Is a Rheumatologist Necessary??

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Is a Rheumatologist Necessary??

Postby TNK* » Tue Jun 10, 2014 4:52 pm

Hiya all

I was diagnosed just over 2 months ago by my GP with FM, I had been backwards and forwards for a while and made an appointment with all my symptoms written down ready for a full on discussion about why I thought I could have FM....Luckily for me my GP is pretty great and before Id even mentioned myself that I thought this is what I had, she actually said herself..."I think you have a condition called Fibromyalgia....have you heard of it?"
I guess you can imagine my relief, i could have hugged her, we had a little chat about it and as she knows me quite well and I have medical training, she prescribed me Amitript 10mg for 4 weeks and to go and research it some more and go back after the script was nearly done.

At the time I did ask if i would need referring, and what she said to that was, she could refer me to a rheumy, but they would probably just say..yeah you got FM carry on with your treatment from your GP...which i suppose is right really.

But I have read on hear about folks seeing their Rheumy and then being referred for all sorts of therapy, from Accupuncture, to physio etc.

So my Q is, should i push for Rhuemy appointment, or should i just be grateful ive got a very good GP and carry on with my treatment from her??

TIA
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Re: Is a Rheumatologist Necessary??

Postby FluppyPuffy » Tue Jun 10, 2014 6:56 pm

The way Rheumys work tends to differ quite significantly from area~to~area, even dept~to~dept. Some will simply give or confirm a dx, then shuffle out of the room, whereas others will take a much more active interest in their patients, recommending/prescribing meds, making referrals for treatments that might be of benefit etc. Then there are the ones that fall somewhere in between. It does tend to be pot luck as to which sort you see, and it tends to be only when you are in with them that you get a feel for how they are.

More and more GPs are making FM dx's. They are able to send you for pretty much every test, scan etc that they think may be helpful in trying to find out what is behind a patient's symptoms and problems, as well as prescribing meds and making referrals to pain clinics, treatments etc.

If you have a decent GP and are happy with how they have arrived at your dx, and feel they are supportive in treating you, a Rheumy referral may not be necessary. If you have any concerns tho, that haven't been addressed when asking your GP about them, then a Rheumy referral could be beneficial.

Ask your GP about accessing things like Acupuncture, physio and other treatments and see what she has to say.
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Re: Is a Rheumatologist Necessary??

Postby carolad » Wed Jun 11, 2014 9:57 am

FluppyPuffy wrote:The way Rheumys work tends to differ quite significantly from area~to~area, even dept~to~dept. Some will simply give or confirm a dx, then shuffle out of the room, whereas others will take a much more active interest in their patients, recommending/prescribing meds, making referrals for treatments that might be of benefit etc. Then there are the ones that fall somewhere in between. It does tend to be pot luck as to which sort you see, and it tends to be only when you are in with them that you get a feel for how they are.

More and more GPs are making FM dx's. They are able to send you for pretty much every test, scan etc that they think may be helpful in trying to find out what is behind a patient's symptoms and problems, as well as prescribing meds and making referrals to pain clinics, treatments etc.

If you have a decent GP and are happy with how they have arrived at your dx, and feel they are supportive in treating you, a Rheumy referral may not be necessary. If you have any concerns tho, that haven't been addressed when asking your GP about them, then a Rheumy referral could be beneficial.

Ask your GP about accessing things like Acupuncture, physio and other treatments and see what she has to say.


There does seem to be a huge variation in how both Rheumatologists and GPs deal with this. The Rheumatologist I saw was useless...he told me I had scoliosis (which I already knew), then waffled on about 'non restorative sleep' and how that causes muscle pain, fatigue and concentration problems, told me to pace myself more and then discharged me back to my GP. That was it....absolutely pointless really! I had to go to my GP to find out what he had said in his letter. It was a vague waffly letter and had a number of factual inaccuracies, but he did have 'fibromyalgia' in the letter. So I think he diagnosed me with fibro, but just didn't bother to tell me!! I still don't really know what is the main cause of my pain - whether it is scoliosis or fibro. My GP reckoned it was a mixture of both - he guessed at 70% scoliosis related and 30% fibro...though it is just a guess so who knows...

So that is a very roundabout way of saying - if you have a good, supportive GP, I think that is all you need. I don't think you would gain anything by seeing a Rheumatologist. But since your GP sounds supportive, I would ask about some of the other treatments available. Although again, in my experience I found NHS physio to be a waste of time! The only thing they did which helped me was acupuncture...but even though it helped, they would only give me 6 sessions and then discharged me. They don't seem to be interested in pain relief, they just want to 'cure' you. And if they can't cure you, they don't want to know :( If you can afford it, you may get better treatment from private physios or acupuncture practitioners.

Good luck with finding something that helps :) x
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Re: Is a Rheumatologist Necessary??

Postby SchroedingersCat » Wed Jun 11, 2014 10:03 am

My GP referred me to a physio, a neurologist and a rheumatologist to confirm/refute his diagnosis of FM, and they confirmed it. I was offered various sorts of help by the rheumatologist, including a referral to the specialist CFS/ME team that Jeany is seeing, and to a pain clinic. To be fair, I turned her down, and she was happy with that, but the options were there had I wanted to take them up.
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Re: Is a Rheumatologist Necessary??

Postby Theresa34 » Wed Jun 11, 2014 9:42 pm

I honestly dont know the answer. I was already seeing a rheumatologist for arthritis which was diagnosed a year ago. He diagnosed the FM in Feb this year. I also see a rheumy nurse inbetween seeing him. I get checked over for both conditions and they help me manage both conditions. The most helpful thing my nurse said was to try Pilates and cardio to help with pain etc.
I am a fibro fighter not a fibro sufferer. I will keep fighting from the minute I get up til the minute I go to bed.
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