Re: Re: Question about lab results

April 15, 2005

,

I'd get that stupid word right out of your vocabulary!!!!! It sounds

like you've been doing your research and learning about these tests and

what they mean. Pretty smart if you ask me! Diagnosing rheumatic

conditions is frustrating as you're finding out. It's even more

frustrating for doctors that know early treatment has the best outcome.

But without a firm diagnosis, many doctors are reluctant to start

treatment. Have you been running a fever? Rash is also common in

several rheumatic diseases, and with a positive rheumatoid factor, RA

is a possibility.

The CRP is a more accurate test for inflammation. CRP levels move up

and down much more quickly than sed rates during inflammation. So if

you weren't flaring when the test was taken, it could explain why your

CRP is normal. Sed rates aren't as reliable as the CRP and many

factors can change their values.

CRP can detect inflammation sooner than ESR because CRP levels become

elevated within 6 hours of the start of inflammation. ESR levels

increase about a week after the start of inflammation.

http://my.webmd.com/hw/health_guide_atoz/tu6309.asp

I'd push for imaging studies to see if there is any bone erosion. Many

times doctors will want imaging done early in the disease to monitor

progression of erosion and to determine if treatment is effective.

x-rays don't always pick up minor erosion in early disease, but MRI and

ultrasound will pick up early erosive changes. It sounds like you have

a very caring GP. We'd all like the pain and fatigue to go away. I

don't think that is to much to ask.

a

On Apr 15, 2005, at 12:24 AM, tandarat wrote:

>

> Thanks, a.

>

> I actually have gone and read a few of the sites you mentioned in

> this post already, and I read the ones you suggested earlier, but

> putting them all together makes even more sense. Thank you. I've

> gotten " stupid " in the last year or so, and it is frustrating. I

> actually know someone with ANA-negative lupus, which she contracted

> after a bout with lyme disease. I'm not sure if this rheumatologist

> believes in it, though. The lab highly suggests retesting in 2-4

> weeks to see if the anti-dsDNA has gone up or my ANA becomes

> positive. I doubt he'll do it.

>

> I also understand the CRP will go down faster than ESR, but if my

> ESR rose 10 points in three weeks, does it make sense that the CRP

> is still " normal " ? I also thought that RF rises when the disease is

> more active...mine had more than doubled in that three weeks. I'm

> still not sure if the N in the results is correct or not, since both

> references for normal on the test were much lower than what mine

> was. It just doesn't make sense to me, and, of course, I'm probably

> not going to get an answer from this rheumy. I do know that a

> couple of days before my appointment, I suddenly went through some

> really severe muscle and joint pain. It only lasted a couple of

> days, and was starting to get much better the day I went in, though

> I was still pretty darn sore. This was the first time my hands and

> feet were involved more than being stiff, and the area around my

> joints in my knuckles swelled noticeably, and my knuckles were red.

> I also had a reddish rash on my cheeks and nose, much like the one I

> get when I'm outside too long, but much larger, covering my entire

> cheek and nose, rather than just the upper portion of my cheek and

> maybe the bridge and part of my forehead if it gets really bad.

> That only lasted a day. Weird, huh?

>

> In answer to your question about my ankles...no I have not had xrays

> done on them...yet. I'm guessing that if I don't get a

> rheumatologist by the time I go in to my doctor again next month,

> she will order them. My cholesterol is also quite high, but she

> said she doesn't even want to think about treating that until we

> find out what is going on with this. Considering I have heart

> disease in my family and have at least two separate arrhythmias, and

> have had surgery to correct one of them which was only partially

> successful, holding off controlling my cholesterol tells me she is

> pretty worried about what is going on. She did say that she is

> concerned, and wants an answer as quickly as possible, but doesn't

> know enough about autoimmune disease to pursue it herself.

>

> I'm just a little frustrated and confused, that's all. I don't have

> much patience, anyway, and when I'm sore and cranky I have even

> less. I'd like to figure out what is going on so I can start

> treating it, and at least minimize the damage. I'd also like to not

> be tired anymore, and I'd like the pain to go away, too. Not asking

> for much, am I?

>

April 15, 2005