I despair of some doctors!!

[poppetpain]

I went to my 3 monthly check up at hospital today for my PMR. My Rheumy specialist was on holiday so another doctor was standing in (not that I met her). A junior doctor took my history.....I explained that I want to stay on 10mg for another few months and referred her to the results of the Bristol treatment which results in lower incidents of flare ups. I had tried unsuccessfully to reduce by 0.5mg. She reported back to the stand in doctor who's instruction is that it's no point reducing by 0.5mg as it will make no difference. She wants me to reduce by 1mg each month and to take pain killers to deal with any "discomfort"! It took me all my control to not have a go at the junior doctor bless her. I refused to even try to follow those instructions as per my research and advice from this forum. If I had been ignorant then I'd have walked out with no advice on how to reduce and what pain killers I could safely take with steroids. I am still fuming. How can progress be made when there are such poorly trained doctors in the Rheumy departments. Rant over. Thanks for listening xx

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Hi Poppetain. Firstly I'm sorry you had such a disappointing appointment and I do agree that more thought should always go into drug withdrawal than obviously does in some places. I too am expected to wean off Prednisolone - which I'm presently taking for my RA - and had to go and ask my GP for 1mg tablets because I was meant to be dropping by 5mg each week.

However I wonder if you meant to post this here on the RA HealthUnlocked because I don't think many here have PMR. I think you probably meant to post it on the dedicated community for this condition?

But for what it's worth I have to agree that there is too much variability in how rheumy departments across the UK keep up to date on the latest research regarding medications and protocols.

[123098]

I totally agree when i saw a locum doctor at the hospital he said i was cured of fibro and RA i told my usual consultant but no comment was made! I will only see the consultant or his registrar now, I do see the RA nurse on regular basis because of the blood tests i have to have . you are right because we suffer from the illness we patients know our bodies.

[nomoreheels]

This is why I'm in favour of only seeing the one Specialist or Consultant. Continuation is the best way forward as I see it, he/she knows your history so there's no need for half the consultation to be taken up going over previous appointments/meds & it's so much better building up a professional doctor/patient relationship so things like you have experienced don't happen. There's none of the needing to go & ask the locum Rheumy in your case as there is no junior (maybe a Registrar?) who is basically still learning & may or may not take Rheumatology as his/her specialty.

When I've tried to taper from steroids, just 3mg so not as high as your dose, I've been directed to do it as follows:

3mg (half a 6mg tablet) on alternate days for a month,

then a quarter of a tablet on alternate days for month,

then a quarter of a tablet on every third day for a month & then stop.

I was advised to take my NSAID to cover any inflammation & pain, not pain relief. I've never managed the last month of tapering to date & remain on the 3mg maintenance dose.

Hope this doesn't come over as a rant, rather it's my view having had both a regular Rheumy every 3 months & a Rheumy once a year with a Registrar at 6 months, the option of a Rheumy Nurse appointment between Rheumy appointments.