My PCP is the Best!

Begin reading with Part 1

The Long Roller Coaster, Part 5
November ’08

Lately I’ve wished I’d attended medical school.  It sure would make it easier to understand some of this stuff! Having no background to understand this new diagnosis, and no information from the rheumy and his PA, I had to ask questions of someone knowledgeable.

I phoned my PCP’s office and asked if I could make an appointment just to ask questions.  That was one of the most beneficial doctor’s appointments I have ever had, and I left feeling that even if insurance didn’t cover it and I had to pay the whole cost myself, it would be some of the best money I’d ever spent.

My first question was, “Do you think I need to see a rheumatologist, or can you treat this?”  He looked at my medications, reviewed the report from the RD, and listened to me.

He explained that it sounded like the problem with the pain medication was an overdose, rather than an allergic reaction.  If I could bring myself to take half of a tablet, instead of two, I should be okay.  But he’d understand if I didn’t want to do that and didn’t push.  Later I searched for overdose data on that medication, and realized that my doctor was right; it definitely sounded like an overdose (even though I took the exact amount prescribed!).

Next we discussed RA, and he said that the medication I was taking was pretty mild, and he could do the follow-up as long as my symptoms were controlled by the mild medications.  My hopes went up.  He continued by saying that most people with RA end up on methotrexate or even stronger drugs, and he prefers not to prescribe those. Crash!  Back on the roller coaster.  My hopes were dashed – the PA had said he’d need to add another DMARD.  Although I didn’t like the guy, I wasn’t going to let that jeopardize my chances of still being able to walk in ten years, so I’d see him if I had to.

 

If there was an award for Best Doctor on the Planet, my PCP would be in the running for it.  He listened to me, explained things to me, and was honest about what he was comfortable treating.  Even though I’d prioritized my questions to ask the most important first, knowing that I’d run out of time before I ran out of questions, my doctor took extra time to answer every question, assured me that there was plenty of time, and never made me feel like I was imposing on him.

Relief…

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originally written as one huge post, and published 1/15/09 on the Arthritis Foundation’s host, I have broken this into a number of smaller posts

I Hate the PA

Begin reading with Part 1

The Long Roller Coaster, Part 4
January 2008

No matter how good the rheumatologist is, it is not a good fit between me and this particular PA-C.  We’d had a disagreement at my first appointment.  Then he didn’t return my phone calls.  Then he blamed me for his mistake with the pain killer. Now he can’t get his story straight.  Either you’re surprised at lab results, or the results confirm your suspicions. You can’t have it both ways – those are mutually exclusive!

Now I’m stuck with a doctor who’s relegated me to a PA who won’t listen to me and blames me for his error.  I don’t trust him to tell me the truth. I don’t trust him to prescribe medication safely.  The last thing I need is the added stress of seeing this guy.

My PCP’s the Best

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originally written as one huge post, and published 1/15/09 on the Arthritis Foundation’s host, I have broken this into a number of smaller posts

Get Your Story Straight!

Begin reading with Part 1

The Long Roller Coaster, Part 3
January 2008

Rant warning!

A few days after my appointment the PA phoned.  He claimed to be surprised by my lab results.  Although my RF was negative, my CCP was strongly positive. Something else to look up at LabTestsOnline!

With a positive CCP, he wanted me to start on a DMARD right away.  My follow-up appointment was rescheduled for a closer date.

Five weeks later I went back for the follow-up.  My feet and hands already felt better because I’d responded very quickly to the DMARD.  An added bonus that I wasn’t expecting:  I had more energy than I’d had in years.  Turns out that fatigue is a symptom of uncontrolled RA.  Since I was doing so well, the PA-C said, it helped to confirm the RA diagnosis.  He added a prescription NSAID, insisted on a CCB to treat my Raynauds, and said he’d add a second DMARD next time.  He was very impatient with my questions.

The PA also told me that a strong positive on the CCP was what he’d expected to find.  ????  On the phone he said he’d been surprised at the results. Get your story straight!

continue to PA

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originally written as one huge post and published 1/15/09 on the Arthritis Foundation’s host, I have broken this into a number of smaller posts