Results
I would like to know the results of my blood tests/x-rays.
Unfortunately, we can’t individually feedback the results of all blood/X-ray tests to our patients. Rest assured, if there is any abnormality in your blood tests or x-ray abnormal the rheumatology team will get in touch with you and/or your GP. If you don’t hear from us, you can assume the results have been satisfactory.
I had an MRI scan but haven’t heard of the results yet.
Once the scan has been performed it can take a couple of weeks for it to be reported. Once your consultant receives the report, they will write to you and your GP or get in touch directly to let you know the results and the management plan.
If you haven’t heard back even after 4-6 weeks, please leave a message with the consultant’s secretary.
Treatment
I have decided not to start or delay my rheumatology treatment, what should I do?
If you plan to delay your start date of treatment by more than a week, please contact our secretary on 0131 5373677 to confirm when your are likely to start as your follow up appointments will need to be adjusted accordingly. This is so as all your initial blood tests for the new rheumatology medication will be checked by the rheumatology nurse.
You should also contact your GP to let them know about it and of any other specific issues you may have.
I have had side effects with my medication, what should I do?
If the side effects are mild, try and persevere with the medication since often they will resolve as you continue to take them.
If the side effects continue for more than a week or two, please contact the advice line number.
If side effects are severe, please stop your arthritis medication and consult your GP who could email your consultant for advice.
I have been on my new medication for a few weeks and don’t see any change.
If you have been started on a new treatment for your arthritis it is likely to take 10-12 weeks for it to work. You may not see any changes prior to that. Please continue your treatment. If it has not proved to be effective despite being on it for 4-5 months, please contact the telephone advice line.
Flare of Symptoms
What should I do if my joints have flared?
Flares can occur if you have missed your medication for any reason, due to stress or sometimes if the medication is no longer as effective and the arthritis has got worse. Flares can be managed with additional painkillers and if not setting steroids (injection or a short course of steroid tablets) may be used to settle the flare. Your medication may also need to be adjusted if this is a frequent occurrence.
How to Manage a Flare
What should I do if I need an aspiration and steroid joint injection?
If you think that you need an urgent appointment you should contact your GP who will then contact Rheumatology to arrange for you to be seen.
I am due to get a steroid injection into the joint. What should I do?
If you have a joint injection appointment, please make sure that you allow 24-48 hours to rest after the injection for the steroid to work for you. You may take pain killers like paracetamol if it is not contraindicated for a couple of days after the injection. You may apply an alternating warm and cold compress to the injected site to relieve pain.
If you are on a blood thinning medication like warfarin, heparin or apixaban please let your practitioner know prior to the injection as you may be asked not to take it prior to the injection and for a day or two after the injection.
I do not feel well, what should I do?
You should contact your GP in the first instance or NHS 24 for out of hours service. If you feel it is a life-threatening situation, then you should call 999.
Travel Advice
What should I do about my treatment when I go on holiday?
Always good to take a copy of your last clinic letter with you for information.
If you are taking tablets these should be taken with you on holiday and can be continued as normal.
If you are on an injection treatment this can also be taken with you in your hand luggage using a cooling bag.
Although these treatments have needles they can be taken through security at airports without any problem or any special letter. Take it through security in its normal container separate from your other hand baggage. Refrigerate the medication once you reach your destination.
Operation or Surgical Procedure
I am having a surgery, what should I do with my rheumatology drugs? (This also applies to dental procedure query)
Most of the biologic drugs need to be stopped before surgery. We usually advise you miss the dose before the date of your surgery. You may resume your medication once your wound has healed and as long as there is no sign of infection.
If you are on medications other than a biologic, you do not usually need to stop your medication.
Please let your surgeon/dentist know what medication you are on so they can confirm the plan with us. For list of individual drugs and specific information please see:
www.versusarthritis.org/about-arthritis/treatments/drugs
Infection
I think I have an infection, what should I do?
You should discuss with your GP as you may need a course of antibiotics if it is a bacterial infection. Most rheumatology drugs need to be stopped when you have an infection except hydroxychloroquine and sulfasalazine.
You can restart your medication once you have completed your course of antibiotics and as long as infection is cleared.
If you have Covid, you may need antiviral treatment.
I do not feel well, what should I do?
You should contact your GP in the first instance or NHS 24 for out of hours service.
If you feel it is a life-threatening situation then you should call 999.
Pregnancy
I am pregnant or want to get pregnant. What should I do about the treatments I am receiving?
If you wish to get pregnant discuss your plans at your clinic appointment with your rheumatologist so medications can be reviewed and adjusted if required.
Please contact your GP surgery if you are pregnant and not sure, or contact the rheumatology telephone advice line.
You can also consult the document about pregnancy and rheumatic disease Pregnancy, DMARDs and Biologic Therapies (nhslothian.scot)
Vaccination Advice
Is it safe for me to have immunisation?
Yes. Immunisations against flu, Covid, pneumococcus and shingles can all be given safely to people on anti-rheumatic treatments.
If you are attending for immunisation please tell the staff what medicines you are taking for your arthritis.
Avoid all ‘live’ vaccines if you are on immune suppressing medication.
