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Old 09-26-2012, 02:36 PM   #1
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Rheumy order weird test, didn't check past labs

Finally after months of waiting, I seen a rheumy. She ordered very strange tests. Didn't redo any that were done back in February, a lot of stuff was border line in indicating a problem. She seemed to dismiss that I repeately get an ANA of 1:1280. I am in so much pain, prescribed me Etodolac 400 MG & METHOCARBAMOL 750 MG TABLET. I pick them up today??? Never even heard of them.

Test ran Creantine Kinase Total, Aldolase, Angiotensin Converting Enzyme

I wish she would of talked to me more. Basically told if something shows up, we will call you in, otherwise see you in 3 months.

Just very frustrated.

I have hypothyroidism, no antibody though. Been taking meds since May. They said that there is no way that the thyroid was causing my tendon/muslce pain.

• Extreme pain all day long in wrist, shoulder and elbow (rotary cuff pain, tennis elbow pain, and carpal tunnel) started July 2nd. Only thing that has helped was getting steroid shot. Last one was 8/31/2012 40 mg Kenalog
• Calves that felt like ice picks stabling them. It was almost daily until recently, now it is just 2 times or so a week. Lasting up to 72 hours then will stop a day, then start back up.
• Charlie horse cramps that range from calves, shins, thighs, under my breast, back.
• Joint pain & weakness especially in the morning
• I can no longer sleep on the right side of my body because of shoulder and elbow pain.
• I wake up in the middle of the night from hand , arm and foot tingling and numbness/asleep up to 5 times a night.
• 1st step out of bed, pain in my feet and calves.
• Getting canker sores in mouth about once a month, pretty severe.
• Getting yeast infections once per month. Difican not helping. Taking probotics.
• I get sharp pains shooting down my arm to my fingers.
• Hands are stiff and ache and I have no hand strength.
• I have tender spots all through out my body. Like I am bruised.

 
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Old 09-27-2012, 06:40 AM   #2
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Re: Rheumy order weird test, didn't check past labs

What is the pattern to your ANA test? were there other antibody tests done as well? Do you have a high SED rate? As to the meds, one is an anti-inflammatory and the other is a muscle relaxant. They should make you feel better, in any event. And yes, hypothyroidism can cause tendonitis and such, as well as raise your ANA. Are you at optimal hormone levels yet? And Vit D levels, have they been checked? Extremely low levels can cause many of the symptoms you describe. It is often frustrating when dealing with possible autoimmune disorders, but a 3 month follow up is great. As always, I suggest that on your next visit, have a list of up to 5 questions that you want to discuss or get answers to. Don't bring along printout from Dr Internet, though. Much of what is out there is not always reliable. That way, I think patients and Drs can work together in understanding what may or may not be going on and focus on getting better, regardless of the cause. And remember that lab values do not reflect the whole story in AI disease, and symptoms can often be vague or mimic other things. I wish you the best!

 
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Old 09-27-2012, 07:14 AM   #3
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Re: Rheumy order weird test, didn't check past labs

My levels are not optimal, just got increased from 60 to 90 mg. of Armour. I take Vit D daily, Vit E, (Glucosamine, Chondroitin, & MSG), Cal/Mag. Potassium.
Sed was 13 range 0-15
ANA 1:1280 diffused speckled,
previous test was 1:320 homogeneous
ALT 35 range 10-35
CRP .4 range 0.00 - .5
Albumin range 4.6 range 3.5-5.2
Rhemetoid factor 11 range 0.00-14.00
Cal, Vit D, potass, all that stuff was in range.

So really, they did a lot of labs and nothing stood out. But when I went in it was only problems with my calves. My calves bother me about 2 times per week, but my shoulder and arm, wrist... oh my.. it can be level 10 on some days. 5 - 7 avg. Only thing that has helped is the steroid shot, which they don't like doing.

No TPO antibodies...

So, looking through my reports Feb. 2012 my Rheum factor was 7
April 22 the factor was 11

is that normal to change that many points?
She did not re-do any test from Feb or April.

 
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Old 09-27-2012, 08:43 AM   #4
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Re: Rheumy order weird test, didn't check past labs

Levels can jump around a lot, depending on why they are elevated to begin with. Were any other antibody panels run with those ANA results? And yeah, I know that tendonitis really, really hurts. Is your pain bilateral or on one side only? That can also be a clue as to the nature of your problems. It is good that your SED rate and CRP are not elevated though, as that is the another clue that Dr's look at when trying to solve an AI puzzle. Hang in there with your thyroid meds! It can take a while to get everything working the way it should! I have Hashi's and was doing a thyroid blood test every week there for a while, lol. I know your frustration but it does sometimes take a while to tease out solutions to our problems.

 
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Old 09-27-2012, 12:22 PM   #5
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Re: Rheumy order weird test, didn't check past labs

creatinine, c4, c3, crp, albumin, rhe factor, c-reaction factor, alt, g6pd qual, ENA AB Panel, DSDNA AB, HBc antibody, HBs Surface Antigen, ALK PHOS, AST, Bilibubin, Bun, Calcium, Potassium, Co2, Eltrolytes, Glucose Random, Protien, CCP igG/IgA cyclic Peptide antibody, TPO, Lyme IGM, Lyme AB, HIV1, HIV 2

this is a somewhat complete test list. Of course standard UA, Blood count workup.

Nothing stood out.

 
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Old 09-27-2012, 01:18 PM   #6
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Re: Rheumy order weird test, didn't check past labs

many of these tests are for communicable diseases including hepatitis, Lyme and HIV. They also looked at your general health and looked at the possibility of rheumatoid arthritis in the beginning stages. The ENA panel was the antibody test for some of the more common autoimmune markers. The Lupus board here has an excellent sticky(ies) on the various symptoms of lupus and is an excellent resource. I can say that if your pains are bilateral as opposed to occurring on one side, it is more likely that you may have an AI process going on. Believe me, I know your frustrations. But these things do take time to sort out. It is good that none of the other tests were out of range, at least. I am wishing you the best.

 
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Old 09-27-2012, 01:27 PM   #7
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Re: Rheumy order weird test, didn't check past labs

Tender points are equal on both sides of the body, but the shoulder, arm, wrist are only on the right side.

ANA has been positive on 4 blood tests starting in February. Last one was 1:1280, not that it means much.

I have been married for 25 years, if looking for a communicable disease, they are barking up the wrong tree.

Thanks so much for your info, I am going to explore the Lupus board, just for info. Who knows, maybe something will stand out.

 
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Old 09-27-2012, 01:34 PM   #8
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Re: Rheumy order weird test, didn't check past labs

The CK and aldolase tests are for myositis, an inflammatory condition of the muscles that causes pain and weakness. It too is autoimmune and can occur in lupus as well as other conditions. Serum ACE is a test for sarcoidosis, that can cause arthritis and other problems, and is considered a granulomatous disorder. Granulomas are like balls of scar tissue that replace normal tissue, and in sarcoidosis it occurs in excess. Have you ever had Smith antibodies checked? Those are very specific to lupus and if positive can help confirm that diagnosis. Not everyone with lupus has them, so a negative doesn't mean anything.

 
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Old 09-27-2012, 01:57 PM   #9
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Re: Rheumy order weird test, didn't check past labs

I only had the anti-dsDNA test done...

No smith

 
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Old 09-27-2012, 02:06 PM   #10
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Re: Rheumy order weird test, didn't check past labs

Actually, the ENA panel that you had tests for all sorts of autoimmune antibodies, of the common sorts that you might find in Lupus, Sjogren's, Scleroderma and the Smith antibody is included in that. LOL, me too @ 25 yrs!

 
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Old 09-27-2012, 02:11 PM   #11
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Re: Rheumy order weird test, didn't check past labs

In your post #5, did you have all these tests done previously and nothing stood out or are these all the tests your new rheumy ordered? It is normal for results to fluctuate each time, so the change in RA factor is not meaningful. Your ANA is quite high, which is clinically significant given all your symptoms. Titers in ANAs are done by dilution, so the bottom number doubles with each dilution, like 1:40, 1:80, 1:160, 1:320, 1:640, 1:1280 and so on.

 
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Old 09-27-2012, 02:41 PM   #12
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Re: Rheumy order weird test, didn't check past labs

Only new test done wereCreantine Kinase Total, Aldolase, Angiotensin Converting Enzyme, HIV 1, HIV 2
I think the HIV were standard given to everyone every 6 months...

My ANA has been tested 3 times, I thought it was 4.
2) 1:320 & last time 1) 1:1280 that was April 28th.

It does make me curious what it is now. Whatever is going on has gotten much worse.

I am in significant pain. It is controlling my life.

 
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Old 09-27-2012, 09:10 PM   #13
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Re: Rheumy order weird test, didn't check past labs

I think that the steroid shots that you took in july has weakened your immune system and that is causing the yeast infection and other mouth issues and viruses ..

If all your tests are normal . there is a good chance that this is CFS or Fibro .. have you researched about this ? .. these 2 have not know tests associated with them to diagnose them, so its usually very difficult to diagnose them. did they run a full lupas panel for you ? ? .. it doesnt look like lupas though as you dont seem to have any skin issues. .

ALso what was you vitamin D levels. . that could be a reason . .mine came out to be 13 .so on that rit now ..

I am in a similar situation for the past 3 months , and my docs are saying its an autoimmune but they dont know which . . so i am kind of jst hanging around with no medication for now.jst the D. which is really frustrating. .

Last edited by achillez16; 09-27-2012 at 09:13 PM.

 
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Old 09-28-2012, 08:59 AM   #14
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Re: Rheumy order weird test, didn't check past labs

I need to have my ANA done again. The steroid shots I got were done after the high ANA. I got the creatine kinase test back and it in mid range. So muscle damage has been ruled out.

I also had a steroid shot done August 30th. So, based on what you are saying, I get the yeast and ulcers exactly one week after I get the shot. That is something to look into. But, considering the pain I was in for 5 days, cutting my arm off at the shoulder would of made perfect sense to me.

 
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