What a Rheumatologist Does at First Visit

Rheumies

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.

#1 Rheuma

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.

Rheumy Q&A

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?

Meds Q&A

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?

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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.

Going Viral

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.