Get personalized, effective rheumatology treatment at Pella Regional Health Center. Our board-certified rheumatologist, Dr. Shelby Dames, has been successful in helping rheumatology patients find relief and strive for better quality of life.
What is a Rheumatologist?
A rheumatologist is an internist who received further training in the detection and treatment of musculoskeletal and systemic rheumatic diseases. Musculoskeletal diseases can affect the joints, muscles, and bones causing pain, inflammation, stiffness and deformity. At times, your other organ systems can be affected such as the eyes, skin, nervous system and internal organs.
Rheumatic diseases can be difficult to identify in their early stages and you can have common symptoms that could be related to much more complex conditions. Dr. Dames is an expert in the evaluation and treatment of autoimmune inflammatory conditions that affect the musculoskeletal system.
When to see a Rheumatologist
Protect your health by getting prompt medical care. We all have general musculoskeletal pains from time to time that last for just a few days to a few weeks. But, when pain in your joints, muscles, neck, back and bones is severe and persistent for more than a few weeks, you should see your primary care provider for an initial evaluation.
Autoimmune conditions occur when the immune system, which normally fights infections, makes a mistake and causes inflammation in areas of the body where inflammation is not needed, causing symptoms and sometimes damage. Inflammation can be reversed, but organ damage cannot be reversed.
Sometimes rheumatology conditions and diseases closely associated with rheumatology condition run in families, so it is important to find out if there is any family history. If these conditions run in your family, you need to communicate this to your health care providers.
Studies show that patients with inflammatory rheumatic diseases have better outcomes if cared for by a rheumatologist. If your primary care provider is concerned about an underlying rheumatic condition, he/she can refer you to rheumatology for further evaluation.
Conditions Rheumatologists Treat
Look to Dr. Dames at Pella Regional to diagnose and manage inflammatory autoimmune conditions of the musculoskeletal system such as:
- Rheumatoid arthritis
- Psoriatic arthritis
- Ankylosing spondylitis
- Raynaud’s disease
- Systemic lupus erythematosus
- Treatment-refractory gout
- Polymyalgia rheumatica
- Treatment-refractory osteoporosis
- Inflammatory myopathies
- Systemic vasculitis
Your First Appointment: What to Expect
Partner with Dr. Dames to diagnose rheumatoid arthritis early and start treatment right away. Sometimes rheumatic diseases can be very difficult to diagnose and it is not always possible to make a diagnosis at the first visit. The process includes:
- A thorough medical history.
- Physical exam looking for signs of inflammation throughout the body and musculoskeletal system.
- Review of the results of any prior tests (labs or imaging) looking for signs of inflammation, organ damage or antibody production.
- Possibly the need to order additional laboratory or medical imaging tests.
Laboratory and Other Testing
Dr. Dames may recommend additional laboratory tests or studies, which would be tailored based on each patient’s case. Additional studies may sometimes include referral to another provider for studies such as an EMG or a tissue biopsy of the muscle, joint, skin, nerve, lung, or kidney.
Medical Imaging Testing
Dr. Dames may recommend medical imaging to look for inflammation, joint or other organ damage. These tests may include x-rays, a CT scan, MRI, ultrasound or DEXA scans (bone density testing).
How to Prepare for Your Appointment
- Outside medical records: These are typically sent by the referring provider, but sometimes, are not available at the time of your appointment. It is in your best interest to try and ensure any results of studies pertinent to the reason for you being seen are available at the time of your visit.
- Insurance card and ID
- Up-to-date medication list with names and doses, including the past medicines tried for your current problem
- Allergy list
- Immunization list
- Family history of any rheumatic diseases
Because exam findings need to be documented by the rheumatologist before beginning long-term immunosuppressive medication treatment, it is important to avoid steroids prior to the visit, which can mask exam findings.
Rely on Dr. Dames to be a guide to help you make treatment decisions on the journey to treat your inflammatory rheumatic disease. She will provide direction and education about medications, coping mechanisms, techniques for regaining or maintaining function, and ways to improve your quality of life.
If it is determined you have an inflammatory rheumatic disease, Dr. Dames will help to develop a personalized treatment plan which may include medication, physical therapy referral, referral to other specialists and joint injections.
The types of medications recommended by Dr. Dames will depend on your diagnosis, other underlying medical problems and severity of your symptoms. These may include:
- immunosuppressive medications such as DMARDs
- biologic medications
Some medications can be taken by mouth, but others need to be injected into the joints, under the skin, or through infusion (IV medications). Dr. Dames does not prescribe opioid medications or marijuana.
Pella Regional offers clinical expertise in meeting the unique needs of our patients using infusion therapies as part of their medication treatment plan. Dr. Dames, infusion nurses and pharmacy staff work as a team to monitor your therapy while helping you manage side effects and avoid drug interactions. The team is dedicated to helping you manage your condition as simply as possible.
The complex and changeable nature of many rheumatic diseases often requires ongoing assessment and evaluation. Dr. Dames will regularly communicate with your other health care providers, including your primary care physician and other specialists. This means your entire care team stays up-to-date on your treatment plan, even as your needs change.