Is it worth seeing the rheumatologist again?

Megrose489
Megrose489 Member Posts: 745
edited 29. Nov 2015, 15:28 in Living with Arthritis archive
I saw the rheumatologist on Wednesday at an Injection Clinic, re the chronic hip bursitis (which I've had for two years and which makes me feel ill), OA in my thumbs and fibromyalgia (which she diagnosed in March). Unfortunately, she didn't have my notes. I had hoped I could have a proper consultation with her regarding medication etc., as she had said in her letter to me. However, because it was an injection clinic - she arranged the appointment - this wasn't the case, which was fair enough and I understood that it was obviously a bit of a mix-up. Whereas last time she gave me injections into both hips and both thumbs, this time she would only give me an injection into my worst hip. Again, to the fair, they were very busy.

I was then treated to, what I can only describe,as a very polite telling off. She told me that 'we all get OA and bursitis is extremely common'. She said that bursitis occurs twice a year because people do gardening etc in the spring and autumn and this is why they get bursitis. 'And for fibromyalgia, ' she said, ' the GP will deal with medication'. She also told me to look at the fibromyalgia website. So, all in all, rightly or wrongly, I felt I was totally wasting her time.

She is writing to my GP to say that she will see me at a normal rheumatology clinic if the GP wants to refer me. But, I really don't feel that it will do any good and I would only be wasting her time again. What do others think? I totally understand that fibro is dealt with by the GP, but had hoped she could give me her expert opinion on medication. The last time I mentioned medication for the fibro to the GP, I was asked what I wanted!

I'd be really grateful for any opinions, whether telling me to pull myself together, or giving good advice.

Comments

  • Starburst
    Starburst Member Posts: 2,546
    edited 30. Nov -1, 00:00
    Hi Meg, I'm sorry you had a bad experience at the rheum clinic. It sounds like she was incredibly dismissive. My understanding is that Fibromyalgia is usually diagnosed by rheumatology and then back to the GP with a plan about how to monitor and manage. I saw my rheum last week who told me that, like most departments, they are just swamped. Although, it goes without saying, that there's no excuse for a poor bedside manner. She was saying that more and more GPs are going to be dealing with more complex rheumatology in general practice and that is quite worrying! Given that your GP is not experienced in managing your symptoms, I would go to the second appt. Perhaps write down what you want; her to give your GP some guidance in managing your health.

    Take care.
  • Megrose489
    Megrose489 Member Posts: 745
    edited 30. Nov -1, 00:00
    Thank you, Starburst. I really like your idea of asking her advice as to how the GP can manage things. As I said, she diagnosed me with the fibro in March and then discharged me straight back to the GP, but, as far as I am aware, there was no monitoring or treatment plan.

    On the plus side, I did hear today from Occupational Therapy who are sending me an appointment to arrange splints for my thumbs. This was from a GP referral, so really pleased about that.

    Thanks again.

    Meg
  • stickywicket
    stickywicket Member Posts: 26,270
    edited 30. Nov -1, 00:00
    It's difficult isn't it? I know Starburst is right. Rheumatology clinics are swamped. My own asked last year if I'd mind going on annual visits rather than 6 monthly ones. Of course I agreed as I'm stable right now and I was assured I'd only to contact them if I'd problems. I guess the thinking with you is that, having been diagnosed with fibro and OA, you have no further need of a rheumatologist as GPs normally treat both.

    I'm just wondering if the dreaded word 'money' comes into it. We know it's in short supply and there's a certain amount of buck passing going on to determine who coughs up for what. If you are under a hospital consultant and the hospital consultant arranges steroid jabs then the hospital foots the bill. If it is your GP who refers you for them (or, in some cases, dispenses them) the GP's surgery foots the bill. Your rheumatologist might be, effectively, saying that, if your GP thinks more steroids are required then that's his responsibility.

    I think it'd be worth a chat with the GP to ask what was said in her letter. Better still, ask your surgery for a copy. Taking the contents of the letter into account it might well be worth another appointment though treatments for fibro seem identical with those for OA.

    You might find something of interest here at Arthritis Research UK on a generalised picture of fibro and its treatments. http://tinyurl.com/6nz8st6
    "The deeper sorrow carves into your being the more joy you can contain." Kahlil Gibran
  • dreamdaisy
    dreamdaisy Member Posts: 31,558
    edited 30. Nov -1, 00:00
    I don't think it is, Megrose. My rheumatologist ignores my OA and fibro and my GP ignores my PsA. I do my best to ignore all three conditions :wink: I've not been told about medication for the fibro but I don't think I'm interested anyway, I take enough junk as it is. I think a good chat with your GP is in order, could you book a double appointment so you have time for an in-depth natter? DD
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • Megrose489
    Megrose489 Member Posts: 745
    edited 30. Nov -1, 00:00
    Thank you, Sticky and DD. I'm already copied in to any correspondence between the consultant and the GP, so will receive a copy of the letter and know when the GP has got it, too. So, I will be prepared to talk about it, when I see the GP. And thank you for the link, Sticky.

    Unfortunately, it's too late to extend my GP appointment, DD, but I could always suggest making another one if we run out of time.

    I'm definitely going to spend some time thinking about exactly what I want and what would help me, before the GP appointment.

    Thank you for all your comments. It's so helpful to hear what others think.

    Meg
  • stickywicket
    stickywicket Member Posts: 26,270
    edited 30. Nov -1, 00:00
    Megrose489 wrote:
    Unfortunately, it's too late to extend my GP appointment, DD, but I could always suggest making another one if we run out of time.

    I'd be inclined to say at the outset that there are a few things I'd like to discuss, I'll be as quick as I can but, if it's taking too long can I make another appointment to continue.

    I once did that. The doc was really kind and patient and we got through everything fairly quickly but I didn't feel at all rushed.
    "The deeper sorrow carves into your being the more joy you can contain." Kahlil Gibran
  • Megrose489
    Megrose489 Member Posts: 745
    edited 30. Nov -1, 00:00
    Thanks Sticky, very helpful. I've made a note of that.

    Meg