Amrit pal S. Sandhu, M.D.

Transcription

1 Amrit pal S. Sandhu, M.D Myhre Place Silverdale, WA (360) PLEASE READ THIS CAREFULLY PRIOR TO YOUR FIRST ARTHRITIS CLINIC VISIT!!! ARTHRITIS/RHEUMATISM SERVICES Arthritis and Rheumatism are non-specific terms used by the general public and the new media to describe every possible musculoskeletal ache and pain. In everyday use, however, the terms may be misleading and of no practical value. Arthritis is one of many symptoms of disease, and it is uniquely defined by pain/stiffness, joint inflammation/swelling and deformity/loss of motion. As a symptom, true Arthritis is found in more than 100 Immunologic ( Rheumatic ) diseases routinely diagnosed and managed by Rheumatologists. Such rheumatic disease result from abnormalities of the immune system, and vary widely in severity, duration, symptomatology, and individual presentation. The Rheumatologist must also understand the many other conditions which adversely affect bones, muscles, and joints, but neither Rheumatic nor Arthritic (ex.: Sprains, Strains, Fractures, Tendonitis, Bursitis, Myofascial pain, Disc pain, Nerve pain, Psychogenic pain, etc.) Many Rheumatic Diseases occur in the absence of any detectable Arthritis whatsoever, and may affect organs such as the kidneys, the skin, the heart, blood vessels, the lungs, the GI track, and/or the brain. The Rheumatologist is called upon to diagnose and treat a wide variety of conditions. Since your particular treatment plan will depend largely on which Rheumatic condition you have, the importance of a correct initial diagnosis cannot be overemphasized. To make that diagnosis, the Rheumatologist must be the Sherlock Holmes of Medicine, analyzing a person s present and past medical history, as well as his/her important physical findings, and the results of fairly extensive X- ray imaging/and/or laboratory studies. The Rheumatologist can take minutes. To minimize patient delays, Rheumatologists have begun employing Initial Rheumatologic Patient Data Base questionnaires such as the one enclosed. This questionnaire will help you document your entire Medical History and even the most subtle manifestations of your current problem(s). Please remember to bring the completed form to your first arthritis clinic visit so that your Rheumatologist can review it rapidly just prior to seeing you. Without this form, lengthy direct questioning by your Rheumatologist will greatly extend your office visit type, substantially raise its cost, and cause major delays in appointment scheduling for all patients. If you lose your questionnaire, forget it, or have difficulty filling it out, please arrive at least one hour before your scheduled appointment so our clinic staff can assist you in completing it. It is also most important that you bring every medicine (prescription and non-prescription) you are taking no matter who has prescribed it, to each rheumatology appointment. The dangers of conflicting medications, prescription/dispensing errors, medication mislabeling, and misunderstanding physician instructions on medications, are substantial. We thus, require careful scrutiny of every medicine you take on every visit. The patient-rheumatologist relationship is a very special one, usually enduring over many years. Establishing a thorough initial base of information regarding your medical background will assure you the highest quality of continuing Rheumatologic care. On your first visit to our Rheumatology clinic, my office staff will interview you after personally reviewing your questionnaire. He/She will

2 ask you specific questions regarding both the written information you have provided and other verbal impressions of your current illness. If your problems are quite simple or very localized, the subsequent physical examination may focus only on the affected region. If your problems are more diffuse or confusing, I will perform a thorough examination. Depending on what information is available at the time of that first visit, X-rays, lab studies, and/or other tests may need to be ordered to help establish the correct diagnosis. At the conclusion of your first office visit, I will provide with a tentative diagnosis of your condition(s), and with your permission, will initiate therapy as I deem appropriate. In many cases it will be necessary to return to clinic for a follow-up visit (usually within one to three months) to evaluate your response to therapy and to discuss pertinent X-ray and lab findings. Any critical lab/x-ray results will of course be relayed beforehand to you and/or your primary physician. Generally, every patient seen by a Rheumatologist has been referred there by another physician who is usually a primary care Doctor (such as a General Internist, a Family Practitioner, a Pediatrician, an OB/GYN Physician, or a Doctor of Osteopathy). It is important for you to remember that your primary doctor will still provide your general medical care after your Rheumatology clinic visit. In general, he/she should be your doctor of first contact for any medical problem. Once comfortable with your progress, I will discharge you back to your primary physician. Information will always be provided to any physicians you request, whether or not you were referred to us by them. Every patient followed through our clinics must have his/her own primary physician to help coordinate Rheumatologic recommendations and to assure continuity of general medical care. During your visits to our clinics, please feel free to ask your Rheumatologist or our staff any questions relating to your medical condition. Additional information regarding Arthritis is also readily available through the Washington State chapters of the National Arthritis Foundation (Hotline ). We welcome any suggestions you might offer to help us be among the finest Rheumatologic diagnostic and therapeutic programs in the nation.

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