I am totally speechless after reading you post Greg - to the point that I need to absorb and process what happened to you before I can offer any response. I"ll likely get a reply posted in the middle of the night when it seems I can focus somewhat.

That has to be the worst doc appointment report I have ever read.

I'm mad as hell!

bring a second objective patient to ANY visit you endure with her in the future (unless you cut bait and run entirely NOW - but not sure where you sit with your meds and such, sometimes this stuff takes time)

bring someone that likes to listen and will be your advocate. could be your spouse but could be a brother or best buddy or some such thing, whomever you think is BEST at setting the attitude of any visit you might have to have with her (but I hope you don't have to have anymore)

start dialing. waiting lists abound and you want to time this with the end of your refills for your injections.

i once had an early rheumie that wanted to do imuran and gold treatments on me....at first...like he was 80 going on 100 and thought the ra standards were like from the 1950's or something. I can't believe i remained as long as I did. I had a quack referred to me by the road back foundation who wanted to talk about Kathleen Turner...during my appointment (who cares, I don't care a rats ass about movie stars he treated). the thread? cut and run as early as possible when presented with lunacy.

you are entitled to I AM statements which define your condition. the doctor can't defy your pain assessment of yourself. YOU name it. as to outcome they are sometimes daft. if you need paperwork you are going to have to ask for it. doctors love to look at functionality. sometimes it also helps if we talk their crap.

depot

Thanks again everyone! I'm still a bit upset and confused but also excited about the prospect of getting a 2nd opinion. I want someone to first and foremost tell me the truth about my diagnosis. Somehow knowing the facts makes me feel better. I felt better reading the ACR 20. I always suspected she was not telling me all the facts and I think it bothered me deep down inside. I work best when there is a game plan based on reality, not fiction! Plus many times she tried to brush me off or pass me off to another doctor even if it had to do with my osteoarthritis. She appears to be overwhelmed with patients. That's no excuse and she' clearly not for me but I really think that's why she acted like she did especially considering she mentioned all the patients she had and all that was on here plate. She got me started on my treatment for RA so going there was certainly not a total waste.

I actually had a very good day other than stiffness. I have an appointment with a different rheumy next Tuesday May 12th. There was a cancellation and I jumped on it. The Lord works in mysterious ways.

Amen to that!

Holy Cow! I would say consider doing what I'm currently doing-making appointments to interview rheumatologists to find a new one.In all my years no Dr. I know would ever, and I do not believe it is ethically correct, to say something will/should work 100%, unheard of.
My Dr. also did not appear to understand the fatigue portion of RA.
No it is NOT your concern, nor should she bring up her caseload.
I'm better when I'm not working also because the drain on my energy and stress that comes with the job wears me down. I haven't brought it up specifically, and now I'm glad I haven't, because I was concerned I would get a response like you did. I figured the documentation in my chart that I have frequent absences, and the FMLA record would speak to that.
Run fast. So sorry you had to deal with this.

I am a caregiver to my husband and run our business. That makes me have two full time jobs - aaaaaaahhhhhhh.....talk about stress. Every time I get away from the caregiving and our business and go to a vacation spot, my RA symptoms are almost non-existent!!! I do believe stress does not help our RA!!!! Sorry to hear the Enbrel is not helping you. I will say that Enbrel and methotrexate have done well for me.

Beechfeet I was hoping my frequent absences would attest to how my job wears me down but she never recording anything about that until I pushed her to do so yesterday. I may need to apply for disability someday and I would hope I have the documentation to do so but I'm not getting it from her. I have print outs of my old visits an there is nothing but bulleted points such as: RA, OA, Fatigue, and Insomnia. No details about my struggle to stay employed or my struggle to even drive in the morning without falling asleep. Funny, they didn't give me one from yesterday. I guess I'll have to drive over and get it. I have decided that maybe with the right doctor and right treatment and can continue doing what I'm doing for a while longer. However, should I have the same struggles next year that I did this year then I may be forced to apply for disability anyway. I'm thinking I'll be upfront with my new doctor and tell him that I want to stay at work but also want someone to support me should that no longer be possible. Those are my expectations along with medical treatment. Is that too much to ask?

Kiddogal. Maybe adding another DMARD is a better option that tossing the Enbrel out the window!

Beech feet, you mention FMLA. I took 3 weeks earlier this year and was paid with my accumulated sick time. Just curious how long you took? My wife asked the doctor what people did in my situation who had constant flares. She didn't say disability but to take a couple years of FMLA! In my profession (teaching) that is disability as the first 2 years are temporary disability but paid through my retirement account. It doesn't really matter at this point but I forgot she said that. How many of us can afford to take 2 years FMLA? We may as well apply for full time disability in my opinion. In teaching if I told them I couldn't work for 2 years they'd can me. Do they even have 2 years of FMLA? Anyway, being disabled doesn't protect a teacher from losing his/her job if they are unable to carry out their professional responsibilities in the state of Connecticut. Not being able to work 5 days a week could lead my school board to send me to independent medical evaluation to see if I was fit to carry out my responsibilities. That hasn't happened, may never happen and certainly won't happen for a while but I'm little freaked out that if I miss 35 days next year like I did this year that I will be called out on it. That's why it's important for me to have a doctor in my corner. Also disability with my retirement board is not like SSDI. A doctor could help me say I can't teach due to the stress, keeping good attendance, etc. It doesn't mean I can't do a light duty desk job somewhere. It just simply means that I can take my retirement early with less penalty (50% vs 25%). It's a much easier process but I still need to find a competent doctor as their documentation is the deciding factor.
Anyway, at one point I tried explaining this to my doctor and she didn't get it nor take the time to listen to my explanation. I got the impression that she would try every Biologic ever made before she would give me the time of day regarding disability or early retirement.

FMLA is for 12 weeks.

I figured she was wrong when she said that but wait it gets better. I have had a swollen right thumb for months. Acute pain at times. Doctor didn't want to deal with it and told me to see a hand surgeon. She said I had Osteoarthritis in that thumb. She said it was based on the x-Rays. I got my X-ray report today and that thumb does not have OA and the X-rays on the hand and fingers all said they were unremarkable which means there is nothing worth noting. I just don't understand why she wasn't honest about these things?? Oh well, at least I felt well enough to use the lawn tractor today!

Well Greg, it seems in the interim you have calmed down and thought this out some - I am so happy for you that you have an appointment with another Rheumatologist next week already. How lucky is that! Like you said - I consider things like that an omen of sorts.

Her announcing the Enbrel being a failure since you are not back to 100% in 3 months is just ridiculous in my opinion. I know some docs want to move on to other meds quickly but in my case I never saw the most effect (positive or negative) until around the 6 month point. Of course I may be very different with that than other folks - like when I read of people taking their first shot of Enbrel or Humira and feeling so much better the following day - huh...??

The fatigue part - from everything I've read fatigue is the #2 symptom reported by most RA patients - to say you need to see a psychiatrist is just....well....insane.

Being you have another appointment already this is probably a moot point, but for myself I out right refuse to be treated like you were today by anybody. I've walked out/away from many places over the years including doctor offices, restaurants, car dealerships, etc. Just ain't happening.

And looking up the road at possible disability - you need your docs to be on your side - very important as you know. This "doctor" could very well likely put a huge wrench in the works if/when you really need to make your initial claim. Could be a very bad situation.

I have one suggestion which you have already probably thought of - make yourself some extensive notes about your condition and treatment in chronological order for when you visit the new doc. I doubt very much the new doc could have your patient file from the old doc in that short of a time so a good history is important. Plus you mentioned that the old doc rarely took good notes anyway. Also at that point with the new doc if you feel comfortable is ask them what they think of staying the course with the Enbrel for a while or switching. I think it will be one of those things where within the first minute of meeting the new doc you will get the good fuzzy feeling or the "oh no - not again" feeling. Consider yourself very fortunate being able to have another doc close enough to you and also getting such a quick appointment. My doc is 90 miles away - the next nearest one would entail an overnight stay because of the distance. But I have felt from my very first appointment that I was in the right place for my treatment with the doc and his PA's - that's "right place" feeling doesn't extend to some of the office staff but that isn't the important part.

I was so mad when I read your post. I can easily imagine what you felt like after that. It sounds like you've calmed down now and put another plan in action already - good for you!

Wow what luck with the new appointment.
Where did you get the name of the new Rhuemy?
Wanted to encourage you to find that DR that understands instead of denies.
Went to a new doc myself yesterday & I could kick myself for not doing this much sooner. The difference between the 2 is like night & day.
He noted the Drs name I had been with & get this, said he had several of her patients come to him. Then proceeded to ask me if I cared to share my reasons for looking for a new doc. Started out with the statement I just did not feel comfortable with her & she was not responding to my concerns. He let me know he had heard it all from her other patients. He became extremely upset on my behalf over a comment she had made to me. Doctors are usually reserved in what they say about other doctors. He made it clear without saying much his opinion of her.
what complete relief I felt walking out of that office.
I'm so glad you have another appointment.
Had him recommended to me by another doctor & patient. Also noted great reviews on line. If need be keep looking.
I never realized just how negligent my first doctor was till I seen this new one. You deserve a answer, understanding & decent treatment.

I'll be watching to see how this new one works out for you. Just in case you may want to consider another & see how far out an appointment would be. You could always cancel & at least you'd have peace of mind with a back up.
Wishing you the best of luck.
Sammy

Good for you Sammy! Hope your post gives Greg some more encouragement that he is doing the right thing.

I had one experience with a terrible doc (specialist) a couple years ago. I won't go into the whole story here but never went back. When my Rheumatologist asked why I wasn't going back I did my best to just say that I didn't agree with what he wanted to do. Bad mouthing one doc to another can gain nothing but in Greg's case and yours the new doc does need to know your concerns.

Feeling good about your doc is very important I think. I'm very lucky that my PCP whom I've been seeing for 20+ years is more like a friend than anything. And with my Rheumatologist (4 years now) I feel I am getting the best care possible considering the area I live in.

Greg,

Coaltrain's suggestion on making extensive notes for your new rheumy is a fantastic one. In fact, I keep a medical binder, very well organized, on just about everything related to RA. That way, I am never relying on a doctor's office to send over records quickly. I divide it into sections like - labs, journal entries, medical history, etc. I have had to pull from this many times. And, I always travel with it.

wow Linda

RASally would approve.

i have it all scattered. great job.

depot