the rheumatology appointment

I’m going to work a little backwards, since I’ve been fighting with my GP for awhile before I finally got the rheumatologist referral (I had to ask four times). But since I didn’t really know what to expect, I thought others might be interested in knowing what the appointment entailed. Of course, your mileage may vary.

The nurse was kind enough to explain the whole process to me before getting thrown into it. She gave me a hospital gown and cheap paper sheet and said I’d go talk to the rheumatologist first, and then come back to the room where I’d take everything off except for bra and panties and put on the gown, and then he’d come in and check me out. Then I’d get dressed and go back in to talk to him.

The rheumatologist asked me a really detailed history, ranging from how dry my eyes were to any appetite or weight changes. It would have been helpful (in hindsight) if I’d brought my own complete medical history so I could reference it. I completely forgot to tell him that I had mono! Luckily my husband was there to remind me.

Since the exam room was freezing and cold makes me hurt, I put my hoodie on over the gown and left my socks on. It seemed to bother the doctor a bit, but my comfort is more important than his. I had to take off my hoodie (and then he later took off my socks when he got to that point) and he gently squeezed my wrists, knuckles, fingers, bent my elbows, rotated my shoulders, and then hit some of the well-known fibro tender points in my shoulders and neck. Those made me pretty vocal and caught me off guard. Honestly, it made the rest of the exam pretty miserable. He had me lay down and he felt my abdomen, my knees, ankles, and feet. He had me stand up and bend over, then walk on my toes and walk on my heels a very short distance. then he pushed on my spine, which hurt like hell (because of the arthritis).

Then he left and I got dressed. In his office, he realised he forgot a couple points, so he poked at my hips and the fibro spots below my hip joint, which made me yelp. I had heard him dictating notes into a recorder when we walked in, and he said “fibromyalgia,” which he confirmed when we sat down. “You have a condition known as fibromyalgia.”

We talked briefly about what that meant, since I was well read on the subject. He recommended a book about fibro. He told me that losing weight and exercise would improve my symptoms. I told him that this would not happen overnight, so what else can we do? He decided to pass the medication game off on my GP, who has been less than useful in that department. I’ll talk about that in another post. The rheumatologist said he would recommend Lyrica and Cymbalta to my GP.

My husband thought to ask the doctor of my bout of mono would have caused all this, and the doctor said “maybe.” Because no one really knows what causes fibro.

I think we left with more questions than answers, to be honest. But! At least I finally had a confirmation of my diagnosis. That counted for a lot.

Be prepared: The tender point test made me hurt for the rest of the day, and made getting to sleep that night really difficult. I would recommend a late appointment so you can maximize your day, and take something to sleep if you don’t normally. I wish I had.


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