Rheumatologist

[Captinron]

First rhumey appointment tomorrow been waiting since May not sure what to expect

[PMRpro Ambassador]

Depends a bit - they all have their preferred approach. But usually someone (not necessarily the consultant, it may be a nurse or even a medical student) will take a case history: symptoms, other medical problems, medication , pain scores etc etc. The consultant (one hopes) will do a physical examination and ask questions. You may be sent for x-rays. They may come to a conclusion then or you may be sent to get blood tests taken and told you are to come back in x weeks for the results.

I was given pred for 6 weeks and a follow-up appointment a bit more than 6 weeks later. He was convinced it wasn't PMR but gave me pred to see if it would help with the symptoms over a trip to the USA that was coming up. Within 6 hours of taking the first tablets I could move and walk normally - within 6 hours of missing the first 5mg tablet I was back to the state I'd been in before. At the follow-up appointment he didn't want to hear anything about that - in fact the entire experience was a waste of time as a different doctor simply did a repeat of the first one and declared himself beaten! But the consultant was still sure it was inflammatory arthritis - I have no joint problems and never have had - but couldn't give me the drug he wanted to as it must be supervised by a hospital doctor and I was about to move so would have to get to see one at my new home. No-one else has ever questioned it being anything but PMR.

However - that isn't the pattern of most starts!

[Marilyn1959]

Hi Captinron. You have done remarkably well to taper from 30mgs to 13mgs in just a few months. However it may not all be so smooth from here on in. Your Rheumy may try to impose a quick taper plan in the light of your experience, but I urge you to stick with no more than10% of your current dose (whatever that may be at any given time). This means agreeing a 0.5mg drop when tapering below 10mgs.

It is likely he / she will want a potted medical history and also he / she may do a musculoskeletal examination. This is a series of small physical activities I.e. turn your head from side to side, bend at knees to squat, grip his / her hand etc. You may need to have a blood test and may be referred for xray / scan if Rheumy wants more information. I don't know if you are also on Adcal as well as prednisolone but if not it is advisable, so you may wish to discuss this with Rheumy. In addition many GPs and Rheumys put people on Alendronic Acid since pred is associated with Osteoporosis. HOWEVER if this is mentioned and you haven't had a dexa scan I advise that you ask for a scan first to check you need be be taking AA. The appointment is also the opportunity for you to ask questions, so I would advise you write these down and use your notes as a prompt. There is nothing worse than kicking yourself afterwards because you forgot to ask.

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This is for different conditions but may help you. 🌻

healthline.com/health/beyon...

[Arflane97G]

Very nice consultant took my medical history, did a physical examination which just really demonstrated how stiff my arms and legs were, looked at various test results (I had already had ct scan and sonic scan of my vascular system plus multiple blood tests to rule out lupus, lyme’s disease etc ) And said - yup, I am pretty sure it is pmr, prescribed steroids, sent me for a chest X-ray and said, see you in 3 months. All very straightforward after the anguish of the previous 2 months. Good luck with your appt. I would say that it is useful to have some one with You as there was a lot to take it, good luck and best wishes

[Captinron in reply to Arflane97G]

Thanks

[shazstep]

I find it helpful to have a friend attend the appointments with me. We are very much individuals with this disease there is no one treatment helps everyone. I would ask about the dexa scan and how often blood tests are required. This is a great site for information from real people. When I first started I would have pen and paper at the ready so I could follow up on other things I had never heard of.

I hope you are happy with your rhumey as many people have had bad experiences as well as those that have a good relationship.

[Gary1310]

When I told my rheumatologist I just woke up one morning with the symptoms, he immediately said, I think it is PMR. He said because it happened “suddenly”.....