I Shot Myself in the Stomach*

Last week in the rheumy’s office I used an auto-injector pen.  Just jammed it against my stomach, pressed the button, and waited.  After what I’d heard – people comparing the sting of Enbrel vs. Humira – I was pleasantly surprised.  It really wasn’t that bad.

In my wildest dreams, I never thought I’d be giving myself shots.  That’s not on my bucket list.  Not even close.  Then again, a lot of the events of these past few years took me by surprise.

Monday morning I get to try it on my own at home.  With a syringe instead of the pen.  Without any assistance or supervision.  If I say that I am not nervous, would you believe me?

This disease provides all sorts of opportunities for new learning experiences.

*technically, “abdomen” but that doesn’t have the same ring to it


Switching Docs

A recent reader comment/question:

In our area, upstate New York, if you have been seen and treated by a Rheumy, and if for some reason, you decide to seek care from another Rheumy, other Rheumies in our area refuse to accept you as a patient and refer you back to the Rheumy to whom you no longer want to seek care from.  We have been rejected by four different Rheumies in our area (without being seen by any of them), only to be told by the office staff that doctor doesn’t take any cases if already established with another Rheumy.

Anyone ever hear of such a protocol????

Yes, I have heard of this.  There’s probably a way around it, though.

There are patients who see a doctor and complain to him/her about the previous doctor.  Before too long they’re not happy with the care they’re receiving from the new guy and move on to someone else, and someone else…  I suspect that after a while doctors get jaded by that.  A doctor who’s already overworked isn’t going to be really happy about investing time and effort into developing a treatment plan for someone, only to have that person leave and go somewhere else complaining about him.

If it’s not working with your current doctor, something needs to change.  There’s got to be a trick to changing specialists without being one of those guys Dr. Grumpy writes about.  Other doctors blog about this, too, but I can’t think of specific posts right now.

Have you read Doctor D’s post on doctor shopping?  Or his post on doctors who are jerks?  He’s writing about finding primary care, but I think there are still some generalities that can apply to finding and working with a rheumatologist.

If your family practice/internist can’t get you in to a new rheumy, maybe you could go back to your old rheumy (the one you want to get rid of), and be up-front about the fact that it just isn’t working, and you’d like his help getting you in to see a different rheumatologist.  Are you self-referring?  Around here none of the rheumatologists take self-referrals.  Did your primary care doctor write a referral only to have consultants decline?  When I told my PCP that I was thinking of finding a different rheumatologist, he had his referral form out immediately.

Make sure you identify the problem with your old rheumy.  Office in an inconvenient location?  Nurse has B.O.?  Doctor doesn’t listen?  Falsely labeled you a drug-seeker and you’d like a chance to start over with someone new?  Standard of care is X but the doctor is doing Y?  Just bad chemistry?  Doubt the diagnosis?  If you ask either your pcp or your rheumy for help finding a different doctor, be prepared to say why.  Good luck.

Anyone else want to add other suggestions/observations?