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Your First Visit to the Doctor

 

You've been experiencing a variety of different symptoms. You may or may not suspect that you've got lupus. Now you've got an appointment to see a specialist to try and get a diagnosis. But what will happen at this visit, and how can you prepare?

Here are some general guidelines to help you to prepare for your visit. It will help to know what sort of questions you'll be asked, as if you're anything like me, your mind goes blank as soon as you enter the room! Go through the questions below and work out how you'd answer them, it may help to write some important points down.

A first consultation typically consists of questions on symptoms and medical history, physical examination and medical tests.


Questions you may be asked

What are your main symptoms (it may help to write down all of your symptoms, even those that seem insignificant)?

How long have you had these symptoms?

[joint pain] Is it worse at any particular time of day?
Do you get stiff or swollen joints in a morning or at night?
What is the pain like (throbbing, sharp, dull ache, etc)?

Do you get fatigue?

Have you suffered from unexplained weight loss or weight gain?

Do you suffer with mouth ulcers?

Do you get a rash in the sun?
How long does it last?
Which areas are affected?
What does the rash look like?

Have you ever noticed a rash on your face (butterfly rash)?
When does it occur?
How long does it last?

Do you get any other rashes?

Do you get dry eyes or mouth?

Do you have any allergies?
Are you allergic to any prescription medications?

Do you suffer from frequent infections?

Have you ever had pleurisy (pain on taking a deep breath)?

Have you had recurrent miscarriages?

Do your fingers change colour (white, blue, red) in cold weather?

Do you have any other illnesses?

Is there a family history of arthritis or auto-immune diseases?

This list is not exhaustive, you may be asked more questions depending on your symptoms and history.

If you have any questions you want to ask, write those down too, as you may forget them when you're in with the doctor. If you do forget to ask him anything, speak to the nurse before you leave (or ring later). Many rheumatology departments have specialist nurses who can offer advice and answer any questions you may have, and can be reached by phone during office hours.


Physical Examination

The doctor may do any or all of the following-

  • Feel your joints
  • Bend and move your joints
  • Look for any joint swelling
  • Listen to your heart and lungs
  • Take your blood pressure and pulse rate
  • Look at any rashes you have
  • Look in your mouth if you have mouth ulcers
  • Feel your neck and armpits for any lymph node swellings

Tests that may be carried out

Blood tests - ANA, ENA, ESR, Rheumatoid Factor, CBC, Renal and Live profiles, Anti-dsDNA, Complement studies, etc.

ECG - to test for any heart irregularities.

Chest X-Ray - if you've had any chest/lung problems

Schirmer's Test - to test for dryness of the eyes.

Urine Test - dipstick test for protein and glucose levels. May also be sent to lab for further tests. I'd advise taking a fresh urine sample to every hospital appointment, just in case!


Further information

Diagnosis
Blood Tests
Procedures
Is It Lupus?

 
 

 

 
 

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