with your rheumatologist

Dr. Manish Jain

Team up to take on psoriatic arthritis (PsA)

Watch Dr. Manish Jain discuss how to partner with your rheumatologist to have a more productive appointment and find the right treatment plan for you. If your PsA treatment isn't addressing your symptoms or helping you reach your goals, be honest with your rheumatologist and ask if it’s time for a change in treatment plans.

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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.

Knowing When It’s Time to Change Treatments

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.

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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?

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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 a Treatment Change

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

Preparing for a Treatment Change

Deciding to change your treatment is never easy, but neither is living with PsA 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.


What that
means for

If you're not getting significant PsA symptom relief on your current treatment plan, speak up. Prepare for a productive appointment with your rheumatologist today.

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