Surgery for rheumatoid arthritis – lower limb
Some of the people we interviewed had lower limb surgery and talk about their experiences here. An important thing to bear in mind is that...
Outpatient clinics for rheumatoid arthritis
Waiting times to see the consultant rheumatologist varied. Most people had been seen within weeks and at least within 3 months. The British Society for Rheumatology and NICE aims for patients to be seen within three weeks of referral to a rheumatologist (see Referral to a rheumatologist). After that they had regular appointments at the outpatient clinic, in a few cases weekly or monthly, but mostly every 3, 6, 12 or 18 months. People who had had surgery also had outpatient appointments with their surgeons. Those on anti-TNF drugs and rituximab therapy need to attend the anti-TNF clinic usually every three or four months, and often this can be combined with the other standard appointments to avoid duplication (see also Biologic treatments).
Apart from seeing a consultant or other doctor at the clinic people also saw a rheumatology nurse to offer advice and support (see Other hospital specialists). A nurse weighed patients and took blood samples before appointments. Sometimes x-rays were taken at outpatient visits. Those on anti-TNF drugs and rituximab also saw the anti-TNF specialist nurse.
One man complained that his clinic appointments were frequently cancelled, but he had direct access to the clinic and could ring the nurse to get an immediate appointment when he had an urgent problem. Other people also said that if they were really bad they could ring up and go to the clinic for an injection, or they could phone for advice.
Complains that routine appointments are often cancelled but he has direct access to the clinic…
Some people had excellent experiences as outpatients. One woman, for example, said that she had a very nice specialist consultant, that the whole team was extraordinarily efficient and very thorough. Another said that doctors and nurses were friendly, helpful and always apologised when the clinic was running late. Someone else said that he was always seen within 10 minutes of his appointment time.
She often has to wait, but the clinic doctors and nurses are always friendly and helpful.
Other people, however, complained that consultants always seemed to be in a rush, that clinics ran late, that they had only 15-20 minutes for the consultation, and that the doctors were sometimes intimidating.
A 42 year old woman had experienced different consultants. The first one didnt appear to listen and didnt seem interested in her problems. Then she saw another who gladly answered questions, listened, gave her plenty of information and made her feel much better.
Different consultants treated her quite differently in out-patients.
Many people complained that they rarely saw their consultant when they attended the clinic. Each time they saw a different registrar who didnt really know them or their individual problems. People were upset about this because they wanted to discuss their treatment with the consultants rather than with more junior doctors (see Choosing treatments and taking part in trials).
Some people preferred to attend the clinic alone because they didnt like to keep friends or family waiting, and because they could concentrate on themselves. Other people preferred to go to the consultation with a friend or family member, someone who could listen carefully and remember things that might be forgotten. Several people found it useful to make a list of things that they wanted to ask the consultant.
Attended his partner’s appointments and felt it helped that both of them were able to hear the…
Waiting rooms at the clinics varied greatly. One woman liked her outpatient department waiting room, which was nicely set out with chairs, a TV, a play area for the children and an electronic screen that indicated how late the different clinics were running.
Other interviewees complained bitterly about their out-patient departments. For example, one woman often had to wait three hours, found the staff off-hand and disrespectful, shouting at her, using her first name. She said staff should introduce themselves and not assume that she could see their name badges. She also complained that she was not told if the clinic was running late. Other people too, complained that clinics were often overcrowded and that that they werent informed about delays.
She had to wait hours in outpatients and was not told that the clinic was running late.
Some people suggested that it was important to find the right consultant, whom you trust and can relate to as it is likely to be a long-term partnership. Two women, for example, felt that their consultant lacked communication skills. They asked their GP to transfer them to a more approachable consultant. For one woman it took a while to change consultant; another said that it was quite straightforward and she felt it was a good decision.
She asked her GP to transfer her to another consultant.
Moving from one consultant to another was quite straightforward.
One man had made a complaint, although a little reluctantly, about his consultant who he considered had treated him badly. This resulted in him changing to a different consultant who he felt much happier with.
Parking was also a problem at many hospitals. People found they couldnt park close enough to the rheumatology clinic so sometimes needed a wheelchair.
Complementary and alternative approaches for rheumatoid arthritis
Complementary and alternative therapies have not been tested using conventional scientific methods, so their effects have mostly not been measured or proven. As the name...