Pediatric to Adult Transitioning with PsA
Last updated: June 2018
You know you have psoriatic arthritis when you visit your rheumatologist more than you visit your family. Eventually, you really come to know and trust them, and this is especially true for kids and their pediatric rheumatologists. The unfortunate part of having a great pediatric rheumatologist is one day, you will be an adult and will have to find another doctor. Transferring to adult care can seem like a daunting and even sad task, but with the right planning, information, and mindset, it can be a smooth transition.
Most people get so caught up on having to change physicians, that they forget that it’s not the only part of pediatric to adult transition; it’s about transitioning responsibility from the parent to the child. In my own experience, I found it so much easier to begin becoming responsible for my health before I even considered adult care. While under my mother’s supervision, at age 12 I could follow my medication schedule, at 14 I scheduled my own appointments, and at 16 I learned to fill my prescriptions. So once I went to college and started seeing an adult rheumatologist by myself, I was confident in giving her an accurate health history, filling out information, answering questions, and wasn’t calling my mum every five minutes for help (which made her very happy).
The age of transition usually occurs between the ages of 16-22. Sometimes the hospital or rheumatologist have an age limit, however most of the time it depends on the patient’s preference; there are college students who hold onto their doctor as long as possible, and 16 year olds who feel too mature for the colorful children’s wards. I would’ve stayed with my pediatric rheumatologist forever if I could have; I had an amazing patient-doctor relationship with him. I only transferred at age 19 because my doctor left my hospital and it made more sense to go to adult rheumatology. Many of my friends stuck with their pediatric rheumatologists through college, with the exception of one who transferred at 16 because the children’s hospital was two hours away from her. There’s not a perfect age for everyone to transfer, just a right time for each individual.
When the time comes to pursue an adult rheumatologist, you need to do your homework. You might even see a few different doctors. I recommend finding a rheumatologist who is used to treating young adults. My current rheumatologist cares for many young people, and she has amazing insight into dealing with arthritis while at college or starting a career. Some hospitals offer young adult transition clinics, so high school students can be treated by both pediatric and adult rheumatologists and already have a relationship with their adult rheumatologist when it’s time to fully transfer.
Even after finding an amazing rheumatologist and feeling totally confident to be independent, I admit that transitioning can be a sad time. I think that having some sort of closure is important, and that may look different for each individual. During my last appointment, I gave my pediatric rheumatologist a letter thanking him for the years of amazing bedside manner, getting me through some of the worst of times, and for every “suggestion” that I do physical therapy. For me, that small gesture was the closure I needed to move on. It was hard, but it was the right time. And only you and your doctor will know when it’s time to transition.
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