From the conversations I have with the thousands of RA fighters that I have had the pleasure of coming across, I have gathered that many, if not all us would’ve done things differently during our first visit to the rheumatologist.
If you have your first appointment coming up with a rheumatologist, I am going to go through what a rheumatologist does at first visit in this article. Rheumatologist appointments are few and far between. In other words, we don’t see them as much as we’d like and so much can happen in-between appointments. I am going to give you my best tips on getting the best out of your rheumy appointment.
Make rheum for a Rheumy
Firstly, what is a rheumatologist? What does a rheumatologist do? What does a rheumatologist specialize in? What are the reasons to see a rheumatologist? What can a rheumatologist diagnose? So many questions! But that’s ok. It’s very common and daunting at first. I get it, I’ve been there.
A rheumatoid doctor (rheumatologist) is a doctor that specialises not only in rheumatic diseases but also arthritis and autoimmune diseases. Rheumatologists are the ones that will direct you through a diagnosis. They will also help treat you with medication that is used to treat Rheumatoid Arthritis symptoms and the chronic pain associated with them. In addition, rheumatologist is also a really long word so they are often just referred to as ‘rheumy’.
If you are displaying symptoms of Rheumatoid Arthritis then you NEED to have a rheumatology consultation. Any other doctor will just prescribe pain suppressants that will help ease the pain but will not treat the symptoms. Rheumatoid Arthritis symptoms that are left untreated will lead to permanent joint damage and disfigurement. Rheumatoid Arthritis can get very bad very fast so if you show any symptoms at all, act quickly.
My rheumy is better than your rheumy
It is important to find a rheumy that is willing to listen. The road to diagnosis can be a slow and long journey, particularly if you have a myriad of symptoms. You can read about my unexpected symptoms here.
Similarly, once you have your diagnosis, it will probably be another long and frustrating journey to finding the right treatment for you. You may experience side-effects with your new medication and/or you might not be feeling that what you have been prescribed is working. This is why it is important to find a rheumy that will listen to what you have to say and be willing to help you.
Rheumies for life
Ultimately, you want a rheumy that you will be able to build a good rapport with. I am fortunate to have a rheumy that listens, is aware of my needs and puts my health first. In addition, he is also very thorough and is willing to answer all my questions.
As with any doctor, if you don’t feel that your rheumy is listening to you or showing any compassion for your chronic illness, it is probably time to change to a different rheumy.
Rheum for one more
So you finally got yourself a rheumatology appointment. Yippee! This is probably an anxious time for you. You have been in such pain and just want it to go away. But you don’t know what to expect? What are they going to say? What is going to happen? Will they be able to help me? You are naturally going to have lots of thoughts going through your head and are probably going through a lot in general. Therefore, I will answer these questions for you.
Preparing for what a Rheumatologist does at first visit for RA patients:
There are a number of things a rheumatologist will do at first visit. Here are some:
- Physical exam – checking for nodules, joint mobility.
- Order rheumatology tests – Blood tests, MRIs, X-rays and ultrasounds are all common tests for Rheumatoid Arthritis.
- Ask lots of questions. Eg: What is your medical history?
- Prescribe medication
- Talk about a treatment plan
A lot happens in the first appointment but it is such an important one. Consequently, I want to help you utilize and get the most out of this initial appointment. Here is the #1 tip on what to do BEFORE your first rheumatology appointment.
Get yourself a notebook as you will need it. After that, it is important to write all this down in a notebook because you will need to refer back to it all the time. At your first rheumatology appointment, you will be asked a lot of questions. Therefore, the notebook will contain most if not all the answers to the rheumy’s questions so you won’t forget to leave anything out.
To make sure you can answer the rheumy’s questions thoroughly and precisely, here are some of the things you should put in your notebook:
- Record any symptoms you are experiencing – big or small, write it down.
- Describe your pain and have a pain scale.
- Note where you are having these symptoms and for how long
- Write down a list of supplements, vitamins or medication that you are currently taking
- Record anything unusual that you have been experiencing – fatigue, dry mouth, dry eyes, itching.
- Try to remember when and where you started noticing something was not quite right.
- If you can think of any questions, write it down.
- Record what you done/taken to improve the pain or make you feel better?
- Keep track of things you notice that make your condition worse. I have a symptoms tracker you can download.
As you digest some of what your rheumy says, you will probably forget to ask questions. Here are some questions you may want to ask as an RA patient:
- What is the rate in which my symptoms are progressing? – This is a vital question because this determines the types of medication you will get and the dosage.
- What tests do I need to get? – There are a variety of ways to detect Rheumatoid Arthritis, the severity of the inflammation and the condition of your other internal organs.
- Will I get worse? – The question will provide you with information regarding your therapy and give you an indication of your pain and treatment management.
- Can I start a family?
- Will I be able to continue to breastfeed?
- What can I do, aside from taking medication, to boost my treatment (diets, exercises, physical therapy)?
- How do I avoid getting worse and permanent damage?
- What can I do to avoid flares?
- How can I tell the difference between RA Pain/inflammation to other pain/inflammation?
- How often will my consultations be? Who can take medical care of me in between that time?
- What other conditions might I get? eg. Lupus
- What should I avoid eating/drinking?
During your first appointment with your rheumy, you’ll also be talking about medication. Therefore, here are some specific questions about medication that you should discuss with your rheumy:
- What medications do you recommend?
- If one med doesn’t work, what’s next? What is my treatment plan?
- How long to trial a med?
- How long until the medication works?
- Who do I contact if I my meds are not working and I need to change?
- What vitamins and supplements can you recommend to complement my treatment?
- What will these medications interact with?
- When will I know to reduce or stop medication?
- What are the potential side-effects?
Subscribe to The Rheuma Mill for your free Guide to rheumatoid arthritis medication booklet.
So much Rheum!
That’s a lot of information right there. In saying that however, it will make sure that you have gotten the most out of your appointment. I want you to leave that appointment feeling like you’ve been looked after and positive about your outcome. Make sure you get yourself a notebook! I have created a checklist of my main points that you can download here to have with you. If you have any questions or comments, please contact me or leave a comment below. I would love to hear from you and your comments are very valuable to the thousands that come to The Rheuma Mill.
One thing that rheumatologists or doctors forget to ask about is your mental health. The effects of chronic pain on your mental health is real. In other words, in addition to looking out for your chronic illness, you also have to be monitoring your mental health. You can read about the effects of chronic pain on mental health here. This was a hugely popular article that was shared all over social media. Therefore, please use the social buttons above and below this page to share any of my articles so it can reach others who need it too.
25 thoughts on “What a Rheumatologist Does at First Visit”
I have been having these signs for over 3 years. Started with my right thumb. Doctor said to take Oesteoeeze tablets. Getting worse, all fingers stiff in the morning. Thanks for advising that i see a rheumy.
Hi there! Thank you for reaching out! Yes, it’s important for anyone who is displaying symptoms to see a rheumy. Better to be safe than sorry. I wish you well and please let us know how you go with your appointment. Don’t forget to download our Rheumatologist visit checklist to take with you!
My mom has been suffering from swollen joints for the past few weeks, and my siblings and I think it could be a symptom of arthritis. We’re planning to take her to a local reputable rheumatologist to check on her condition. I like that you said we should look for a doctor who is willing to listen because it takes a long time and many procedures to get a diagnosis. I’ll share this with my siblings later so we can start looking for rheumatologists in our area. Thanks a lot!
Hi Levi! Thank you for your comments. I am sorry to hear that your mom is experiencing symptoms but so happy that she has such amazing children who are looking out for her. It is important to get her to a rheumatologist and glad that my article was of help to you. Please come back and let me know how she went and if there is anything else I can do to assist.
I am so glad I stumbled upon this article. I have my first rheumy appointment coming up in a month and now I can be better prepared. There is so much to think of. Thanks for making it easier. God bless.
Hi Kevin! Thank you so much for your contribution to The Rheuma Mill. I’m really glad that the article was helpful. I don’t think many people are aware of what a rheumatologist does at first visit so thought it would be an important piece to write. Good luck and let me know how you went.
This is such a helpful list of things. I go to my first Rhuemy appointment in 2 weeks. I have had a terrible time with pain in my big toe and the joints behind it. After 3 months of limping along, I now have terrible hip and ankle pain. I have been told numerous times its probably gout. Blood tests, and x rays showed nothing, not even an increas in my Rheum factors, so I was referred for an ultrasound which once the results were in they referred me to the Rhuemy. I show signs of inflammatory arthritis, my dad has RA so it feels really validating to finally be going to a rhuemy and not being told its probably gout.
This list will be very helpful in preparing myself for my visit
Hi Emily! Thank you so much for your comment and feedback. Gout can often be misdiagnosed as rheumatoid arthritis and vice versa so I hope you get that sorted soon. A rheumatologist should be able to give you a definitive diagnosis. I’m so glad that my article about what a rheumatologist does at first visit will be of some assistance to you. Best wishes and let me know how you go!
I am so glad I found this article! Thank you for posting this. I have my appointment coming up soon and was so nervous. Your article has put me at ease and I’ll be much more prepared now. Thanks!
Hi Chelsea! Thank you for your feedback, it is much appreciated. I’m glad that my article was of use to you. First visit with the rheumatologist can be a challenging time. I wish you all the best on your visit. Let me know how you go!
Hi just got diagnosed with RA. Started with shoulders almost paralyzed the day after pulling luggage on a trip. Many more incidents like this in past 3 years that jump from elbows to knees to wrists and now affecting fingers. RA doctor started me on trial 10 mg prednisone but my primary doctor disagrees and said I should just use NSAIDs instead. I am sooo confused. Fingers are inflamed and cramped.
What do you think. I have been on prednisone for 7days
Hi Sandy! Thank you for visiting The Rheuma Mill and for your question. I’m sorry that you are going through this. I can very much relate with what you are experiencing. In answer to your question, I am not a medical profession so can only give you information based on experience. I would say that your rheumatologist has prescribed you the prednisone to help with the inflammation and pain. Prednisone is very quick and effective with inflammation and pain. However, it is usually only prescribed as a short term solution. NSAIDs are probably more effective long term and to be used alongside DMARDS to stop any further damage to your joints. You should definitely discuss that with your rheumatologist. If you subscribe to The Rheuma Mill, you get a free medication guide that you can use to see what’s available and discuss these with your doctors. Let me know you go!
Excellent article. I’ve had RA for a year now and would still benefit from your advice. Thanks!
Hi Natalie! Thanks so much for your comment and feedback. Wishing you all the best on your RA journey.
Hi, what an amazing post. I recently had surgery on my foot – the pathologist sent a red marker back to my surgeon saying there was signs of Rheumatoid arthritis in my tissue sample so waiting for an appointment. I didn’t really think but I’ve had a lot of symptoms for a while now, luckily I took photos at the time so I can show them at the appointment…I’ve got pain in my wrists, big toes, feet, swollen ankles, stiff when I get up and knee pain. The thing is I also have another health condition so I’m really nervous to find out if I have another condition. My condition is a mass on my brain called an AVM (arteriovenous malformation) it makes me ill a lot and I’m in pain most days. It’s also inoperable. I’m usually on strong pain painkillers. I wondered if you’ve known anyone that’s been told to get tested because of a tissue sample? Thanks…also thanks for all the advice it’s so helpful xx
Thank you for this article I’m almost 2 years diagnosed with R. A. 🙃 Have anyone on here been diagnosed with fibromyalgia aswell? I’m on Humira Humira injections for R.A. Also, you mentioned lupus my dad and older sister have skin lupus and am sure Lupus, R.A. are linked genetically.
Hi Lisa! Thank you for your contribution to The Rheuma Mill. There are many on The Rheuma Mill who also live with Fibro and Lupus. You can join our Facebook support group and get to know other members there. Hope to chat to you soon!
So so helpful. Great article and great blog. Thank you
Hi Clare! Thanks so much for the feedback and huge compliment. Best of luck!
I just had my first appointment with my Rheumy and had wished I had ready this article before hand. Still very handy information to have even if it’s not your first. Thanks for compiling this list.
Hi Murray! Thanks so much for your feedback and wishing you all the best on your journey
Really useful information. Thank you
Hi Jarrod! Thanks for the feedback. Good luck!
Thank you for this! I have my first rheumatologist visit in 4 days. I first found your blog because my symptoms also started in my big toe but I dismissed it as hallux limitus, or osteoarthritis of the big toe. Since then, all of my joints have been aching and swollen and hot so my PCP is sending me to the specialist. I’m nervous because two years ago I went through a crazy time of being diagnosed with vestibular migraine. I guess whatever happens, happens and I’ll deal with it as it comes but I appreciate your offerings of advice and “may be” combing through your blog of advice🤣🤣
Hi Emily! Thanks so much for your contribution to The Rheuma Mill. I hope your rheumy appointment went well. All the best to you!