do you have a local teaching hospital of any hospital?

does it have an ortho department?

is someone in the ortho department a specialist in foot?

i think my podiatrist walks on water but once 10 years ago i had to use a foot ortho for a foot fracture.

depot

Hey depot and Sally,

Well, as predicted, my rheumy doesn't know what to do. I'm not mad, that sounds a little harsh. As I said for my PCP, this is complicated, and not their field.

Depot thank you so much for your thoughts. Yes, I am in a large metro area with two, yes, two teaching hospitals. However... the rheumies I have seen (the first two who blew me off) were educated there. So... the institutions here are the source.

I am considering ortho right now, it's just they have long waits too.

Sally... I think you're right about undertreated. I am on the triple DMARD, but I wonder if my MTX is too low... or if it's time for a biologic.

I have had plain xrays two years ago, one nuke scan, and the podiatrist 2 weeks ago did use US. (Yay!) But he wasn't looking for swelling everywhere. He was looking at the R MTP joint and my R ankle.

Why am I not on a biologic... It took a lot of convincing to even get on MTX. I've said it before, my rheumy washes between RA-maybe-not-fully-RA. I get a lot of skeptical grimaces. But he has said a few times it's RA. I almost think he forgets my details. I have a voicemail around here with a definite pronouncement of RA. My point is since he washes so much, we haven't even discussed a biologic.

I definitely get symptoms down played.

He is reluctant, but can be pulled along. I am just so afraid of the other incompetents that are out there. He is treating me at least.

I have not had a positive blood result for anything. And I think you, or some other wise person here noted, I probably never will. I have been on prednisone and naproxen for almost two solid years. My whole (reluctant) diagnosis was based on symptoms, progression, and the nuke scan. My PCP was convinced on symptoms alone, but did not feel comfortable putting me on mtx.

You guys have me thinking about Mayo in Rochester.

I feel like something needs to be done right now for my feet. I think my right toes are curling. I wonder about the walking boot, but I think it would pound my left foot into more distress. My right toes are worse than my left, but it won't take much to even them out.

I'm still considering an urgent care clinic today, but I have a sneaking suspicion they won't touch me.

I guess a walking boot, or some thoughts on splinting, is what I think/thought a urgent care can do. I am waiting on a return message from my rheumy. The podiatrist mentioned it might be necessary. The walking boot that is.

I am not normally a spazzy person. This sh!$ makes me spaz. Surgery... permanent damage... Your house-on-fire analogy is apt. My brain is screaming "DO SOMETHING!" especially when I saw one of my toes moving towards claw toe.

I agree about over use of medical care. I work in an ER, and that gets us riled up. My plan was, after a socially acceptable introduction, to say I do not need pills. Well, maybe other than a pred burst. I have more pills than I need. Just prevent my tendons and ligaments from rupturing... please.

Excellent point about records. Maybe someone else will read this and think they need to do it too. I have actually kept a medical diary of sorts. I knew early on that the intricate details of the beginning of this hot mess would fade rapidly. So I wrote, and colored anatomy charts, with where this all started. I need to update it.

I am in the Midwest, but the Rochester office will still be a significant haul. Insurance will cover it based on out of network rates, I am pretty sure.

It is summer, and this is a holiday week- I wonder if the podiatrist is on vacation for the next couple of weeks. Changing horses midstream is often a bad idea, but is there anyone else who could see you sooner?

If your toes had just been injured urgent care would know what to do, but if this is just the wonderful world of RA you'd be lucky if they had even ever heard of it.

Sally is as correct as usual that you might want to consider finding a more aggressive rheumy, or at least getting another opinion on your general treatment. Yours is awfully hung up on lab results, even when they don't correlate with symptoms.

You do know how this will end, don't you? With a lecture from the podiatrist, starting with, "Why on earth did it take so long for you to get back in here?"

Ah, excellent points Alto. Although I'm glad I wasn't drinking anything while reading your post. I would have spewed it all over my computer about the podiatrist chastising me for taking so long to see him.

The podiatry office didn't seem too keen on anyone else seeing me. It's unfortunate they don't post this stuff in their office. You know, if you have an urgent need, we'll see you in a couple weeks.

I did manage an appointment earlier than the 16th... Late next week. So, there's that.

You're right about the urgent care. I didn't go. You and Sally are also right about my rheumy. I just need to decide about Mayo. Time to look at my insurance policy.

Thanks to you, Sally, and depot.

When I dealt with stress fractures in my feet due to after effects of prednisone and Nexium - I bought a walking boot from an online medical brace supplier. Cost around $40, and was delivered in 2 days.

Same brace at the ortho would cost $200 and take two weeks. So ortho recommended I buy one online.

Hey Buddhacat. Worst case scenario would be a ruptured tendon or ligament, which means surgery, pain, possible complications, and on a good day it means a lot of time off work and a lot of money. I get what you're saying. That would certainly show them wouldn't it? It occurs to me that I should say that to my bosses. "Hey, I am destroying my feet for you!"

I have heard that about Mayo, that it isn't always the best. That's what stops me from going today. Good point about the podiatrist. He is very busy, and very booked, so I hope that means in the end that he is also very good/skilled.

Good luck with your foot cleaning.

Ooo, good thought sis. Amazon could probably have one on my doorstep tomorrow. I might test drive one in the ER first.