Connected Rheumatology

Connected Rheumatology We are a concierge rheumatology practice in the Dallas/Ft.Worth area that takes a truly holistic approach to immune and musculoskeletal health.
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Dr. Elizabeth Ortiz is excited to bring her education and experience from Cornell and USC to Texas! Connected Rheumatology serves patients 18 years and older who have been diagnosed with or are suspected of having an autoimmune or musculoskeletal condition. This can range from complex conditions, such as Systemic Lupus Erythematosus, Rheumatoid Arthritis and Vasculitis to pain syndromes such as Os

teoarthritis and Fibromyalgia. Connected Rheumatology takes a truly holistic approach to Rheumatology, evaluating medical history and lifestyle to come up with an individualized treatment plan. The Connected Rheumatology patient wants a more thorough approach to their health and well-being while being an active participant in their own care and health.

Developing a new way to deliver compassionate, holistic and state-of-the-art Rheumatology care (in a pandemic, no less!)...
12/31/2021

Developing a new way to deliver compassionate, holistic and state-of-the-art Rheumatology care (in a pandemic, no less!) has been quite the journey in 2021. Here's to continued growth in a happy & healthy 2022!

https://www.mdedge.com/rheumatology/article/249891/business-medicine/alternative-rheumatology-practice-models-aim-avoid?fbclid=IwAR0B1YCQBrk_i_ufEhRvX4Ov1nfa0Xogg__C1NseHZaEIexqyJlP2-zpJXI

Dissatisfied with the status quo and declining reimbursement, rheumatologists set their own rules with direct care and concierge pay models to better assist patients.

New blog post up and out! If ever faced with a prednisone prescription, you know the relief but also the fear of side ef...
12/20/2021

New blog post up and out! If ever faced with a prednisone prescription, you know the relief but also the fear of side effects that comes along with it. Learn about what it is, how we use it in Rheumatology, and most importantly, how to get off of it!

Prednisone use in Rheumatology is common but many don't understand it. Learn what it is, how it's best used and how to come off of it!

Check out our latest blog post! We discuss a common scenario found in Rheumatology clinics and give you a peek inside yo...
11/04/2021

Check out our latest blog post! We discuss a common scenario found in Rheumatology clinics and give you a peek inside your doc's process.

Without the anti-CCP antibody it can be hard to diagnose Rheumatoid Arthritis. Maneuver this common scenario and get to the right diagnosis!

Suggesting a person's emotional state could be impacting their physical symptoms can start a difficult conversation.Many...
09/24/2021

Suggesting a person's emotional state could be impacting their physical symptoms can start a difficult conversation.

Many of us worry that engaging in this conversation can "label us" and our questions & concerns will no longer be taken seriously.

It's tricky territory, I know. Unfortunately, those fears aren't entirely unfounded, but it doesn't diminish our need to investigate how our emotions are affecting our physical symptoms.

But how do we bridge this communication divide that can be created by this one word: "depressed?"

How can we feel confident we are being heard, while also remaining open to a conversation about our mental health?

Try this on your : "I understand my __(insert emotion)___ could be contributing to my __(insert symptom)___, but in an effort to not miss anything, are there any tests or consults you would recommend I pursue?"

And see where the conversation goes...😘

Happy Friday!

"Do you think you are depressed?"This question can cause a   visit to go south quickly! It can be such a loaded question...
09/22/2021

"Do you think you are depressed?"

This question can cause a visit to go south quickly! It can be such a loaded question, but it doesn't have to be!

Assumptions, misunderstandings and hurried visits don't do us any favors when starting to discuss our emotions and how they may or may not be impacting our symptoms.

💡We are comfortable with the concept that short-term emotions can lead to physical changes in our body. Fear = heart racing, palms sweating, Sadness = difficulty concentrating, poor memory

💡Long term or chronic emotional states can lead to physical changes too! These may be harder to see, however, if they have been ongoing for weeks, months or even years.

💡"Depressed" is likely overused. Let's be more specific with our emotions. Fear, Anxiety, Grief, Uncertainty....not everyone has to be crying or sad to feel an unpleasant symptom in their body.

💡Appropriate testing for symptoms is still...um...appropriate! Inviting the idea that our emotions could be contributing to our symptoms DOES NOT mean we forgo all testing! It simply completes the work-up.

Learn more in this week's blog & video!

With the over-specialization of  , we have lost something. Dividing up the body and it's systems into specialties and su...
09/20/2021

With the over-specialization of , we have lost something. Dividing up the body and it's systems into specialties and sub-specialties has created a false idea that our bodies, our systems, aren't, in fact, .

One of the most damaging divisions has been the separation of our and from the rest of our body. We pursue tests and consults for explanations to symptoms we feel in our body and never entertain investigating our brain or mind.

Being open to investigating how our emotions may impact our physical symptoms is seen as "giving up" or admitting it's "all in our head." This couldn't be further from the truth!

Incorporating into our usual work up for , , stomach pain, chest pain, , etc etc etc is EXPANDING our work-up, not limiting it.

Happy Monday!

Doctors can sometimes forget how to speak.After a decade (or more) of learning medicine and how to read scientific liter...
09/17/2021

Doctors can sometimes forget how to speak.

After a decade (or more) of learning medicine and how to read scientific literature it becomes second nature to speak "medicine." It becomes our default when rushed or stressed....which is how most doctors are while on the job.

How are we supposed to work together, when we don't speak the same language?!!

Let's begin to chip away at this divide and define some often used medical jargon, starting with "false positive"

Used in a sentence:
"Your result is a false positive."

A "false positive" simply indicates that although the result of the test is positive, the individual does not have the associated condition.

"Your ANA result is a false positive" = "Your ANA result is positive, but based on your symptoms, your physical exam and your other lab results, there is evidence you have an condition."

Happy Friday! 🙃
(leave your recommendations below for which jargon you want explained next!)

Often checked and rarely understood!A quick Dr.Google search of the anti-centromere antibody can send pulses racing! Und...
09/15/2021

Often checked and rarely understood!

A quick Dr.Google search of the anti-centromere antibody can send pulses racing! Understanding the basics, what it may mean and how your doctor thinks about will help put your in a position to do something about it.

🧬The centromere complex is a key part of our . As it is a part of our complex, and our DNA resides in the nucleus of our cells - the anti-centromere antibody is an antibody against something in our nucleus. ....see where I'm going with this? ...the Anti-centromere antibody is a TYPE OF (ANTI-NUCLEAR ANTIBODY). All this means, is that if you are anti-centromere antibody positive, you are most likely ANA positive.

🧬The anti-centromere antibody may be checked because of certain symptoms you have (ie phenomenon) or it may be checked simply because it is part of a large autoimmune panel checked by your doctor.

🧬The anti-centromere antibody is most closely associated with (aka limited ) but it can be seen with many other autoimmune conditions.

Learn more in this week's blog & video!

One of the earliest steps anyone interested in taking control of their healthcare can take is knowing their family histo...
09/13/2021

One of the earliest steps anyone interested in taking control of their healthcare can take is knowing their family history.

✔️Heart disease, cancers, mental health problems and autoimmune conditions are all important to note.

But with autoimmune conditions, don't limit your research to the condition you may or may not have. Any autoimmune condition in the family can put you at higher risk and is important information.

While doing this research, keep in mind - we are all different and finding out a condition runs in your family does not mean you are destined for this fate as well!

So much more than dry eyes! Everyone's path to the diagnosis of   is unique but almost all of them involve a lot of conf...
09/08/2021

So much more than dry eyes!

Everyone's path to the diagnosis of is unique but almost all of them involve a lot of confusion.

👀 Classically considered a condition of and - the most commonly affected organs in Sjogren's is the lacrimal and salivary glands. (which produce tears and saliva, respectively)

👀 But it can be so much more! , , rashes, photosensitivity and even lung and kidney problems can be see with Sjogren's. With symptoms that can mimic and , it's no wonder it can be confusing!

👀 Just to add to the complexity - Sjogren's is often seen WITH other autoimmune conditions. In these cases, it is always important to take the time to figure out, what is my Sjogren's and what is my other condition.

👀 We can't forget the association with lymphoma. This may sound scary but with appropriate check-ins with your , you can keep on top of this important possible complication.

Learn more in this week's blog & video! https://connectedrheumatology.com/sjogrens-syndrome-facts/ -1093

These are key questions to ask your   when you get a diagnosis of Sjogren's Syndrome.  Getting a diagnosis of   can be c...
09/07/2021

These are key questions to ask your when you get a diagnosis of Sjogren's Syndrome.

Getting a diagnosis of can be confusing and take a long time for many patients. Understanding the link between Sjogren's and other autoimmune conditions, like and will put you ahead as you position yourself to take back your health.

Learn all about Sjogren's Syndrome in this weeks blog and video!

https://connectedrheumatology.com/sjogrens-syndrome-facts/ -1093

Did you catch our latest Blog & Video post? Check it out to get into the mind of a   (usually a VERY nerdy place 🤓)and u...
07/30/2021

Did you catch our latest Blog & Video post?

Check it out to get into the mind of a (usually a VERY nerdy place 🤓)and understand how we think about treatment.

To treat any autoimmune condition is to become a master of the Risk:Benefit ratio. But this isn't only for the doctors, patients can and should do this too!

Understanding what is most important to you and your life, will help you & your doc make the best treatment decisions for YOU.

Starting treatment for   can feel like being on a runaway train. 🚄New medications at every visit. 😱Possible side effects...
07/28/2021

Starting treatment for can feel like being on a runaway train. 🚄

New medications at every visit. 😱
Possible side effects. 🥴
Possible drug interactions. 😔

It's no wonder compliance with our prescribed treatments is low!

Although prescription medication is NOT the only answer for those with , for many, it is a necessary part of a well-rounded treatment strategy.

Learn more about the meds available and how your rheumatologist uses them in our most recent blog and video post!

Making the right decision for your health can get complicated.There is so much information out there, especially when it...
07/26/2021

Making the right decision for your health can get complicated.

There is so much information out there, especially when it comes to and and so many things to consider when deciding on the right treatment for you.

We are inundated with headlines and horror stories of possible side effects. News stories, advertisements, advertisements that look like news stories, news stories that talk about the advertisements....it's all too much!🥴

The list of possible side effects for any given medication or procedure can be enough to make anyone run for the hills. 🏃‍♀️

But when thinking about your own condition and putting your list of questions together for your doctor, keep in mind: POSSIBLE IS NOT THE SAME THING AS PROBABLE.

Ask your doctor:
❓What are the most common side effects you've seen and how can we: a) prevent them or b) catch it early?

❓Are there any other treatment options?

❓What signs or symptoms could I experience that let me know I'm having a side effect?

Your doctor is there to help you navigate these issues but knowing what to ask is key!

There are so many ways we can keep track of joint pain and inflammation when you have conditions like  . 🔥Doctors tend t...
07/23/2021

There are so many ways we can keep track of joint pain and inflammation when you have conditions like . 🔥

Doctors tend to focus on labs while patients tend to focus on pain, which can lead to a lot of crossed wires in the clinic. 🤦‍♀️ Given how individual pain is and how quick our appointments are, it can often feel like our doctors don't REALLY understand how much pain we are in.

Keeping track of how often we reach for our anti-inflammatory pain medications can help bridge that gap. It gives both the patient and the doctor a lot of useful information and can get everyone on the same page.

Take note:
✏️ How often do you need your anti-inflammatory med?

✏️ Are you usually needing it in the morning, at night, or it seems random?

✏️ What part of you hurts when you reach for it?

✏️ Does it actually help with the pain?

Paying attention can go a long way in getting you feeling better!

Getting a diagnosis of   is life changing. It impacts every part of your life, but one thing that many find difficult is...
07/21/2021

Getting a diagnosis of is life changing. It impacts every part of your life, but one thing that many find difficult is dealing with all the new medications. 💊

It can be particularly hard when you have never had to take medication before. One can easily go from zero to 6 meds a day! 😬

Know what your medications are, what the possible side effects are and WHY they are being prescribed to you will enable you to:

➡️ Feel more confident in your treatment plan
➡️ Keep up with your treatments
➡️ Have more productive conversations with your doctor

Check out this week's blog and video to learn more!

What a blessing to have so many options now for Rheumatoid Arthritis! 💊💉But many factors go into finding the right medic...
07/19/2021

What a blessing to have so many options now for Rheumatoid Arthritis! 💊💉

But many factors go into finding the right medication for each individual. Friends, family & social media may mean well with their opinions but the decision regarding which med to use is between you and your doctor. 👩🏻‍⚕️

Educating yourself on your symptoms and the treatment options is a good first step towards working with your doctor to find the right med for you!🤝

Arthritis is simply a reminder to take care of your body. NOT a mandate to hang it out to dry.👟The best antidote to stif...
07/16/2021

Arthritis is simply a reminder to take care of your body. NOT a mandate to hang it out to dry.

👟The best antidote to stiff joints is to keep 'em moving! 👟

It may require a little trial and error to find the activities you enjoy and make you feel good, but it's worth it!

Take your pick: (or let me know your favorites in the comments!)

💛 Walking
💛 Swimming
💛 Dancing
💛 Yoga
💛 Pilates
💛 Barre
💛 Tai Chi

This is how you would plan a   vacation in 1993. At your kitchen table reading the most up to date Disney Vacation Plann...
07/15/2021

This is how you would plan a vacation in 1993. At your kitchen table reading the most up to date Disney Vacation Planning book. 📖

My mom, like my dad, was a big believer in the 5 P Method.

Proper 👏Planning 👏Prevents 👏Poor👏 Performance👏

And in this pic, I'm pretty sure she is planning how she is going to trick me into getting on , knowing full well, I'm a giant scaredy cat. 🙀

The spontaneity of life is what keeps it interesting, but not in the doctor's office. Coming to your visit prepared will help you get the most of your appointments. I find the 5P method can be used in any number of situations, but especially when preparing to see your doctor.

But how to prepare?

📝1. Have your questions written down - with your most important at the top.

📝2. Educate yourself on your condition and medications. Know what you are taking and if you need any refills.

📝3. Be specific with your symptoms. Are you having pain? Where is the pain? When does it happen? What makes it worse or better? Being as specific as possible, helps your doctor get to a diagnosis.

📝4. Do you have forms you need the doctor to fill out? Have them ready at the beginning of the visit.

📝5. Take notes during the visit. Ask you doc if you can record what they say, so you can listen to it again to make sure you understand everything.

#1993

We continue on our journey through all things RA!This week is Part II of our series: The Top 10 Facts about Rheumatoid A...
07/14/2021

We continue on our journey through all things RA!

This week is Part II of our series: The Top 10 Facts about Rheumatoid Arthritis. We get into the genetics, the treatment and what YOU can do to ease your pain.

To feel your best in the face of RA, you MUST take an active role in your treatment and your health. ☑️ Understanding how your doctor approaches RA and your treatment will help you have productive and effective conversations about the best treatment for YOU. 🤩



Learn more in this week's blog and video!

Even what seems like simple decisions, should be approached with intention and with eyes wide open 👀.Walking out of appo...
07/12/2021

Even what seems like simple decisions, should be approached with intention and with eyes wide open 👀.

Walking out of appointments with prescriptions or orders for things you don't understand, doesn't do anyone any favors. Knowing WHY you are doing something increases your chances of following through and getting the desired effect. 🙌

But what if you doctor doesn't explain? THEN ASK!🗣️

🔸"Why do I need this?"
🔸"How will I know if it's working as it should?"
🔸"What are some of the more common side effects?"
🔸"What would happen if I don't take this?"
🔸"Are there any other options?"

You deserve to participate in your own care. That means that you do your homework on your condition and that you know your body. This can allow for a true back-and-forth with your doctor, so that together you can reach the best plan for YOU.

Happy Monday!

Rheumatologists are joint whisperers. We are trained to be able to identify the slightest inflammation or abnormality wi...
07/09/2021

Rheumatologists are joint whisperers.

We are trained to be able to identify the slightest inflammation or abnormality within the joints. We HAVE to be able to do this because our blood tests are imperfect.

Understanding auto-antibodies lab results is a vital ingredient to making a good rheumatologist. 🔬But being able to sniff out the inflammation in a joint makes for a great one. 🥇

Did you miss this week's blog and video? We are talking all things Rheumatoid Arthritis!

Rheumatoid Arthritis is an autoimmune, systemic, inflammatory disorder that affects millions of people around the world....
07/07/2021

Rheumatoid Arthritis is an autoimmune, systemic, inflammatory disorder that affects millions of people around the world.

The fear of developing it as we develop aches and pains as we age drives many to seek out a rheumatology consultation. But it doesn't have to be scary. 😱

Knowing what doctor's look for, what questions we will ask and how we approach diagnosing it and treating it, will help ease your anxiety and help you become a true partner with your doctor. 🤝

Check out this week's blog and video to learn more!

Labs like the Rheumatoid Factor and the anti-CCP antibody are important. But they tell us the entire story.📖How you have...
07/06/2021

Labs like the Rheumatoid Factor and the anti-CCP antibody are important. But they tell us the entire story.📖

How you have been FEELING and what your joints look like will always tell us more.

Don't let lab results send you for a tail-spin. They are simply clues we use to help us understand your body and your condition. 🔍

New Video drops today! Don't miss it!

Happy 4th of July!Stay safe!🇺🇸🎇🇺🇸🎇🇺🇸🎇🇺🇸🎇🇺🇸🎇🇺🇸
07/04/2021

Happy 4th of July!

Stay safe!
🇺🇸🎇🇺🇸🎇🇺🇸🎇🇺🇸🎇🇺🇸🎇🇺🇸

I love the movies! 🍿Specifically I love sci-fi 👽, fantasy🧝‍♀️, comic book🦸‍♀️, and space movies🚀. But I won’t just go wi...
07/02/2021

I love the movies! 🍿Specifically I love sci-fi 👽, fantasy🧝‍♀️, comic book🦸‍♀️, and space movies🚀.

But I won’t just go with anyone to the movies because I have a “situation.” No talking (except during the previews, just to say “I want to see that”) and no bathroom breaks. I don’t want anything getting in between me and (insert superhero, alien, wizard, hobbit, jedi or elf).🤓 I get so into the movie that I hardly move and when the movie is over, I'm not quite jumping out of my seat like I used to.

When I started seeing patients with AS and other spondyloarthropathies, this scenario was the first thing I thought about when learning of the back stiffness AS patients can experience. And it is why I ask patients “When you see a movie, is it difficult for you to get up? Have you stopped going to movies because you know you can’t sit for that long without pain?” Granted, this question might not be so poignant anywhere outside of LA (where I was at the time) but it definitely gave me alot of information. ☝️

Stillness becomes the AS patient’s worse nightmare. Sitting, standing or laying down for extended periods of time can cause the low back (the joints, muscles and tendons) to tighten up, causing severe pain. The stiffness can make it difficult to walk for hours.😖

Thankfully, we have many more medications, specifically targeted and developed for AS and similar conditions, than we did when I started working in rheumatology. I love seeing patients get back to their loved activities…and the movies!🎬

To learn more check out this week’s blog and video post and make sure to share! AS patients can be misdiagnosed for years, so the more people we educate about this condition, the better!

Ankylosing spondylitis (or any of the other sero-negative spondyloarthropathies) are not conditions many people have hea...
06/30/2021

Ankylosing spondylitis (or any of the other sero-negative spondyloarthropathies) are not conditions many people have heard of. By the time someone gets diagnosed with AS, they may have spent YEARS bouncing around doctor’s offices, being told they needed to lose weight, cut foods out of their diet, or see a psychiatrist. This can last even longer for women or people of color.😡

AS is a systemic autoimmune inflammatory arthritis, similar to rheumatoid arthritis. But unlike, RA, the inflammation is not in the small joints of the hands, wrists or feet, but in the back, knees, shoulders and tendons. The treatment strategy, however, is similar: treat early to prevent any long term damage.

Thankfully we are not only getting better at diagnosing AS early but we also have many more medications that are targeted specifically for this and similar conditions (as opposed to just using RA medications and hoping they work).🙏

The topic of AS and all the spondyloarthropathies (hint – spondylo = back, arthro= joint, pathy = disease) is more nuanced than an IG post can handle, so to learn more, check out this week’s blog and video post!

😈Hahaha – for no reason except it made me laugh. Hoping everyone’s week is starting with a laugh!🤣
06/28/2021

😈Hahaha – for no reason except it made me laugh.

Hoping everyone’s week is starting with a laugh!
🤣

Did you miss this week’s blog and video post? 🧐This week we talked about all things Raynaud’s, answering the 3 top quest...
06/25/2021

Did you miss this week’s blog and video post? 🧐

This week we talked about all things Raynaud’s, answering the 3 top questions Rheumatologists get.

Follow the link to learn more and Happy Friday!

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