Evaluating My AS Offensive Scheme

I love the names of NFL offenses. I only have a rudimentary understanding of what they mean, but the names intrigue me. This past season I heard names for all kinds of offenses. Those names prompted my memory of offenses years ago. Prior to retirement, I used these names to describe what I saw on TV, even if I did not fully understand them. I have used names like:

• Option offense
• Run and shoot offense
• Smashmouth offense
• Air Coryell
• Spread offense
• West Coast offense
• Pistol offense
• Pro-style offense
• Marty ball

Joining in the conversation by using these offense names allowed me to at least pretend that I understood football.

Even today those names make me think of coaches and players of old, like Marty ball, which was felt by many to be the most boring football. Marty Schottenheimer developed it. The offense relied on safe runs, short passes, and a strong defense. Things that the modern NFL seems to have abandoned. The Smashmouth offense relies on ball control and uses receivers and tight ends as blockers. Then there is my favorite Air Coryell, named after Don Coryell, coach of the San Diego Chargers, which requires the quarterback to call a three-number play which tells the receiver where to expect the ball. The three receivers were the essential part of this offense. Because it used the pass play almost exclusively. These games were electric to watch; every play might be a touchdown, interception, or close incomplete pass. Air Coryell made for great television, even if it was not always successful.

What is my doctor's offensive scheme?

Offensive names make me think of my rheumatologist. When assigning a medication or treatment, is he calling an offensive play? He uses shorthand like Metho-Cimzia. That would mean a combination of Methotrexate and Cimzia or Sulfa-Tal for Sulfasalazine and Taltz. Are our doctors known for their favorite combinations or solo use medications?

I think of the variety of possibilities, yet I suspect doctors tend to get in a rut like most humans. The old saying that every problem looks like a nail when a man has a hammer applies to our rheumatologists. I am sure my doctor, who retired at the end of March 2022, was in a rut. That is not a terrible thing. It worked for me, he had prescribed my current biologic for over seven years, and I think that if I went to him and said I wanted a change, he would say it was a matter for my new rheumatologist to decide. That would not be an uncaring response, just a statement of where he was in his career.

Are you or or your doctor in a rut?

However, if I were in my 20s and I thought my biologic was not working as well, I would expect my rheumatologist to help me find an aggressive therapy that I could afford. So many times, I hear people say that their rheumatologist is unapproachable. That makes me sad. I view my rheumatologist as my partner in treating AS. Not the sole decision-maker. I insist we work together, not allowing him/her to be the sole decision-maker. I hope each of you also has that kind of relationship.

It is time to call an audible to break the routine. Ask if there is a better infusion center, a different means of taking your medication, or maybe if a different medication exists. I am not suggesting you break up a perfect treatment plan just for fun. Instead, I recommend it, so your rheumatologist knows you wish to have a part in the decision-making.

Who does not want a fabulous offense named after them? In my case, I call my treatment pattern the Ricky-Ritux-Metho. It is suitable only for me, but it includes one absolute feature, I hate to be in a rut. It has served me well over the years and may be modified as I begin a relationship with a new rheumatologist. But oh, the joy of making sure things are working the way they should. Because if they are not, I will call an audible, and that is when we will know how Ricky-Ritux-Metho is working.