All Boards >> The Living Room

Posts     Flat       Threaded

Pages: 1 | 2 | 3 | 4 | (show all)
lupus/RA -- what to expect/ask rheumatologist?
      #271358 - 06/28/06 08:51 AM
jen1013

Reged: 05/06/05
Posts: 1322
Loc: the wabe

I posted about this several days ago (and thanks to everyone who responded). I've been having symptoms that made my GP suspect lupus or RA. She ran bloodwork on me and my ANA was positive. So off to a rheumatologist I go.

So, from the people here who have been diagnosed with lupus/RA ... what kind of tests should they be doing? (Do I have to shave my legs?) Are there certain things I should be asking?

I also tested positive for anti-thyroglobulin antibodies. My GP is starting me on a small dose of Synthroid to see if that will help, even though the other thyroid values were all within normal range. I looked up this test because I'd never heard of it and lupus was listed as one of the potential causes for a positive. Of course, thyroid disease is listed as one of the potential causes for a positive ANA, so who really knows what's going on at this point.

Anyway, I will do some obsessive Googling on lupus, RA, etc. before seeing the rheumatologist, so I'm not really looking for information on that -- I just want to hear what others had to go through to get diagnosed. And I guess I want to know what a good rheumy should be doing, too -- Michele, I've been following your story (so glad you have this great new doctor, but I'm so sorry her outlook for you isn't that great), and I'm afraid of getting stuck with a crappy doctor who just lets something progress instead of treating it.

Thanks!

--------------------
jen

"It's one of the most serious things that can possibly happen to one in a battle -- to get one's head cut off." -- LC

Print     Remind Me     Notify Moderator    

Re: lupus/RA -- what to expect/ask rheumatologist? new
      #271372 - 06/28/06 09:32 AM
michele

Reged: 06/02/03
Posts: 6886
Loc: southeastern michigan

Hi Jen! Sorry about the medical problems-I'm afraid I don't know about he thyroid test, my thyroid tests are always normal. However, as far as the ANA goes, you need to get to the bottom of whats causing it. They need to do a LOT more blood work, I just had yet another 12 vials of blood drawn this morning. I don't really know exactly what the names of all the blood tests were but the basics are the RA factor, sed rate, cbc blood count and a liver panel as most of the drugs they would use to treat Lupus or RA can have a negative impact on your liver so that will need to be monitored.

At the bare minimum, I would expect them to do some x-rays, at least hands and feet because bone changes usually show up there first. If you are having any specific problem with any other joints, they should x-ray those as well. They should do an external exam, probably best to shave your legs! They will poke and prode various places on your body, nothing overly personal. I wore gauchos and a twin set with a tank top yesterday and no bra, so I didn't have to get into a gown or anything.

I remember reading a bit about whats going on but my memory is a bit foggy to say the least. Can you give me a summary of your symptoms and I'll be able to help more!

--------------------
Taking it one day at a time.....

Print     Remind Me     Notify Moderator    

Re: lupus/RA -- what to expect/ask rheumatologist? new
      #271398 - 06/28/06 10:53 AM
Janey

Reged: 10/25/03
Posts: 1716
Loc: Maryland

I would definitely shave your legs. When I saw the Rhemy doc for the first time I changed into a gown (it was cold so I had jeans on) and he examined all the joints that I was complaining about, hands, wrists, knees, elbows, feet and ankles.

Like Michele said they will probably do blood work and x-rays. That is what happened with me.

Good Luck!

--------------------
Janey

Print     Remind Me     Notify Moderator    

Re: lupus/RA -- what to expect/ask rheumatologist? new
      #271409 - 06/28/06 11:55 AM
lj

Reged: 09/24/04
Posts: 179


Jen,

Yes, shave your legs! Also clip your toenails! I always forget that part and my rheum. always spends a lot of time on my feet because they are inflamed while I look at the ceiling trying to pretend that I'm not embarrassed about it! Expect to be sore after the appt because at least my doc always manipulates just about every joint in my body to note the level of inflammation.

Expect to give a lot of blood. Because there are no definitive tests for these types of diseases, there is a lot of overlap and a good rheum should check for other auto immune problems like Sjorgren's, etc, etc.

That's all I can think of right now and my daughter is crawling all over me. I will post again later if I think of anything else important.

Laura

Print     Remind Me     Notify Moderator    

toenails new
      #271629 - 06/29/06 12:38 PM
jen1013

Reged: 05/06/05
Posts: 1322
Loc: the wabe

Thanks Laura! I never would've thought about the toenails -- I've always just been able to leave my socks on even when I had to get undressed, so I don't even think about that. I don't know why I care so much, I'm sure that the doctors see way worse. Though I guess in general you want to avoid being the break room anecdote of the day!

I know you've said that your doctor isn't actually positive that you have lupus -- what symptoms/test results made him give you the tentative diagnosis? I've been reading about the diagnostic criteria for lupus and my head is swimming.

--------------------
jen

"It's one of the most serious things that can possibly happen to one in a battle -- to get one's head cut off." -- LC

Print     Remind Me     Notify Moderator    

Re: lupus/RA -- what to expect/ask rheumatologist? new
      #271631 - 06/29/06 12:46 PM
jen1013

Reged: 05/06/05
Posts: 1322
Loc: the wabe

Thanks Janey. Are you doing any treatment right now or is your doctor just waiting to see if your symptoms get worse?

--------------------
jen

"It's one of the most serious things that can possibly happen to one in a battle -- to get one's head cut off." -- LC

Print     Remind Me     Notify Moderator    

Re: lupus/RA -- what to expect/ask rheumatologist? new
      #271642 - 06/29/06 01:26 PM
jen1013

Reged: 05/06/05
Posts: 1322
Loc: the wabe

Thanks Michele ... I can't believe you got twelve vials of blood drawn. I had four taken a couple times recently and had a tough time making it to my car, so hopefully they won't need tons. On the other hand, I do want them to be thorough, so I guess if they need that much blood then I'll give it willingly. A doctor's office is a good place to pass out, after all.

As for my symptoms ... I went to my doctor initially complaining about really bad fatigue and joint pain. On a "normal" day the joint pain isn't bad, I just feel sore and stiff and creaky, but if I try to do anything remotely strenuous, the pain starts getting bad. It's worst in my elbows, wrists, and hands -- my knees bother me too (and actually hurt a lot right now). My fingers also swell up, nothing too bad though. And a little activity goes a long way -- I worked on scraping paint off woodwork a couple days ago and I still feel miserable today.

I do have a moderately bad case of endometriosis, which does cause fatigue and greatly contributes if not causes a lot of lower back pain (it gets unbearable during my period). So, this clouds the waters a bit.

My GP got all lupus-suspicious about a rash I had, but it was on my toe and not a typical lupus spot so I'm not that worried. It did show up when I was feeling really awful and faded away when I started feeling better, but could be a coincidence. I can definitely identify with several lupus symptoms, but since they're also symptoms of thyroid issues I'm not that worried. I guess the only thing that might be lupus-only and not thyroid is that I've been having problems with swollen lymph nodes for awhile, but maybe that could be explained by something else too.

I've also been having breathing problems and my chest really hurts when I try to breathe deeply, but chest x-rays looked OK and all of my allergy tests were negative (except very very very mild reaction to dust/cats) and I don't have asthma, so my pulmonologist is confused on that score. I know from what you're going through that you can have breathing/chest problems with autoimmune disorders, but unless I am mistaken this kind of thing should show up on chest x-rays, so I am going to assume that this is a different problem.

Basically, I am 24 and I feel like I am about 74, and I'm sick of it!

Okay, so that was a novel. Whew! I'll be seeing the rheumy on Monday with tidy toenails and shaved legs -- any other tips/advice you can think of would be much appreciated. Thanks!

--------------------
jen

"It's one of the most serious things that can possibly happen to one in a battle -- to get one's head cut off." -- LC

Print     Remind Me     Notify Moderator    

Re: toenails new
      #271650 - 06/29/06 01:46 PM
lj

Reged: 09/24/04
Posts: 179


Jen,

The tentative lupus diagnosis came after a positive ANA and anti-DNA. I'm also super sensitive to the sun. I have solar urticaria which is a fancy way of saying that I break out in welts when I go out in the sun. This can happen just from going into the store and then back to my car, not just from going to the beach or something like that. It depends on the time of year and cloud coverage too though.

I also have strange patches of skin on my scalp that come and go(OK gross, I know. Don't usually tell people about that one). Malar rash has been noted esp. after sun exposure. I also have sore throats and low fevers that last anywhere from one hour to several weeks.

Oh, and of course arthritis. That is what got me to the rheumatologist in the first place. My foot and thumb were so swollen last summer that he didn't think it was presenting like lupus. I did test positive for RA too, but the level was not sky high. My x rays have so far shown no joint damage. I am due for another round this summer.

The thing that confused him most is that my sedimentation rate is only slightly elevated and considering the symptoms and visible swelling, he was surprised.

Keep us posted on what happens. I have read your other posts and I know exactly what you mean about feeling 74 after trying to do anything remotely strenuous. Taking Carson to the park will do it for me every time. We're too young to feel this way!

Laura

Print     Remind Me     Notify Moderator    

Re: lupus/RA -- what to expect/ask rheumatologist? new
      #271660 - 06/29/06 02:15 PM
lalala

Reged: 02/14/05
Posts: 2634


Hi, Jen! This is kind of long, but I hope it helps. I've been really sick the past three years, thinking it was just frequent IBS attacks getting me down, but then realizing that a lot of other symptoms were not normal IBS symptoms. About a year or two ago I had an echocardiogram because I had open-heart surgery as a child and one of the doctors I saw was worried something might be up. But that was normal. Still feeling bad and starting to have anxiety and panic attacks, I continued to see my doctor and push for more answers, especially since I had similar problems in college.

So, my PCP ran the following blood tests (about six vials of blood):

CBC (complete blood count)
Sedimentation Rate
Comprehensive Panel/Metabolic
Glomerular Filtration Rate
Iron and TIBC

These came back normal, even the sed rate. But my PCP knew something was wrong because I wasn't getting better and was suffering from the following: pain with the slightest touch, high blood pressure when I was in pain, difficulty walking, insomnia, strange rashes for the past few years, general weakness, fatigue (sleeping 14+ hours a day), weight loss (down to 104 lbs, so about a 20 lb weight loss in less than a year), joint swelling...oh, and then one week my earlobes swelled up and then another week my right nostril was inflamed! Anyway, because of the muscle pain and swelling and moving and feeling like I was a hundred years old, she sent me to the rhuemy.

The rheumatologist checked my joints but couldn't feel any swelling except in my feet. He said this was good because he could tell my joints weren't damaged. He also moved my limbs around, not sure how to described it... He rotated my arms and legs, bent my fingers and toes. He also checked my skin and asked a million questions about my health history, symptoms, and family history. Be sure to bring a list of symptoms and find out if any family members have autoimmune diseases; he also asked if I had ever experience seborrheic dermatitis, eczema, sun sensitivity, rashes, or frequent fevers. Then he ran more blood tests (about four more vials):

CCP
ANA Lupus Analyzer Panel (5 different autoantibodies test)
some thyroid tests
CPK
RA factor

I ended up having a positive ANA with positive dsDNA autoantibodies (this is positive in 80% of people with lupus) and testing positive for the RA factor. So then the rheumatologist diagnosed me with lupus. He said I had a mild case of lupus (Oh boy, mild?! I really don't want to know what it's like to live with moderate or severe lupus!) because it hadn't affected my organs. After that diagnosis, he had me do a urine test to make sure my kidneys were fine. That came back normal as well.

Now I have to see him every six months and have blood tests once a year to monitor lupus activity. I also have to take Plaquenil/hydroxycholorquine indefinitely, even once my lupus goes into remission.

I just went fot my three month checkup on Tuesday. No blood tests, but he just wanted to see how I was doing with the medication (very well!) and to make sure I see the eye doctor every six months (a very rare side effect of plaquenil is vision loss). I asked him if I should expect to get sick (like colds or the flu) more often now, but he said no because Plaquenil is NOT an immunosuppressant. He also said I could still have flare-ups, but they'll be very rare as long as I'm on Plaquenil and make sure not to over exert myself or tan.

Please ask if you have any more questions. Oh, andLab Tests Online is a great resource if you want to find out more about various lab tests and screening for different diseases.



Edited by Maria!Maria! (06/29/06 02:30 PM)

Print     Remind Me     Notify Moderator    

Re: LJ new
      #271661 - 06/29/06 02:18 PM
lalala

Reged: 02/14/05
Posts: 2634


Your symptoms are a lot like mine. My sed rate tests always comes back normal, so even though I would have swelling and fatigue my doctors never thought of referring me to a rheumy. It was until things progressively got worse this past winter that my PCP decided to get a specialist involved.

How are you managing your lupus diagnosis?

Print     Remind Me     Notify Moderator    

Pages: 1 | 2 | 3 | 4 | (show all)

Extra information
0 registered and 1264 anonymous users are browsing this forum.

Moderator:  Heather 

Print Thread

Permissions
      You cannot post until you login
      You cannot reply until you login
      HTML is enabled
      UBBCode is enabled

Thread views: 7272

Jump to

| Privacy statement Help for IBS Home

*
UBB.threads™ 6.2


HelpForIBS.com BBB Business Review