Working well with your healthcare team

Important information to tell your healthcare team

When you're going to see your GP or rheumatologist - whether it's for the first time with symptoms that might be ankylosing spondylitis or for a follow - up appointment - it will help if you are prepared. Try to think about what you want to say, and how your symptoms have been affecting you recently.

Here are some things you may want to think about:

• What are your symptoms? Pain, swelling or stiffness? Don't forget to mention other symptoms that you think are commonplace, such a headaches and problems sleeping. For some people these symptoms could indicate an underlying health problem.
• Your ability to do every day activities e.g. looking after your family, working
• Changes in your normal routine e.g. if you are going on holiday
• Other medications you are taking - even if these are not being prescribed
• The impact of your AS on the people around you
• How you are feeling emotionally as well as physically
• How you feel your treatments are working

If you have already been diagnosed with ankylosing spondylitis you might want to think about other things as well:

• How have your medicines been working? Do they stop your symptoms coming back until you need your next dose? Or do you experience breakthrough pain (pain that comes back before it's time for your next tablet)?
• Have your symptoms changed since your last visit? Are they worse or better?
• How is your mobility? Are you still able to do all the things you were doing last time you saw the doctor?
• Have you experienced any side effects from your medicines? For example, stomach pain, indigestion, or rash?
• Do you think you might benefit from seeing an occupational therapist (who can help you with adaptations in your home), or a physiotherapist (who can help you with exercises to improve your strength)?

Questions you might be asked

It might be helpful to prepare yourself for questions your healthcare professional might ask you at your next visit. These may relate to your symptoms, your treatments or how you are feeling and coping. Here are some questions you might be asked:

Questions about your symptoms

• What symptoms do you have?
• Have your symptoms changed since your last visit? Are they worse or better?
• How is your overall level of fatigue/tiredness?
• What is the overall level of ankylosing spondylitis pain in your neck, back or hips?
• What is the overall level of ankylosing spondylitis pain/swelling you have had in joints other than in your neck, back or hips?
• What level of discomfort have you had from any areas tender to the touch?
• What level of joint stiffness have you had when you wake up in the morning? How long does it last?

Questions about your treatments

• What treatments are you receiving/taking to relieve the symptoms?
• How well do you feel your treatment is working?
• Are you experiencing any unwanted side effects which you think might be related to the treatment?

Questions about living with ankylosing spondylitis

• Is your ankylosing spondylitis stopping you from doing any activities that you were previously able to do? What are these activities?
• Are your symptoms affecting your ability to work?
• Is your ankylosing spondylitis affecting you emotionally?
• How is your family coping with your ankylosing spondylitis?

Questions you might want to ask your healthcare team

Often, the time you spend with your healthcare professional is limited. Think about the questions you would like to ask them before your appointment and write them down. Take these with you to your appointment.

It is important that you can leave your appointment feeling satisfied that you were able to ask and have answered all of the questions appropriate to that healthcare professional. Knowing what you want to find out before you go in can help achieve this.

Questions you may want to ask include:

• What lifestyle changes can I make to help me cope with my symptoms?
• Why have you chosen this particular treatment for my condition?
• Can I use other medicines while I am taking this treatment?
• How long will it typically take to see results?
• How can my progress on this treatment be monitored?
• Will I need any tests while I'm on this treatment?
• What will happen if I stop using this treatment?
• What are the potential side effects of any treatment you are prescribing?
• What other treatments are available?
• Can I take this medication if I am trying to get pregnant or father a child?
• Who can I speak to if I have any questions after this visit?
• Are there any activities or situations I should avoid?
• Where can I get more information about ankylosing spondylitis? There may be useful websites or patient support groups.

It's important not to think you are wasting your doctor's time. Your health is important, so if you do feel that you need more time with the doctor you could always ask whether a double appointment is available.

Role of the pharmacist

If you and your doctor decide you need some medicines for your ankylosing spondylitis, you may find that the healthcare professional you have the most contact with is your local pharmacist.

It's good to remember that your pharmacist is more than just someone who sells you your medication. A pharmacist is an expert on how medicines work and interact, and can advise you about any safety concerns - especially important if you're taking more than one medicine at the same time.

As part of the service to make sure your medications are right for you and that you're getting the best from them, your pharmacist can offer you a free Medicines Use Review (MUR).

Navigate the NHS

Understanding how the NHS works - and what NHS services are available in your area - can help you to get the most out of your interactions with healthcare professionals. This will enable you to manage your Psoriasis better and live your life in the best possible health.