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How do I get a referral if my friend refuses?

I’ve been to my dr as concerned about joint pain and swelling. I’m also exhausted all of the time. I had a telephone consult with my Dr and had bloods done which were all normal. I was told to take ibruprofen. It’s affecting my work and home life. I asked for referral to a rheumatologist but they refused as bloods were normal.


  • Mike1Mike1 Posts: 1,186 ✭✭✭✭

    Did he suggest what your symptoms could be? Rheumys only look after Rheumatoid arthritis; it could well be that you have Osteoarthritis which would only show up on X Rays or CT scans; it could also be that you have Fibromyalgia but there is no specific test for that. I would suggest that you check out the symptoms of RA, OA and Fibro on Google or through the info available on here to see if you can self-diagnose; then make a list of symptoms and how you are affected day to day then go back and see a different GP.

  • nj235nj235 Posts: 12
    He just said it must be some type of arthritis and to take ibruprofen
  • Mike1Mike1 Posts: 1,186 ✭✭✭✭

    Remember that GP stands for GENERAL Practitioner, without being rude they know a bit about most things but do not necessarily have in-depth knowledge about specific complaints. I recommend that you do what I suggested in my first post. Good luck.

  • nj235nj235 Posts: 12
    Yes I understand that. I’m a veterinary nurse and I explain to owners that vets are the same really. Thank you
  • LilymaryLilymary Posts: 638 ✭✭✭
    edited 12. Jul 2020, 10:54

    Hi, sorry, I don’t do short posts, but there maybe a few nuggets in here that help. I hope you have a cup of tea handy!

    Sorry to hear your struggling and feeling unsupported. Invisible illnesses are a b*gger like that. In some ways bloods coming back “normal” is a good thing, as it rules out so many conditions, but it still leaves you thinking “well what the heck is it then?”. It can take a bit of a push to move on from this stage. I’ve been through this so I know how it feels.

    I’d suggest try the course of ibuprofen and see if it helps. If it does, that may suggest that it is an inflammatory condition that you have, which starts heading you off on that next stage of the journey. If it makes no significant difference, go back to your GP and tell them, and ask what further tests they can do.

    I went through several years of slowly reducing mobility in my hip and random pains down my leg, and my phsysio suggested a couple of times it would be worth doing an xray to see what was going on, but when I mentioned it to my lovely GP, she said “no point, there’s no treatment for wear and tear anyway”. Eventually after a tumble and VERY rapid deterioration of mobility in my hip and massive increase in pain over the course of a week, my GP agreed it was time for an X-ray which found very advanced osteoarthritis and I was instantly put on a list for a new hip and told to walk with a stick, without me ever having previously been aware that I had arthritis at all. Hips can be funny that way, I’ve since learned.

    So what I’m saying is that sometimes it’s a bit of trial and error getting to the right diagnosis and appropriate treatment. (I’m sure your vet colleagues see that a lot too.) Give the ibuprofen a go for a while (make sure your tummy is well protected though) . If you can afford it, go to a reputable private physio for an assessment too, to see if there’s anything they can pick up. (Mine is about £40 for a consultation and worth every single penny), and as Mike suggests, look up on this site for info about the various different guises arthritis comes in, and see if that rings any bells. The NHS site is quite helpful too.

    Exhaustion can be a symptom of arthritis, but is also an indicator of pretty much every other medical condition from what I can tell, as well as a potential side effect of pretty much every drug. Or sometimes, it’s just life or emotional stress that leaves us exhausted. As someone who has been through two longish spells of CFS/ME, (on the mild end of the spectrum but that was bad enough!) and have now been crowned with osteoarthritis, I also know that pacing is key to coping with exhaustion, whatever the cause. It’s really hard to get the balance between being active up to a point that benefits you before you crash, and knowing when your body needs to rest (and then ACTUALLY resting). I still regularly get it wrong, but it really does help, and in particular it has helped me manage my OA, to the point that some of the pain-inducing inflammation in my joint has settled down a bit. When you start to the balance right, while it’s as annoying as hell that you can’t just do stuff the way you always have done without consequences, it does give you some sense of control over your life, and anything that reduces the pain a bit is always a bonus.

    it helps if you can also get family and maybe a few friends on board with this, so they understand that there’s a REASON for you not rushing around partying/knocking up gourmet meals/being an all round self sacrificing angel at the moment, rather than thinking that you just can’t be faffed/don’t care/general party pooper. They still won’t probably fully understand, but it’s a good idea to be able to at least “not feeling so great today, maybe next week?” and have them being able to understand why.

    it may also be worth having a chat with your employers to see if there are minor adjustments that might make life less painful or exhausting at work. As vets they see all the time the effects of pain and being run down in their four legged patients, and it’s in their interests to help you stay feeling well so that you minimise the risk of sick leave, and the better you’re feeling the better you can do your job (and as a cat slave, I salute you). So maybe where possible make sure you can do tasks sitting down, or intersperse your “on your feet” tasks with “sitting down” tasks so that your body gets a bit of a break.

    But most of all, accept that it’s ok to cosset yourself. YOU are your patient now, and you need to help your body recover, and allow yourself to feel tired or miserable from time to time, then find small things that cheer you up. This really helps too, often better than the pills do.

    I hope this helps a bit. Keep moaning on here, or share successes. We all know what it’s like.

  • nj235nj235 Posts: 12
    Thank you so much for taking the time to share your story, I’m glad you’ve got your diagnosis and are finding ways to cope.
    My partner and mum have been very supportive as well as worried so that side of things luckily isn’t a problem, if anything my partner is wrapping me up in cotton wool too much and I have to tell him not to!
    I already have had to adapt slightly at work as I had knee surgery last year and was supposedly having the same again on the other knee this year but obviously that’s been put on hold! So the doing things sitting down etc is quite normal for me. I did briefly tell my manager Thursday due to them wanting me to do so too much with a situation on the Friday and I came clean to them about what was happening. They were fine as expected but I didn’t go into much detail as that’s just me and my private ways but I know I will have to let them know. I’m seeing my manager Thursday as she’s doing a work up on one of my cats so I’m sure she’ll ask me then.
    I’m going to put together a list of symptoms for my physio phone consult to make sure I get everything included and don’t forget. I’m going to try the ibruprofen but I’m waiting for the chemist to sort my omeprazole prescription and hopefully actually find some ibruprofen as the shops local to work have been out of stock! The chemist will hopefully have some though and I’ve got my mum on the mission too when she goes shopping.
  • LilymaryLilymary Posts: 638 ✭✭✭

    That all sounds really positive NJ, I’m so pleased you have supportive people around you (and cats!). It sounds like you’re well on the way to having an action plan, but these things take time and some degree of process of elimination to get a final diagnosis. I hope this helps you manage your pain and exhaustion so that you can maintain some sort of daily routine. Some physios are doing hands on treatments now (mine has just started), so that may help you too.

    keep us posted. X

  • Mike1Mike1 Posts: 1,186 ✭✭✭✭
  • nj235nj235 Posts: 12
    😂😂 crazy animal lady is part of my job!
  • JoeBJoeB Posts: 83

    Mike - You are mistaken.

    Rheumatologists manage a wide range of auto-immune and connective tissue disorders not just Rheumatoid Arthritis.


  • Mike1Mike1 Posts: 1,186 ✭✭✭✭

    Oops, what I meant was that they do not look after Osteoarthritis; I was trying to keep things simple as nj235 had not received a diagnosis, I am aware that they look after other things including:

    • Sjogren's syndrome. ...
    • Scleroderma (Systemic Sclerosis) ...
    • Dermatomyositis. ...
    • Polymyositis. ...
    • Polymyalgia Rheumatica. ...
    • Septic Arthritis. ...
    • Sarcoidosis. ...
    • Gout & Pseudogout.

  • JoeBJoeB Posts: 83
    edited 12. Jul 2020, 15:11

    Based on your occupation and the fact you are experiencing fatigue - do check the anaesthetic gas scavenge system is working correctly.

    Pleasse feel free to PM me for more information if necessary.


  • nj235nj235 Posts: 12
    I have to weight the scavenger every day so I know it’s working ok
  • JoeBJoeB Posts: 83

    It was just a thought based on a personal experience.


  • nj235nj235 Posts: 12
    Thank you for the thought
  • LilymaryLilymary Posts: 638 ✭✭✭

    Wow, never heard of that. Obvious really when you think about it.

  • Hi NJ235 (and thanks for all the posts forum folk)

    If you feel that the GP may have closed the door on getting to a rheumatologist, it can sometimes be helpful to gather evidence to support some further investigations. A good option can be seeing a physiotherapist. If they find anything useful, you can ask them to email your GP. Also a benefit of seeing a physio will be to go over your current routines, to see if changing your self-management might be of benefit in the meantime.

    In some parts of the UK you can self-refer to NHS Physiotherapy - sometimes called the musculoskeletal pathway (MSK).

    But if you gone down this path already and are feeling stuck, you'd be most welcome to ring us on our freephone 0800 5200 520 9am - 8pm Mon-Fri.

    Very best wishes

    Guy - Helpline Team

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