In her training, Melanie Rohr, MD, has learned to pay attention to subtle symptoms, tracing their causes in order to target the best possible courses of treatment for patients suffering arthritic pain.
“Arthritis is definitely one of the most common things we see in rheumatology,” says Dr. Rohr, who joined Arthritis and Rheumatology Clinics of Kansas (ARCK) in Wichita in July. “I like to think of it in two broad categories: inflammatory versus non-inflammatory.”
She says non-inflammatory, or osteoarthritis, is by far the most common. While there are no medications to reverse the damage, she says symptomatic treatment options abound.
“We talk about joint preservation, physical therapy, weight loss, what types of medicines we can use for pain relief, and, if conservative methods don’t work, injections or joint replacement.”
On the other hand, inflammatory arthritis encompasses different categories, and Dr. Rohr brings experience differentiating among symptoms and utilizing the many diagnostic tools available at ARCK to get patients on the road to managing conditions such as rheumatoid arthritis, reactive arthritis, psoriatic arthritis, inflammatory bowel disease-related arthritis, gout and pseudogout.
“We’re really tweaking patients’ immune systems to treat their inflammatory arthritis.”
— Melanie Rohr, MD
“Treatment is very different, which is why diagnosis is important,” Dr. Rohr says.
As she joins the team of physicians at ARCK, which is growing in Wichita and expanding into the Kansas City market this summer, Dr. Rohr says she is excited to be able to continue her rigorous training in ultrasound, which began during her fellowship.
“We did a musculoskeletal ultrasound program at University of Nebraska Medical Center,” Dr. Rohr says, adding the technology’s advantages are straightforward. “If your patient has a history of inflammatory arthritis but you don’t see anything on an exam, you can put the ultrasound probe on it. It’s more specific than MRI, and you can really see changes.”
She says once patients’ conditions are diagnosed, she can begin working with them on selecting the best treatments from a growing number of options, many of which are prescription-based.
“We’re really tweaking patients’ immune systems to treat their inflammatory arthritis,” Dr. Rohr says. “I want to focus more on patient education and really having an open dialogue with patients. I try to discuss with patients where I’m coming from, why this is what I think and what are the avenues we can pursue.”
She says she also discusses costs of treatment strategies, including disease-modifying antirheumatic drugs (DMARDs), which target different parts of the immune system in order to decrease attacks by patients’ bodies on their joints, and biologics, which block out one specific part of the immune system.
“Unfortunately, most of the drugs don’t work fast, so we’re talking relief in weeks to months,” Dr. Rohr says. “It’s really about diagnosing early, and then it’s the long haul. I tell my patients, ‘It’s not about a quick fix. It’s about long-term tolerance and long-term safety of the drugs, and then preventing the crippling disease of arthritis.’”
Dr. Rohr says the long-term relationship with patients is one of the aspects she enjoys about her specialty, which she fell in love with during her second year of residency.
Her studies took her throughout the Midwest, beginning with the University of Kansas Medical School, then residency at Loyola in Chicago and a fellowship at the University of Nebraska, but her desire has been to return home to practice.
“I really wanted to come home to Wichita,” Dr. Rohr says.