what happens at a Rheumatologist?

[kkgirl]

today my doctor referred me to a rhuematology "Referred to Rheumatology for evaluation of defuse joint pain, rash, and elevated ANA." is what its on my paper work

[Hidden]

When I was referred the rheumatologist took down my family history (riddled with auoimmune disorders), did the Schirmer test on my eyes, and discovered they were completely dry, looked at my joints, and said it was not rheumatoid arthritis, asked me about my symptoms and then gave me prompts eg "and what about bla bla, and do you have bla bla", wanted to do a lip biopsy, which I declined so sent me for an ultrasound of my parotid (spelling) glands instead. He then gave me a script for hyroxchloroquine, and said it was either lupus or Sjogren's syndrome or both, it didn't really matter as the treatment is the same. I already have autoimmune hepatitis and am on powerful immunosuppressants for that and had markedly raised ANA when I saw him. My 3 month trial of hydroxychlorquine is nearly finished so I am about to see him again.

Hope this helps!

[Lupylass]

My first appointment with my rheumatologist involved asking about my medical history; lots of questions such as did I have a history of migraine etc, asking about my family history and a full medical examination (I was down to bra and pants so wear matching undies!). I too had a schirmer test.

Lots of blood tests were done on the day.

The rheumatologist diagnosed Sjogren's on the day but wouldn't commit to lupus for a while. I got prescribed hydroxychloriquine and steroids and asked to return in 6 weeks.

I'd advise you to write down a succinct history of symptoms (even if you think they aren't relevant) and take photos of rashes (in case they're not there on the day of your appointment. Write down any questions you might have, consider taking someone with you (two sets of ears are better than one) and ask the rheumatologist to send you a copy of his or her letter to your GP.

Hope this helps!

[flo_IarFachYrHaf]

yes take photographs of rashes, any discolourations on limbs, anything, especially if not always present.

and yes try and think about all the things that have been going on, things different to what you consider "normal"

in my experience first appointments with rheumatology take A Long Time, a lot of tests. All good advice above!

When I first saw rheumatolgy 10 years ago I had quite a few appointments to achieve a best guess diagnosis. Rheumatology seems to have to deal very grey areas and you sometimes have to accept that things aren't fixed. with my most recent diagnosis the experience was very much like Bitternwatcher. It ws preceded by a letter from my GP who had been noting symptoms over a couple of months and deciding it seemed like SLE/Sjogren's

My rheumatologist is not allowed to send letters to patients only GPs [budgets] but suggests asking the GP for a copy, mine is happy to do that

[Wendy39]

Hi. I have had two appointments with a rheumatologist now (2 different ones) following diagnosis of lupus in November 2013. The GPs tests had confirmed my positive ANA, along with numerous other symptoms. I had to complete a questionnaire for the rheumy before the appt. At consultant appt I had medical history taken, numerous bloods, urine samples, physical examination, ECG and X-rays of chest, hands and feet. I also have appointments for heart ECO and lung function tests. I will then see her again for results in 2-3 months time. I have been started on hydroxy already but exact diagnosis will be confirmed at next appointment. I have also seen a dermatologist. I hope this helps and good luck!