So I went to the rheumy to find the results of the MRI of my feet. He said that MRI’s were the best indicator of psoriatic arthritis. He said that my feet MRI showed no damage. He asked how I had been doing, and I told him the truth: stiffness, pain, poor sleep, fatigue, joints red and soar, etc. He said that if I doubled up on Naproxen I should be okay for now and to see him in six months. He said “I wouldn’t start on the heavy medications yet.” That was my visit.
Now I wonder: was I truly just being a whimp? I will do the 1000mg of Naproxen, but is that going to really end my pain, stiffness and fatigue? I am just sick of doctors so I don’t know if I have the energy to go on a doctor chase to sort through all the dismissive ones. I guess I will just manage to endure - but six more months?
I was on different NSAID for a couple of years (maybe 5?) until I started mtx and a biologic. It did manage to keep it under good control for a while. I still take Naproxen 500 mg twice a day and Tylenol 1000 mg 2-3 times a day in my attempt to avoid narcotics. Though the biologic (my fifth to try) and mtx keep it under pretty good control, I think, I still have pain, fatigue and stiffness. You can shop for Rheumies in a slow manner if you want. I found one who listens to me, recognizes me out of the office and is gentle in her approach. She seems to know what she is doing though I do not always like what she says. She is frequently right but does hear what I think ( if must be hell to have "know it all" nurses as patients!) I guess you have to figure out what you want in a Rheumy and pick from there. But do remember you may not always agree with nor like what the say.
I had horrible pain in my feet and was bed ridden for two weeks. The MRI only showed inflamed tendons in my feet.
I started out on NSAIDs only for almost a year, and then had Plaquenil added in. I never had any imaging done at that point. Fatigue was a major issue at that point in time. It sounds like his choice of treatment is reasonable, but he may not be the best choice for you personally.
What's funny is there have been a few times where I've seriously considered switching rheumys, but a little bit of time and thought, and I have stuck with her. I feel like my treatment overall has been good, and the relationship is good enough. What I realized is that it is fine and acceptable to question her statements and treatment, and this is the only way that I will get optimal care.
You asked if you were being a wimp. No. It may help with your symptoms, or it may not be sufficient. You can ask for more frequent monitoring. I've never been on every 6 months. Even when I was just on NSAIDs, I was every three months. Since I added in a different DMARD, I've been going every 2 months.
If you take what he says and take it every day WITHOUT FAIL you may be amazed at what happens. It may take a couple of weeks, it may take a change in NSAIDs but you will be amazed. miss a dose or a day, and you may have to start over.
We honestly undersestimate these things because we are so used to popping a couple for a headache or whatever and can't imagine the doing much for our "real pain"Taken right they can be very powerful Just don't miss a dose Ever and don't lie when he asks. He CAN tell from your feet.
My rheumy’s rule is that if I am on NSAIDs that I must be on Prilosec as well. You may want to bring this up.
One thing to be cautious of taking high (therapeutic) doses of NSAID's if you are also on an SSRI (a certain class of antidepressant), because the combo can cause increase risk of bleeding. This can be quite dangerous. I needed blood transfusions when I had a spontaneous abdominal bleed from the combo. This was 9 years ago when the danger was first starting to be understood.
TNT Lamb is right. NSAIDs have become thought as just a pill for a now and then minor issue but, if taken regularly and with something to protect against acid build up can be very powerful. I am on Remicade and leufludomide but man if I miss my toradol doses I know it. We have been, as a society, trained to think it must be stronger or prescription to work. The reality is is most of the time (not all) when over the counter medications are taken properly they have great results.
As for the shop around Rhuemy query, I myself have no choice -there is only one. You can look around if there are reviews. The other thing I would suggest is book an appointment and prior to going write down all your questions. Make sure you give him a copy of you questions and ask him to go through them for you. He may need time to reply to them and may be able to write down and send to you, email or snail mail the answers. Or he may be able to answer right there. Most doctors would prefer patients did that as then they can answer what is bothering people and get a better assessment of your overall health as well.
I always write down a list on my iPhone and if need be email it to my clinic. That way you know if you are satisfied with his patient care. I do not always get the answers I want but I do get answers.
Some specialists don't have a good manner, but this does not affect their ability. How much time does yours allow for each appointment. My appointments are 7 minutes. Once I looked at medical practice as a business which allows Specialist to earn a high income. Then the doctors surgery is where they offer this service to you. Many of them don't have time for any unnecessary conversation and they prefer to stay detached. If you find one which does show compassion is pleasant and allows a little more time then this is a bonus or be careful your not paying extra for this.
It can also be the system of try this particular medication, then wait and see what works before going up to the next stage of meds and it has absolutely nothing to do with being a whimp or whinning or how much pain you can tolerate.
If your Naproxen does aggravate your reflux then you may be able to take another medication to avoid this and to protect your stomach. You might need to speak to your general practice doctor and rely more on that doctor for in between your Rhuemy visits.
There is always the option of ringing the receptionist and leaving a message or requesting an earlier appointment if this treatment does not work out for you.
Dont give up! U know ur body better than anyone,i believe we r smarter that most the docs we have 2 weed out!! It does get so frustrating & makes u wanna give up but u cant! U keep looking until u find 1 thats gonna help u!! I dont no how many times ive left doctors office crying feeling so alone that not even the doc get it but i couldnt let it bet me.if people dont have it they dont get it! Never give up on ur self!!
Your endoscopy doctor should advise you about whether or not you should be taking the NSAID. They normally do a report back to your doctor you could ask him to also send a copy to your results to your Rheum.
It sounds like you're dealing with a lot! No info here, but I just wanted to say I hope you get it all sorted out and get relief from it all soon!