Finding The Right Rheumatologist: What Determines If A Rheumatologist Is The Best Vs Worst?

 

At this time of writing, there have not been a cure for Arthritis Rheumatoid. A lot of people have to go through pains and depression for many years. However, there are treatments to help with the pain and symptoms of Arthritis Rheumatoid. But having the right doctor to prescribe medications can be very hard. A lot of people who have been diagnosed with Arthritis Rheumatoid have been though multiple rheumatologists and have not see any difference from one to another. They start with confirming you have RH, then recommend which meds to take, usually starting with the likes of sulfasalazine, then methotrexate, then Humera. Honestly, seems like some rheumatologist just throws shit against the wall to see what sticks. An example is first recommending that you take 6 pills of (like) methotrexate weekly. Then, suggested you move to 8 pills a week once realizing the arthritis goes up than normal. Most rheumatologists would even tell you to try switching to Humera, or Arava.

With all that said, is there an advantage of finding "the best" rheumatologist out there? What would they do different? What determines if a rheumatologist is the best vs worst?

To answer this question, you need to know a few things first.

What are you hoping for in a rheumatologist?

​The treatments above are what they are. They start with the traditional dmards (mtx, sulfa, etc.) and then move to the biologics, as needed. There really isn't any other medical treatment for the disease, for the most part. Some people may need physical therapy or even surgery if their joints get bad enough. But otherwise, the treatments are dmards and/or biologics.

If you aren't willing to change meds or try biologics then you are kind of stuck. There are no rheumatologists who will have other treatments or special treatments. If your decision is not to follow standard medical treatment for your condition, then there's not much else they can do for you.

Find a good rheumatologist that listens to you, explains your disease any why they recommend a specific treatment, and also stays up on the most current research and meds.

Methotrexate is a very popular Arthritis Rheumatoid meds. However, Humira is a pretty common first biologic, as it has been around for a while and has typically good results. You need to know what you want from a rheumatologist? Every drug affects every person differently, both in good and bad ways. Go in to your appointment with a list of what you want to address and don't be afraid to ask questions during your appointment.

Don't just go throwing meds at the body and see what sticks. Some don't stick after awhile, which isn't consistent between people, and you start the seemingly random med throwing again. Side effects are what they are. They usually level out over time. Mtx can make you sick to the stomach with each increase. But eating breakfast the next morning, can reduce the issue.

There's no alternative treatment approved. You can try physical therapy to alleviate muscle issues, talk therapy for chronic pain, occupational therapy for accommodating your disease, but ultimately medication is what treats the disease, and nobody knows what will work for you until you try it.

What do you think tells them what will work for you? Every body is different and the best rheumatologist is the one you work with. There isn’t really a way to tell which medicine is going to work the best for which patient. It is often combination therapy which works better for many patients with rheumatoid arthritis but not all. So it is not usually this or that, but this and that. This would also fit better when you consider that the immune system has many duplications and many work around mechanisms.

I think most modern rheumatologists favor combination therapy over mono therapy for people who have breakthrough symptoms on a single drug.

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