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Thread: What is the role of a Rheumotologist?

  1. #11
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    Ugg! I hate that this is so common!
    Mari

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    I'm so hoping I can find a Rheumatologist here.. that doesn't suck. The only one I've ever seen was definitely a piece of work. I had months of lab results from my GP that indicated AI disease and inflammation. (how he diagnosed Lupus) I had bad Ascites and really bad Edema. I was quite frightening to look at, lol! All bloated up and limping in pain. But.. I "was fine". Oh, ok. Yes, dismissed by a rheumalotologist as not having ANY Auto-immune disease. It "wasn't in my DNA" she said. Oh wait... she wasn't the Rhumy at all, it was his asst, he was too busy to check me out himself. But SHE made the diagnosis of "Nothing". So, yes, I've often wondered what exactly we are paying these people for. Why do they even need to exist when so many of us seem to get the best care from our awesome little, old fashioned family practitioners? It's very frustrating to say the least. You'd think someone who has studied AI specifically would know there is not really a test like that. Personally, me thinks my insurance wasn't sufficient. or something. Blahh!

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    I got a good chuckle out of this thread.
    The excellent rheumy that I had in San Antonio checked everything, all of the time. Each time I walked into that office, all of my vitals were checked, I had to fill out a form about where I was hurting and what my concerns were, and the NP would go over everything and prioritize before I saw the doc.
    The rheumy herself would take time to talk to me and would examine anything that I complained about. She had lots of diagnostic tools and even a lab right there in the office. She is also a personal friend of my PCP, and they had no problems sharing information.

    The arrogant excuse for a rheumy that I have now gave me four minutes at my last appointment. All she does is renew my prescriptions and then hustles out of the room. I've also gotten the ping-pong thing - the rheumy says "see your PCP", then the PCP (who thinks I'm a hypochondriac) says "see your rheumy".
    I recently tried another rheumy, and he proved to be one of those who looks at the lab work, not the patient. He tried to undiagnose everything that my good rheumy had diagnosed - sigh.

    I'll be moving back to San Antonio in April, and even though I dread the heat there, I can't wait to see my great docs.
    I LOVE Rob's idea.
    Hugs,
    Marla

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    i wanted to add something that was started a year ago.

    http://forum.wehavelupus.com/showthr...rheumatologist

    it might help you understand what a rhuemy really does....

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    Steve, thank you so much for that! I think my last Rheumy had lessons from that guy!

    Here's hoping my new one turns out to be better. I just want someone to understand I'm not a fat lazy teenager. I'm a 26 year old woman who has gained weight since taking steroids and struggling to walk distances (my form of exercise was walking everywhere, for miles!) I don't have bad hygiene...the reason 60% of my mouth is covered in cold sores is because that's what happens when I flare. I don't know why my joints hurt even without redness and swelling....but they DO hurt, don't just ignore that because I don't fit your text book model. And no no no it's not all because of my bipolar disorder...but YES I am friggin depressed a lot of the time because of being in constant pain and missing out on life.

    Raaaaah rant over! Sorry guys, guess I'm just nervous about seeing a Rheumy again for the first time in too long. I try not to go in there on the defensive but I soon feel like I'm having to "prove" that I'm having problems.

    If it turns out to be the guy in the video Steve posted then at least ill get a laugh out of it!
    I spent 2 years travelling Australia. Check out my travel blog at http://travelpod.com/members/helenlear

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    I've been thinking about this thread.
    When I worked with a midwife, she mentioned to me that for many of the poor, rural Moms that we saw, our pre-natal care was the only regular medical care that they ever got. That was why she read up a lot on spotting medical issues such as high BP, heart problems, etc. She also researched and made herself aware of where to refer the Moms for cheap or free medical care in the counties where they lived. Often these were Moms delivering a fifth or even sixth baby, so she was also very careful to refer them for contraceptive advice, if they were receptive to that. She is a "lay midwife", but she has a lot of training and is a responsible person. I think that a lot of obstetricians, at least the good ones, also realize that they are often the primary care provider for many women and tend to check for lots of issues and make lots of referrals while that Mom is under their care.

    I think that rheumatologists need to have this attitude, too. For many patients who don't have insurance, or have very inadequate insurance, they may be the only doc that the patient sees regularly. If a person barely has the money to see one doctor, they might pick and choose which one they can afford to see.
    For this reason, I think that our rheumy's should check vitals, blood, etc. often and should be aware if we are presenting with symptoms that could indicate an issue that might be out of their little box. They just might catch something before it gets serious and save a life.

    I think that my rheumy back in Texas might have had this attitude. She seemed to have a lot of patients who were elderly and were badly crippled with various forms of arthritis. Knowing that San Antonio has a fairly high poverty rate and little help from the state, she might have been the only doc that those folks were seeing. I'm thinking that might be why she and her staff were so careful to check each patient so well.
    I truly admire her for that.

    My current rheumy is the total opposite, and I don't have respect for her. She has no staff other than the receptionists who collect the fees. My last appointment lasted four minutes - I paid $30 and my insurance paid $190. She doesn't even carry a stethoscope and doesn't bother to physically examine me. As someone else mentioned on this thread, she doesn't even check my heart rate or BP. I keep track of that myself by using the machine at the pharmacy.
    I think that our rheumatologists need to take a lot more responsibility for the well-being of the patients in their care.
    Just my two cents worth...
    Hugs,
    Marla

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    You really come up up with some great points Marla.

    I am horrified to hear that your last appointment was 4 minutes long...that is absolutely disgusting! And how dare she charge $120 dollars for 4 minutes?! What exactly makes her think she and her 4 minutes of service is worth that?!

    Are you putting in a complaint? She shouldn't be allowed to get away with that. I'm sure the insurance companies would be appalled to know that they paid out $190 for her to barely look at you!
    I spent 2 years travelling Australia. Check out my travel blog at http://travelpod.com/members/helenlear

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    Sadly Marla's story isn't uncommon. My first rhuemy never spent more than 6 min with me. EVER! The second one spent 15 and I thought I was in heaven (I wasn't). The sad truth is that we go in not knowing what we need or what to expect so too often we get bad care and don't even know it
    Mari

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    ~Winston Churchill~







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    6 minutes...disgusting! How can they justify this?!

    I think that's one if the great things about this forum..we can learn so much from others experience and get to know a little more of what to expect, what questions to ask and I know it gives me a little bit more confidence in talking to doctors..I'm better at putting things into words if I've already chatted over it on here with you guys. Sometimes I feel like I live on this forum and devote too much time to thinking about lupus but I think it's a great thing for us all.

    Thank you everyone x
    I spent 2 years travelling Australia. Check out my travel blog at http://travelpod.com/members/helenlear

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