Anger management - a healthy habit challenge

How to make me furious? Be a doctor who is an incompetent and egotistical arsehole.

The only ‘local’ rheumatologist here (Dr Ekkehard Röther in Donaueschingen, retired in 2025), has invalidated my diagnosis of spondyloarthritis (and the extended family history of that) in one 10 minute appointment. Where he and his (medical secretary) wife assured me that all my problems are because of obesity, and that also I don’t have lymphedema or lipedema (both diagnosed by other specialists).

The wonderful head rheumatologist at the hospital in Leipzig made and confirmed this diagnosis last year, where I was admitted to hospital three times under his care - his team got to observe and test me thoroughly over a period of 3.5 weeks. But because they didn’t follow the local rheumy’s strict diagnostic criteria, he considers their diagnosis invalid.

I’ve been furiously running repeats of the conversation with the local rheumy (in German!) in my head, and preparing to explain (again in German) to my GP, why I wanted to change rheumatologists.

Doctors who harm patients should lose their licenses

I argued with the rheumatologist. But as I did not have a medical degree, he simply talked over and down to me.

These are the falsehoods that the local rheumy tried to convince me were true (and the real scientific, researched facts in brackets):

• There is no such thing as undifferentiated spondyloarthritis (rheumatology textbooks and research papers say there is, and it is usually diagnosed as such before knowing in which direction the disease will develop 2, 3, 4).
• Spondyloarthritis can never occur without the HLA-B27 gene (10% have spondyloarthropathies  without this gene 1).
• Spondyloarthritis can never occur without sacroiliitis (psoriatic arthritis, lupus, and Crohn’s don’t usually include sacroiliitis, but are also spondyloarthropathies 5, 6, 13, 14).
• Enthesitis can never occur in the hands (even the basic rheumatology textbooks and well-known pain clinics state enthesitis commonly occurs in hands 7).
• Enthesitis can never occur without the Achilles tendon being inflamed (enthesitis can occur on any tendon, where it attaches to bone, individually or in combination, and may not be physically swollen 8).
• Celebrex (celecoxib), a COX-2 inhibitor, has no anti-inflammatory action, and is a pure pain killer (the COX-2 enzyme is directly responsible for inflammation and pain 10, and celecoxib is an NSAID 9).
• Prednisolone does not affect inflammation in any way (prednisolone binds to glucocorticoid receptors, which then either synthesize anti-inflammatory proteins, or block the production of inflammation 11).

He has advised the GP to take me off all anti-inflammatory medication, including Humira as well as stop all forms of physiotherapy - something which kept me much more mobile in the last year.

He blames my raised inflammatory markers purely on being overweight (even though my markers are far too high for that), and the tendon pain and obvious swelling purely on fibromyalgia, which he believes is a psychiatric disorder, instead recommending anti-depressants (which did nothing for me back in the 90s), and exercise.

To say I’m angry about this, is an understatement. I’m being consumed by anger at this point.

Anger is not healthy

Fury is not healthy, in both the short and the long term, let alone when trying to manage chronic illnesses 12.

• It makes you sleep very poorly, especially when conversations are constantly replaying in your head.
• Muscle tension rises off the charts and encourages cramps.
• You get chronic headaches, jaw pain and eye strain.
• It is impossible to concentrate on anything - work and relationships suffer.
• You can’t find any fun in normally enjoyable activities.
• Good habits fall by the wayside, bad habits are picked up.

So, while I wait for an appointment with a non-local rheumatologist for the next 6-8 months (yeah, long waiting lists), I need to calm down, focus on getting through the upcoming disabling time, and pick up my good habits again.

Focusing on good habits to chase away anger

The experts say to focus on one habit at a time, and that it takes 21+ days to build a habit. That’s how I started those habits last year, and I was doing well for many months.

Because I had established two of the habits last year, I’m going for two to start with.

• Feb/March - Drink 2L water & meditate for at least 10 minutes with the Calm.com app.
• March/April - Stretches and foot exercises, following Katy Bowman’s Whole Body Barefoot and her daily Movement Multivitamin.
• April/May - Write 750+ words each day (not including work), following the Right to Write.

Update 2026: The doctors who were going to give me a second opinion at Freiburg Klinik cancelled my appointment after 3 months of waiting, saying I had to see Dr Röther in Donaueschingen.

We moved back to Leipzig in 2019, and one of the main reasons was to return to my rheumatology clinic. The leading rheumatologist at the hospital here was horrified, and immediately put me back on Humira (adalimumab), noted that the ibuprofen I was forced to take to somewhat control the inflammation had halved my kidney function. And following another hospital stay full of tests, she diagnosed me with systemic sclerosis, another severe autoimmune disease that should have been noticed a lot sooner.

My problems were never from obesity or fibromyalgia or a psychiatric disorder!

With the rise of AI this year, and how it has taken away all my freelance writing, editing, English teaching, art/photography and translation clients, fury and anger is once again a problem that is making my chronic illnesses much worse.

I shall have to do another healthy-habits challenge.