A Letter From Our Doctors
THE NATURE OF RHEUMATOLOGIC DISEASE
There are many different rheumatologic diseases. Some of them you may have heard of such as rheumatoid arthritis and lupus, but there are dozens of others that are less common. Rheumatologic diseases are also often called connective tissue diseases or autoimmune diseases. Many of these diseases can affect different organ systems, not just the joints as in arthritis. Many of the same symptoms can be seen in different diseases. For these reasons, it may take some time to collect enough information about your illness to diagnose a specific disease.
THE FUNCTION OF A CONSULTANT
Your primary care physician may refer you to a specialist for one of several reasons. He or she may decide that a specialist is necessary to diagnose your illness. You may already have a diagnosis, but your physician may feel a specialist for that illness should care for you. Alternatively, your doctor may wish to arrange cooperative care with the specialist for that disease. Lastly, your primary care doctor may want you to be evaluated to rule out a rheumatologic disease or to confirm one that he or she plans to manage. Rheumatologists and most other specialists cannot assume your general medical care.
WHAT TO EXPECT DURING YOUR FIRST VISIT
First, you will be asked to fill out our new patient packet, which will give us basic information about your medical history, your family medical history and your recent problem. You may print this off our website here. This should be completed before seeing the doctor. After you arrive at the clinic, a nurse or assistant will weigh and measure you. These measurements are important for many reasons. The nurse will then ask you a series of questions regarding your health history and your current symptoms. Bring with you a list of the medications you are taking (a form for your medication list is available for printing on our website here). If it is easier, you may bring the medicines themselves for us to see.
You will then be asked to change into a gown for a complete physical exam. Children should wear (or bring along) a t-shirt and shorts for the exam. A full physical exam is an important part of your visit. This is because rheumatologic diseases can affect many different parts of your body, and you may not be aware of changes that a rheumatologist would find significant.
Your exam may also include blood tests or x-rays. Some insurance companies restrict the amount of work that can be performed at the specialists office, and you may be required to go back to your primary clinic for these.
We often see patients whose primary doctor suspects that the patient has fibromyalgia syndrome. As many of the symptoms of this syndrome can mimic serious rheumatic diseases, we are asked to see these patients to confirm the diagnosis and rule out rheumatologic illness. If the diagnosis of fibromyalgia syndrome is confirmed, we will discuss various general management strategies with you. Because fibromyalgia syndrome is not considered a rheumatologic or autoimmune disease, we will refer you back to your primary care physician for continued care and management.
When your rheumatologic evaluation is complete, we will send a letter to your primary care physician summarizing our findings and laboratory interpretation.