Q. I have rheumatoid arthritis. How frequently do I need to consult my rheumatologist?

Answered by
Dr. Naval Mendiratta
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 01, 2019 and last reviewed on: Dec 06, 2019

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 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.

#

Hello,

Welcome to icliniq.com.

I have gone through your history. The only part I did not get was, that 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 now it has 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 rheumatology nurse. So once you are through with first visit and improvement comes, then a three months 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, it 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.


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