How to Prepare for an Initial Visit With a Rheumatologist

A rheumatologist is a certified internist or pediatrician that has undergone additional training in the diagnosis and treatment of arthritis, systemic autoimmune and inflammatory diseases, as well as other conditions affecting the joints, muscles and bones. If joint pain and swelling is a concern, worsens with time, or does not improve, a consultation with a rheumatologist may be recommended. Systemic symptoms, such as fever, fatigue, or unexplained weight loss, may also warrant a visit to a rheumatologist.

In most cases, a diagnosis is not made during the first appointment. The rheumatologist will likely take a medical history, perform a physical exam, and order additional testing.

Below are some tips for an initial appointment with a rheumatologist.

Tip #1 Track and know symptoms.

Keeping track of symptoms before a rheumatology appointment can make the actual appointment more productive. It may be helpful to write down any details about symptoms on paper or keep notes in a cell phone app, such as PainScale. Below are some tips for communicating symptoms:

• Be prepared to describe the duration and intensity of symptoms and the type (dull, sharp, achy, etc.) of pain felt.
• Keep a journal or log of symptoms for a week or two before the appointment. Note what makes symptoms better or worse and how the symptoms impact functionality.
• Gather copies of labs, tests, and imaging reports to bring to the appointment. This may also include imaging CDs and appointment notes from other physicians.
• Bring a list of current medications. Also, list the effectiveness of previous medications and treatments.
• Be prepared to share any family history of musculoskeletal or inflammatory disease.

Tip #2 Prepare Questions

Write a list of questions to bring to the appointment. In the days leading up to the first appointment, it may be helpful to carry around a notebook or use a smartphone app, such as PainScale, to jot down questions as they come up. Some examples of helpful questions include the following:

• What treatment options are available and what are their side effects?
• How long will it take to notice improvement from the new treatments?
• When should the rheumatologist be notified of new or worsening symptoms?
• What is the best way to contact the rheumatologist between appointments?
• What type of at-home treatments are recommended? (ice? heat? rest?)
• How often are labs needed?
• Is it safe to become pregnant with the disease and any needed medications?
• What is the long-term prognosis and expected progression of the condition?

Tip #3 Consider bringing a family member or friend.

A family member or a friend can help take notes or ask questions, as well as act as moral support. Most doctors do not have an issue about family members attending in-person appointments. It is best to check if someone else is allowed during a phone or video appointment, prior to the appointment.

Tip #4 Follow up, if necessary.

The following may warrant contacting the rheumatologist before the next appointment:

• New or worsening symptoms
• Intolerable medication side effects
• Starting a new medication prescribed by an outside physician