Speaking to a Healthcare Professional
Your GP and your rheumatology team are experts in arthritis and medicines, but you are the expert in your own health. For this reason, it is important that you can explain your thoughts and feelings to the people who are there to help you, so that you can all work together to get you the help you need.
Many people feel more comfortable if they go to hospital or GP appointments with a friend or family member. That’s absolutely fine – it’s your health and having a supporter can really help.
Doctors might have passed a lot of exams, but they are human too. It’s important to remember that if you feel worried about speaking to them. They have families and children and their own set of problems and worries just like you, which helps them relate. Don’t be scared to speak up.
Everyone you meet in the NHS is there to help you. Don’t be afraid to ask for what you need. Ask questions if you don’t understand anything.
One of the most important things that will help you get the most from your healthcare professionals is to get organised and write everything down. Knowing who is who and who does what in the rheumatology team can really help in the long run.
You are likely to need long-term rheumatology care and there will be different priorities at different times, but your team are there to help you with whatever you need.
Who is who and who does what in rheumatology?
General Practitioner (GP)
Your GP will usually be the first person to speak to if your joints are hurting, stiff or swollen. GPs only have about 10 minutes to speak to you, examine you and to decide what to do, so it’s really important to think about what you will say before your appointment. Many GPs now offer their first consultation on the phone or by video, but if you have swollen joints it is essential for you to be seen and examined in person, so insist on being seen face-to-face.
Useful things to think about or write down to get the most from your GP are:
- Where does it hurt?
- What is the pain like?
- What time of day is the pain worse?
- What time of day is the pain better?
- Do you have any joint swelling?
- Does anything make the pain better or worse?
- Do you have any other symptoms like feeling unwell, a temperature, a rash, or weight loss?
If you have swollen joints or symptoms that makes your GP think that you may have arthritis (which means inflammation in the joints or spine), you should be referred urgently to your local rheumatology department to be seen in their Early Arthritis Clinic. Guidelines suggest that you should be referred within 3 days of your GP seeing swollen joints, and that you should then be seen in the hospital within 6 weeks, ideally within 3 weeks, although local waiting times vary.
Your GP will also be the person who you will speak to about regular blood tests and repeat prescriptions in between hospital visits. they are also there for any medical problems that are not connected to your joints or arthritis medicines.
Rheumatologists are consultant doctors who work in hospitals and are experts in joint problems and arthritis. They will usually be the person you see when you first visit the hospital.
You will sometimes see a more junior doctor who is training to be a rheumatologist and will move to another hospital in time, but they will always be supervised by a consultant who will be in charge of your care in the long-term.
Rheumatologists will have about 30 minutes initially to listen to your history, to examine you, to arrange any necessary tests, to explain what they think is wrong, and to start you on treatment if necessary. This is a very short amount of time to deliver a lot of information, which can be difficult to understand at a time when you may be feeling worried or upset, so again it is important for you to be prepared so that you can get the most from your appointment.
It can be quite frightening to see a hospital consultant, but remember that they are human, just like you and that they want to help, and are paid to be there to help you.
To make the most of the time that you have with the consultant, it’s best to be prepared and think ahead. You can take someone with you to write things down and you can of course ask whatever questions you want and write down anything they say.
Useful things to keep in mind when speaking to your rheumatologist may be:
- What are your main worries?
- What will happen next?
- Do you need more tests or scans?
- Is this a condition that you will have for life?
- Do you need to take regular medicines?
- When will your next appointment be?
- How can you get help if you have any questions or problems?
- What can you do to help yourself?
- Are there any changes that you should make to your diet or lifestyle?
- Should you be exercising more or less?
You are entitled to receive a copy of all medical information that is written about you, so it can be useful to ask for a copy of the clinic letter about you that your GP will receive.
After your first appointment, you will be given follow-up appointments with a doctor. These will usually be for an even shorter time – typically 15 minutes – so again, being organised is vital. Appointments with hospital doctors can often feel rushed because there is so much to do in a very short time, therefore doctors tend to concentrate on facts like blood tests and medicines. Obviously living with arthritis is much more than being about blood tests and medicines, so luckily there are lots of other people in the rheumatology team who can help you with other aspects of your arthritis that may be much more worrying for you.
Rheumatology specialist nurses or practitioners are senior healthcare professionals, usually nurses or physiotherapists who have trained to be experts in rheumatology. They work with the rheumatology doctors to help care for people with arthritis. They often do a lot of similar work to the doctors but have extra time during their appointments to advise on self-management, exercise, work, vaccinations, emotional problems and pain management.
Specialist nurses are often the easiest people to talk to about things that are worrying you, because they have more time and will not feel so rushed. They can be really useful sources of information on where to go for help. Some specialist nurses have a special interest in advising people about reproductive health and fertility issues in rheumatology. Specialist nurse appointments are often a good time to discuss worries or questions about medicines.
Most rheumatology departments have a nurse-led advice line number which can be useful if you have any questions about your medicines or blood tests, or if you are having side-effects or a flare-up of your arthritis. Speak to your rheumatology department about whether this is available for you, and make a note on how you can contact them if you ever need to.
Physiotherapists are expert physical therapists who offer hands-on treatment for painful or disabling musculoskeletal problems, arthritis or injuries. They work in hospital departments, and some work in the own practices or are based in GP surgeries. They can offer help and advice with exercise, physical fitness, stretching and sometimes offer acupuncture, hydrotherapy (exercises in the water), massage, or manipulation of joints. Most rheumatology departments have specialist rheumatology physiotherapists who are experts in arthritis.
Occupational therapists are usually hospital-based therapists who can help with advice and devices to make the things you need to do easier. They cover a very wide range of activities. This could be with gadgets to help you use your hands more easily, advice on workplace adaptations for example computer devices, seating or posture. Some therapists are trained in pain management, exercise and rehabilitation, or splinting painful joints, while others can help with relaxation, breathing exercises, or emotional support.
Podiatrists are experts in foot and ankle health and can advise on insoles, footwear and all aspects of foot mechanics and health to make your feet and lower limbs more comfortable.
Clinical psychologists are experts in helping people with a wide range of emotional and mental health issues because of their physical health problems. For people with arthritis, this can include anxiety or worries, low mood or depression, sleep problems, family or relationship difficulties, or even serious mental health problems like post traumatic stress disorder.