I Think I Have A Flareup

[Al]

I've seen people kept on low doses even after the intro period. There's probably a time and place for it for certain people, but as a whole I don't think it's a good plan. Docs do it to avoid using larger doses, but the person winds up staying on it longer and with disease that is only partially-controlled. Then they use occasional spikes in pred to control flares instead of using the immunosuppressant as the main engine. I've never seen a Wegs specialist do this. It's common with docs who don't see much Wegs.

I think this is because most docs do not fully integrate whatever they know about the immune system (if, indeed, they learned all that much in med school). In part, I blame the specialist system for this, which does a couple of bad things: It encourages the Big Fish in a Small Pond syndrome--a demigod in a very small universe; and it discourages cross-specialty assessment of the situation. Wegs is, almost by definition, a kind of meta-specialty. A good wegs doc is, of course, a specialist, but also far more of a generalist, in an important sense: willing to integrate many fields and overlapping symptoms.

Al

[pberggren1]

This is true Al about a Wegs doc being able to integrate many fields and overlpping symtoms.

[Al]

This is true Al about a Wegs doc being able to integrate many fields and overlpping symtoms.

Thanks, Phil--I forgot the all-important word, "able".

Al