Making the Most of my Doctor’s Appointment

We’ve all heard that it is important we play an active part in our healthcare treatment but Imagewhat exactly does that mean? Here are some of the things that I try to keep in mind when visiting my rheumatologist or physio.

1. Prepare: Before my appointment, I write down questions, items to discuss, and any changes in my condition so I can make the best use of my time with my doctor.

2. Questions: Unless I’m 100% clear on what my doctor is saying, I will ask for more of an explanation. I find that seeing x-rays or using diagrams can often help.

3. Bring a family member or a friend: Not something I have done in a while but it can make the experience of visiting the doctor less daunting. Moral support is always nice as is having someone to help you get around!

4. Describing pain and symptoms:  I find it useful to think of how I am going to describe the pain and symptoms I’m experiencing in advance so I can give an accurate description during my appointment: Where are my symptoms? How much does it hurt? When did the stiffness start? Have things changed over time?

5. Recording major events: I try to jot down anything that I think might be significant in relation to my arthritis since my last visit. For example, if I’ve been having trouble with my neck at work, I will record this at the time and tell my doctor when I visit.

6. Scaling my pain: I find it useful to give the level of pain I have been feeling a number based on a scale: 1 representing no pain at all and 10 the worst pain possible. The doctor sees this as a helpful way to track my pain levels.

7. Prioritise: During my appointments I try to ask the top things that are concerning me at the beginning rather than the end. This means that if we run out of time, I will still have had the most important things covered.

8. Write down: If I’m worried that I will forget something my doctor advises, I will ask him to write it down for me so I don’t have to be concerned about not remembering some important information or detail.

9. Keep a diary: Keeping track of all of my medication, treatments, symptoms and pain levels can be very useful over time as I start to spot trends emerging. I keep track of my overall health, not just arthritis-related symptoms so I get an accurate general picture. At Arthritis Ireland we have developed ‘My Health Organiser which is a handy place to store all of that information. There are also a number of mobile apps available that you can download for your phone.

For more tips on making the most of medical appointments check out ‘Let’s Talk Arthritis’ information booklet.

Laura Hickey is Arthritis Ireland’s Young Arthritis Ambassador. If you have any questions or would like to join the Young Arthritis Network, please email lhickey@arthritisireland.ie. 

10 Tips on Pregnancy and Parenting with Arthritis

Pregnancy with arthritis

Pregnancy and Parenting with Arthritis

Becoming a parent and raising a family is one of the most rewarding and challenging parts of life and having arthritis should not exclude anyone from experiencing it.

Granted, additional things will have to be taken into consideration but  giving birth with arthritis and raising children is now a very common occurrence.

Arthritis Ireland is running a number of workshops around the country for young people (aged 18-40) living with arthritis, which will focus on the topics of pregnancy and parenting with arthritis and working with arthritis.

The first of a two part series on the new Arthritis Ireland Blog will focus on pregnancy and parenting with arthritis with 10 key things to keep in mind when deciding to start a family.

  1. Medication: It’s important to discuss with your doctor whether you may need to adjust your treatment before you get pregnant. Some drugs such as DMARDs, anti-TNFs, methotrexate, cyclophophamide or leflunomide should not be taken if you are trying to conceive or are planning to breastfeed (for further information see our leaflet on Drugs and Complementary Therapies).
  2. Fit for pregnancy: During pregnancy, some women find that their arthritis remains unchanged or even improves, while others, especially those with osteoarthritis of the hips and knees, may find that it worsens as they gain weight. It is best to try to lose some weight  through exercise and healthy eating before you get pregnant – this will not only help your joints but will make it easier to become pregnant and make for an easier and less complicated pregnancy.
  3. The first trimester (weeks 1 – 13): Many women find the symptoms of their pregnancy to be most pronounced e.g. fatigue, morning sickness, heartburn and dizziness. If it’s all getting too much, remember that you’re not superwoman. Slow down and take some time out from your schedule to look after yourself. If the fatigue is too much for you,
  4. The second trimester (weeks 14 – 27): This is one of the most exciting times of pregnancy – many women share the news of their pregnancy with others, and their bump starts to show. Luckily, some of the more unpleasant symptoms of the first trimester fade and energy levels usually return to normal. In fact, approximately 70% of women with rheumatoid arthritis experience an improvement in arthritis symptoms beginning in the second trimester and lasting until after the baby is born. Unfortunately, arthritis symptoms will usually return once the baby is born.
  5. The third trimester (Weeks 28 – 40): The last 12 weeks often prove to be the most difficult time as the joints and muscles may be affected and problems with weight-bearing joints (hips, knees, ankles and feet) may become worse due to increased weight. Muscle spasms in the back can occur as the uterus grows and the spine curves slightly to support it, leading to pain, numbness and tingling in the legs. Breathing can also become difficult, especially if your arthritis affects your lungs or rib joints and you may experience shortness of breath – if this occurs, you should rest whenever you can.
  6. Delivery: The big day has arrived! Having arthritis does not mean you cannot have a normal labour, and there are many different positions in which you can give birth. If, for example, you have difficulty because you cannot move your legs enough in one position, the midwife will discuss with you some other suitable positions. In some cases, women with arthritis will be advised to deliver their baby by C section, but this is not common. If your arthritis affects your spine, getting an epidural may not be possible. 
  7. After delivery: If you have rheumatoid arthritis you may experience a flare up in the weeks following your pregnancy. Other diseases including scleroderma may become more active after delivery too. If you are on medications that suppress your immune system, it is important that you are extra vigilant for infection as you may be more prone to it than others, but the majority of these infections can be cleared up quickly and easily with antibiotics.
  8. Breastfeeding: If you would like to breastfeed, you should discuss the best medication choices with your doctor as certain medications can interfere with it. Feeding may mean sitting in the same position for a long time on a daily basis so make sure you are comfortable! This may involve using cushions under your elbows, a special support or a small bean bag.
  9. Carrying and lifting: Many parents with arthritis find it easier to lift their baby using their larger joints, like their elbows or forearms. A sling can also be useful in the early stages, before babies become too heavy at around nine months. Other parents use baby carriers or pushchairs.
  10. Equipment: Deciding what equipment is suitable for both you and your child can take a bit of research. Try to choose things that are easy to use. The idea that reputable brands will always be suitable isn’t necessarily reliable as most buggies and high chairs are not designed with parents who have arthritis in mind. Try to choose equipment that is light, well-padded, equipped with wide shoulder and waist straps, easy to fold and unfold and equipped with handles that are comfortable to grip and easily adjustable.

The Young Arthritis Seminars will feature expert speakers, including rheumatologists, clinical nurse specialists, occupational therapists and patients, who will focus on pregnancy and parenting with arthritis and working with arthritis (to be covered on the blog next week).

The events will take place in:

  • Athlone: Sheraton Hotel, Saturday 19th January, 11am.
  • Dublin: The Gresham Hotel, Sunday 20th January, 11am.
  • Cork: Maldron Hotel, Saturday 2nd February, 11am.

Admission is free. Contact Laura Hickey on (01)6470208 or email lhickey@arthritisireland.ie.