Good evening everyone.....
I have my first appointment tomorrow, but reluctant about any medications that might be prescribed. I have a large list of conditions including B12 deficiency and PA and thyroid conditions so will be taking a script with me. Can you tell me what to expect at my first appointment?
Many thanks in advance.
If you put first appointment in the search box top right you will get previous posts - it is a popular subject.
In general the rheumy will take your history, so it helps to have prepared a bullet point list of when symptoms first started, what they were, how it has changed, and any drugs you have tried (and their effect).
You may be examined - not sure with covid whether more than hands and fet - but best underwear and easy to remove clothes just in case.
The doc will look at any blood test results taken by your GP, and may ask for them to be repeated.
You may not get a diagnosis at the first appointment. It depends on how clearcut your situation is.
And even if clearcut you may not be prescribed any DMARDs, as you might need chest x-rays first anyway. So time to consider things.
There is little time at appointments, so if you have questions try to write them down now! And try to keep an open mind about drugs. I doubt if any of us were keen to accept them, but they have changed my life for the better so I wouldn’t be without them.
I don’t know what PA is...
Thank you. PA = Pernicious anaemia and I have respiratory problems amongst other things.
Hi good news you've got your first appointment but sorry you've had to have it (if you know what I mean); I had my first rhemy appointment back in June this year.
They took note of my weight, height, blood pressure then saw consultant who took my medical history and then asked me about my current symptoms, she examined my joints and then said it looks like arthritis .
She gave me a prescription for oral steroids and said if I still had the pain after stopping the steroids then I would need to go on DMARD medication, she gave me leaflets about the dmard medication .
I had my bloods done also.
I didn't feel forced medication wise and it was all very friendly and I felt I was on my way to getting some help.
I think over the whole 8 months I've been treated i've seen the consultant twice and been mostly interacting with the rhematology nurses so I would write down everything you want to know as you don't get to see the Dr often (rhemy nurses i found are great but they do have to refer back to Dr about somethings so can take time).
Good luck x
Thank you. I hate the weight question and the body shaming. Lets just say, I am a chubby chick. I am more concerned about my hands, although the xrays indicate that I have RA and OA in both my hands and feet. We will just have to see. But thank thank you for the tips.
I am chubby too so had the fear of dread when they said they wanted to weigh me, they didn't refer to it at all.
I was the one to say I should loose weight and they agreed but they said be kind to myself and do it gradually.
Thank you very much. x
Please do try not to think of it as body shaming. If you do have RA then weight can make a huge difference to the success of your treatments and ability to cope with it all. My rheumy was not judgemental but just keen that I really understood what I could do to help myself. I lost several stones.
Thank you x
Dont worry about the weight just ask them not to tell you out loud you don't have to know it.
The trouble is I know, it has been the same for a while.
My nurses just need to know for drugs as some can make you gain or lose so they need a starting point. They should not be shaming you as that is not professional however mine was done with courtesy and I felt very comfortable. I have put on weight since I have had RA but trying to sort a new regime.
I think from my experience. I never had a weight problem until my thyroid medication was messed around (a very long tiring story), needless to say, it started a whole new chapter in my life and a massive weight gain was one of them. Some of it me, I don't deny, but very sensitive of being bracketed in one particular category, if you see what I mean. I am most probably overthinking things as usual. I will see what they say tomorrow, but it is good to know what to expect. Thank you.
I hate it too as I am twice the woman I was in my youth! However, they don't shame you - they know YOU know you are overweight. With RA they know it's often difficult to excercise and lose it! 😄
Thank you Notabenenot,They briefly mentioned it, but that is as far as it went, so I felt relaxed. They seemed more concerned with my flare up. x
Hi JOLLYDOLLY and welcome.
My first appointment was August 2019 during which I had my weight, height and BP taken and I had to provide a urine sample. I had the meeting with the consultant who took a history of all health problems (and I have a few) and an ultrasound of my hands which were very badly swollen and painful. I was prescribed my medication and then had bloods taken and given a depo medrone injection in the buttock to control the pain and then sent for a chest x-ray. I was also very reluctant about the medications but knew that it was necessary if I wanted to get any relief. I hope your appointment goes well, try not to worry too much, let us know how it goes. x
I can tell you that I have an over active thyroid (Graves disease .. I take Carbimazole and my thyroid has never been affected by the RA meds.) They are used to seeing people with several medical conditions and will monitor you carefully. Yes a list is a good idea so you don’t forget anything/get thrown off track. They will most likely send you for blood tests after your appointment on your way out and weigh you and do your blood pressure before you go in to see the rheumy - that’s standard for each visit. They will do a physical exam of your joints and ask you what meds you are taking. Best of luck and hope you have a really good appointment. 💗
Thank you very much. <3
Great advice from helix. Good luck with your appointment. Remember this. It will be the first day on the way to a better life.
Just to say thank you all very much for your tips and advice for my appointment today.
It was not as bad as I anticipated but a mixed bag and a lot to take in. Basically the diagnosis, is more OA than RA, although there is some. The main concern is that they think I have Gout, especially in my lower limbs! Fortunately in a way, I had a flair up today, so they were able to see for themselves.
They think because my uric acid results from the dr's is double to what it should be and is due to my current diuretic! Which has basically caused calcium crystals all in my joints. A recent scan for something else, did mention calcium deposits, so it would make sense.
So for the next four months I have to take Colchicine, one every twelve hours until my next blood test around 14th January (I also had blood taken today), if the uric acid is still high, then I will be on it, until I am in normal range.
I also have to take Allopurinol x one every day for always - a preventer. The diuretic will be changed also. If I get a flare up I will be given Prednisone? which I believe is steroid based for flare ups?? So time will tell.
Did not ask about my weight other than weight loss will help the pressure on the joints and that was it.
They were very thorough and checked my skin and asked about it.
Again thank you very much. I do appreciate it. Just wish you all well and keep safe.
Love from little old me xx
I’m delighted it went well and you got some answers and a plan 🤞🏻all goes well. You can now enjoy Christmas 🎄
Thank you J1707. You have a Merry Christmas as well x
First rheumatologist appointment 
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First appointment 
