Tell US About Your Appointment With the Rheumatologist..

Do you feel that. your rheumatologist spends enough time with you? Are all of your questions answered? How do you. Remember details of your conversations with your Rheumatot?logis? Do you bring something or someone to help you remember questions that you want to ask? How long is your typical appointment?

[ebut]

I have a rheumatology who is excellent.nothing is too much trouble and appointments last at least half an hour or as long as it takes

[linda55]

My first visit was rough but he was considerate and when he was done took an hour he asked if I had any questions. .He also called me personally to tell me my blood results..

[Hidden]

My typical appointment is 45 minutes. I have labs right before my appointment. I take my husband or mom with me and my notebook for them to write down details. My nurse also types important notes and prints instructions for me. I never leave without a plan for big flare ups. He keeps a prescription for steroids and pain medicine so l can just call to start it between visits. We discuss next step too and reading materials are given to me. Before l go home. For the next appointment we continue or execute next plan. We get a lot accomplished each appointment. I always get home and then think.. oh yeah, forgot to ask about this and that. X

[Karen77]

My appointments are typically on time, less than 10 minutes in length. Most of that time is spent reminding my rheumatologist of my current meds and doses, and calculating which will need refills (and how much to refill) to get me to the next appointment. She will let me ask questions, but often shows impatience and is frequently dismissive. I've only been seeing her for 14 months, but left nearly every appointment in tears. I won't see her again until end of May (4.5 months since my last appointment). I'm just glad my RA is pretty much in control these days.

I'm from Ottawa, Canada.

[d-creasey]

I have not seen my Rheumatologist since 2013 and my appointments are around 15 minutes. He checks my knees, elbows. Shoulders, and wrists/fingers and then says I will see you in a year only to find his registra who I was equally not impressed with. I have now asked for a new consultant as I have been with him five years and no where's near under control. X

[Hidden in reply to d-creasey]

D creasey, I hope that you are in good shape as far as trouble with your joints being very little...that's really not good to go so long if you are having problems. Do you ask what to do between appointments if you are getting more symptoms? My jaw hit the floor when reading this. Hugs to you and luck in getting a new consultant, You did the right thing, I think. I can't go more than 3 months or I am on that phone with new or worsening symptoms - I have a mixed bag of health issues. X

[d-creasey in reply to Hidden]

Wishe I was in good shape but unfortunately I'm not. I have two wonderful nurse specialists and I can call them whenever I need and they will see me. I am on Enbrel injections and they stop the flare ups but not the pain. Sorry to hear you have a lot of health issues. Delia. X

[Hidden]

Haven't seen my Rheumatologist in 11 months!! My GP has emailed and written several letters try and help me. Also 10 min appointment and she tends to go on how you are on the day. Not listening to what your actual symptoms are. My daughter was sadly recently diagnosed with RD at 26 and her consultant goes on her symptoms and must admit he was amazing!! So not that impressed.

[Hidden in reply to Hidden]

Then don't answer how you are for the day.. answer with an average for the last week. it seems like everyone feels better on appointment day. I have a lot of anxiety when I don't have an appointment for 2 more months and I am doing poorly. Doctors always seem to cover more when mom is around to help the daughter be heard. haha.. they better or they will hear from mom and daughter!

[Mimi21]

My appointments last about 10 mins and feel rushed. I haven't had a consultant for 18 months-2 years and have seen locums that just mark me forward. It takes approx 8 months to get an appointment. I have been having lots of flares this year but been unable to get to see anyone. I have at last got an appointment later this month and I'm going to go armed with a diary, photos, list and ask for a full review and x Rays ....!

[Hidden in reply to Mimi21]

Lots of people print off notes from previous visit and have them ready at the next appointment along with lab reports... that's key what you are planning on doing. The doctor will have more time for you.. Can you have a plan between doctor and you so you can call and start up medicine for between appointments if there is a big flare or a lot more pain than you can stand so you can just call the nurse and the prescription will be there for you?) I do that and usually have a steroid shot available to me if I flare really bad)

[oldtimer]

It varies. I always prepare well for each appointment to get the best out of it.

The best appointments are in the teaching clinic when the consultant has someone else in the room learning the job (nurse or doctor). Then he listens properly, discusses treatment and I feel that I have a plan of sorts until the next appointment. Or with the Rheumy nurse who is very thorough.

The worst ones are when the consultant is running late, the clinic is over-booked or I see the registrar. Then no-one listens and I feel fobbed off and a nuisance.

I keep my own medical record which I take with me. Then I can quickly remind the doctor about when I had an investigation and the result.

I give a verbal summary of what has happened since my last appointment based on what I have prepared before the appointment.

I have a list of questions which I check before I leave the room to make sure I have had them answered (if an answer is possible).

But it is often frustrating because it is "we'll try this and see how it goes".

[craigsif]

first rheumatologist was not up to much, its taken since 2008/9 to come up with a diagnoses , and that is a result of me looking on the net, and this forum.

[craigsif in reply to craigsif]

i seen several registrars, one prescribed hydrocliquine!! I said I am allergic to quinne, dont worry its only a small amount, was the flippant reply, results massive rash/psoriasis across chin, face, even though I have said to various experts=X and spurts!!! i keep getting this dry itch skin etc they just ignored me. apparently hydrocliquine?? should not be given to people who have psoriasis as it sets it off. DOH one lady at uchl told me my feet swelled because my shoes were to tight??, psoriasis arthritis loves the feet and ankles and the crystals don't show in the synovial fluid and PaS mimics gout/AR and several others. the one and only reason I kept going back to the rheumatology was my GP was adamant that I was ill, last week took photos in of my feet whilst flaring. showed them to the new senior registrar and consultant who then went I think your right you do indeed have PaS,!!!! now chasing dermatology for appointment to confirm so I can start methotrexate, as to say I am depressed would be an understatement. I thinks its the falling over without the benefits of falling down water lol. take photos keep diarys, note and keep going folks dont give up. remind the doctors you are the patient not the disease/illness.

[Glyn612]

I have only ever seen my actual rheumatologist once and since then it has been a different registrar each time. The last one asked me how I was doing on MTX and didn't know that I'd had to come off the drug due to lung damage a month earlier, hence my appt with him. He then spent the next ten minutes ignoring me and looking at my chest xray and ct scan on screen. He asked me how I felt about going back onto the drug and I told him that my doctor had strongly advised me against it. He then went to the office next door to consult with my actual rheumatologist and came back with a leaflet on HCQ and said that this was the next DMARD to try. He was very well dressed, obviously well paid, and extremely dismissive, as has every consultant I've seen. My actual consultant, who saw me after having prescribed sulphasalazine at the first stages of my RA, and which worked very well for me for the first year, said that 'He'd cured me' - I had to refrain from reminding me that it was the drug that had cured me, not him! They all seem to have a bit of a God complex in my experience. I know that they go through a lot of training and hard work, but they seem to be well compensated for it. And basically it seems that really all they have to do is prescribe one DMARD after another, until they get it right. I could do that!

[Hidden in reply to Glyn612]

Glynisdyson, Is it possible for you to write down names of medicines that you did try and reason that you quit taking it so you have it right at the doctors fingertips?

Sounds like you might have to be the doctors secretary? Maybe you need to go in armed with your latest labs printed and your questions all ready to ask Like oldtimer and I do.. that way you have more time to discuss what matters to you. Don't be afraid to take some pictures of your swollen joints to show the doctor. Complain about pain or anything if it's bothering you. Write it all down on a calendar if that's easier for you to do.. we have to give the doctor the whole picture and do it quickly, I think.

You sound like such a nice person.

[Glyn612 in reply to Hidden]

Thanks for the advice. Yes, I have an appointment next Monday with the rheumatologist so I aim to have everything to hand and not to leave the office until something is done. Fingers crossed xx

[ZanyLady]

I had my latest appointment with my Rheumatologist this week which would have been lucky to have lasted 10mins... This is the 2nd Rheumatologist (Private Specialists) I have been to since moving interstate, both have been ladies and both didn't really seem that interested... Maybe I was too used to my original Rheumatologist who would spend as much time with you as needed, would go through all your blood test results check the swelling, movement and reflexes on all your affected joints, talk about your medications.. Even when I told the Rheumatologist I was feeling really tired, unwell and very down she just said the MTX could do that... What do I do I am so disheartened.

Nonnie

Australia

[Jeanabelle60]

First of all I have to say that I really feel bad for all the sufferers on here who don't know what its like to have a first class Rheumatoligist. I can't begin to imagine what its like to go through the pain, flares etc, etc that we go through and not have the reassurance that there is someone there to look after us and to give us that one to one attention that so many of us don't get from those closest to us.

I have to say and I have said it many, many time on this site that I am so lucky to have an outstanding Rheumatoligist. When I go to see him he firstly he will say something to make relax me, not that I need it with him. Sometimes he'll say "your looking very nice today Jean"......unless I'm ready for the knackers yard I always go out of my way to look my best when I go to see him...we have a bit of light hearted chat for a minute but all the while he is feeling my hands, shoulders, knees......he even looks at my feet, not many do that!

He looks at me when he is explaining something, calls me by my name, he lets me know that for that 30/45 minutes I am the most important person to him and always answers any questions I may have.....my lovely Dr David Armstrong is a marvalous Dr and a really nice fella into the bargin.

I didn't want to end this reply without mentioning my Rheumatology Nurse, Bronagh, whom I see inbetween seeing my Dr Armstrong. She is just as good as any Rheumatoligist, Dr Armstrong said as much when he first arranged for us to meet. When I can't get to talk to Dr Armstrong I know that Bronagh is at the end of the fone. If she is busy and can't speak to me there and then she will ring me before the end of her working day to answer any questions or concerns, she is wonderful, all of the team are......I'm very blessed to have them.

[Shelley1701]

I've never seen my actual consultant just one of his 'team'. One of them is also one of my GP's a few days a week and she is great. Really nice and listens. The male Dr I see mostly is nice enough but appointment lasts about 10-15 mins at most. Only interested in how I've been that week. The best consultations I have are with the specialist nurse. She should be the consultant. She listens, understands, gets things done and has time to chat, whereas with the Dr I feel he can't wait to get me out the door.

My hands are quite bad. Dislocated knuckles one hand and slipped tendons on the other. I asked to be referred to an occupational therapist for some resting splints. Dr told me they hadn't got any money to give people splints anymore. Lady Dr did refer me when I saw her. Two weeks later I saw OT and got my splints.

I often wonder if some Drs are in their profession because they care or for the money.

[Hidden]

My Rheumy is excellent..he always takes time to listen to my questions and concerns, which I always write down, so I don't forget...My apps can take as long as is needed and I know he treats all his patients the same..co's he often runs late..Which I do not mind, co's I know he is being thorough and supportive and will do the same for me..

[Hidden]

In Rheumatology I think that there are so many updates and new

treatments coming out that the consultant (highest up the command chain)

needs to be right on top of that. It's a fulltime job. They also need to be able

to take care of the most urgent matters-- there are a lot of us to keep him/her busy. They oversee the entire practice and review all cases but it takes time, too much time so they are more and more in the background these days and we are seeing associates that gather the information. They want to treat the most current conditions that you have and that means really only this past week. The past month and months before that are really important too especially for you to be able to see how you are doing over-all. "That" is what you can tell the doctor about when asked how you are doing.. the consultant hears about pain way too often so they are somewhat skilled in shifting right over to other subjects. They know what drugs you are eligible for and how much funding is available...must be so frustrating to have so little when so many need things.

Some people might be from other geological areas or areas that have more funding. I live in the USA where private insurance determines how often we see the doctor or what treatments I get. I have one doctor. I live in a city that is not that large. The doctor is accepting new patients right now so he has time to spend with me. That's not the case everywhere so keep that in mind.

I think that if you go into the appointment with the information for the doctor to glance at while he/she looks at their computer - then you at least have a chance of being heard. Sometimes I think that the doctor's ears only perk up if they hear something alarming, otherwise they are just in their own little world.. too bad that the computer doesn't work harder for them so they can have face to face time with them. Now they have to cover themselves in case of a law suit or a malpractice suit (in the USA, at least) They need a good salesperson with a big medical background debater to fight to get you what you need - doctoring isn't a service just to you anymore. Sadly.. so I think that doctors are not in it for the money but are loving their jobs less and less as others decide what power they have to treat you vs what a few people decide who know less about the conditions and need are making the decisions.

[krysia]

No I seem to be in and out am due to go in June and intend to ask a few more questions this time.Guessing I would say the appointment lasts about 10 mins or so .

[Hidden]

Does anyone ever think of making grafts to show your pain over the months so the doctor can look at it quick without reading the details unless he/she wants to look at your diary? I do that and the doctor really appreciates it. I do the same with my blood pressure and for me blood sugars ( I am borderline at times when steroid use is heavy) I use highlighters to alert the doctor to those times. .

I have to do most of the work for myself. I resent it at times because It's

a wasted appointment for me. He doesn't ask the right questions or I

just get flustered and forget to tell or ask things.

The more that you can do to help yourself and the doctor very quickly access how your body is doing, the better you will get what you need or want . You sometimes have to step away from the little details..