A recent blog post from Lene got me thinking about an appointment with my rheumatologist tomorrow. Since follow-up appointments are limited to 15 minutes (which cost about $250 – another story for another day), it’s important to plan ahead in order to maximize the time. Since there can be many issues and symptoms with RA, doctors probably want to focus on the most important issues. And the most important issue is how effective the RA treatments are working. If they are working well, all other issues will be minimized.
As issues occur or come to mind, I will jot down notes in my smart phone. The day before the appointment, I will review the notes, edit them, and prioritize the issues. Below represents the list for tomorrow’s appointment. I will open this list up on my phone and make sure to raise the issue if it doesn’t naturally come up in the conversation.
1. How well is the Actemra/Azathioprine combination working? I predict that this will automatically be the first question my rheumy will ask since this follow-up was scheduled to check on the impact of doubling the Actemra infusion dose.
2. Should I increase the dose of azathioprine to 100mg? The last time I tried, it caused severe nausea. Can I try 75mg or take 50mg twice a day.
3. My left hip hurts constantly whether sitting, walking, or lying down. The cortisone shots a few months ago did not help. Perhaps this will be taken care of if inflammation can be controlled with medication.
4. What should be done about the elevated cholesterol levels caused by Actemra?
5. A recent prescription was delivered with confusing dose instructions and I need clarification.
In addition to the issues above, my list also contains another task to address while at the clinic. I need to stop by the business office to pay off my recent Actemra infusion bills using the co-pay card.
There were several other issues that didn’t make the cut for tomorrow’s appointment.
1. There is fluid and some pressure in one ear which may be an infection. This can wait and I can always see my Ear, Nose, Throat (ENT) doctor who performed the recent sinus surgery or I can go to an urgent care if needed.
2. My fatigue levels are very high. But this will also likely get addressed automatically if the RA treatments are working.
I’m a linear thinker and very task oriented and I want to get the most out of these expensive appointments that are also taking time out of my busy day. This can cut down on follow-up phone calls, emails (best thing my doctor does), and lingering questions.