Rheumatologist vs Internal Medicine Doctor

By rosettasweitzer Latest Activity July 17, 2010 at 5:20 pm Views 3,687 Replies 17 Likes 4

rosettasweitzer

Ive had RA for two years. Ive been on a variety of meds, none of which have worked, and have been in a flare for two years.

I see a Rheumatologist on avg about every 6 weeks due to pain or increased swelling and fatigue… problem is the Rheumatologist refused to change my medication. She claims the problems I am having are diabetes related. To which my Endocrinologist disagrees.

When I was diagnosed with RA two years ago, it was in both shoulders. I now believe I have it in my hands, wrists, ankles, feet, knees, and hips due to the lack of proper treatment. My hands and fingers swelll and are stiff and painful, I cant walk more than 50 ft without getting pain in my knees bad enough that I need to sit down. My ankles and feet hurt with little or no activity to the point that when I drive somewhere I am stopping the car at least once due to extreme pain. I am unable to be intimate with my husband because my hips cause me excrutiating pain…

I have explained all of these symptoms to my Rhuematologist as well as shown her pics of my increased swelling and she still claims my medication is doing its job. when I question this statement, she says the medication i am on works for her other patients so she doesnt believe its not working for me..that my problems are muscular or diabetes related to her. She refuses to send me for xrays, ct scans, or mris… so I am at a loss.

I have filed for SSD for which I was denied but am in my appeal process now… my attny sent her an arthritis functional capacity form and she refuses to fill it out! I am also a diabetic as I think I mentioned before…and her statement to filling out the form was…"i dont have the time to be called into court to defend any info i put on that form…try getting it with your diabetes complications…"

I have no health insurance. My dr appts and prescriptions are paid with the discount health plan I have through the county I live in… I think this is why she treats me the way she does.

I also live in an area where the office I travel to is the only office in a 35 imile radius. The next closest area with other Rheumatologists not affiliated with HER office is in Hershey, PA at a teaching hospital that isnt covered by my discounted health plan because its in a different county. Im on a waiting list (have been for 15 months) for PA State Health Insurance but who knows how long THAT will take.

I sometimes see my PCP for my RA when I cant get in to see the rheumatologist or when the pain I am experiencing is just too bad (because the RA wont prescribe pain meds). She sees my RA as an issue and tells me she doesnt think the treatment I am on is working. She is an Internal Medicine Specialist. So I guess my question is can an Internal Medicine Specialist take over my RA treatment if the Rheumatologist I am seeing is incompetent? Is this within their relm of expertise?

Im at my wits end and don't know what to do… I also suffer from Depression and Generalized Anxiety Disorder. I have been feeling VERY overwhelmed because I feel like i am hitting my head against a brick wall. I just dont know what to do…

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Replies (17 replies)

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  • Lori Byrnes
    Lori Byrnes October 15, 2011 at 8:10 pm   

    You definately need to get rid of this chick immediately. Your internist should be able to treat you untill you get the State Health Insurance. For her to say that your swelling and aching joints is related to your diabetes is ludicrous. She just doesn't want to admit that she's wrong. Just because one medication works well for one patient, it doesn't mean it works well for everyone. Diabetic neuropathy pain is normally a burning type of pain, and doesn't include swelling and pain in the joints. While diabetes does cause a myriad of other problems, that's not one of them. It's also ridiculous that she won't prescribe you any pain medications. Have you tried a pain management doctor? I know you have no insurance, but it would be well worth your time and money.

  • sandypops
    sandypops October 15, 2011 at 5:08 pm   
    Edited October 15, 2011 at 5:30 pm by sandypops

    If your doctor continues to disregard that the medication she has prescribed is not helping you, request a copy of your medical records and get a second opinion. You need a doctor who is open to listening to you, and a doctor who isn't afraid to think outside of the box. Honestly, we all react differently to these pain and arthritis medications. I pray that things get better for you soon. Hugs.

  • squog master
    squog master June 21, 2011 at 9:25 pm   

    I just fired my Rheu. I just felt I wasn't connecting with her. She talked at me not with me.

  • MWmelbourne
    MWmelbourne June 21, 2011 at 8:23 pm   

    well I will get in line and agree with everyone else.. Your rheu doc doesn't sound right to me. I've had many (due moving about) and they are not all the same. Find a doc that you like that treats you with respect. It is a shame that insurance dictates the level of care some times.

    My husband has a saying not every doctor graduated at the top of the class.

    If your PCP is not comfortable taking over your care, see if they can refer you to another Rheu. doc [I can't believe they are all affiliated , there has to be someone independant, but with the shake in health care these days a lot of my doctors are worried here] If your PCP is unable to offer the assistance you need keep looking.

    My PCP is an internal med spec and I jokingly call him the ring master of this circus, ( I can't count all my doctors on 2 hands..) someone to keep all the specialists and surgeons in the same sand box.. A lot of times they give conflicting advice because they are looking at a narrow perspective - their focus on their particular speciality.

    With multiple Dx and overlapping issues with Rx it is good to have someone look at the big picture!

    To rate doc's or locate doctors check out sites like HEALTHGRADES http://www.healthgrades.com

    You can see where a doctor was educated, if they have any problems (malpractice), locations and patient satisfaction ratings. In looking up doctors I know, so far I have agreed with every assessment!

    Good luck.

  • ZOWLUCY
    ZOWLUCY May 21, 2011 at 11:05 am   

    I have only one suggestion on this Leave this RA doctor sounds alot like the first RA doctor I had Soundsl like all she wants is the money and not actually do anything for you You have got to find a RA doctor and Primary or specialist that will work together Ask your lawyer about the RA not filling out the paperwrk perhaps there something he can do to help I hit that brick wall several yrs ago and didnt like it one bit But dont hold still for the attitude your getting from "all knowing one " Find someone to work with you and not against you Take care Hugs and just letting you know my thoughts are with you and I dont cost a thing Martha

  • squog master
    squog master April 5, 2011 at 6:36 am   

    After this long if the meds are not working for you I would suggest you change Rheumatologists. What works for some will not always work for others plus it should only take a few months for you to see any results. After 2 yrs if the meds are not working & the Rheu won't change it's tme to fire him. Remember he works for you.

  • spiderwoman93
    spiderwoman93 September 18, 2010 at 9:41 am   

    If your RA doctor will not work with you at all, you may really think about changing. Have you seen your results from a recent SED or CRP blood test? This would tell you if??? your meds are working… as is shows how much inflammation is in your body at the current time. I've never heard of a RA doctor that wouldn't work with the patient…this is very unusual. Remember that the RA cannot win !! Try to keep going… Lying down or in bed generally makes you stiffer… I know I have been fighting severe RA & Fibro for 5 years now… I refuse to give up !! Hang in there !!

  • Lana
    LanaPA July 18, 2010 at 1:18 pm   

    I am sorry about the obstacles you are having with RA.

    As for the rheumatologists, doctors will always disagree with each other on different plans of treatment. About six months ago, I changed my rheumatologist because I did not feel that she and I were on the same page for treatment options. Also, I was concerned with her experience with fibromyalgia of which she had very little. I looked at rheumatologists approved by insurance company and studied their credentials. The new rheumatologist has training in fibromyalgia.

    See if you can find another Rheumatologist who has training with diabetes patients. Do your research. Perhaps a recommendation from your internal medicine doctor? You can also the American College of Rheumatology member search as well. Then research those suggestions. You have a right to decide what doctors you want to see to treat you. Perhaps your discount plan can give you a new referral. Many of the drug companies offer assistance with RA meds.

    As for the issue with the health insurance issue, here are a couple links with resources that might be helpful to you.

    http://www.arthritisconnect.com/discussions/6...
    http://www.arthritisconnect.com/discussions/1...

    I hope this information is helpful to you. Be your own advocate. Educate yourself and do not trust someone’s judgment, regardless of their profession, simply because they tell you to.

    Good luck to you.

  • Lilevanbr1
    Lilevanbr1 July 18, 2010 at 6:30 pm   

    Ye i understand

  • Lilevanbr1
    Lilevanbr1 July 18, 2010 at 6:30 pm   

    I wish we were all human iam budist abnd wer really ghost

  • rosettasweitzer
    rosettasweitzer July 19, 2010 at 6:38 pm   

    Thanks! I called and made an appointment with my internal med specialist (PCP) and i made a point in telling them the reason for the appt. The nurse said "well Dr Hamilton isnt the dr she wanted you to originally see anyway! The dr she WANTED you to see at that time wasnt accepting new patients…but you're already an established patient at that office so you should be able to get an appt with her… So we'll see what happens Friday when I see the PCP.

  • rosettasweitzer
    rosettasweitzer July 24, 2010 at 10:37 am   

    So i had my appt at my PCP's office yesterday. She said she thinks the Rheumy is a "quack" not working for best interests, She is finding me another Rheumy, also put me on meds for anxiety and depression, and filled out my functional capacity form for SSD…

  • richi rich
    richi rich August 6, 2010 at 5:55 am   

    Rose, I have been on Orencia for 1 1/2 yr and it has helped with stifness and flare ups along with other Prescription meds. sorry to hear you have had a lot of trouble. I had to go thru 3 RA Doc's to find the right one. dont give up . there are a lot of meds out there and some of them have discounts .

    from richi

  • Peggy50
    Peggy50 July 17, 2010 at 6:27 pm   
    Edited July 17, 2010 at 6:30 pm by Peggy50

    First of all I would go see a different Rheumatologist. It sounds like you have severe rheumatoid arthrits, which I have. It must be very frustrating to have the doc tell you it isn't what you have that causes you that pain. Not all docs are good docs, second opinion or even a third is what I would do. I am not telling you what you should do, only sharing my opinion of what I would do in the same situation.

    I was having a whole lot of knee trouble (amongst all my joints) and the knees were in horrible pain. I asked for an x-ray or MRI and she said we didn't need that we know what it is (RA). I had by this time been using a cane and a wheel chair. So… I went to an orthopedic doc on my own, and no surprise here, my knees were almost disintegrated. Got my knees replaced and am walking just fine now. I found a different Rheumatoligist.

    I think that depression coincides with RA, seems a lot of people with RA suffer with it, and it's no wonder… it is a tiring, painful disease.

    I am getting SSD because of this disease. It is typical for them to turn you down the first time. After that, go see a lawyer. Hang in there!

  • rosettasweitzer
    rosettasweitzer July 17, 2010 at 7:58 pm   

    Thanks for the input. I might just have to swallow my opinions of her and go see a different dr in that office. I guess if they tell me the same thing she does I will see about a dr in Hershey. I was just prescribed a cane a couple of weeks ago. I had to order one online because the canes I found locally were too big…

    Ive already hired an attorney for my ssd denial and he seems pretty sure i can get it with my diabetes complications alone but said the RA helps too… I just wish I had a better support system both from my Rhuematologist and certain family members, i think that too, helps.
    Again, thanks for the input… I really appreciate it!
    Rosetta

  • MLQ
    MLQ September 5, 2010 at 2:41 am   

    Rosetta,

    Although I wasn't in the exact same position as you, I, too, had problems with the first Rheumatologist I went to see. The other issue I had is that the Dr.'s in this big Rheumy group (and the only one in my area) did not want you to switch Rheumatologist's. This was my PCP's recommendation, but it wasn't going to work. So, eventually my insurance added on another Rheumatology group…about 45 mins away, and I am SO glad I found him. These 2 docs are like night and day. I felt like a huge weight was lifted off my shoulders when I found him. I am so thankful for him, his staff, and the care that I receive. There were also no complaints about filling out SSD forms. My attorney sent them to him and it was done…not questions asked. I do see my family doc for many other things, so she does prescribe my pain meds. I haven't ever had to ask him, (I have been seeing her for years) but he did offer at one point—and I said I didn't need any. Anyway, my point in all of this is that I fired my first Rheumatologist, and you have that right, too! We are the patients. We pay the Dr.'s…we can hire and we can fire. Just to add here that I am a certified medical assisant and previously worked in the health care field…for physician's, and after going through that kind of treatment once with that 1st Rheumatologist, that I would never stand for it again. If you get this new Rheumy and you still do not get the treatment you want. Don't give up. Keep searching and find another who will treat YOU…the whole patient. You deserve it. We all deserve it. It is our right. Good luck!

  • Peggy50
    Peggy50 July 18, 2010 at 9:49 am   

    Sure thing, I been there and we will always have this disease to deal with. Let me know what happens with a new doc!

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