Lupus and the first new rheumatologist appointment

positive – reassuring – affirming

In three words, my first appointment with my new rheumatologist was positive, reassuring and affirming.  After twenty years with my previous rheumatologist, changing doctors was not a lightly considered move.  I am generally a very loyal patient, and honestly, it was a bit scary to think about changing.  But, it was time to make the change!

much prayer and advice

Much prayer, consideration and soliciting of comments from my circle of personal advisors went into this decision.  Thankful for many around me who listened and opined during recent weeks, my final choice to make the move was based on multi-faceted health, economic and philosophy-of-practice concerns.  Any apprehension I felt before making the change, vaporized the moment my new doctor stepped into the examining room with a smile.

“Hello, glad to see you again,” was her greeting, as I shook her outstretched hand and reciprocated the gesture.  We had a brief first exchange acknowledging the thread of our first social conversation outside the clinical setting.  Confirming my intent to opt for completely transferring my care to her, and not just getting a second opinion, we launched into her review of my medical and treatment history.

diagnostic tests

It was clear she was extremely “present” in the conversation, intuitive, highly knowledgeable, and gave me a strong impression of her competence and confidence.  Without seeming to be in a great hurry, she efficiently completed a thorough history and head-to-toe physical exam, while fleshing out important details forming her composite picture of my present condition.  She determined she would continue my current treatment plan, at least at first, and ordered several diagnostic tests to help establish the baseline for my continuing care.

We discussed my recent failed attempt at steroid withdrawal, and the results of my personal “crash and burn” that occurred about ten days before Christmas.  I was relieved that she didn’t seem troubled at all that I had felt the need to self-medicate to handle the crisis, and understood my concerns about preventing a repeat of the botched process.  She concurred with keeping my daily prednisone dose at 7 mg, and commented that “it is not at all unusual for many lupus patients to stay on steroids indefinitely.”

All but one of my other current medications, including plaquenil and Benlysta infusions were also continued.  We discussed the fact that I have never taken Cytoxan or Cellcept, and it seemed she was intrigued about that not having been used in the past.

establish baseline levels

My new doctor went on to explain to me that she doesn’t ordinarily recommend attempting steroid withdrawal in the winter months, the season when most lupus patients tend to flare.  She made me feel the approach I took to handling my pre-Christmas crash, burn out and flare was just fine.  I was glad for the affirmation of my judgment, while voicing my commitment to medication accountability to her.

Walking out to my car, sunshine gently warmed my shoulders, as body and mind released into a deep sigh.  I felt the affirmation that I had absolutely made the right decision.  Driving away in my little PT Cruiser with a smile, I was glad.  Apprehension of the unknown, and the reluctance to face a major change was behind me, with foundations in place for a healthy patient-doctor relationship ahead.

the right choice

Now, after having placed myself under the care of a new, highly knowledgeable specialist, a great sense of peace and relief followed the important first appointment.

It was indeed the right choice!