What to expect?

What to expect

 

 

 

ApointmentWhat to expect when you come to the rheumatology clinic?

What’s on this page?

What is rheumatology?

Rheumatology is a specialty that involves the non-surgical evaluation and treatment of rheumatic diseases and conditions. Rheumatic diseases and conditions are characterized by symptoms involving the musculoskeletal system (joints, muscles and bones). Many of the rheumatic diseases and conditions affect the immune system so rheumatology also involves the study of the immune system.

What is a Rheumatologist?

A rheumatologist is a doctor who is qualified by additional training and experience in the diagnosis and treatment of arthritis and other diseases of the joints, muscles and bones. Rheumatologists are specially trained to do the detective work necessary to discover the cause of swelling and pain in the bones, muscles and joints. It’s important to determine a correct diagnosis early so that appropriate treatment can begin early. Some musculoskeletal disorders such as Rheumatoid Arthritis respond best to treatment in the early stages of the disease. Rheumatic diseases can be complex, chronic disorders and therefore long-term follow up may be necessary. These diseases often change or evolve over time and changes to the treatment plans are common. Rheumatologists work closely with patients to create plans that are acceptable to both parties.

What kind of training do Rheumatologists have?

After four or five years of medical school and a number of years of training in general medicine, Rheumatologists devote an additional four years to specialised rheumatology training.

What do Rheumatologists treat?

Rheumatologists treat arthritis, certain autoimmune diseases, musculoskeletal pain disorders and osteoporosis. There are more than 100 types of these diseases, including rheumatoid arthritis, osteoarthritis, gout, lupus, back pain, osteoporosis, fibromyalgia and tendonitis.

Appointments

If your GP refers you to the rheumatology department you will be sent an appointment letter for one of our outpatient clinics. The main clinics are at Royal Cornwall Hospital and Derriford Hospital but clinics are also held at Bodmin, Falmouth, Newquay, Redruth, St Austell and Penzance ++++

What will happen at my appointment?

If you are unable to keep your appointment please call xxx to inform our receptionist as soon as possible so that your appointment time can be offered to someone else.

Please bring a list of all your current medications and dosages. If you have had a previous rheumatology appointment and have been given a drug monitoring booklet please bring this too. You should also bring a sample of urine for routine testing.

It may also be helpful to write down any specific concerns which you wish to discuss at your appointment.

Each time you come for a rheumatology clinic appointment you will be booked in by our receptionist. You will then be seen by one of our health care assistants (HCA) or nurse, who will weigh you, check your height, body mass index (BMI) and blood pressure and test your urine sample.

At your first clinic appointment you will be seen by a member of the rheumatology team; this will be one of the medical team. You will be asked about your general health, previous medical history, what medication you take and if you have any drug allergies. Any relevant family history will also be noted. If a physical examination is necessary you may be asked to partially undress. If you need assistance, one of our staff will be available to help you, and a chaperone will be available if you wish. Further investigations such as blood tests or x-rays may be needed before a further appointment is arranged.

Following your clinic appointment you may need to start new medication. You will usually be given a prescription which can be dispensed by any pharmacy, or you may be advised to consult your own doctor for this. You will generally only be issued with a small supply of medication and will need to obtain further prescriptions from your GP.

Regular blood tests are often required when taking many of the disease-modifying treatments used in rheumatology and it is important that you have these tests – you will be told how often tests are needed for your treatment program. The blood tests are usually arranged at your GP practice.

A further appointment will be arranged.

We try to keep to time but that is not always possible. Some problems can take longer to sort out than others. We ask you to be patient and understanding. The clinic nurses will keep you informed if there is any delay.

You are welcome to bring a relative or friend with you if you wish.

What tests will I have?

The person who sees you in clinic will discuss with you any investigations which are necessary. Blood tests and plain x-rays can normally be done at your clinic visit. Scans and other special tests can be done by appointment at a later date.

What treatment will I be given?

Most rheumatic diseases cannot be cured but effective treatment can allow people who have these conditions to live pain-free and active lives. Treatments include pain relief, medication, exercise, dietary control, rest and relaxation, and education on how to best manage the condition. Other treatments may include the use of appliances, such as splints or braces.

It is important that the doctor and the patient work together to develop a treatment schedule that helps each patient maintain or improve his or her lifestyle. Sometimes a combination of treatments may be required.

One important aspect of your visit is that you will be given information about your condition and you will have the opportunity to ask questions. Sometimes medication is appropriate in which case you may be given a prescription or advised to contact your own GP for a prescription. You will usually be given a prescription which can be dispensed by the hospital pharmacy, or you may be advised to consult your own doctor for this. You will generally only be issued with a small supply of medication and will need to obtain further prescriptions from your GP. 

To see more information about medication visit our pages on ‘Medication’ ‘Medication for RA’ ‘Medication for OA’

More information is also available by clicking on the following button: Click here 

In some cases, the medication prescribed will need careful monitoring, usually by blood tests with your GP. In this case you will be given a monitoring booklet to record the results from these blood tests. Regular blood tests are often required when taking many of the disease-modifying treatments used in rheumatology and it is important that you have these tests – you will be told how often tests are needed for your treatment program. The blood tests can be done at the ????hospital Pathology Department, or by a practice nurse, district nurse or phlebotomist at your GP practice. You will need to check if your surgery provides this service. Click here for more information about blood monitoring.

In some circumstances injections can be helpful: injections into joints or muscle may be done in clinic but for more complicated injections such as epidurals a later appointment may be needed. Click here for more information about monitoring

Sometimes you will be referred for physiotherapy or for occupational therapy.

Who else might I see as part of my treatment?

Arthritis is best managed with the help of the multi-disciplinary team. Team work is important because arthritis is a long term condition. We often rely upon the help of many skilled professionals including specialist nurses, physiotherapists, occupational therapists and podiatrists. Health care professionals can help people with arthritis and their families cope with the changes the disease causes in their lives.

Rheumatologists may also need to work closely with other doctors such as:

  • Orthopaedic surgeons (who perform joint replacements, soft tissue reconstruction and repair and nerve decompression).
  • Radiologists (who report on X-rays, CT, MRI and ultrasound scans).
  • Dermatologists (who diagnose and treat skin diseases).
  • Respiratory physicians (who diagnose and treat lung problems).
  • Gastroenterologists (who diagnose and treat disorders of the gastrointestinal tract).
  • Neurosurgeons (in particular for neck and back problems).Your consultant will always keep your own GP fully informed of your clinic reviews.