How do you know when to go to GP versus Rheumy?

[Luna]

I have only been diagnosed sinse early june. My Rheumy has not really informed me much about certain things. I have been doing research on my own. I don't know if I should call him everytime I feel bad, or am sick or what?

Luna

[eyeamdry]

I hope more people will come on and tell you their preference.  I'll tell you mine in the meantime.  I don't think there is a hard and fast rule on this unless one of the doctors has stated their preferences/rules regarding this.

It might be who is closest to you, who can get you in to see them first if this is an infection or emergency.  I like my rheumy and GP equally, but my GP is a few miles away and my rheumy is 90 miles away.  My rheumy requires I see her 3 or 4 times a year and get bloodwork etc.  So, basically that leaves me clear to make an appt with my GP no matter the problem if it requires an appointment.

I get some of my meds from each doctor and have a list I give each so they know what I'm taking from all drs.  I never try to get extra meds from another doc.  If my docs were both close, then probably the quickest I could get in for something that both would treat.  After that, some things only the FP would treat and that would make that decision easy.  Lucy

[SueAnn]

luna,

I think a lot depends on the type issues you are having at the time as well.  I go to my GP for sinus infections, when I lost my voice,  and bladder infections, I don't have these often. 

My Rheumy monitors my SJS and will help with pain issues such as bursitis, joint pain, flares in where the fatigue and pain are bad.  He gives me a prescription for prednisone to keep on hand for the flares. 

When I was having numbness and tingling in my face, fingers and toes, he sent me to a neurologist and now they work together to treat those. 

Some people have lots of different doctors who treat different issues,  such as an ENT for chronic sinus infection or ear and throat issues.   

Next time you see him, flat out ask him when you should go see him and for what issues.  Don't wait for them to tell you because they won't.  Write down your questions and ask them, the one thing that you must do is be an advocate for yourself.  If you can take someone with you to ask the questions and write them down.  My husband went with me for the first couple of years and would ask and write everything down for me because my head would be spinning when I left the doctor's office. 

SueAnn

[Luna]

Thank you guys for the replies. This can be a confusing disease among the other problems.

Luna

[Patze]

Hi Luna,

Yeah, thats a tough question, and like the others mentioned, there is no "real" answer.  For me, I usually go straight to the GP instead of the specialists...she's a lot easier to deal with thats for sure!


Patze

[waterbby100]

I understand how you feel. I like some of the others go to my Rheumy between 2 to 3 times a year. I will go to him outside of my regular appointments when I am really nervous about the progression of my autoimmune symptoms and want some really concrete answers and help. I go to my GP for everything else, ear infections, sinus infections now I have a swollen gland that will not go down, so my GP referred me to a ENT. It looks like I might have another Tumor. I had a Parotid Tumor removed in 2004. Nasty things.
Anyhow I hope that helps some.   

I think that bringing someone with you to your appointments is smart. I find that my husband can give a clearer description of what I am going through and he remembers what the doctor says better than I do. I have a tendency to say" I hurt all over fix me!!" and then the brain fog makes me forget half of what he says.

[Scottietottie]

Hi Luna 

I'm in the UK and our system works differently. After I was referred to a rhemy he asked to see me again in 4 months. Then 6 months and now I only see him once a year.

If things crop up I go to my GP. If my GP thought I needed to see the rheumy I would be 'fast tracked' for an appointment because I am already in the system.

My GP has referred me to other specialists as well and I keep my own notes about who I see, for what and when. I type it up and give oit to the rheumy when I do see him.

This works for me.

Take care - Scottie 

[Nancy60]

Great question and interesting to hear how different people handle this. 

For myself, I see my rheumy 3-4 x a year for regular follow-ups and can call for an appt in between times if I am having increasing joint pain that isn't resolving, or an increase of symptoms, new concerning symptoms like rashes, swelling, etc...that would make me think I was having a major flare. 

I go see my PCP for other things like colds, sore throats, stomach/GI issues, female problems etc...  Usually she will run tests and give meds for more common diagnoses, but if I don't respond then she will consult with the appropriate specialist.  This has worked pretty well for me.  I consider my PCP my Primary doctor except for sjogren's related issues but always keep both her and my rheumy informed of what the other is doing whenever I go to see them.  I keep a journal now of medical and dental things going on to help me remember between visits.

Nancy

[Luna]

My Rheumy saw me once a month for two months,then said he would see me in october unless something gets worse or if somethng new comes up..I didnt clarify that. I should have. THe language barrier does not help. He is a great doctor I keep hearing. And I believe he is. Just has such a heavy accent I can't understand him. I started to get more nauseaus than usual and realised I am having trouble digesting food. Then noticed a lump is sticking out between my stomache and bottom of my ribs. So I think that is the problem. I just didn't know who I should go see. I don't Know if my GP is familiar with Sjogrens and they have misdiagnosed me so many times before I was concerned about going to them.  I guess it is time to find out if they are familiar. I will call them tomorrow. THank you all for your replies.

Luna

[Carebear]

Hi Luna,

I see my GP first, then let her decide if it is Sjogren's related or something else.  If we decide I should see my rheumy, my GP then refers me.

But I don't think there is any right or wrong here.  There may come a time when I will call my rheumy directly as well.  Best of luck to you. 

[Pisces24]

 I go to my GP for "regular stuff" and if he thinks it is needed, he can call one of my other -ologists and probably get me in quicker. He'd have more "clout" than I do.

I have a great GP in that if he doesn't know something or gets concerned, he will send me to a specialist. Heck he is the one that started me on my 6yr journey that resulted in a Sjogrens diagnosis. He only got grouchy at me once when I said work probably would not let me stay home ( I had the H1N1) and he said "I am telling you to stay home!". Work didn't, called dr (Who probably did some cussing in his office - as I would have) and he made me out the FMLA. Nice to know if my company gets intractable, I can sic my dr on em. 

NOTE: Go to your GP that knows you. Unless you are desperate, don't go to an InstaCare type place that does't know you. Though ok, they are not the brightest bulbs for you to read by.