Hi I hope it goes well with the childminder, it sounds ideal. I felt terrible when I sent Jim to the childminder at first, so I could go back to work but it turned out to be amzing for him. It broadened his social horizons so much, interacting with new adults and children. By the time he started school he was so bright and confident he did really well. Plus, this might seem a bit cold, when you are paying a childminder as an employer, you don't suffer all the guilt and anxiety you have in relying on family. The boundaries are a lot clearer. Does that sound awful? I don't mean my family did ever make me feel guilty for helping out but I felt bad some days, wondering if they were too busy, watching the clock all the time to make sure they didn't feel I was taking advantage of them etc. I'm sure Bernice will love to have some playmates.
As for the rheumatologists offer, I hope you take this up. Even though it would appear that he is not fully au fait with your situation, it could be a good starting point if he does listen to you and maybe he could put the wheels in motion to get you some more co-ordinated care.
Take care.
Julie x