Rheumatoid Autoimmune Disease, doctors and stress

It is no secret that, in general, I do not like doctors and do my best to avoid seeing them on a professional level. Since Tanya moved here I have been with her on several visits to see her rheumatologist; the experience has not done much to change my opinion of the profession. I will admit, after the first visit I thought that perhaps I had been too harsh; there are specialists out there that will really listen to their patients. I thought it was quite refreshing and I looked forward to the experience.

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When we went in for the second visit I was dismayed when the doctor thumbed through the research Tanya had provided two weeks earlier as though it was his first time. Still, he was conducting new tests and was suggesting new medications so I had to reserve judgment; besides, the first appointment was after lunch and the second one was in the morning. We decided that we would only schedule afternoon appointments as he seemed less busy and more able to spend time with Tanya.

Tanya used to inject Enbrel weekly at $550 a shot so it cost a couple grand a month. It did not seem to be working well, so the doctor suggested she switch to Cimzia. Now Cimzia only has two shots once a month, but those two shots are $1,100 each, so not cheap. On top of that, the first month you have to “load up” so she had to use twice as much the first month. The doctor said he had samples that she could use for the first dose and said she could come back for a second dose, and she could replace the Cimzia samples with some extra Enbrel she had at home. Because of insurance issues, she always has a few extra doses at home, and it did not make sense to waste $6,000 in meds. This sounded very good and fair to both of us.

When we returned for the second “load up” the doctor informed us that the “samples” he said he was giving her was actually medications purchased for other patients and he had hoped to replace the Cimzia with free samples from the company rep. Apparently the company rep told him that he had used up more samples than anyone else, so would have no more freebies. He now wants Tanya to buy the samples he gave her. I do not know if he somehow got the impression that coughing up $4,500 was something easily achievable by most, but it is not easy for us. So, now we have a doctor that is adding stress to Tanya’s life.

I am not going to begin questioning why a doctor would give away someone’s medications in hopes of getting a free sample later, I do not know enough about the profession to know if this is common or not. What I am going to question is why would a rheumatologist do something that they would have to know is going to cause stress to their patient? The doctor in question even went so far as to suggest that the medication probably will not work anyway. That was a 180 from two weeks earlier when all he could do is sing its praises. I guess when the free samples disappeared, so did its promotion. Now Tanya gets to find a new doctor. More stress.

I really feel sorry for her. I can make the conscious choice to not allow a doctor to treat me; she can not. I remember several years ago when I decided to get a group health policy for my company. Just the stress of trying to choose a doctor from a list of people I had never heard of was enough to get me to use the old dartboard method. Where the dart landed would be my doctor. Doomed to failure, but as I was not planning on using them anyway, no great loss. The point is, finding a doctor is stressful, especially when that doctor has as much effect on your life as a rheumatologist does on someone with Rheumatoid Autoimmune Disease. It is tough enough trying to keep someone’s life stress free, it certainly does not help to have a doctor adding to it.

You can read Tanya’s version on her blog.

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