To make the most of a visit with your rheumatologist, it’s important to know what your doctor wants out of the visit, too.
“In general, the goal of the physician is to know how the patient is doing,” says Neal Birnbaum, MD, a rheumatologist at MarinHealth in San Rafael, California, and a past president of the American College of Rheumatology. “We want to know, is the patient responding to the treatment?”
Typically, Dr. Birnbaum says, a rheumatologist will ask a series of questions about your RA, such as:
- Do you have any painful, swollen joints?
- How long does joint stiffness in the morning last?
- Are there activities you have trouble with?
- Are you taking your medication as prescribed?
- Are you experiencing unpleasant side effects from your medication?
Sometimes, Birnbaum says, your doctor will use a questionnaire and possibly other measures to “score” your arthritis severity, as a way to tell if your RA is getting better or worse. But often, he says, such assessments aren’t needed.
“By and large, people come in and say either, ‘This drug is working great, I’m doing fine,’ or ‘This isn’t working, I’m not happy,’” says Birnbaum.
Some medications require monitoring for potential side effects. For the widely prescribed drug methotrexate, for example, Birnbaum says your doctor may order blood tests to check for anemia or liver inflammation.
In general, Birnbaum says, your doctor is likely to order tests prior to your appointment that assess your RA disease activity, although this may not be needed for every patient before every visit.
Whenever your doctor is evaluating a new or current treatment, they’re assessing both risks and benefits. “We’re looking at the patient’s arthritis, their overall health, and then trying to pick something that has the highest chance of success and the lowest chance of causing problems,” says Birnbaum.
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