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5 Things to Discuss With Your Rheumatologist

The most common question I get asked by my patients is who is a rheumatologist, and why did my physician want me to see you? A rheumatologist is a doctor who has completed training in internal medicine and has additional training in the evaluation and treatment of autoimmune diseases and musculoskeletal conditions. Autoimmune diseases affect more than one organ system and cause multiple symptoms depending on the organ it affects. The specialized training we receive as rheumatologists, makes us the experts in connecting all the dots, to help ensure early diagnosis and prevent damage to organs.

1. Any new medications

As a rheumatologist I may prescribe a variety of medications to ease your pain or to prevent further damage to your joints or other organs from your autoimmune disease. Sometimes, other medicines prescribed by your family doctor may interact with your arthritis medication, causing your arthritis medicine to be less effective or worse, can irritate your liver or kidney.

One such example would be a cholesterol medicine(statins), which can irritate your liver. It is very important to know any medications that were added to your regimen. Please always have an updated medication list with you at all times, and if you cannot, please bring your pill bottles to the office visit

Some arthritis medications can suppress your immune system. Your pharmacist and your family doctor have to be notified as well, especially if they are considering immunization. Administration of live virus vaccines is not advised when your immune system is suppressed.

2. Any change in health status

It is imperative that your rheumatologist be notified about recent hospitalizations or illnesses. Any serious infections can be the result of immune suppression and may necessitate change in your medicines. Developing a condition like diverticulitis may preclude your ability to start or continue treatment with rheumatoid medications. Treatment for conditions such as heart failure may require water pills, which would then increase your risk of having a gout flare. In other words, every system in our body is interconnected, and therefore, any change in your health status plays a big part in your treatment.

3. Your care team

Communication between all healthcare providers involved in your care is crucial. As we know, rheumatologic conditions involve multiple organ systems, such as your heart, lungs, kidney, skin, etc. Always make your rheumatologist aware of the specialists you are seeing and establish communication channels between them. Constant communication between the doctors in your care team will help me provide excellent care for your arthritis.

4. What have you learned from the internet?

In the age of direct to consumer marketing, we are all inundated with information on the newest drugs. From the commercials and interest searches patients hear and see multiple side effects from medications. Not all side effects apply to all patients. It depends on other medical conditions you have and medicines you are taking. I always recommend that my patients obtain information regarding their disease or medications only from legitimate sources of information, for example the American College of Rheumatology.

It is important to have open communication with your doctor so we can work as a team to help you. If you have any fears related to side effects of medicine, such as hair loss or weight gain, please make sure to discuss with me at your visit. We can always figure out another way to help you.

5. Depression

I read a quote that said,” You don’t get rheumatoid arthritis until you get rheumatoid arthritis.” When you are diagnosed with a life-altering illness such as lupus or rheumatoid arthritis, it can make you feel sad and lonely. Having depression can make your arthritis worse, decrease your response to medicine, and increase risk of heart problems. If you are feeling depressed, always talk to your doctor about it. Depression and arthritis can co-exist and both are treatable conditions.

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