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Damned76
#1 Posted : Monday, March 28, 2011 9:03:49 PM Quote
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Does anyone else feel nervous about seeing their rheumatologist?

I really can't talk to mine and find him quite dismissive. He is the type that looks at your latest blood test and if that's not bad - you're out of there in 30 seconds.

I haven't seen him for nearly a year and he doesn't know I was put on Humira. He just kept upping the MTX and said he was going to put it up to 30 mg per week if the 25 didn't work. When I went for physio though and was still in a 'flare' on the 6th week I saw them, they called a doctor from the Rheumy ward at the Hallmashire in Sheffield and she did my first anti-tnf assessment there and then. The nurses did the follow up assessment and I started Humira in Novemer. I am kind of scared that as I haven't had a massively positive improvement, he will try to chuck me off it tomorrow.

Am dreading it.

Julie x
flw93
#2 Posted : Monday, March 28, 2011 9:23:17 PM Quote
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Hi Julie,

Try not to worry. I had a similar problem with my rheumatologist. I was in fact in and out in 30 seconds. Luckily though at my hospital there are other consultants. I complained to my RA nurse and was moved on to a different consultants list. He was much better when I saw him in Feburary. I am on Enbrel and is has not done much for me. My consultant has told me to persevere for another 6 months. Hopefully, this is what your consultant will say tomorrow

Keep calm before you go in and remember it is you who is the patient, you with the disease and you know how you feel. Dont let him bully you.

I will be sending you positive vibes.

Louise
Rose-B
#3 Posted : Monday, March 28, 2011 9:27:41 PM Quote
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Location: Somerset


Hello Julie

I agree with what you are saying that the Specialist have you in and out and that we
are not given the time which we should be. I think they are soo FULL and this is the
reason.

Do yourself a 'pointer' list it may help you to say everything you want to discuss, I
did this last time and it was quite useful.

Good luck and let us know how you get on


Rose
LynW
#4 Posted : Monday, March 28, 2011 9:36:25 PM Quote
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Hi Julie

I can understand your predicament and concern. But do try not to worry too much ... after all, it was a health professionals decision to put you on Humira in the first place and without good grounds, such as total inefficacy, it won't be stopped. Have you had your DAS checked recently, mine is always checked by the nurse a couple of weeks before the appointment so I arrive with some facts. Are your blood tests up to date?

That aside as you haven't had a particularly positive response might a change in treatment be in order? Not sure how your Trust view sequential anti-tnf, mine will go ahead if it is in the patients best interest. Can't remember now, have you tried Enbrel?

Shame I can't come with you I am very much in 'red boot' mode at the moment ... not up for nonsense, had enough!!!

Do let us know how you get on, will be thinking of you ThumpUp

Lyn xx
My son, Ian, completed the BUPA Great North Run on 15th September running for the National Rheumatoid Arthritis Society (NRAS). You can read his story at http://www.justgiving.com/ianlukewilson

dorat
#5 Posted : Monday, March 28, 2011 10:02:09 PM Quote
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Can't remember Julie, it's 3 years since I saw a consultant and I don't even have one now!Sad

Good luck with seeing yours tomorow.
It will be in your notes that you are on humira so he should know you are on it!
Let us know how you get on.

Love, Doreen xx
Julia17
#6 Posted : Tuesday, March 29, 2011 12:51:34 PM Quote
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Hi Julie

Really hope all goes well for you today with the consultant, look forward to hearing how it goes for you.

Julia x
JulieM
#7 Posted : Tuesday, March 29, 2011 1:02:50 PM Quote
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Julie- when you go in just think of this and remember he is an ordinary human being !
YES I'VE CHANGED, PAIN DOES THAT TO PEOPLE.
jeanb
#8 Posted : Tuesday, March 29, 2011 4:04:17 PM Quote
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Hi Julie

Been thinking about you on and off most of the day and wondering how you got on. I hope you didn't wear one of your flimsy numbers?!

I must be extremely lucky, as I have a brilliant rheummy and his second in command is just as good. When I went two weeks ago, my bloods were all over the place and he said " Well, I don't just look at the bloods, I'll look at your joints and you can tell me how you feel and then we'll decide where we go from here". Rheumatology in Bolton is very special - from the hugs (Snr Sister and HCA's) to the lovely smile and handshake from rest of the team. I feel so incensed that everyone doesn't get this care. Bolton prove it is possible.

Please post when you can and let us know how you get on.

Lots of love
Jeanxx
Sara-R
#9 Posted : Tuesday, March 29, 2011 4:39:48 PM Quote
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Hi Julie,
The whole medical profession make me nervous and I've spent most of my life trying to avoid them! So my tactic is, make a list and don't leave until you've got to the end. Its your appoinment not his, you're in control not him, go girl, go! I think I've borrowed Lyn's red boots. Good luck, let us know how you get on.
Sara
x
suzanne_p
#10 Posted : Tuesday, March 29, 2011 5:08:00 PM Quote
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hi Julie,

really sorry to hear you feel like this.

i had my 4 monthly follow up and saw my Consultant this afternoon. i know she couldn't do much for me as i waiting to go on Humira. but i made full use of the appointment by asking questions, telling her about the infections i've had since Christmas and my general well being overall.

i go back to see her in 4 months when hopefully i am established on the Humira ... and the appointment was specificially made to see her.

when i was making the appointment the Receptionist was telling me it's harder for newly diagnosed to get seen quickly which is worrying.

and i know i have my Rheumy Nurse i can contact on the day or get a call back within 24 hours.

so i really do feel lucky ( not that anyone should feel lucky !! ) to have this brilliant service when i read stories like your's and others.

i hope your appointment was helpful to you.

do let us know how you got on,

Suzanne x
Damned76
#11 Posted : Tuesday, March 29, 2011 7:02:59 PM Quote
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LOL LOL It's a good job I have you to make me laugh. What are you going to do now Doreen. I knew your rheummy dept had closed but who is prescribing your drugs and checking up on you?

Appointment went pretty much as expected. He looked at last blood tests and said inflammation has settled nicely. I said I knew that it was going down but I was concerned as my right hip has been extremely painful. He ignored this comment and went to my x-rays I had done over 12 months agoConfused . He said that my hands showed very little damage and the damage in my feet did not appear to have increased since the year before. He was just about to try to fob me off there but I mentioned that I noticed that the rheummy nurse I saw 3 months ago had recommended new x-rays. He said I would get some today. He then looked at my hands and said they looked fine and that you wouldn't know that I have RA. Then did some rather painful prodding and poking. What he doesn't know is that my fingers are massive compared to how they were 4 yrs ago. I'm assuming that he considers one thumb being nearly twice the size of the other is normal. He then commented on the lump on the back of my hand and I said it doesn't look spectacular today but it really swells and get quite large and it feels like I have toothache in the tendons. He said he thought it was the tendon sheath - 'as it's made from the same stuff that surrounds your bones'. No advice on how I can prevent this or whether I should rest the hand when it happens. No answer about hip, no examination. No invitation back to clinic to review x-rays of hands and feet.

He then told me that I am on the 'gold standard' of treatment (as if there is nothing else) and made me feel as though I should be truly grateful to him and doff my cap or something. He proceeded to try to pass the buck back to my GP for everything and I told him that the rheummy nurse has booked and appointment for me in June as last time she did my DAS score it was high and my blood results were fluctuating. He agreed that I could keep this appointment and that I should stick with Humira. Bye for 6 months.

Up until just over a week ago when the weather started getting better, I was in a real tangle and was slipping back into deep depression. Now I've seen him - he makes me think I'm making it all up Sad

Thank goodness I still have the appointment with my lovely nurse in June. She clearly knows what he is like and when I told her he doesn't listen to me, that's when she decided to book me back in with her in advance. Her advice was that I shouldn't have been struggling like I was and maybe I should consider changing Anti-tnfs. At least I am not at a dead end like some people are.

Sorry for ranting but I don't bother telling anyone else this as they just don't understand. There - feel better for getting this off my chest already!

Julie xx
jenni_b
#12 Posted : Tuesday, March 29, 2011 7:19:32 PM Quote
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Hey Julie,

He's not a neurologist in his spare time is he?! RollEyes

LOL

Listen, you made the best of a rough old appointment, especially as you were nervous. Thank goodness for a good rheummy nurse. She must dispair of the consultant!

Is there another one up there you can see next time? What about the one who put you on Humira?

Ha!

I bet he said "gold standard" treatment thinking you were on the MTX still....! Plonker....

Sending kindest support.

Jenni xx
how to be a velvet bulldoser
jeanb
#13 Posted : Tuesday, March 29, 2011 7:21:11 PM Quote
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POSTED THREE TIMES ACTUALLY, NOT JUST THE TWICE!
jeanb
#14 Posted : Tuesday, March 29, 2011 7:21:12 PM Quote
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What an absolutely useless so and so he is! Why don't these people LISTEN?! We are the only ones who know how we feel and they seem to think they can tell everything going on with us and the RA by spending a couple of minutes poking and prodding. NO NO NO.

Any chance you could see someone else? The only thing I would say is that some of the rheummy nurses know almost as much as the consultants. As you have access to a good one when you need help, this has got to be a huge plus.

Take care and try not to get too depressed. Remember, we're off to "The" wedding on the 29th April and must ALL look our best.

Thought I'd just fill you in on Dor's current situation, but please don't let on who told you. Did she tell you why the rheummy left so suddenly? No, I'll bet she didn't. I'm afraid she did one twirl too many with those tassels and he ran

Much love xxxxx
jeanb
#15 Posted : Tuesday, March 29, 2011 7:21:13 PM Quote
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Sorry, posted twice - must've been the thought of Dor's tassels!!
dorat
#16 Posted : Tuesday, March 29, 2011 7:34:28 PM Quote
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Jean you promised you would say nothing!Scared LOL

He sounds like a locum "consultant " I saw Julie, absolute waste of time.
Why don't you try to change consultants, there is a lady there ,Deborah Bacs I think her name is. I heard her give a talk and she was fantastic, if you could see her it would be great for you.

Well, I was thinking of asking to be referred to Sheffield but maybe not.
I am not going to do anything. I get my humira prescribed in Halifax but no check-ups apart from 3 monthly bloods. I refuse to beg for any more appointments.

Thank goodness you have a good rheumy nurse. She got you onto the humira so if she thinks you need a change she probably will be able to do it.
Glad you are feeling a bit better now the weather is improving. You need to keep practising with the tassels if you want to be as good as us for The Wedding. Steer clear of Lyn though with those scissors!Scared

Love, Doreen xx
LynW
#17 Posted : Wednesday, March 30, 2011 9:14:30 PM Quote
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Hi Julie

Now I've calmed down from your ordeal I can perhaps reply! Well, what a waste of your time that appointment was and what a waste of space that ignorant rheumatologist is! They make me really cross these stupid people, do they not realise their ineptitude is at the very core of poor rheumatology practice? We all know what they should be doing, a thorough examination, a face to face conversation about our pain, fatigue, swelling etc, a show of concern for our needs. But what do they do, ask uneventful questions, prod and poke achieving nothing, look at material that is eons out of date and generally provide answers that are glib and inadequate! Can you tell this is a route well travelled? RollEyes

Is this rheumatologist about to retire by any chance? He hardly seems to be at the cutting edge! Thank goodness you have a decent nurse with a good grounding in common sense as well as rheumatology. But you do need to think where to go from here. You are entitled to a much better service than you are getting although a big plus for the nurse.

I have a lump on the back of my hand; I was told it was synovial fluid! It gets bigger as the RA gets worse, nice Smile Oh well, it can't cause too many problems on the back of a hand ... it could be the sole of the foot!!!

Cheer up Julie we have plans to make for 'The Wedding' which is only a few weeks away. RA has to take a back seat whilst we get organised. I think if I were to trim your tassels with my scissors ... just 'til you get the hang of it ......

Lyn xx

My son, Ian, completed the BUPA Great North Run on 15th September running for the National Rheumatoid Arthritis Society (NRAS). You can read his story at http://www.justgiving.com/ianlukewilson

JulieM
#18 Posted : Thursday, March 31, 2011 8:44:40 AM Quote
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jeanb wrote:
What an absolutely useless so and so he is! Why don't these people LISTEN?! We are the only ones who know how we feel and they seem to think they can tell everything going on with us and the RA by spending a couple of minutes poking and prodding. NO NO NO.

Any chance you could see someone else? The only thing I would say is that some of the rheummy nurses know almost as much as the consultants. As you have access to a good one when you need help, this has got to be a huge plus.

Take care and try not to get too depressed. Remember, we're off to "The" wedding on the 29th April and must ALL look our best.

Thought I'd just fill you in on Dor's current situation, but please don't let on who told you. Did she tell you why the rheummy left so suddenly? No, I'll bet she didn't. I'm afraid she did one twirl too many with those tassels and he ranMuch love xxxxx



The rumour I'd heard was that he hasn't really gone, he just hides behind his desk when he sees Doreens name on his list???
YES I'VE CHANGED, PAIN DOES THAT TO PEOPLE.
Eve_V
#19 Posted : Thursday, March 31, 2011 9:12:21 AM Quote
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Hi Julie
Unfortunately at consultant level these medical professionals would appear to be accountable to no-one. It is inexcusable that they are so disorganised at your precious appointment and we don't like to complain about their manner directly to them for fear of it compromising our treatment and even if the nurses have heard it many times before there is little they can do. A friend of mine worked at BP in a managerial position and they had a a system of "reporting up" ie the minions were able to input into their bosses' staff reports. They may have reached the heady levels of consultancy but that doesn't mean they still don't have a thing or two to learn and the people "underneath" them, you and me, can teach them, the problem is finding a way to do this without upsetting the apple cart. Regarding your feeling nervous - bear in mind that he is your servant.
....eve xx
Rebecca D
#20 Posted : Thursday, March 31, 2011 10:14:13 AM Quote
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Hi Julie

Nobody deserves to be treated like that, I know consultants are very busy and stressed but just to show some comapssion and understanding to you costs nothing. If it was me I would have to change consultant, it's bad enough managing the disease but with a consultant who doesn't listen is unacceptable. Makes me realise how lucky I am with the Rheumatology team in Exeter.

Best wishes
Rebecca
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