Yes, ginnier, this a lifelong battle. I too cannot give you first hand info. But I have watched my 45 year old daughter struggle with this nasty disease for 25 years. First you need to know that treatment has advanced greatly since her grandmother's struggle with RA in the 70's. DD was hospitalized more times than we can remember in the early years. Then came methotrexate, which helped the RA greatly, but she was in the hospital twice with infections caused by her weakened immune system from it. She took it for a time by mouth and it eroded her esophagus, so she was put on injections for 8 or 9 years. She did quite well during that time, but by the age of 40, she had both knees replaced and a wrist fusion. When enbrel came out she was put on it in addition to the methotrexate. Since then she has been doing well, but I am aware of a slow but steady decline in her stamina. She has worked for 20 years as a physical therapist assistant. She knows what to do to keep herself at her physical best. She rides a bike when she can, and does water therapy regularly, but has just applied for SS Disability because she cannot be a reliable support for the patients she works with in her job. What she wants is retraining for perhaps Occupational Therapy through the BVR, but she must be declared unfit for her present occupation first. Stress does play a role in RA. When you are stressed you are more likely to have flareups. And the disease does ebb and flow. DD had months of symptom free time and with the addition of the newer drugs her flareups were further and further apart. The support of family and friends will be a big help to keep you less stressed. A positive outlook (I know it will be almost impossible at times) will be your greatest ally, along with a close relationship with your doctor.

Have posted on other forums but am new here. Hope you don't mind if I join in. I had a German Shepherd who had hip problems. At times he too would have trouble walking outside or getting back in so I kept a large beach towel handy. I would put the towel under his belly, hold the ends together above him and help him walk out, let him do his business and then replace the towel and help him back in. The towel was wide enough that it didn't cut into him belly. Maybe this would help when Sadie can't get up. I also found that a bean bag chair was a wonderful bed for dogs with arthritis. Not only is it comfortable but when my Thor got to the point that he would occasionally wet himself, the beanbag cover was such that it let the urine flow thru to the paper below and kept the wetness away from him until I saw it and cleaned it up. (Need to have a two beanbags ) The "beans" were in a cloth bag container and I would hose them with soapy water and hang it outside to dry and just throw the main cover into the washer. I finally had to have my Thor Man euthanized after he had a stroke. He was 14 years old. It's been over 12 years and I still miss him. Good luck with your Sadi. It's so hard to see your "babies" growing old. I have a 14 year old Australian Shepherd/Chow mix, an 11 year old Lab/Chow mix and two 9 year old German Shepherds. I can see the age making changes in even the 9 year olds but we just adjust our ways of doing things and continue on loving and enjoying each other.

I had written, "ChiSue, have you ever really looked at an EOB form after Medicare pays the doctor/provider? While I agree that the "amount billed" by doctors/providers can be outrageous, the amount paid by Medicare is a pittance of that amount." ChiSue responded to my post with, "Lindsey -- Thanks. I'd forgotten to include that in my mini-tirade. These vendors hook people by playing up the reimbursement. Then...whoops, the individual has a contract to pay thousands." I know that you are in an upper income bracket and it, unfortunately, makes you come across sometimes as condescending. It also causes you to post inaccurate or incomplete information in an effort to make your point. Please explain, in detail, where you got the information that an "individual has a contract to pay thousands." In the "world of Medicare," there are doctors who accept the Medicare assignment all of the time and they are referred to as "participating providers." There are other doctors who accept the Medicare assignment only for certain patients and/or for certain procedures. Folks also need to know that Medicare determines what amount they are going to pay for each and every procedure, whether it's a simple office visit or complicated surgery. Medicare will pay 80% of that predetermined amount. The patient is then responsible for paying the other 20%. The total the doctor will receive is 100% of that pittance amount that Medicare has predetermined. That is the "Medicare Assignment." (If the patient has a Medicare Supplement policy, aka a Medigap policy, that policy generally will pay the patient's 20%. I say "generally," because there are a couple of Medicare Supplement policies that either make you pay a specific amount as a deductible before the policy will pick up and pay, or else they still have the patient pay an office-visit copay. ChiSue has posted before that she and her husband have a high-deductible Medicare Supplement policy, so they have to pay something like $2,500 before their Supplement policy will pay anything.) There are also doctors who are known as nonparticipating providers. They see and treat Medicare patients and will bill Medicare, but they do not accept the Medicare-approved fee as their full fee. However, this does not mean that they can bill you a sky-high amount. Medicare has a limiting charge which, as the name implies, limits the amount a nonparticipating provider can charge a patient. As I stated before, Medicare has a predetermined amount that it will pay, and then it pays 80% of that amount. When a nonparticipating provider submits a bill to Medicare, Medicare lowers the predetermined approved amount to 95% of the approved predetermined amount for participating providers. It then pays 80% of that lower amount. Medicare allows the provider to charge the patient 115% of the lowered (95%) fee. The math works out to an end result of the patient being responsible for an extra 9.25% of the Medicare approved fee. There are other providers who have absolutely nothing at all to do with Medicare. They will not bill Medicare for you, and if you submit a bill to Medicare yourself, Medicare will not pay. Those doctors are free to charge you whatever amount they want, and you are responsible to pay it. So, if Medicare is paying anything to a provider, that means that the patient cannot end up with "a contract to pay thousands" as ChiSue has erroneously stated.

I would expect that a "country vet" might have clients that raise animals for slaughter. I also suspect that those ranchers certainly can distinguish between a "profit center" and a "pet"but the Vet and the Rancher may be somewhat more pragmatic in their end-of-life decisions. I have a Greyhound dog that raced 147 races at the track in Tampa, FL, before sustaining a non life-threatening injury. It appears that she was very well taken care of while she was winning but when she injured herself she was a money-loser and was likely going to be destroyed. She's sleeping by feet as I type and I periodically send photos to her her original owner in FL. He had named her after a granddaughter of his, but it was about owing a "pet." I suspect when I have to let her go, I'll cry, her original owner will not.