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“We have to do whatever we can to help our patients function.”

– My rheumatologist

Both my rheumatologist and my family doctor support my need for treatment that enables me to live my life. That includes prescribing opioids, steroid shots, or thinking outside the box to find solutions. I know that makes me a lucky duck — I hear a lot about how others with rheumatoid arthritis (RA) have a terrible time getting the pain treatment they need, reporting being treated like an addict or drug seeker. So I thought I’d share some tips from my experience that might help others get the treatment they need.

Find a good doctor. Often, the relationship between doctors and patients is a bit weirdly authoritarian. It’s easy to forget that your doctor is a highly trained expert hired by you to help you solve a problem. If they are disrespectful, treat you badly, or aren’t actively working with you to solve said problem, you should fire them. That’s what you’d do with a plumber or tree doctor who didn’t take you seriously.

Obviously, this depends on the availability of other doctors in your area, but think about it. Even if your doctor’s fee is covered by taxes or insurance, you are still paying them for a service, albeit indirectly.

Work on your relationship. Your family doctor and specialists will be part of your life on an ongoing basis. Like any other person who shares your life, nurturing the relationship is important. Both my family doctor and my rheumatologist have been on my health care team for almost 20 years and we know each other by now. We recognize each other as people, as well as doctor/patient. It’s taken time to get here and there have been some bumps along the way, but we kept working with each other.

Working on your relationship is also really important if you don’t have a lot of options to change doctors or your doctor seems like they have potential for improvement.

Be excruciatingly honest. I still remember the time I cried in my rheumatologist’s office. She immediately kicked into high gear to get me the treatment I needed. That’s when I realized that for a long time, I hadn’t told her how bad things were. I don’t know what it is that makes us minimize our problems when we go to see the person who we’ve hired to help us solve those problems, but I know I’m not the only one who’s done this.

If you need help — either a change in your treatment or better pain control — tell your doctor exactly how bad things are and be specific. Share how your condition and your pain is impacting your life, what it’s preventing you from doing, how it’s destroyed your quality of life.

Know what you want. Over the years, I’ve learned to get very specific with my doctor. Often, that means that I come to the appointment with a list of issues or questions. That written list makes it likely that I don’t forget something, and it makes it more likely that the appointment is focused on what I need, rather than what the doctor thinks I need.

Doing a bit of research ahead of time to educate yourself about your options and rights when it comes to treatment will help you not only put together a list, but also be focused on the agenda you have developed. Think of it this way — would you hire a plumber without knowing that your toilet needs repairing or see your bank manager without a specific request?

Push back. If your doctor refuses to change your treatment or give you a prescription, it’s okay to push back, but did so respectfully (even if you don’t feel respected yourself). It reduces the risk of the encounter going completely sideways and makes you feel better about yourself.

Ask them why. Acknowledge that they are dealing with some significant challenges in pain treatments and ask what you can do to mitigate that. Would a shorter prescription with a follow-up appointment make them more comfortable? If you haven’t before, this is the point where you tell them exactly how your life is impacted by your pain. Tell them what you’ve tried, what haven’t worked, ask for other options. Talk about your openness to work with them to manage any risk that may concern them. Keep the conversation going to the point where it becomes a real exchange between two individuals with a common goal: getting you to feel better.

Because that’s the job, the mission, even the duty of a medical professional, whether they are involved with your care on a long-term basis or if you’re seeing someone at urgent care. This interaction between the two of you is about them helping you live the best you can with RA. Sometimes, the need to control pain and improve function means taking a calculated risk with treatment.

This post is part of RDBlog Week. To see more posts about living with RA from other participating bloggers, check out the RDBlog Week page.