If you’re about to see a rheumatologist for the first time, you're on the right path. Studies show the earlier you’re treated for your rheumatoid arthritis, the more likely you are to feel better sooner and stay active longer.
Rheumatologists have the special training to make a treatment plan just for you. Your first visit will be part conversation, part examination. Your appointment may take an hour or more, but it will be well worth the time. Because RA is a long-term disease, you'll see this doctor often.
Do Your Homework
Rheumatologists are like detectives looking for clues to relieve your pain and treat your condition. To give your new doctor a head start:
Create a timeline. Go back as far as you can remember. Describe your symptoms and how they've changed over time.
Do some family research. What kinds of problems run in your family? Find out what you can about the health of your grandparents, parents, and any brothers and sisters.
Brown bag it. Your rheumatologist will need a list of your prescriptions for RA and other health problems; over-the-counter medicines like aspirin, rub-on creams, and other pain relievers; vitamins, herbs, and supplements. To make it easy, toss your medicines into a bag and take them with you.
Ask your other doctors for copies of your records and any test results or X-rays, and take them with you, too.
Do Ask, Do Tell
It’s important to be honest and open with your rheumatologist from the first time you meet. Be ready to ask and answer questions. Tell your doctor how you feel and what you do to take care of yourself.
One of the first questions the doctor will ask is, "What brings you here?" This is your chance to tell him how RA is affecting your life.
Then, get ready to answer a lot of questions, like:
- What are your symptoms?
- How often do you have symptoms? (All the time, daily, weekly, every now and then?)
- What makes you feel better? (Exercise, rest, medicine?)
- What makes you feel worse? (Lack of activity, not enough sleep, stress, eating a certain kind of food?)
- What activities cause pain? (Walking, bending, reaching, sitting for too long?)
- Where on your body is the pain?
- How bad is the pain?
- Which words best describe your pain? (Dull, sharp, stabbing, throbbing, burning, aching, cramping, radiating?)
- How does the pain make you feel? (Tired, upset, sick?)
- Does it stop you from doing things you enjoy?(Gardening, shopping, taking care of children, having sex?)
- Are there symptoms other than joint, muscle, or bone pain that seem to be linked? (Rashes, itching, dry mouth or eyes, fevers, infections?)
Some questions may not seem to be about rheumatoid arthritis, but your doctor has a good reason for asking them. Tell him if you want to know why or if you feel uncomfortable.
The Physical Exam
You’ll change into a medical gown so the doctor can check you from head to toe, including your eyes, mouth, and skin. He'll look for signs of inflammation, like swelling, warmth, redness, nodules (growths under the skin), and rashes. He’ll take your pulse and listen to your heart, lungs, and bowels.
Next, the doctor will press on your joints to see if they're sore. He'll ask you to bend, flex, and stretch your joints and muscles. The rheumatologist will compare the joints on one side of your body to the other, because RA often affects both sides. This part of the exam may cause some pain, but it’s important for the doctor to see you move. Speak up if it hurts too much.
He may use a needle to take blood or joint fluid while you’re in the office or send you to a lab for these tests. The results may show signs of infection, inflammation, or other problems. X-rays, MRIs, and ultrasound images give your doctor a picture of damage to your joints.
What Comes Next?
Between what you've shared about your RA, your medical history, the exam, and test results, your rheumatologist will have enough information to decide on the next steps.
If your RA is further along, you may need stronger medications called biologic response modifiers. Over time, you and your rheumatologist will find the right mix for you.
Exercise and weight control will be part of your treatment plan. You need to move your joints to keep them from getting stiff and to strengthen the muscles around them. If you’re overweight, shed extra pounds to take stress off joints and lessen pain.
Your rheumatologist may recommend physical therapy or occupational therapy. Physical therapists can give you exercises to help you move your joints and make them stronger. Occupational therapists can teach you how to reduce strain on your joints during daily activities.
Before You Leave the Office
Ask any questions you have about the visit and the recommended treatments. It's natural to wonder about things like:
- How long will it take for me to start to feel better?
- What can I do to sleep through the night?
- I don’t like to take medicine. What are my other options?
- Will I have to take RA drugs for the rest of my life?
- Where can I find resources to help me learn more about living with the disease?
- How can I find a support group?
By the end of this first visit, your new rheumatologist will know a lot about you and your RA. And you will have a new, valuable partner on your health care team.