When RA flare-ups hit, I feel sick. My brain, muscles, bones – even my skin falls ill. These days are hardest to get through. I push my body to the limit which doesn’t take long at all, then I rest. I used to lament, now I surrender. This morning, I am off to my see my Internal Medicine physician – my Coach for all other doctors. He has a line of sight for all my health needs.

Our discussions today will be – when I feel sick, when my brain doesn’t respond well, or when my muscles give out – what do I do? Do I exercise? Do I rest? Do I fast (my least favorite choice)? I will follow his instructions and let him know how I fare. This is the back and forth relationship as patient and doctor. I tell him how I feel, he advises, I choose the path, then let him know if it’s working. I will let you know how it goes in a future post.


Last August, I suffered from severe hot flashes – yes, I am in that season at age 51. I had about 20 to 25 per day. And at night – oh boy – night time my skin started pumping enough water to swim in. After two months of this nonsense, I made an appointment to see Dr. A.

We sat in the exam room and I described my hot flashes, “It starts it in my scalp, then it moves to my face and creeps down my body until I feel like I am in a sauna.”

“Hmmm,” he said, “That sounds like a hot flash to me. Let me see what we can do about that.” Then came the questions,

Dr. A.: “How many times do these occur per day?”
Me: “About 20 to 25.”
Dr. A.: “How are your emotions?”
Me: “I burst into tears sometimes, but isn’t that normal?” laughing
Dr. A.”No, that is not normal.” seriously
Me: “I am not so much worried about my emotions as the hot flashes keeping me up at night and distressing me during the day.” Regaining composer
Dr. A.: “Here are your choices. You could try to take Vitamin E and see how that does. Or I could prescribe an anti-depressant.”
Me: “I would rather take the holistic route, but I will think about it on the way home.”
Dr. A.: “Ok, I will call in a prescription just in case. If you choose not to take it, no worries. Just let me know what you decide and how you are doing. If you go with Vitamin E, it will not touch your emotional symptoms. If you take the anti-depressant, you will have to watch for side effects (& he listed all of them).”

On the way home, I knew my choice was Vitamin E and I sent him a message via the patient portal once I was back on my home computer. “I will try the Vitamin E for now and see how I do. If it doesn’t work, I will go pick up the prescription,” I messaged. He responded with, “Great. Let me know how it works.”

Vitamin E supplements may not work for every woman suffering from hot flashes, but boy did it work for me. Within 5 days of adding Vitamin E to my morning and night supplement/medicine routine, the hot flashes were GONE – not just diminished – completely and totally GONE. Miracle? I like to think so.

I was very pleased the supplements provided my body with what it needed to regulate the menopausal symptoms. With my RA medication, I don’t want to add anything else that may interfere or diminish the effects of how the Plaquenil and Xeljanz are working. Don’t mess with a good thing, right now.

So this is my relationship with Dr. A. – I tell him how I feel, he advises, and I make the final choice. It is a collaboration in managing my disease and whatever else my body decides it wants to do. I hope everyone finds a Dr. A. to collaborate, give advise, and help you make an informed decision on your health.