Consultant Appointment from Hell Today !

pols090607

Well today I had an appointment with a Rheumatologist Consultant I have seen a handful of times in the past, in which he has been fine, but today was really quite something !

I told him how the hand therapist had said I had trigger finger - he said I didn't but was willing to put a steroid injection into it as it's causing me problems ! (The hand therapist had pre-warned me on Monday that he may not like being told what to do by a mere OT)

He asked about all the meds I'm on, when I gave him the list he asked me was I on any stomach protectors, I said no and that I was concerned as I take a fair lot of pills and he said 'that's not a lot'.

He said that I have to get used to the idea that I will be on tablets for the rest of my life, and a lot more than I'm taking now - he said if you have to take them you have to take them, it's all about quality of life !

I told him my hands and right knee are playing up at the moment - he examined me and said there's no inflammation !

He called in the Rheum Specialist Nurse who has been amazing in the last 6 months, she was the one who has sorted out the metho due to the joint damage in my hands. In front of me he asked her 'Why did you decide on Methotrexate', the nurse explained about the inflammation, bone damage, raised markers from the blood tests etc and he said to her in a very abrupt manner 'So what are you going to do now, she's had metho for 7 weeks and still in pain, what are you going to do if she comes back in 6 weeks with no further improvement'. I felt so sorry for the nurse, she really is lovely and she looked as though she wanted to tell him where to go ! She advised him that it was still early days and they would keep an eye on how things were going. He also told her that DMARDS are not given based on blood results and only when visible swelling is occuring. He kept saying something about an ultrasound scan which can measure something in the joints - I got lost at that point and he asked the nurse also if she thought I was sign/synovic (??) something like that - I cannot remember now, it was sign something ??

He said I will get no improvement off 10mg of Metho and that you would need to be on at least 15mg to see any benefit. So he has told me to up it and if I need anti-sickness then I can have them.

The nurse also had a look over me and without her knowing I had said my hands and knee where playing up she told him she could feel inflammation in the left wrist and right knee. This at least made me not feel so much like a fraudster !

He made me feel as though I was lying if I am honest. I ended up in tears and felt all flustered ! My list of questions stayed at the bottom of my bag as I felt like I just wanted to get out of there.

It didn't go at all well, I still feel really upset All the while he was talking really fast and when he seen I was filling up and tearful he just carried on speaking in a really overpowering way. Sorry for such a long rant, I am sure others on here have been in similar situations and can maybe offer me some advice ?

Thanks for getting this far down the post.... !

Pols xx

stlucia

What a horrid time you've had, I think you have my consultant!!
Thank goodness for the Rheum nurse. It is awful when you feel like they don't believe you. I sometimes feel like saying don't you realise what arthritis is like to live with day in day out.
Give yourself a good talking to about the silly man, have a cup of tea and just know that we understand!

pols090607 wrote:

Well today I had an appointment with a Rheumatologist Consultant I have seen a handful of times in the past, in which he has been fine, but today was really quite something !

I told him how the hand therapist had said I had trigger finger - he said I didn't but was willing to put a steroid injection into it as it's causing me problems ! (The hand therapist had pre-warned me on Monday that he may not like beingrest told what to do by a mere OT)

He asked about all the meds I'm on, when I gave him the list he asked me was I on any stomach protectors, I said no and that I was concerned as I take a fair lot of pills and he said 'that's not a lot'.

He said that I have to get used to the idea that I will be on tablets for the of my life, and a lot more than I'm taking now - he said if you have to take them you have to take them, it's all about quality of life !

I told him my hands and right knee are playing up at the moment - he examined me and said there's no inflammation !

He called in the Rheum Specialist Nurse who has been amazing in the last 6 months, she was the one who has sorted out the metho due to the joint damage in my hands. In front of me he asked her 'Why did you decide on Methotrexate', the nurse explained about the inflammation, bone damage, raised markers from the blood tests etc and he said to her in a very abrupt manner 'So what are you going to do now, she's had metho for 7 weeks and still in pain, what are you going to do if she comes back in 6 weeks with no further improvement'. I felt so sorry for the nurse, she really is lovely and she looked as though she wanted to tell him where to go ! She advised him that it was still early days and they would keep an eye on how things were going. He also told her that DMARDS are not given based on blood results and only when visible swelling is occuring. He kept saying something about an ultrasound scan which can measure something in the joints - I got lost at that point and he asked the nurse also if she thought I was sign/synovic (??) something like that - I cannot remember now, it was sign something ??

He said I will get no improvement off 10mg of Metho and that you would need to be on at least 15mg to see any benefit. So he has told me to up it and if I need anti-sickness then I can have them.

The nurse also had a look over me and without her knowing I had said my hands and knee where playing up she told him she could feel inflammation in the left wrist and right knee. This at least made me not feel so much like a fraudster !

He made me feel as though I was lying if I am honest. I ended up in tears and felt all flustered ! My list of questions stayed at the bottom of my bag as I felt like I just wanted to get out of there.

It didn't go at all well, I still feel really upset All the while he was talking really fast and when he seen I was filling up and tearful he just carried on speaking in a really overpowering way. Sorry for such a long rant, I am sure others on here have been in similar situations and can maybe offer me some advice ?

Thanks for getting this far down the post.... !

Pols xx

marion1952

Hi Pols

That's really awful that he has upset you.. thank goodness the nurse was there though - and thank goodness she has been so helpful to you over the last 6 months.

10 mgs is quite a low dose - I was only on that for a couple of months, and then I went up to 12.5 and was on that for about 12 months, and then I increased it to 15 mgs.. My joints REALLY improved when I went onto 15 mgs.

Try not to let that consultant get you down ... when I meet people like him I just think 'Pity his poor wife (if he's got one)'..

Marion x

mandyu

Sounds just like mine too!
I remember on one of my first appointments, a scared little 20 year old - I asked if I'd need to be on anti-inflamatories forever as I was concerned about their effects on stomach etc and he replied abbruptly "it's your choice, you either take them or you don't, you want pain or you don't, it's up to you".
Over the last 17 years, I have learnt to smile through it and listen more to the Rheumy Nurses, as they seem to have far more knowledge and patience than the Consultants!

I hope you get your meds etc sorted soon. :P

dreamdaisy

Male doctors are generally not good at the empatheitc part of medicine. Men see things in either black or white, women are more prone to spotting the various shades of grey. I don't know how many pills you are taking at the mo: a woman might have explained more gently the role of a stomach protector, why you should have one to guard against further problems etc. Essentially, he's right: if you don't want pain take the pills but there are better ways of phrasing it tho. Men also tend to be more impatient: I don't think anyone can guarantee meth results - I'm on 17.5 and it does nothing. Everyone is different in how they react to these drugs - he should bear that in mind but he's a bloke, thus the take on it is 'This is the problem, I've given you stuff to fix it, it should be working.' Not all male doctors are like this - some are lovely, empathetic and good at explanations but I think they are in a minority. In all my experience of male doctors I have only met two who were fundamentally kind, as well as knowledgeable and who weren't flustered by tears. Most men cannot cope with tears.

The syno bit is synovial fluid probably - the bane of my life. Your joints are covered with a fine layer of synovial tissue. This in turn is 'oiled' by synovial fluid - it's the colour of lucozade, well it is in me! When my knees are stressed they over-produce synovial fluid in order to protect the joint. This also happens now in my ankles and toes. It's the cause of my inflammation and the cause of yours by the sound of it. It shows up beautifully on an MRI, not so good on Xrays and ultrasound, well, not as detailed at leaast. Gosh, I'm tired, can't focus now. I hope you get some sleep tonight - if I have any further thoughts I'll come back tomorrow. DD

salamander

hi Pols, sounds as if he's got some problem with the nurse, not you. 7 weeks isn't long for mtx to work. My consultant told me a minimum of 10 weeks, perhaps longer. I'm lucky with him, he's a very lovely man but I know they are not all like that.

hileena111

Hi Pols...what an appointment......that was awful. Thnk goodnes for the nuse


Love
Hileena

pols090607

Thank you all for the support and thanks DD for the valuable info !

Feeling a bit better today I just wish I was a much stronger person and didn't get upset over things like this, I would have been able to ask a lot more questions and stood up a bit better for myself

As my hubby says, in a months time I won't even think twice about that appt so just try and forget about him and cheer up xx

frogmorton

Hi Pols

Yes hubby is right - you will forget it to a large extent, but next time he better go with you.

He might not be so abrupt if you have 'protection'

I feel really really bad for you - he was not nice and clever he might be - he dloesn't know how to care about people.

I am so sorry

You take care

You want me to FUMP him??

Love

Toni xx

oneday

How awful and the poor nurse,glad she stuck to her guns. Can you see a register with your questions next time?

I am trying to think of all ones i have seen for various things. Saw one consultant who said i had to have an op (off course didnt fancy one and said so!) and when i seemed reluctant he stood up to end appointment. In the end i did have operation and he was nice!

Seen another consultant, nothing to do with arthur, and he so chatty with everyone and you could hear laughter when sat in the waiting room. Also seen ones where they say..we will do such a such a test and to rule out cancer - !! well,fantasic, the C word wasnt even in my head and he got me in a right state - had a moan about him to a nurse who said yes thats his manner!

Good luck.

nanarose

Hi Pols

Sorry to hear about your awful consultation.

I admit I've had one Dermatology consultant, who although wasn't rude was absolutely hopeless. He spent the whole appointment swinging back and forth on the legs of his chair and looking out the window! He didn't even examine me, gave me no ideas about further medication, and I was the one who had to suggest things! Unbelievable! Luckily, I haven't seen him since, but I came away totally demoralised, so I can understand just how you feel.

My Rheummy is a woman, and now that I have been diagnosed she has been very good, but on previous occasions, I found her rather patronising and not terribly keen to listen to what I had to say.
Also, have you ever met someone who smiles at you, but its a really false, insincere smile? Maybe it was just me....who knows?

I find the Rhemmy nurse far more sympathetic and willing to listen and answer any queries I have.

Also,I was told that it might take up to 3 months to see any improvement with Mtx, and I have found that to be the case. It's only now that I'm on 17.5mg and more than 3 months in, that I'm finding some benefit.
It seems odd that A rheummy doctor would be so quick to dismiss it and say it wasn't working for you.

Hang on in there, and give it a bit more time, and hopefully you will see some improvement.

I think your hubbys advice is spot on too - forget all about it, but next time as has been said, try and take him with you if you can. Doctors aren't so quick to belittle people when they have an audience!

x

speedalong

Hi,

what a horrid appointment, I'm not surprised you were upset. Sounds like your doc definitely got out of the wrong side of bed that morning!! He was rude to not only you but the nurse too and contradicted the hand therapist ... Oh dear. Thank goodness you only see him occasionally ... pity the poor lovely nurse who has to deal with him on a regular basis. Can you request to see a different doc at your next appointment? I hope the mtx works for you at the higher dose and then at least something good will have come out of the appointment.

Speedy

Wonkylegs

Hi Pols & so sorry you had a bad appointment.

my appointment today was so much of a relief after having endured many similar ones to that you describe.

All I can say is that in my case it often helped if I took someone with me (couldn't always though, hubby has to work :roll: ) but if I couldn't then I used to practice what I wanted to say before-hand. That felt odd but did help.

The arthritis care helplines people are good at helping to talk through these kind of problems , and might be able to help you before your next appointment.

try not to worry

hugs
WOnky