Rheumatologist

[LikesKnitSewGarden]

Please could I have a recommendation for a rheumatologist within 50 miles.

I live in Gloucestershire .

Thanks .

[rosie_jones]

Good Morning LikesKnitSewGarden.

I'm in Gloucestershire and see Dr Coombs at Gloucestershire Royal. (gloshospitals.nhs.uk/our-se... She really listens, gives you lots of time and I really trust her advice. I don't think she does private work though and there may be a long wait for an appointment.

(I like knitting and gardening too - not sewing!)

[LikesKnitSewGarden in reply to rosie_jones]

Thank you very much for the recommendation .

[AyJayBass]

I have recently seen Joel David privately in Oxford and got on well with him. As I have experienced several flares over the past year my GP thought I might need Methotrexate and recommended I saw a Rheumy. Rather that wait a long time for an NHS referrral to a local Rheumy, who might not be very good at PMR, I opted to see Dr David as aI had heard good things about him. He has given me a very slow tapering schedule which works out at 1mg every 4 months. He said I had tapered too quickly in the first few months of PMR.

[PMRpro Ambassador in reply to AyJayBass]

Hallelujah - we approve of him!!! Tell him to publish - PLEASE!!!!

[AyJayBass in reply to PMRpro]

I'm pleased to hear that, thanks!

Tapering schedule is like this, starting on 8mg for example. Month1, 8mg every day. Month2, every 3 days: 8,8,7 all month. Month 3: 8,7,8,7 ... Month 4 every 3 days: 8,7,7 Month 5: 7mg every day. Or could be expressed as Mth 1: O, O, O .. Mth2: O, O, N ... Mth 3: O, N , O, N .. Mth 4: O, N , N .. Mth 5: N, N, N .. Where O = old dose and N= new dose.

I am at the end of month 2 now and it has been going well.

Note that he doesn't use 0.5 mg increments.

Also he was emphatic that the full dose should be taken in the morning as this is when the body produces natual cortisol. I take mine with breakfast.

[PMRpro Ambassador in reply to AyJayBass]

Them and their natural cortisol!!! Their concept of taking pred at 8,30 to 9am which is what they usually suggest bears no relation to physiology. The natural peak is about when you wake, take it at 9am and the peak won't be until about 10am!

[DorsetLady PMRGCAuk volunteer in reply to AyJayBass]

Hope it works, but as you get lower you may need to think about 0.5mg drops -see how you go,

[AyJayBass in reply to DorsetLady]

That had occurred to me DL. I have to visit him again in Feb and will mention it to him (if I remember!!)

[LikesKnitSewGarden in reply to AyJayBass]

Thank you.