1. Community
  2. Bones, joints and muscles
  3. Polymyalgia Rheumatica and GCA

GP and/or Rheumy?

Posted , 6 users are following.

erika59785
erika59785

I am quite happy with my new young female GP. Should one have both?  Can a GP take over with the necessary ESR/CRP blood tests?

  I had seen my Rheumy for nearly 10 years, and he is very busy and gives me less than 15 minutes of his time. Also, he usually wanted me to reduce too fast when I had a RA flare.  Of course the flares became more painful when I was diagnosed with PMR by my GP.  The Rheumy doubted the diagnosis initially. 

He belongs to a big Medical Center here in Portland, OR. where they are very regimented.

I feel I get better care with my new GP. 

Luckily I found this very informative and caring forum.

Your input would be much appreciated. 

2 likes, 9 replies

9 Replies

  • judy50581
    judy50581 erika59785

    Posted

    Erika, my gp would not see me for PMR. She suggested that I get a rheumatologist. Which I did and I love her.
  • lodgerUK_NE
    lodgerUK_NE erika59785

    Posted

    erika59379

    If you are happy with you new GP, stick with her.  The ESR and CRP are only guidelines.

    If you send me a PM  I can send you two plans for reduction then you can discuss them with your new GP, who because she is young will not be set in her ways.

    Also with RA, methotextrate is the gold standard for RA in the UK.   It can also be useful as a steroid sparing agent which then helps with the pain of RA and because of that reduction can enable you to reduce the pred.  But all this needs to be discussed with your GP.

    Click on the Polymyalgia on the right hand side column on this page in red.

    Read the links and follow them to the websites run by three Charities for PMR and GCA.  There is a wealth of kowledge and also Eileens imput.   Knowledge is Power.

     

    • margaret22251
      margaret22251 lodgerUK_NE

      Posted

      Hi lodger my gp sees to me never been to a rheumy, and she does all blood test for me.
    • erika59785
      erika59785 lodgerUK_NE

      Posted

      Thank you very much for you helpful information.  I personally think I can deal with my GP better. She was more open to the very slow reduction program I told her.  My Rheumy always wanted me to be on MTX, but I refused.  The RA flares were not often and not bad, and 5 mg of Prednisone controlled RA.  The recent PMR diagnosis changed all this, and what I hear,  MTX does not work for PMR.
    • erika59785
      erika59785 margaret22251

      Posted

      I would think that the GP could order all the blood work needed, but I have to check with her because she is new to me and the Clinic.
  • EileenH
    EileenH erika59785

    Posted

    In the UK you would have been managed by your PCP anyway - would have seen a rheumy possibly once to confirm the diagnosis and been returned to the GP for ongoing care. If the course of the illness is straightforward then often patients never see a rheumy - if the dx is clear and the patient responds to the moderate dose of pred and reductions go fairly well there is not necessarily any need to see a rheumy. 

    I work with my GP - she hands over the drugs, I sort out how I reduce, reporting back to her. She does any blood tests - and that would be the case even if I were under a rheumy here in Europe.

    MrsO has said that one of the top rheumies in the UK feels all query PMR patients should be seen once by a specialist. My personal opinion is that that is fine in an ideal world - but if you have been ill for 6 months before getting to see a rheumy but your GP has been managing things well and the rheumy sees you looking well and pain-free there is always a chance he will dispute the dx and interfere, and try to stop you taking pred. It was the other way round - but the 2 rheumies I saw dismissed things as once "nothing but OA" and once "definitely not PMR". GPs are perfectly satisfied with what they saw and my 6-hour response to pred. The rheumy didn't want to listen.

    If you have a good GP - stick with her. The doctor who has time for you and will work with you is far more use than the chap in his ivery tower charging the insurance (or you) for a 15 min "nothing" consultation. Then it depends on your insurance - will they play ball with the PCP doing it all. After all - it is only the sort of routine blood tests a GP would be ordering to monitor other things, there is no need for the fancy autoimmune stuff in rheumatology.

    • erika59785
      erika59785 EileenH

      Posted

      THANK YOU, Eileen.  You explain it well, and I fully agree with you.

      Yes, the important Rheumy living in the Ivory Tower!  It is so true --- I feel I am just a NUMBER, and they do charge plenty the insurance company for a 15 minute visit.

      It just did not make sense to me, and I was impressed by this new and young M.D.  who is knowledgeable about PMR.  She took 45 minues to talk to me and it was pleasant. 

      She called me that the blood work was mostly normal and not to worry about it.  I received the print-outs, and so convenient that she is only 3 minutes away from my home to her office.

      So good to know your opinion.  Danke vielmals, Erika

       

  • Mrs.Mac-Canada
    Mrs.Mac-Canada erika59785

    Posted

    Hi Erika,

    i see my Rhuemy and like him but my GP was the one that originally ordered my blood work and if I happen to be seeing her before going to my Rhuemy I ask her for the blood requisition with no problem.   I don't think it would be an issue really.  

    It is really important to have a Dr. that listens to you and is willing to work with you through this long process.  Why not let your GP know you are happy with the way she's handling things and see what she says.  

    That being said, the  medical system is different in the US than in BC so there may be regulations about who does what but it's worth checking.

    Good luck my dear👍.

    Hugs, Diana🌸

    • erika59785
      erika59785 Mrs.Mac-Canada

      Posted

      Hi Diana,

      I thank you for your advice.  I will check with my GP in two weeks when I have another appointment.  She is much more readily available, than the Rheumy.

      I will follow up with email to you tomorrow.

      Hugs, Erika

Back to top

Report or request deletion

Thanks for your help!

We want the community to be a useful resource for our users but it is important to remember that the community are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the community is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.