When is referral appropriate

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I have suffered pain in my shoulder for over 2 years. I also have pain in other joints. Eventually I had a blood test but not because my GP suspected RA but to rule out other problems because I have Raynaud's Syndrome. Anyway the blood tests showed a slightly raised Rheumatoid Factor and raised serum protein. My GP has said because the normal range is up to 20 and mine is 22 she doesn't think a referral to a rheumatologist will serve any purpose. I have had a repeat blood test for the serum protein and I am waiting for that result. I'm unsure if my GP is right and referral is unnecessary. Just wondered if anyone had any experience of this?

0 likes, 14 replies

14 Replies

  • Posted

    Personally I would insist on a referral. Why should you be suffering pain and be expected to just put up with it?! Rheumatologists are the only ones that can diagnose properly and therefore get you the relevant treatment. Gp's are not specialised any where near enough to determine what medication or treatment you may need. You can insist and should. Hope you get some answers x
    • Posted

      Thanks for that. That is how I feel about it as well. Just didn't want my GP or a rheumatologist to think I was over reacting. I have now been prescribed Naproxen 250 mgms 3 times a day which help along with codeine phosphate. But did think I need to see the experts!
  • Posted

    Bluntly stated, you need a new GP.

    Over 20 percent of all people with RA have sero-negative blood tests, so the very fact that your tests are minimally raised means a lot.

    Push for a referral and don't let up.

    I think it's outrageous that your doctor let you suffer that long.

    • Posted

      Thanks CA-Lynn. I will make an appointment. Regarding the suffering. You're right. The pain has been, and still is at times very painful. Sleepless nights and restricted mobility in that arm. I just thought because the level is 22 it would be ok.
  • Posted

    I had a similar problem with GPs and non referral to a Dermatologist.  I had to see my daughter's GP and I told him that mine wouldn't refer me to a Dermatologist and he said 'money'!  From what my daughter's GP told me, it seems that my practice would lose money if I went to a Dermatologist.  I eventually saw a different GP in the same practice and she referred me.

    Persevere Matron!!

    • Posted

      I meant persevere and insist on a referral in the nicest possible way, so that they think it is their idea!!
  • Posted

    Hello Matron.  I asked for Xrays to be done and to my surprise they agreed!  I think you have to be a bit pushy and ask for a second oppinion maybe.  I had a shoulder replacement after suffering for ages.  I just wanted someone to hit me hard with a mallet.  When they did Xray they found it was so worn away I was put top of the list.  Now after even more pain they found I had a torn rotator cuff and that was at my request for Xrays.  The doctors are good but overworked and on a budget so keep at them.  Look up the range of the factor because I've had RA for about 35 years and mine is between 7 and 15.  I've had an elbow replacement too and waiting for one on the other elbow.  Usually in quite a bit of discomfort but find ibuprofen is about the best over the counter remedy.  Good luck and hope this helps a bit.  Sannie
  • Posted

    Thank you everyone for your replies. You've all made me realise I'm not over reacting and must do something about it.
    • Posted

      Today my ESR is 7 and I'm in quite a bit of discomfort so don't give up hope.  I think we don't complain as much as we ought as we're terrified of disapproval and people in so called 'authority'.  You are certainly not over reacting.
    • Posted

      ESR 22!!! You must be suffering so much.
    • Posted

      Hello Dannie. It's my rheumatoid factor that's 22 not my ESR. To be honest I'm not sure what that is. When I get my results next week for my serum protein levels I'll ask. Apparently 20 is the high end of normal so 22 is just over. In some ways I wish it had been higher then I would have been referred!
    • Posted

      Sorry sannie silly predictive text. It changed your name to Dannie. Apologies
  • Posted

    Hi Matron.  Keep in touch and let us know how you get on.  Best wishes, Dannie... oops sorry, Sannie.
  • Posted

    Thanks to everyone's support here I contacted my GP surgery requesting an appointment. I was told on Thursday I would have to wait 2 weeks. The pain in my shoulder and feet has just got worse. I'm not sleeping and feel generally unwell and lethargic. I felt the wait was totally unreasonable. Fortunately I spoke to one of the nicest receptionists who arranged a telephone consultation for tomorrow afternoon (Monday). So I've got everything crossed and hope I can get the referral. I've written everything down so I don't panic and forget to tell her all of my symptoms.

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