How To Prepare for Your Rheumatology Appointment

October marks Health Literacy Month – a time dedicated to recognizing the importance of making health care information easy to understand.

The doctor-patient relationship is critical in helping individuals make informed health decisions. Yet, meeting with a physician can be nerve-wracking — even more so when you think you may have a chronic condition and are meeting with a rheumatologist to confirm the diagnosis. You’ll likely have questions and concerns, but you may not know where to start.

It is best to come to your first meeting prepared. Rheumatologists rely heavily on your story, possibly more so than most other doctors. Even though your records are in the system, it’s still helpful for us if you point out what you think may be important.

Common questions that your rheumatologist will ask may include

• When did the symptoms start, and how has it evolved?
• What makes it better or worse?
• How do you feel in the mornings?
• If you feel worse in the mornings, how long does it take to get you feeling better?
• Do you have any joint swelling? What other symptoms have you had?

You may have already seen other doctors, such as your primary care physician, a neurologist, a dermatologist, a gastroenterologist, an ophthalmologist, or an orthopedist. Your rheumatologist wants to know about those visits! What tests were done? What diagnosis were you given? What treatments have been tried? If you tried something, did it work? Did you have side effects or stop the treatment for any reason?

These questions can be difficult to answer in the moment. If you think you’ll be nervous or that you may not remember all the details, try writing out your story before your visit. Give yourself an outline of the relevant time points and events. Bring a list of your medications, too—this is the best way to make sure the information is accurate. Include the dosage (how many milligrams?) and frequency (how many times in a day? In a week?). Don’t forget to include your non-prescription, over-the-counter medications and supplements too.

After your doctor takes this history and examines you, they may have an approximate idea of what the problem is. The next step will be to confirm the diagnosis. Sometimes it’s obvious and nothing else needs to be done; other times you may need confirmatory lab tests or imaging (such as x-rays). Some doctors prefer to discuss test results in-person, while others will be happy to do it over the phone or via a patient portal. Before you leave the visit, make sure to ask your doctor when to expect the results and how they will be relayed to you.

Once diagnosed, it is time to discuss treatments. There are a wide variety of treatments available to individuals with rheumatic diseases, ranging from non-medication treatments like physical therapy, to injection treatments like steroid injections, to treatments that suppress your immune system. You will likely have questions about these treatments—do not be afraid to ask! It’s best to get the information you need from your doctor rather than from unverified sources.

You’ll also want to discuss the potential side effects of the medication and the likelihood that they’ll occur. You’ll need to weigh those potential side effects against potential benefits.

Don’t forget to ask how soon you can expect to see a difference. Some medications work quickly, while others can take up to several weeks to take effect. Some medications need monitoring for side effects, so ask your doctor how often you need to do this and what tests are needed. If you are trying to start a family, knowing if the medications are safe for pregnancy and breastfeeding is important.

Finally: Sometimes the answers are obvious, but often they are not. Be patient. If the story is not so straightforward, it may take a few visits and a few trials of a few different treatment options before you arrive at the correct solution. Even if the first treatment plan didn’t work, don’t give up! It’s helpful for the doctor if you provide feedback. Knowing what does not work will help inform the next treatment option.

Ultimately, a good doctor-patient relationship is one based on trust. Find a doctor with whom you feel confident and with whom you can have a frank discussion about your concerns. A good fit makes all the difference.