如何为下一个风湿病学家做准备

风湿病学家在您第一次访问期间做什么

您的第一次访问可能比随后的访问更长。期望它可以持续约一个小时。您的医生将希望进行彻底检查，并与您谈论所有症状。

Note:Many of these tools won’t be available if you’re using telehealth services, so speak with your doctor about how they want to see you for your visit. If you’re doing a telehealth session, make sure you’re prepared with a stable connection and have all of your health and medication information on hand.

Physical examination

您可以期望进行身体检查，以评估您的一般健康状况，以及任何可能表明关节和其他区域发炎的关节肿胀或其他症状。这可能包括肿胀，温暖，发红，皮疹或结节（异常组织的生长）。

They may ask you to move or stretch in certain ways to test for flexibility and mobility. If you feel any pain, let them know.

Lab testing

Lab tests, including urine, blood, or joint fluid tests, may be ordered to test for various factors, antibodies, and genetic markers of specific conditions. Here are a few examples for which you may be tested:

• anti-cyclic citrullinated peptides (anti-CCP) antibodies
• 抗核抗体（ANA）
• 全血数（CBC）
• c-reactive protein (CRP)
• erythrocyte sedimentation rate (ESR or sed rate)
• HLA-B27 genetic markers
• 类风湿因子
• synovial fluid analysis
• various vitamins and minerals such as calcium and vitamin D

Imaging tests

您的医生可能会订购成像测试，例如X射线或CT和MRI扫描，以实现正确的诊断或对您的病情及其进度有更多了解。

诊断和治疗计划

你可能不会马上诊断,should be aware that many autoimmune disorders may take a number of years to fully evolve. In many instances, symptomatic treatment is initiated before a definitive diagnosis can be made.

如果一个诊断可以工作,你可能to return for more visits to determine a final diagnosis and begin a treatment plan to meet your needs.

This could include:

• Medications.These could include nonsteroidal anti-inflammatory agents (NSAIDs), disease-modifying antirheumatic drugs (DMARD), corticosteroids, or biologic response modifiers (biologics).
• Exercise, physical therapy, or occupational therapy. Remaining active and moving muscles and joints are often key to effective treatment. Your doctor may refer you to specialists in these areas.
• 生活方式改变。Dietary, weight management, pain management, mental health support, and other wellness goals may be included in your treatment plan.

It’s important to remember that you’re visiting a doctor, but you’re also establishing a long-term relationship with them — since many diseases, even when well-managed, may be lifelong.

在您的下一个风湿病医生访问中准备的技巧

Keep a log of your symptoms

您的风湿病学家在不知道自己的感觉的情况下无法对待您。保留您日常症状的日记，与他们分享。包括此信息：

• 哪些关节受伤？
• When did the pain start? What were you doing when it started?
• 感觉是什么样的 - 锋利，沉闷，跳动，疼痛，嫩？
• How severe is the pain on a scale of 1 to 10?
• How has it changed over the last few days or weeks?
• How does the pain affect your daily routine?
• Is it worse when you get up in the morning?
• Does anything help the pain, such as over-the-counter (OTC) pain or anti-inflammatory medication or exercise?
• 您还有其他似乎相关的症状吗？
• 您知道您的家庭中其他人患有关节炎，自身免疫性疾病或其他类风湿病吗？

Your answers to these questions can help your doctor develop a more targeted treatment plan for you.

为您的医生列出问题

超负荷的时间表可能会迫使医生只花15分钟，on average，每个患者。当您考虑需要讨论的所有问题时，这并不多。

通过提前写出一些问题清单，充分利用您与风湿病学家在一起的时间。随身携带小型笔记本，或者使用智能手机的记事本来记下您的想法。

一些问题可能包括：

• 您认为我对症状的最佳治疗方法吗？
• What kinds of improvements should I expect to see with my treatment?
• 还有哪些其他治疗选择？
• What do you plan to do if I don’t see any improvement, or if my symptoms get worse?
• 我应该多长时间服用这种药物？
• 如果我对治疗有副作用，该怎么办？
• 如果我整夜睡觉，该怎么办？
• Could I benefit from seeing any other healthcare providers, like a physical therapist, pain management specialist, or nutritionist?
• Could I benefit from any clinical trials for new treatments?

Bring a list of your medications

保留您服用所有药物的运行清单。

Also, include medications you take to treat other conditions. List any herbal supplements or vitamins that are part of your daily regimen as well. Write down the dose, and when in the day (morning or evening) you take each medication.

您也可以将所有药物放在袋子中，并将其带到您的约会中，尽管带有剂量的详细清单将花费更少的时间来审查您的医生。

Knowing exactly which medications you take will help your doctor make changes to your regimen or add a new prescription if you need it. Your doctor can see right away if, for example, a new medication might interact with something you already take or if you’re on too high a dose.

招募朋友或家人

请您的伴侣，值得信赖的朋友或家人与您一起约会（只要大流行规则允许）。他们可以做笔记，因此您可以专注于与医生的对话。

They can also remind you of any questions you’ve forgotten to ask or issues you were planning to bring up. You’ll also have a supportive person to champion you if needed.

找出您需要的测试

Your doctor might use imaging tests like an X-ray or MRI scan to look for changes in your bones or joints. For some of these tests, you might need to prepare by not eating or drinking for several hours, or by removing anything containing metal, such as hearing aids or dentures.

Make sure you know what you need to do to prepare at least a few days before your test.

扩展您的治疗讨论

Because of time constraints, your doctor might keep the focus of your appointment on medical therapies. Yet lifestyle changes can also help you manage the symptoms of your condition.

如果您尚未与医生一起介绍这些主题，请在下一次约会中提起它们：

• how often you should exercise, and what types of workouts are best and safest for you
• 您是否应该使用热和/或冷，如果是的，则多久
• if you smoke, what methods you can try to help you quit
• how to achieve and maintain a healthy weight for your body, if recommended by your doctor
• how to get emotional and community support if you need it

带走

患有痛苦的慢性病可能会像身体上一样困难。不要忽略你的情绪状态。

如果您的风湿病学家无法满足您的心理健康需求，请向心理学家，精神科医生或辅导员提出转诊。

Living with a rheumatic disorder can be hard, but it can also be successfully managed with the right treatment. Being prepared and helping your rheumatologist make the most of the time they have with you is key to the best outcome.