Your Rheumy is very Much behind the times. EULAR substantially changed their protocols years ago Heres the discussion:http://m.ard.bmj.com/content/70/6/896.full
You are so right - I seem to have gotten a whole flock of them.
It seems to me that no protocol is being followed with the ones I have seen otherwise, they would have been supporting organizations outside of the US (such as EULAR). Although the one I saw the one time last year was thorough and I liked her, when I mentioned a study conducted overseas, she politely told me she was in the US and had to abide by what had been established here.
My Mom who lives in the area went to another one last week and really felt comfortable with her. Since I really haven't established a relationship with the one I just went to and his appointments are so far apart, I decided to have a referral sent to my Mom's Rheumy....wish me luck!
I'm not sure this was the report I was looking for but clearly good information by the company.
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They have. no effect on your symptoms and very little on your treatment.
I must differ on the above comment as I see over and over others that haven't proven any fusion be denied treatment. I went through that last year when who I think is a really good Rheumy hit the roof over my films after hearing I had been denied treatment and even told it was in my head but now after years of that, have damage in my neck, thoracic and SI/Hip areas.
I don't know what kind of radiologic evidence you have but for the early birds out there, it can really cause havoc before someone believes them.
I'm curious as to what exactly you are defining as treatment? If it's biologics I think you are defining treatment incorrectly. Lets be clear, the US is really one of very few places in the world where biologics are first line treatments. In most places in the world this isn't the case. As I understand from my rheumy who is a Fellow and active on the world scene, there is no agreement that they should be first line treatments....
Your Rheumy is very Much behind the times. EULAR substantially changed their protocols years ago Heres the discussion:http://m.ard.bmj.com/content/70/6/896.full
The US on the otherhand still utilizes step thaerapy and DMARDs in far too many instances
Actually the EULAR recommendations from 2010 in regards to anti-tnf therapy is... " Anti-TNF therapy should be given to patients with persistently high disease activity despite conventional treatments according to the ASAS recommendations. "
That is not first line treatment. The only recommendation for first line treatment is NSAIDS in the EULAR recommendations...
Last edited by CanuckMom; 12/22/1504:37 PM.
Officially dx'ed Nov/10 after being symptomatic 10+ yrs. HLA-B27 positive. 200mg Celebrex twice a day, Targin for pain. Started SSZ in Nov'13 for peripheral issues. Jan '14 added Gabopentin for SI flare related nerve pain. Nov '14 added MTX to the mix. July '15 liver enzymes went crazy and off SSZ and MTX. Back on both at reduced dosages in Aug'15. March '16-son#1 dx'ed AS
Thats right but the comment section apparentl didn"t changed thst significantly. The 2010 recomendations are no longer current.
You're the one who brought up the EULAR recommendations regarding biologics first line treatment recommendations... SO what exactly was the point you were trying to make? I stand by mine BTW there really is no agreement that biologics should be a first line treatment.
Officially dx'ed Nov/10 after being symptomatic 10+ yrs. HLA-B27 positive. 200mg Celebrex twice a day, Targin for pain. Started SSZ in Nov'13 for peripheral issues. Jan '14 added Gabopentin for SI flare related nerve pain. Nov '14 added MTX to the mix. July '15 liver enzymes went crazy and off SSZ and MTX. Back on both at reduced dosages in Aug'15. March '16-son#1 dx'ed AS
The only recommendation for first line treatment is NSAIDS in the EULAR recommendations... 
SO what exactly was the point you were trying to make? I stand by mine BTW there really is no agreement that biologics should be a first line treatment.