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Before the COVID-19 pandemic, I used to wish that some of my doctor appointments could just be a phone call instead of the hours of hassle of traveling back and forth for an appointment that took no more than 10 minutes.
During the pandemic I’ve had a few health scares that required both me and my son to seek medical attention in a frightening enough time. I had plenty of visits with doctors over the phone and Zoom, as well as in-person visits when virtual ones did not give us the answers we needed.
As unfortunate as the pandemic has been on countless levels, I am glad that this type of health care has become available, especially to chronic illness patients like me. But like most things, telehealth (or telemedicine or virtual health) has its share of pros and cons.
Here’s what I’ve observed over the past few months, as someone with rheumatoid arthritis and other conditions who’s been using a mix of telehealth and in-person visits.
The Pros of Telemedicine Visits When You Have Chronic Illness
Telehealth visits are better for fatigue
Living with a chronic illness is a full-time job. I’m constantly juggling medical appointments, treatments, and self-care.
Virtual health is tremendous for those living with chronic fatigue. Traveling from point A to point B can be exhausting, as can just getting ready to leave the house. On a bad fatigue day, something as simple as taking a shower can make my body crave a nap. Commuting to a doctor visit can leave those of us with chronic fatigue too spent to really communicate how we want to during the appointment. Fatigue often comes with brain fog, which can make it difficult to remember what the doctor says.
But when I see a doctor virtually now, I find myself with more energy to spare before and after appointments that would normally tire me out for the entire day.
Telehealth visits are perfect for bad days
One of the biggest challenges I felt when first diagnosed with rheumatoid arthritis — and didn’t have the right treatment plan yet — was just making it to all of my appointments because of how sick I was at the time. Some days I was sleeping up to 18 hours a day. Getting to appointments on my own was too difficult. If only I had the option to just call in for some of those appointments when I was at my sickest. It would have been so much better to handle things like a simple prescription renewal over the phone instead of dragging myself to the doctor when I could barely even sit upright in bed.
With a chronic illness like rheumatoid arthritis, which flares and ebbs, chances are that I will get very sick again. I hope telehealth will be an option for me when that happens.
Telehealth visits help keep immunocompromised patients safe
Long before COVID-19 made everyone more conscientious of germs, people with compromised immune systems — like those of us with inflammatory arthritis — worried about our exposure to potential germs in doctor office waiting rooms or during our commutes.
During the pandemic, telehealth visits have allowed us to keep getting care while minimizing our exposure not just to COVID-19, but infections generally. This is also great if we’re under the weather ourselves. We don’t need to cancel an appointment or worry about infecting others if we have some sniffles or a sore throat.
My rheumatologist was even able to treat me virtually (over the phone) while she herself was infected with and recovering from COVID-19. I stayed safe and got the continuity of care I need.
Telehealth visits save us money
Doctor’s visits can have a lot of sneaky costs we don’t always think about, but they add up. With telehealth, I don’t have to pay for a babysitter for son or for public transportation. Many patients don’t live anywhere near their specialists — they have to take days off work or even stay in a hotel to just see a doctor for 15 minutes.
Telehealth therapy makes me feel more relaxed
Out of all my virtual visits, I enjoy talk therapy over the phone with my clinical social worker the most. I found myself able to be more relaxed at home. I had less anxiety. I could even stay in my PJs if I wanted.
Telehealth can connect those who speak the same language
Language barriers can be a huge problem when it comes to seeking medical help for someone who may not speak the country’s native tongue. While this isn’t an issue for me personally, I hear about it in the patient advocacy community. It may be easier to find providers over telehealth who speak the same native language than in person in your local community.
Telehealth transforms access for those in rural communities
I think the main reason I love the option of virtual and telehealth services is because there are so many people in rural communities who don’t have access to right providers — or they can’t get to the doctor as often as is ideal. Many people with chronic illnesses like inflammatory arthritis need to see a rheumatologist or other specialists every few weeks or months.
The Cons of Telemedicine Visits When You Have Chronic Illness
Telehealth doesn’t work as well when you need a physical exam
If you live with a progressive illness like I do, virtual health isn’t a great fit when you need a physical exam. Because of the pandemic, I haven’t been able to see my rheumatologist or physiotherapist for a joint exam when I really needed it. I know doctors and researchers are studying how joint exams can be conducted better virtually (by coaching patients on how to do them), but there’s something comforting about a professional assessing my symptoms in person.
Telehealth isn’t good for getting out of the house
Many of us with chronic illnesses spend a lot of time at home — during the pandemic, yes, but even before that. Sometimes just getting out of the house can make me feel a bit better when I’m dealing with the whirlwind of symptoms that my rheumatoid arthritis causes. A bit of fresh air, movement, and face-to-face contact with others can bring some surprising health benefits. They can energize my day a little and boost my mood.
While on the whole, virtual care is better when you have a lot of fatigue or disease activity, there is something to be said for having a reason to leave your house for a bit. More time at home means more joint stiffness and less motivation. It’s a tough balancing act.
Telehealth doesn’t replace face-to-face connection
Face-to-face on video just isn’t the same as literally being in the same room with your provider. When you have a chronic illness, you can develop deep connections with your doctors. I’ve been seeing some of mine since the early days of my diagnosis. I’ve even worked closely with some on research studies over the past few years.
Having months of mostly virtual visits has made me realize how much I actually miss seeing them and how much subtle socializing came out of just going to my appointments. Seeing them from my home is, well, kinda lonely.
Telehealth is not the best for an emergency
This one may seem obvious, but I don’t merely mean the kind of emergency for which you should call 911 or head right to the hospital.
When you have multiple chronic illnesses, having new or bizarre symptoms you’ve never experienced before can be an emergency.
During the beginning of the pandemic, when my area was in a lockdown, I started to experience some bizarre intense symptoms of numbness and popping sensations in my legs. My hands felt and feet felt like they were on fire.
I started out with virtual visits, but they didn’t do much except freak me out even more and prolong my diagnosis.
When I told my rheumatologist and general practitioner about these symptoms, I could hear their frustration that they couldn’t do a physical exam to rule out some serious illnesses that my symptoms were mimicking. Both advised me to go to the emergency room to see a neurologist the soonest I could. After two physicals, an electromyography (EMG) — a test to assess muscle and nerve health, and a lot of bloodwork, we discovered that I live with a rare copper deficiency that was causing my strange symptoms.
Telehealth: Not Perfect, But Game Changing
Despite not being perfect, telehealth is game changing for people with chronic illnesses (or even just a busy lifestyle). I hope that the changes in access to telehealth that arrived during pandemic stick around long after it and continue to evolve to improve our care.
Want Better Virtual Care with Your Rheumatologist?
For personalized advice on getting the most out of your rheumatology telehealth visits, check out our new site eRheum.org.
