About a year ago I got fed up with an elbow that wouldn't straighten, fatigue, inability to walk a straight line in the morning, hurting hands, you all know the package. Labs normal, x-rays showing osteopenia around the joints in my hands. Saw the rheumy, prednisone, mtx, Humira, just started Enbrel when she decided, for reasons that remain unclear, that I needed to go see the rheumys in the big city. That took almost 3 months to set up. The big boys' office is as disorganized and user-unfriendly as can be, but, oh well. After a more-than-2-hour wait, I see the great and wonderful Wizard of Oz. We talk, he orders x-rays and blood tests for everything from RF to Dutch elm disease. I go back two weeks later. Only an hour's wait! The Wizard tells me that all the labs are normal, the x-rays show problems but they mean nothing, says I have no swelling, asks me questions but interrupts before I can answer, tells me I just have a little bit of osteoarthritis, and that the drugs I'm on- mtx & pred- aren't doing me any good. He suggests I go off them to see, or not, then tells me to come back in four months.

WTF???

Doing what I have been doing for four more months, while new joints continue to act up, seems stupid. I can't risk a major flare by quitting them right now- too many commitments. Do I ever return to Oz? Go back to the first rheumy, who may or may not have closed her practice? Ask her office for another recommendation? Go cry on my PCP's shoulder?

Parting shot: on my way out of the kingdom, the Wizard remarked that I don't actually have a definite psoriasis diagnosis. (Good chance I actually have PsA.) My dermatologist, 3 PCPs over the years who have helped me treat it, and my first rheumy would beg to differ. After a year's worth of mtx, it's minimal at the moment, though.