Just curious what a typical rheumatologist appointment is like for everyone?
At mine, the nurse gets my weight and blood pressure and then the doctor comes in. If I've been stable, she'll leave my meds alone (methotrexate, prednisone, and Plaquenil), listen to my heart and have me take a few deep breaths, feel a few of my joints and send me for labs (CBC, BMP). Right now I am going every 3 months. If I have been increasingly achy, she'll increase my prednisone temporarily and increase my Methotrexate. No different labs or anything else.
I've seen a lot of posts about the sed rate or ANA or other labs going up or down...just curious if most doctors monitor these on a regular basis? I had labs like this done right before I was diagnosed, but they've never been repeated. How about checking for protein in the urine? I have that done about every 6 months (sometimes comes back a trace, other times negative).
I am home from work today....can barely walk due to joint pain, very fatigued, short of breath when climbing stairs. Thought for once I would stay home and take care of myself instead of pushing through another work day. Didn't know if this would be a good time to have different labs drawn?
I haven’t been to too many appointments but my current rhuemalogist talks to me about what’s been going on since my last visit (new aches, pains,fatigue) and we also go over any blood work I have gone for. Based on the discussion I either get more medication added on or taken off and usually more blood work. He then has me change and does a complete exam, (checks joints, breath and heart sounds and checks major organs). The nurse comes in before hand and checks weight and blood pressure.
My first rhuemalogist never did a body exam, never really explained my blood work and never really explained to me what lupus was. He seemed more interested in getting my coplay and not bothering him after hours. Needless to say I left him as soo as I could!
About blood work, I was still in the process of getting all my blood work done which is why I keep going for it. But I think if your still having a lot of symptoms and pain it means that the lupus is still active and an ANA would be positive. So it seems pointless to waste all that money on a test they know will be positive. Maybe they could do a sed rate to see how much inflammation you have but even then it doesn’t sound like a reliable test. Urine they test every so often (not quite sure how often) but if they don’t suppect kidney damage no need to really do the test. The particulates change based on if your hydrated and what time you have the urine test. First thing in the morning your urine will be the most concentrated and if your dehydrated it only adds to the concentration.
My appt:
Nurse come in …weight, bp, temp
Rheumy comes in n gets on comp , goes over any labs that have come back, emails I’ve sent etc. talk about how I’m doing and what should be done next. (More tests, blood work, med changes). Only body exam if I’m having severe flare or high bp or heart rate. Not all the time. Then follow up in 6 weeks.
If you already have a firm diagnosis then there is little need to repeat diagnostic basics such as ANA The CBC and BMP monitors all your major organ functions and gives the doctor a good idea of any impending medical problems. Unless there will be a change in your treatment program as a result of the lab results, extra labs do not add any value. I have not had an ANA or sed rate for more than 4 years and don't need one either When there is a question as to the underlying cause of symptoms then they usually run activity markers which for me are my C3, C4
My Dr. gives me a body check, breathing, heart check etc. The lab work he usually calls for is CBC, CRP, sed rate, urinalysis. This is after the nurse does her thing of BP check, temp, and the dreaded weight check!!!! I think it depends on what's going on with the Lupus at the time. I've been on the Benlysta treatments, and they do a CBC to make sure everything is ok before the treatment.
Mine are about the same as described above. I also agree about no need for follow up sed rates - the sed rate is a very general test that says "something's wrong somewhere" and is probably best used to help pinpoint the intial diagnosis.