The Spa Treatment of Rheumatology Appointments

Patient Expert

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One of the most difficult parts of saying good-bye to New York City was saying good-bye to my doctors. Though I hadn't been seeing them for all that long (two years isn't a lot in the life of a chronic patient), these were the doctors who went through my diagnosis of rheumatoid arthritis and the worst of it with me. They were all I had ever known, and it was a strange feeling to walk out of Beth Israel for the last time, given all that had taken place there. I got excellent care at Beth Israel, and I really trusted and respected all of my doctors.

When I decided to take my new job in Baltimore, having access to quality medical care was not just a factor, it was a requirement, and what could be better than moving to the home of Johns Hopkins -- one of the nation's top medical hospitals and research centers? I felt confident I would be in good hands. Nonetheless, starting a new relationship with a new medical team is daunting and full of insecurities. And since I'm no longer a total RA newbie, I know what I'm looking for in a rheumatologist and what I'm not. I also know my disease much better than I did when I was first diagnosed. I may not be a doctor, but living inside this body for two years has taught me a thing or two about my RA.

So it was with a little bit of apprehension and a lot of vulnerability that I went in search of a new rheumatologist. Luckily for me, I had help in the form of a blog reader who e-mailed me to give me the scoop on the city and the medical scene, and she generously offered to put me in touch with her rheumatologist. I took her up on her offer, and shortly after moving down here, I secured an appointment .

My first clue that things were going to be OK in Baltimore was a massive packet I received in the mail, welcoming me to the rheumatology center. It contained all the details of my appointment, including what to expect, what to bring, how long it would take, and how to get there. It also included pages of forms for me to fill out ahead of time at my own pace about my entire medical history. It was a lot to go through, but I appreciated how comprehensive it was. They didn't want to know just  about my RA history, they wanted all of my history, from medications I had taken as a child and why, to all the supplements and alternative treatments I currently use.

The day of the appointment came, and I left work midday to drive to the Johns Hopkins campus in Bayview. The security guard at the rheumatology center  entrance smiled at me and took the time to tell me which floor to go to and which way to turn when the elevator doors opened. Um, that never happened in New York.

The reception area  was bustling, but when I signed in, they greeted me warmly as they handed me a few more forms to fill out. After turning them in, it was only a few moments before I was called to come back and get my vitals taken by a nurse who was friendly and focused. A few moments after that, I was escorted to the exam room.

Like a small child, I always get nervous sitting in the room waiting for the doctor to come . Will  they listen to me?  Will I like what they have to say? But all of that went away when my new rheumatologist opened the door with a big smile and a warm handshake. He sat down, looked me in the eye, and right away, I felt at ease. I was prepared with my usual list of questions and needs since I usually have  only had about 10 or 15 minutes with doctors, so  I know it's crucial to be organized and focused. The  thing was, my rheumatologist talked to me like there was all the time in the world  or at least it felt that way. He had clearly read over all my records, but he started by asking me to tell my story from the beginning. He listened, and listened some more, and then asked me some more questions. About the time I thought he should be finishing up, he told me to go ahead and change into the gown so he could do an exam. There was more?

Boy was there. After the exam, he came back in, and we had another discussion, this time about his treatment approach, some initial ideas he had, and then he said the most wonderful thing: He understood that I was doing really well and feeling pretty good for the most part, but his goal was to get me feeling the way I had before I had RA. He said it might not happen, but that was what he wanted to shoot for. He didn't want me to just feel well enough -- he wanted me to feel well. That pretty much rocked my world. Since my meds have been working decently, part of me has started feeling like that's all I have the right to hope for. Trying to get back to feeling like I did before RA would be staring a gift horse in the mouth. . . wouldn't it? Apparently not.

After he wrote out my prescriptions and tests, he stepped out and one of the nurses who heads the patient education program stepped in. She introduced herself, then told me who I'd be working with in addition to my rheumatologist, as well as what role each of them played, and how I fit into the team approach for managing my treatment. She wanted to know if there was anything I felt I needed more information about, or wanted to discuss. Then my rheumatologist came back in to introduce me to one of the residents there and see if I had any other questions for him. I felt positively like a star at the center of their universe.

Once my time with them ended, the nurse escorted me to get my blood work done, and then I sat down with the patient coordinator, who went over all my next steps and future appointments. I practically skipped over to the imaging center for my X-rays, where again, even the security guard was all smiles and directions. More than one person happily offered to escort me to where I was going and people couldn't have been friendlier if they had tried.

All in all, the whole appointment took about two and a half hours, and the majority of that time was spent being treated, not just waiting for treatment. They've even been in touch with me since to follow up on an appointment I needed to make with the ophthalmologist. Suddenly, starting over with a new team doesn't feel so scary anymore.

Sara is the author of the blog, The Single Gal's Guide to Rheumatoid Arthritis.