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7 Reasons to See Your Rheumatologist

Medically reviewed by Nancy Carteron, MD, FACR on February 1, 2017Written by Elea Carey
rheumatoid arthritis

If you have rheumatoid arthritis (RA), you likely see your rheumatologist on a regular basis. Scheduled appointments give the two of you the opportunity to monitor the progress of your disease, track flares, identify triggers, and adjust medications. You should also take this time to report any lifestyle modifications such as an increase in exercise or dietary changes.

But between your scheduled appointments, there may also be times when you need to see your rheumatologist more urgently. Here are seven reasons you should pick up the phone and ask to be scheduled sooner rather than later.

1. You’re experiencing a flare

“An office visit may be needed when someone experiences a flare of their RA,” says Nathan Wei, MD, who practices at the Arthritis Treatment Center in Frederick, Maryland. When the disease’s inflammation flares up, the problem is more than painful — permanent joint damage and deformity may occur.

Each person with RA has unique flare symptoms and severity. Over time, as you consistently meet with your doctor during flares, the two of you can determine the best treatment approaches.

2. You’ve got pain in a new location

RA primarily strikes joints, causing redness, heat, swelling, and pain. But it also can cause pain elsewhere in your body. The autoimmune malfunction can attack the tissues of your eyes and mouth or cause an inflammation of blood vessels. Rarely, RA attacks the tissue around the lungs and heart.

If your eyes or mouth become dry and uncomfortable, or you begin to develop a skin rash, you could be experiencing an expansion of RA symptoms. Make an appointment with your rheumatologist and ask for an assessment.

3. There are changes in your insurance

“If ACA is repealed, sick people might be left without essential health coverage or pay much more for less coverage,” says Stan Loskutov, CIO of Medical Billing Group, Inc Some private insurance companies may cover a pre-existing condition if you haven’t had a lapse in your care. Considering the current uncertain insurance landscape, keep your scheduled appointments and consider checking in with your doctor more frequently to show continuity of care.

4. You’ve had a change in sleep or eating habits

It can be difficult to get a good night’s rest when you have RA. A sleeping position can be comfortable for affected joints, but not for other body parts. New pain or joint heat can wake you. Along with this, eating can also pose special challenges. Some RA medicines affect appetite, causing weight gain or nausea that prevents you from eating.

If you notice you’re sleeping less or changing how and when you eat, see your doctor. It’s important to learn if changes in sleep and eating are related to some of RA’s most devious effects, depression and anxiety. Your doctor can talk to you about lifestyle changes and medications that could help you.

5. You suspect side effects

The most frequently prescribed drugs for RA are nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, disease-modifying antirheumatic drugs (DMARDs), and newer treatments called biologics. Although these treatments improve the lives of many with RA, they do have side effects.

Some of NSAIDs’ side effects include edema, heartburn, and stomach discomfort. Corticosteroids can elevate cholesterol and blood sugar, and increase appetite, leading to weight gain. DMARDs and biologics interact with your immune system and can lead to more infection, or rarely other autoimmune symptoms (psoriasis, lupus, multiple sclerosis). If you experience side effects from your RA medication, see your doctor.

6. A treatment doesn’t work as well as it used to

RA is chronic and can be progressive. While many begin taking frontline RA treatments such as NSAIDs and DMARDs as soon as they’re diagnosed, those treatments might have to be augmented as time goes by.

If your treatment isn’t giving you the relief you need, make an appointment with your rheumatologist. It may be time to change medicines or consider advanced treatment to relieve discomfort and forestall long-term joint damage.

7. You’re experiencing a new symptom

People with RA can have a change in their symptoms that represents a significant change in medical status. Dr. Wei points out that new symptoms that don’t seem related may be due to underlying disease.

For example, it was long thought that people with RA wouldn’t develop gout, another autoimmune disease. But research no longer supports that thinking. “Gout patients can have kidney stones,” says Dr. Wei.

If you develop a new symptom that you don’t immediately relate to RA, you should ask your rheumatologist about it.

The takeaway

Having RA means you get to know your entire medical support team quite well. Your rheumatologist is the most vital resource on that team. They can help you understand your condition and its evolution as well as consult with your other caregivers to coordinate care. See your “rheumy” regularly, and don’t hesitate to contact them if you have questions or your condition changes.

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