How frequently should a rheumatologist be consulted for RA?

Question

Hello doctor,

I have rheumatoid arthritis. There is a long waiting list to see a rheumatologist in my place. I am thinking of seeing a private doctor, but I have limited funds. How often would I need to see a rheumatologist? I cannot afford it every week or maybe every few months. How often do you think I need a doctor's visit? I am hoping to be prescribed a DMARD like Methotrexate. Then, when my slot comes up with the NHS, I will go there. I take Naproxen, which is not enough, and I had a cortisone injection in my knee a couple of months ago. The swelling did not go down completely, but I walked better. It has worn off now, and I have pain in more joints and a feeling of lumps under my feet. I am on a special diet and my CRP, ESR, and high rheumatoid factor have gone down by half. But lately, I feel unwell. I would like to know the frequency of visits needed.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your history. The only part I did not get was, how come there have been no DMARDs (disease-modifying anti-rheumatic drugs) for 10 years? It is a bit unusual. If you could throw some light on the history of arthritis, it would be helpful. If it was an intermittent one initially, or has now become persistent?

Well, as per the treatment, if it is confirmed rheumatoid arthritis, they will start you on Methotrexate straight away. The follow-up visits are usually within four to six weeks for the first time, and then after three months. But a lot depends on your treating rheumatologist. Most of them advise liver function tests after two weeks to see if the dose is not giving you side effects. But that can usually be followed up with a rheumatology nurse. So once you are through with the first visit and improvement comes, then a three-month visit suffices. But if the disease keeps bouncing back, then a bit more frequent visits are needed. But hardly before six weeks, as that much time takes for any new DMARD to act. So it is a bit tough to predict, but do not worry. No rheumatologist will call you back in a week or two.

I hope this helps.

Thank you.