals that you see, know, and trust. In my case, I see a lot of different doctors, but my top go-to health support team is my rheumatologist and my general practitioner. I highly recommend having at least two. (As an aside, I would also like to have a nurse I could call but currently do not. The reason is that they may know you better and be easier to reach than a physician, and can get a doctor’s attention if that is needed.)

I have a pre-arranged plan with my rheumatologist for when I have a flare. He has arranged for me to have access to emergency prednisone and if that doesn’t work within a certain timeframe, I call him for more guidance.

Additionally, because I am taking a biologic medication, I have instructions from my rheumatologist to call immediately if I should ever get a fever. His reasoning is that fevers are a sign of infection, which is very dangerous for people taking biologics due to the suppressed immune system not being able to mount a quick and proper response. If I have a fever I need to call him and get a visit with him or another doctor as soon as possible.

Most of my health problems are RA-related, so my primary plan for when I’m in trouble is to call my rheumatologist. However, I have found it important to have a responsive general practitioner as well. I will call her, in addition to my rheumatologist, to give her updates and ask for guidance. She can often get me in quicker for an appointment and prescribe antibiotics if I have an infection or consult with my rheumatologist as needed.

Know your limits and be proactive

Every person is different and should have a discussion with trusted and reliable health care professionals about when to call. My personality and preference is to try to self-treat for a day or two before calling my doctor (except for a fever), so I have a plan that has been arranged around my comfort with this.

But I think it’s also important to know my limits. I know the signs of infection well, and so take extra precautions if I suspect one. I also am careful to watch if I am healing or improving—if not then I had better call and get help. If I have persistent symptoms that I’m not sure are getting better (such as a cough)—then again, I need to call.

Discuss how you feel with a loved one

If possible, I think it’s also helpful to have a loved one be a part of these discussions and be vigilant on your behalf. If I am not feeling well, I often consult with my husband to ask what he sees and talk over my symptoms with him. I know that when I do not feel right, my thinking and decision-making is compromised. If he is concerned, then I had better call the doctor. I often ask him to make the call because he can relay what I say and also add his observations.

It’s often not a clear decision about whether to call the doctor or not. In those cases, I always call because I feel it’s better to take proactive action for my health than to later regret not getting help.

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