“Is there anything else you want to tell me?” Dr. McA asks. We’ve already been through the usual: How my RA—and the hip bursitis—are treating me; what, if anything, hurts; the medications I’m taking and how I’m tolerating them. I’ve ticked off most of the questions on my list.

One item, however, remains.

“I just want to point this out,” I say as I draw a line through it and look back at him. “The Arava has made my hair curly.”

There’s a short silence, and then Dr. McA explodes into delighted laughter. “Yes!” he shouts, and laughs some more. I laugh too. It’s impossible not to.

“I’ve had many of my patients tell me that,” he says, catching his breath. “They say, ‘Doctor, I don’t have to straighten my hair anymore!’ or, like you, their hair is curly where it used to be straight.” He chortles again, thoroughly enjoying himself, then sobers. “It really shows how serious the chemicals are in that medication, doesn’t it.”

“It sure does,” I agree.

“I’m sorry about your hair.”

“Oh, no!” I laugh. “I love it! I’ll never have to get another perm again!”

And so it went. Dr. McA reaffirmed that my “cocktail” of meds, Arava, plaquenil and sulfasalazine, are keeping my RA under control. The two prednisone tapers, bi-weekly visits to the physical therapist and daily stretching exercises have combined to lower my hip bursitis pain to a low, intermittent grumble. I have two more PT appointments left; I’m satisfied that two will be enough.

Since I last saw Dr. McA I’ve lost several more pounds. I’ve also grown two ganglion cysts, one in my left wrist and the other on the top of my left hand. Finally, I’ve been sleeping better. Thank you for the nortriptyline, doc.

Dr. McA, as usual, was in a jovial mood. He told me that since doing his residency in the early 80s, he’s seen the treatment of RA move ahead in leaps and bounds, one new, effective drug after another. “I was talking to a colleague the other day,” he said. “It occurred to me that I’ve been around to see nearly all the RA drugs we use today developed. I remember when plaquenil for RA was new and cutting-edge. I’ve seen so many people like you be able to bring their RA under control because of them. There’s so much more hope now than there was.” He smiled. “I guess curly hair isn’t such a hard price to pay, is it.”

“No, it’s really not,” I said.

Dr. McA told me to come back to see him in 90 days, unless there’s a big change in my condition. We shook hands and he whisked across the hall and into another exam room.

“Good morning, Mr.  Jones,” he said, pulling the door closed behind him.

“Doctor! Good morning!” The smile in his patient’s reply was clear as a bell. I hope his ailment is under control, too. We’re lucky, I thought as I walked out to my car for the long drive home, my appointment for August clutched in my hand. We’re both lucky we’ve got such a caring, pleasant person as our rheumatologist. Amazing how much difference it makes.