The Rheumatology Team

Your Appointment

Please be aware that some appointments are telephone appointments. Double check your appointment letter before attending for a face to face Consultation.

How to make the most of your appointment

In order to be able to provide you with the best possible care your doctor and other clinic staff need to make sure that they understand your concerns and problems. It is important that you make the most of your time with the clinic staff and do what you can to help them understand your needs. To get the most from the clinic visit it helps to do the following:

Before the consultation write down what you want to achieve from the discussion and any questions you have.  Doctors and nurses tend to ask you if you have any questions at the end of the consultation and by that time you may feel unable to take up more time. Try to ask the most important questions first.   Although you may have a longer time with the specialist, you will not be able to ‘pop back’ for clarification of a point, as you can with your GP.  Take a pad and pen to note down yourself what the doctor recommends or ask a friend or partner to accompany you to the consultation and make notes on what is said. 

Explain to your doctor or nurse that you are going to write down important points.  Do not be afraid to ask him/her to spell or write down for you any medical terms or drug names that you want to note.  Ask him/her to explain any medical terminology or jargon which you do not understand and don’t be afraid to ask them to repeat anything.  It may be a good idea to spend a few minutes immediately afterwards writing a brief summary of the main points covered in the consultation.

Medicines

When you come for your appointment make sure that you bring a list of  all the medicines that you are taking including any medicines that you buy over the counter (without a prescription), herbal or homoeopathic medicines and any vitamins or supplements that you take.

At each visit make sure that you inform your doctor or nurse if there are any changes in what you are taking. It is very important to mention any over-the counter or herbal remedies you are taking as they may interact with the medicine your doctor has prescribed for you.  Tell your doctor or nurse  about allergies you may have.

If you have been prescribed any medication, make sure that you get full instructions about when and how to take it.  Ask about any common side-effects you might experience.  You will often be given a leaflet on any new medications.

Tests and Investigations

If the doctor or nurse suggests further tests or hospital treatment the following checklist will help you obtain all the information you need about next steps.

If any tests are planned you may want to ask:

Do not leave the clinic without a clear understanding of what the doctor or nurse believes the problem is and how the condition should improve with the proposed treatment.

Do not forget to ask what developments or change in symptoms you should look for and where to seek help and advice if you need it.

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, 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 rheumatology team 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.

In some cases, the medication prescribed will need careful monitoring, usually by blood tests with 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 can be done at the hospital or by a practice nurse, district nurse or phlebotomist at your GP practice. You will need to check if your surgery provides this service.

In some circumstances injections can be helpful: injections into joints or muscle may be done in clinic but for more complicated injections such as ultrasound guided injections, a later appointment may be needed.  Many patients find physiotherapy or occupational therapy very helpful.

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:

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

After the consultation

Following your consultation, your doctor or nurse will write to your GP to inform him about your problem.  You should also recieve a copy of this letter.  Sometimes your specialist will tell you at the consultation what he or she recommends.  However, a letter will always be written to your GP.  If tests have been done, the specialist will usually write to you with the results once they have been received.