When should a patient seek a clinic like JH?

Question  My wife has been in treatment for supposed Rheumatoid and Osteo Arthritis for 10 years. It has affected her back, shoulders, neck, and spine. Though she has joint pain in her hands and knees, and several of her fingers have begun to deform, that pain is mild compared to the other.

She has gone through the standard set of single and combination medications, Prednizone, Methotrexate, Remicade w/Methotrexate, Humira w/Methotrexate, and is now through the fifth infusion of Orencia. Her SED rate was 46 when she started the Orencia, and the day of her latest infusion around the 25th of Sept., it was 55. The combination of Remicade with Methotrexate worked the best, but after a while, the dosage had to be continually increased until the onset of Lupus symptoms forced her off the Remicade. She is in so much pain most of the time that she can't stand up in one place for more than a few minutes before she starts to shake, get nasuated, and has to sit or lie down. The fatigue is chronic, and the combination of Predizone at different times and the nausea causing her to only want 'bready' foods or potatoes has caused severe weight gain.

The latest suggestion from the Rheumatologist is to go through a couple more Orencia infusions to see if it starts working, and if not, they want to put her on Enbrel. I think it's time to have a more in-depth study, which I'm sure our medical plan would pay for, but we don't know where to go or how to do it. Thanks for any help you could provide.
 
Answer  If your wife is not doing well, then it might be worthwhile to get a second opinion. Often times a fresh look can dome up with new ideas, not matter how good your present rheumatologist may be. See the section on how to make an appointment.

Last update: 02:20 PM Thursday, April 26, 2007

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