Prepare for consultation with rheumatologist
Some want the doctor to control the entire consultation and decide what seems to be the best. Others will themselves have the most control and self-determination. The trend is to ensure that patients are more informed about the diseases and then actively participate in decisions. The need for patient information about illness, investigation and treatment is therefore increasing. However, please note that the consultation time is limited. You must have time to present the most important thing and the doctor must finally be able to investigate and inform you of the assessment.
Three advice for doctor consultation
Your preparation is important. The specialist has information about you from earlier. At the first meeting there is usually a referral letter from the general practitioner with a summary of the relevant one. In the case of later checks, the doctor will have information previously available through your medical records. However, not all information is up to date. To get the most out of your doctor's time, you should prepare well. At least you should prepare three things:
- Think it out up to three important disease-related issues you want the doctor to consider. Tell about these early in the consultation (for example: your main symptom, concern for possible disease development / prognosis, treatment options you have read / heard about)
- Include a list of all the drugs you are currently using and any drug allergies
- Before check-ups, prepare for your doctor to ask about what's new with your health lately (illnesses, treatments, examinations)
What the doctor asks for?
The specialist in rheumatology will during the consultation hear about your main health problem at the time and especially about rheumatic symptoms. Further investigations and assessments may in part be guided by what you tell, but the doctor will ask more questions and do investigations such as checking joints and internal organs.
- What is your biggest health problem at the moment?
- What rheumatic symptoms do you have now (pain, stiffness, visible changes in joints, back, muscles and tendons)?
- When did the symptoms begin?
- Have you had similar before?
- Do you have symptoms from internal organs (lungs, heart, kidneys, bowel)?
- Eczema or other skin symptoms?
- What medical examinations / examinations of blood and urine, X-ray, CT, MRI, specialist assessments… have been done for the relevant symptoms so far? When was it (years)? Where (GP, specialist, hospital)? What did the results show?
- If blood and / or urine tests have recently been made by your GP (or other), you can bring a printout
- If new samples are to be taken, bring a urine sample (preferably morning urine) on a clean glass
- For blood tests you usually do not need to be fasting
- Take your medicine in the morning as usual unless otherwise agreed
- What other diseases have you / have had (high blood pressure, heart failure, blood clot, spontaneous miscarriages, low metabolism, diabetes, cancer, mental health problems ...)?
- Have you been examined in hospitals (why, where and when)?
- The medications you are using now
- Drug allergy and other allergies?
- Stable weight last 3 months (and your weight now)?
- If you have recently changed your GP, you must report so that your doctor's report can be sent there
- If you need new prescriptions, medical certificates or want to discuss anything else that will take some time, you should mention this early in the consultation.
Some doctors (and nurses) use ready-made questionnaires in addition to the medical consultation to map the number of swollen and tender joints and then calculate a measure of disease activity in arthritis (for example DAS scores). This applies most to research studies. Pain also affects the result that must be interpreted with caution and always linked to overall health. In case of joint disease it is therefore important to evaluate symptoms also beyond joints (eyes, mouth, lungs, heart, stomach / intestine, skin, nerves).
If you are going to start with new medicines
If you have not received information, you should ask about this:
- Do I need this treatment?
- What are the risks and side effects?
- Is there an alternative?
- What happens if I do not start treatment?
Report / epic
Usually, a report from the consultation will be sent to the referring doctor and to the GP. You can also request a copy, but be aware that it is in professional language that can be difficult to understand. If you have any doubts about the content, you can inquire about the contents of your GP or ask at the next rheumatologist consultation. Obvious errors in the report should be communicated to the specialist via contact information that should be found on your letter of invitation.
In parts of Health South-East you can see your own journal. Please read more about my journal here (in Danish)
Not everyone needs control with a specialist, but by active inflammation or the use of immunosuppressive drugs recommended specialist controls in addition to the GP`s follow-up.