What does a rheumatologist do?

[chrisnsteph1022]

I know they're joint/bone docs, but what will they typically do on a first visit? I've had hip pain for years, but it recently became very severe (like, went to the ER, couldn't work for 2 weeks, using a cane). It is tolerable now, but I'm still taking muscle relaxers and pain pills daily. The ER said it was due to spinal issues (degenerative disc disease), which I DO have, but have never had this much pain with it. An ortho surgeon said the disc bulges were not severe enough to cause that much pain, and the pain was not in the 'right' spot (outside and front of hip, down FRONT of leg).

Anyway, I'm seeing a rheumy for the first time in 3 weeks. What can I expect? Any blood tests may be skewed because I'm on remicade and imuran. :/

 

[Jennifer]

Before I was given an appointment they had me do a blood test before they even considered seeing me. I don't remember what test it was but it took three weeks to get the results to the doctor. I'm seeing the Rheumy for the first time today to find out the results of the blood test (I'll ask what they were testing for) and just to see what he has to say about my pain in general.

I have hip and back pain and was told I have Osteoarthritis most likely caused by the Crohn's so I requested a Rheumy. The pain was getting bad enough in my hips where I wanted to buy a cane and couldn't walk as much as I would have liked to. The Entocort did help with my joint pain but I'm tapering off of it now and am only on 3mg so the pain has been starting to come back. I also recently started having pain in my neck and left knee. Both my mom and her dad have Rheumatoid so I'm hoping to rule that out (probably what the blood test was checking for me thinks).

My appointment is in 2 hours. I'll post about it when I get back.

 

[chrisnsteph1022]

Good luck! I had to buy a cane, too, which gets you lots of funny looks when you're young!

 

[Natalie38]

Hi,

I have had a rheumatologist for about 5 years now.
When I was first referred, I was asked to do many blood tests. Xrays were required, along with a bone scan. This was BEFORE I saw the specialist. During my first visit to the rheumatologist, he did a physical ceck with me, which included him asking me to bend in specific ways etc, mostly looking at movement challenges. Then we discussed my xrays, results etc.
After that, it was FInally determined I had AS. Then we discussed a plan, wich included Humira that was going to improve my ability to function.
After that initial appt, I saw him 6 months into Humira. Now, I have an annual appt with him. We do blood work, and renew my request to Medical for Humira. I do not know if the meds you are on will skew the tests. I would imagine not though. Cause I have monthly blood tests required by my GI and they dont skew the tests. And the specialist is probably already aware you are on these meds.
I hope you have a good experience and that you find out whats going on so you can treat this!

Good luck

Nat

 

[nikimazur]

Just had my first rheumy visit Monday. She is affiliated with the same university as my GI, and was able to view my complete history. I have severe swollen joints, a history of multiple fractures, and also a family history of both AS and RA. She wanted me to get further blood tests, as well as more X-rays, and hopefully it's just osteoarthritis and not anything more damaging. Right now I'm on prednisone for crohns, which has helped with the swelling, but both my GI and her want me off that as soon as possible. Next step most likely will be Humira, to help both the joints and crohns.

She looked/felt most of my major joints, asked tons of questions, and did a complete exam. I follow up with my GI Tuesday, and her in a month. Its just a long process. I'm just hoping that there's no permanent damage, considering my age (24).

 

[chrisnsteph1022]

I have had the xrays (hip looked fine), MRI (spine only-showed degeneration, bulges, tears) and bone scan (normal). My GI did the CBC, ESR and CRP, all of which were normal.

 

[Jennifer]

Got back from it. It went sooooooooo well! Seriously one of the best doctors I've ever gone to.

I asked him about the blood test and he said it was checking for a specific type of arthritis, something along the lines of Crohn's arthritis. Mine was negative. I didn't write it down cause I was just so taken with the whole appointment. Went by fast to me but I think I was there for an hour.

He checked every joint. I didn't even know there was something wrong with my toes until he pressed on them. He says I have arthritis in my feet as well. Had me bend multiple ways, follow his finger with my eyes and pressed on my stomach the way a GI should (my GI pokes around while I'm sitting in a chair :/ You're supposed to lay on your back). Apparently my abdomen hurts almost everywhere. Go figure.

He decided to go over my GI's head and prescribe Humira. He said, "we need to treat your Crohn's first and get that under control before we can treat the arthritis." But he also said that the Humira will likely help with the arthritis. He also felt that my GI heading towards a diagnosis of IBS if the pill cam shows nothing is a lot of BS. I'll continue on the 6MP for a while until he feels I can start coming off of it. I learned how to use the pen for injections while I was there and am now just waiting for authorization from my insurance.

He's also ordering more blood work. He's checking for RA (apparently there are two different blood tests for it, I was negative for one already), my bone density (since I have a long history with steroids and it hasn't been checked since I was a kid) and he's checking to see if the 6MP is doing anything (checking the therapeutic levels).

He listened to all my aches and pains and asked so many questions, even asked if I get up at night to urinate. That's funny, how did you know? Its like he knew everything about me. Was the craziest thing.

It was like seeing a GI, Neurologist, General Practitioner and Chiropractor all in one doctor. Best thing ever! This guy knew everything!

 

[chrisnsteph1022]

I hope my guy is that great! I'm already on a biologic (and imuran). Maybe the ortho was right and all the hip pain is referred from my back. I'll feel better hearing it from the rheumy, though.

 

[Paislee]

I have been referred to a rheumatologist as well. I have been suffering with knee and wrist pain for years and it all started after I was diagnosed with Crohn's. My knee pain got really bad with my last flare in April, to the point it keeps me awake some nights. My GP did give me pain meds but I don't think it is strong enough because it just gives me an hour of milder pain. It never fully goes away. My knee also swells. Unfortunately it's a long wait to see a specialist here, so my suffering will last a little longer. Hopefully when I get a chance to see the specialist it will go as good as the rest of your experiences.

 

[outlier]

I have AS and go to a rheumatologist. He has become my head doctor. glad you liked the one you saw. they can be really useful, just remind them that crohn's and NSIADS don't go together.