Rheumatology Appointments 101

Rheumatology Appointments 101

Are you undiagnosed or newly diagnosed and not on Biologic or DMARD treatment? Are you frustrated with how tired and painful your life has become? You deserve better care than this, and you can get it with a little work.

You have done your research. You know all of the signs and symptoms of PsA. You are experiencing a lot of these symptoms daily, yet you aren't getting the care you need to manage the disease. Follow these steps below to prepare for your next appointment with your provider.

  1. Make an appointment with a reputable Rheumatologist in your area. Ask friends if they have a favorite doctor, ask your GP if they know a good Rheum, look online for references (Yelp.com, Angieslist.com, etc. often have reviews of local doctors), and check the list on Ben's Friends.
  2. Do plenty of research with reputable sources. Read the Gladman & Chadran book, Psoriatic Arthritis: The Facts or The Atlas of Psoriatic Arthritis by Mease & Helliwell (both available on Amazon), read the information on the LwPsA site or visit the National Psoriasis Foundation or the Arthritis Foundation. All of these references have the very best and most up-to-date information on symptoms, prognosis, care, and medications.
  3. Make a written list of your symptoms. There are all sorts of apps that can help you keep track of this information. Many will even allow you to email or print nice reports that you can hand directly to your doctor. Some are free and some are paid, but you should be able to find one that addresses most of the information below at little to no cost. Be sure to include the following information:
  • Morning Stiffness: How long does it last and how does it impact your life. For example, are you late for work because it takes you longer to get going, do you have problems opening jars or doors, what other mobility problems does it cause for you?
  • Problems with Function: We all have pain, but make detailed entries that illustrate how it impacts your daily living. Are you having problems dressing yourself, bathing, driving, preparing meals? Make note of it.
  • Photos: Have you noticed that one day you have sausage fingers and toes and a knee that looks like a canatloupe and then the next day it is gone? It happens to all of us and the best way to prove that you're not a crazy person when you see your rheumatologist is photos...lots and lots of photos (pics or it didn't happen applies here). You may even go so far as taking measurements of your joints when they are "normal" and record a photo of this, then take follow up measurements when they are swollen or otherwise deformed.
  • Make a list of your symptoms such as: swelling, psoriasis, nail pitting, redness and swelling at the joints, fatigue, gastrointestinal issues (IBS), etc.
  • Make a list of your medical history and your family medical history, especially any autoimmune diseases.
  • Chart your pain: On a scale from 0-10, how bad is your pain? 0 is no pain and 10 is the worst pain you could ever imagine. Make a daily log of this information.

4. Prepare for your appointment. Make a short list of the most important things that you would like to discuss. Be concise, if you include too much information in one appointment, it is less likely that the doctor will address all of your concerns. At this point, your discussion should include treatment in the form of a DMARD or Biologic and an antiinflammatory and Physical Therapy (if indicated). Keep this appointment straight-forward.

5. Practice what you want to say with friends or family. Make sure that you are comfortable with the information that you will be discussing.

You will be amazed at how much more satifying an appointment can be when you have prepared for the meeting in advance. If you leave this appointment and do not have a definitive plan indicating how your doctor will proceed with your care, it may be time to seek a second opinion. It is your right as a patient to seek a second opinion and it is sometimes necessary in order to get the care that you need.

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