TheLupusSite.com banner

1 - 4 of 4 Posts

·
Registered
Joined
·
336 Posts
Discussion Starter #1
Sorry this post is long but I have been mulling over this for a few days and wanted others opinions on what is going on now.

I had my Neurologist appt Tuesday and all is basically OK. He gave me some samples of 2 other Migraine meds because the one I had been taking has been giving me some side effects I don't like much. I told him my headaches had been increasing here recently (like the last month or so).

I also asked him about my muscle twitches and tingling hands and feet.

He spent a long time listening to my carotid arteries while feeling my pulse in my wrists at the same time, and even for awhile afterward, he kept on checking my wrist pulse in both wrists. He didn't say anything about it (either good or bad) and I didn't ask, wish I had now. He also spent a fair amount of time listening to my heart, asked about what the Rheumatologist has said about my "arthritis" and what kind did she say I had (Sjogren's syndrome, possible lupus but no ds-dna or sm antibodies at this point).....

He felt like the hand and feet tingling were probably coming from my neck and my back (degenerative spondylolisthesis at multiple levels) and as long as they were mild and intermittent he would just watch them, but I am to call him if they get worse or more frequent....and he told me with my spine being like it is to be careful and not fall or get in any accidents!! I know that...LOL

He said the muscle twitches sounded benign but again said to call if anything worsened or new symptoms came up....Kind of sounded ominous to me....I wish I had asked more questions now.

I also got a copy of my labs from the Rheumy.

ANA and all ENA antibodies are negative, but the ANA is listed at 1.1 with positive being >1.09.....so wouldn't 1.1 be positive?
I had read somewhere that this testing method 1.1 was equivalent to 1:160 on the FANA. (I have been as high as 1:1280 in the past so it is really a mute point to test it at this time)

All the other antibodies were negative and a lower number than last time she ran them so overall everything is down.

My CBC and CMP had all kinds of flags though and wondered if anyone could help figure them out for me.

My MCH was high at 31.3 (range 27-31.2),
Monocytes were low at 3.6% (4-13%),
Granulocytes high at 77.6%(40-74%)
and my Lymphocytes were at the bottom of the range at 1710 (1700-3560).

My Sodium was low 132 (134-149),
CO2 low 19.7 (21-32),
Creatinine high 1.9 (0.6-1.3)
and Alkaline Phosphotase low 45 (50-136)

My Sed rate was 20 (0-20),

RF 13.2 (0-16) this is much higher than it has ever been for me before though.

I've never had so many things be off at one time, usually it is 2 or 3 things only....

My rheumy didn't call or anything so I guess I won't worry about it and just ask her at my next visit in November.

I know this is a lot, that is why I am having trouble putting it all together, guess that is why I'm not a doctor though.....What do you all think? I know you aren't doctors either but do any of these jump out at you as something I should look into more with my doctor before my next visit. I am feeling about status quo, some aches and pains and fatigue etc, etc... but nothing to bad at the moment.

Nancy
 

·
Registered
Joined
·
4,444 Posts
The only thing that really jumps out at me is your high creatinine. And I have noticed that there are no U/A results (urine test)? Were you on high doses of NSAIDs when the blood was drawn or on any other meds that can make the creatinine go higher? This test indicates that your kidneys aren't functioning at a good level, and is really the only one of your results that would concern me. Mostly because the other ones are only barely out of range. Alkaline Phosphotase being low is almost never of any concern... higher levels are more concerning than lower levels actually! Likewise with CO2 being a little low.

Don't you just hate it when after the appointment you start wishing you had spoken up and asked what they were checking for/thinking about while doing certain parts of the exam? The carotid artery thing... it is known that lupus patients are at increased risk for blockages in the carotid arteries, so I'm sure he was evaluating you for that possibility. If he had found/heard/felt anything suspicious, then I'm sure you would have been sent for an ultrasound of your carotid arteries. The fact that he didn't do this should be overall reassuring.
 

·
Registered
Joined
·
336 Posts
Discussion Starter #3
Thanks for responding

Maia,

Thanks for responding. It's funny how when something new comes up I revert back to the tongue tied patient in doctors offices. If it is something I know about I can talk/ask questions easily!! :lol:

The only thing that has changed in the last couple of months medication/health-wise is I have been having ongoing GI problems to the point I have stopped my NSAIDS (thank goodness the Plaquenil is working well enough now that I can manage without the NSAIDS). I am on BP meds, Thyroid meds, Plaquenil, Evoxac, Lipitor, baby aspirin, Protonix, and of course Lodine (NSAID) prn that I did take most days until about 2 months ago, migraine med prn.

I went to the doctor about the GI stuff and she put me on a bland diet (the BRAT diet) to rest my GI tract and also prescribed antibiotics for 7 days as there has been a bad GI bug going around the area (Cryptospiridium) - I didn't want to do any culture so she agreed to try the antibiotics first but said if it continued I would have to do some other studies:sad: to find out what was going on. I got better initially but now, 3 weeks later, it is all starting up again so will probably be giving her a call next week.

I had just had a UA done a couple weeks before the rheumy appt and other than a few WBC's and my bilirubin being 2+ it was OK (no protien, blood etc...)

I have had some ankle swelling last weekend for 3 days but also was driving out of town for about 5 hours each way, so I thought it was from that. There is no swelling now. Guess I will ask my primary about all of this when I see her about the GI stuff next week.

Thanks again for your reply, it really helped. I knew creatinine had something to do with kidneys, but didn't know exactly what or if it was something to follow-up on.

Nancy
 

·
Registered
Joined
·
4,444 Posts
Some of the meds you take (particularly the BP meds) can kinda artificially raise the creatinine level such that while it may be elevated it's not elevated due to bad kidney problems but more just due to the medication. Hopefully that is the case for you. Definitely something to ask your doctor about though too as a creatinine that high corresponds to a fairly low GFR. {there are calculators online to calculate your GFR if you're interested = Glomerular Filtration Rate). Depending on age/gender/race... your GFR would likely be in the 30s somewhere which is fairly low.

Your discussion about your digestive difficulties recently actually most likely explains a lot of your other slight blood abnormalities as they often are found with diarrhea/malnutrition problems.

Good luck & I hope you post with an update soon with answers from your doctor too!
 
1 - 4 of 4 Posts
Top