Partner

with your rheumatologist

Dr. Manish Jain
Rheumatologist

Team up to take on rheumatoid arthritis (RA)

Watch Dr. Manish Jain discuss tips to have an honest, productive appointment with your rheumatologist and find the right treatment plan for you. If you still have RA symptoms after 3 months on treatment, ask if it's time for a change in your treatment plan.

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DR. JAIN: I don’t think you can overshare. The more accurate and complete of a picture you can give me, the better care I can deliver.

My job is to put puzzles together, and sometimes it is a puzzle trying to figure out how to best adjust treatments to meet our combined treatment goals.

Coming prepared to that visit is really the best way to make sure we’re squeezing the juice out of that appointment.

Here are three ways a patient can help their rheum understand their symptoms: the symptom severity, symptom frequency, and then also helping me understand the burden of how the symptoms affect day-to-day activities.

Patients often feel like they can tough it out, or that they’re complaining or whining. That’s really far from the truth.

Patients are really the true experts in their symptoms because they’re living with those symptoms 24 hours a day.

Making the Most of Your Visit

Dr. Jain discusses how to prepare and why it’s important to be upfront and honest with your rheumatologist at every appointment.

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DR. JAIN: There’s no goal that would be off-limits for a patient to share with me.

Everyday goals are really, really important. First of all, ‘cause, y’know, they’re often vital things that we need to do—to, y’know, go about our day.

Something as simple as opening a water bottle, or buttoning up one’s shirt, right? Being able to sit in a car for an hour on a long commute.

Setting treatment goals is really a two-way street.

One of the most important things to me as a rheumatologist is to empower my patients, both with an open line of communication, but also with the information that they need so we can make the right treatment decisions together.

Talking About Goals

Dr. Jain talks about the importance of setting treatment goals with your rheumatologist.

Still Feeling Symptoms? Say More

See it in action—Dr. Jain helps Rob get honest about his ongoing RA symptoms with his doctor.

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DR. JAIN (OC): As someone with RA, you know a thing or two about talking to doctors. But are you making the most of every appointment? The more you share, the more we can help.

Take Rob...

RHEUMATOLOGIST: Rob! It’s been 3 months. How are you feeling?

ROB: I guess I’m OK.

DR. JAIN [POP-UP]: When you say you feel “OK,” that’s exactly what your doctor hears – you're doing OK. Instead, share as many details as you can about how you’re feeling.

ROB: But...I’m still having issues with some everyday things like opening jars and bottles...buttoning up my shirts...

RHEUMATOLOGIST: Hmm. Anything else?

ROB: Well, some days...most days...I just feel exhausted.

DR. JAIN POP-UP: That was great.

Sharing details about your symptoms, and how they impact you, plays a big role in helping your doctor understand how well your treatment is working.

ROB: I’m a bit better than I was a few months ago, but I just wish I could say I’m feeling good. Is this my new normal?

RHEUMATOLOGIST: Well, I want you to feel as good as possible. So let’s talk...

DR. JAIN POP-UP: Rob might not feel great, but this is great communication. He's clearly expressed that he’s not where he wants to be.

DR. JAIN (cont’d): Remember, if you still have symptoms after 3 months, feeling just OK is not OK. And you don’t have to settle.

And it’s up to you to say more – so your doctor knows how you’re doing on your current treatment plan.

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DR. JAIN: I would give a patient about three months on a new treatment to see how it’s taking effect. But I rely on you to tell me how you’re feeling.

So some key words or phrases that I’m on the lookout for to indicate a treatment change:

  • – “Doc, I don’t think this treatment is working anymore.”
  • – “I’m finding myself waking up in the middle of the night with pain.”
  • – “Is this my life now? Is this my new normal?”

So those are just some of the clues that I’m always on the hunt for when it comes to figuring out is my patient on the right treatment, or is time to make a change?

Knowing When It’s Time to Change RA Treatment

How do you and your rheumatologist know it’s time for a treatment change? Learn what Dr. Jain wants to hear from his patients at each appointment.

Not Sure Your Treatment’s Working? Say More

See it in action—Dr. Jain helps Rob ask questions about his current treatment plan and other options.

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DR. JAIN (OC): You’ve spent months—maybe years—on your RA treatment, but you still have symptoms. You know feeling “just OK” isn’t OK, but you’re not sure how to ask for a treatment change.

DR. JAIN (OC): I get it. Let’s look at how to make the conversation easier.

RHEUMATOLOGIST: So, Rob, you’ve been on your treatment for 3 months. How’s it going?

ROB: It’s OK. My hands still swell up and it can be tough to do stuff like text and type. And my knees keep locking up—

I guess I just need to give it more time to kick in?

DR. JAIN [POP-UP]: Actually, if you haven’t seen symptoms improve by 3 months, don’t hesitate to discuss a treatment change.

RHEUMATOLOGIST: Let’s talk about your goals...

ROB: Well, I’d LOVE to be able to wake up without feeling exhausted— or just wake up without my hands locked in fists.

Are there any other treatments to consider?

DR. JAIN POP-UP: Now THAT was helpful.

Sharing detailed symptoms and personal goals is critical in assessing your current and future treatment.

ROB: I definitely want to stop feeling the pain, but making any treatment change is nerve-racking—I’m scared of getting worse again.

You know, what if it doesn’t work? Am I going to run out of options?

RHEUMATOLOGIST: Well, there are lots of different treatments, and they work in different ways...

ROB: OK, I’d love to hear about some.

DR. JAIN POP-UP: Feeling concerned about losing any progress you’ve made is normal. It’s important to bring up these concerns with your doctor—using your voice and making sure you’re heard can make all the difference.

DR. JAIN (cont’d): Remember, if you still have symptoms—say more. Your doctor doesn’t want you settling for treatment that isn’t working. And you don’t have to.

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DR. JAIN: Just being good, isn’t good enough.

Patients should always feel free to start that conversation about wanting to change treatment. It can be something as simple as, “I don’t think this is working like it used to,” or “I think it’s time for a change.”

Come up with a list of the symptoms they are having on their current treatment, and bring this up early in the patient visit.

It’s my job to try to figure out what’s so important to them, and within that, then try to personalize and customize a treatment regimen for them.

There’s no doubt I might’ve made you better with X,Y, or Z treatment. But how good is good enough?

Well, nowadays, it’s gotta be really, really good.

We have multiple treatments and multiple medications to help control your disease. We shouldn’t settle for, you know, partially controlled disease.

We’re really shooting for the best control we can get.

Asking for an RA Treatment Change

Hear how Dr. Jain recommends talking to your rheumatologist about a treatment change. There are many different types of RA treatments available, and it’s important to find the one that works best for you.

Preparing for an RA Treatment Change

Deciding to change your treatment is never easy, but neither is living with RA symptoms. Watch Dr. Jain address the risks of uncontrolled inflammation and further irreversible joint damage.

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DR. JAIN: I think it’s extremely common for patients to be worried about making a change in treatment, that they’re going to get back all the way to square one.

And that’s a fear that we’re going to tackle together.

It’s important to remember that there are some real risks to under-controlling their condition.

One of the risks to having uncontrolled or under-controlled disease is irreversible joint damage, and a loss of functional ability over time.

I’ll tell patients, “I care about your day-to-day pain, but I really care just as much at long-term functional ability.

Are you gonna be able to dance at your kid’s wedding?”

That long-term functional preservation and preventing irreversible joint damage is just really important.

Change is hard, and change can often be scary.

But even though that change can seem a little bit scary, if we think that that’s the best route to our end goal, change is often what we need.

Get Mission Ready

Create your game plan to take on RA with tools that will help you assess your symptoms, set goals for the future, and prepare for your next appointment.

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