Help! I have questions about RA

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areil
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Date Joined Feb 2006
Total Posts : 8
   Posted 2/15/2006 7:28 PM (GMT -7)   
I was told I had RA about a year ago. I had an ESR of 33 and ANA of 2.4.
Then I got tested again and had an ESR of 34 and ANA of 2.1.
Now I just found out i might not have RA because my ANA was 1.4 which is borderline, but my ESR is 37. Can someone tell me wha this means. Why would I have a higher ESR and a lower ANA now.

hippimom2
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Date Joined Jul 2005
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   Posted 2/15/2006 8:10 PM (GMT -7)   
Your ANA can fluctuate. ALso a positive ANA and elevated sed rate can indicate the possibility of several autoimmune diseases including RA, lupus, and some others. It can be really hard for docs to figure out what you might have because so many of these diseases have overlapping symptoms. Your doc will have to look at your labs and your list of symptoms in order to try to diagnose you. I have a positive ANA which is sometimes only mildly positive and also an elevated sed rate and a few other positive labs. I also have had a borderline rheumatois factor. Have they tested your rheumatoid factor? My rheumy seems to be leaning toward lupus, but I have a feeling it will be quite a while before I get a definite diagnosis. My doctor said that treating my symptoms is more important than labeling my disease and she has a point. I hope this helps a little. I'm sure other people will have more info for you. Trying to figure out these diseases can be very frustrating. Hang in there and welcome to Healing Well.
Dx:  Suspected Lupus 2004, CFS 1991, Secondary Raynaud's 2006
Meds:  Plaquenil 400mg, Tramadol 100 mg 3x day, Amitriptyline 10mg, Neurontin 100mg


areil
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Date Joined Feb 2006
Total Posts : 8
   Posted 2/15/2006 8:21 PM (GMT -7)   
Thank you, I hope they find out soon. I appreciate you help.

curley
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Date Joined Mar 2005
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   Posted 2/16/2006 7:56 AM (GMT -7)   
Let's see where do I want to start.Ok I have crohn's was diagnosed in 2-15-03and in 4-3-03 was diagnosed with RA and then I was told that I have OA amonth later and i came back posative for Sjerens syndrom and now I have a High HLA-B27 ANTIGEN DETECTED A.Ok this mean's that I carry the genes for these'disease's and that I more than likley have Lupus to boot.Oh and not let me forget i was told yesterday that I have ANKYLOSING SPONDYLITIS AS WELL and I high colesterol as well we tryed to get it down but was not able to do so so now I'am taking LOVASTATIN.

Just all way's be up front with your Doctor's and they will intern do the same.It is very imported to have trust in you Doctor and the same goes for him as well that way your Dovtor's can treat you a lot better.
Thanks
Curley......
a.k.a.Mela...........


areil
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Date Joined Feb 2006
Total Posts : 8
   Posted 2/16/2006 8:11 AM (GMT -7)   
Thank you for your post, I feel so confused with all the info I read on RA, and I wonder
now if what I have is RA or Lupus, or OA. It all seems so confusing. Can someone please tell me some of the sysmptoms they experience from RA, and Lupus, that way I can maybe figure out which one I have.

hippimom2
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Date Joined Jul 2005
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   Posted 2/16/2006 8:01 PM (GMT -7)   
areil, if you look on the lupus foundation of america website, they list a lot of the symptoms as well as the criterea for diagnosis. I don't know as much about RA or OA. I know it can be really confusing because so many symptoms for each of these diseases are the same. It is really important to have a doctor you trust. It also never hurts to have a second opinion. Take care
Dx:  Suspected Lupus 2004, CFS 1991, Secondary Raynaud's 2006
Meds:  Plaquenil 400mg, Tramadol 100 mg 3x day, Amitriptyline 10mg, Neurontin 100mg


areil
New Member


Date Joined Feb 2006
Total Posts : 8
   Posted 2/17/2006 8:17 AM (GMT -7)   
Thank You hippimom2. I will look the info. up at the lupus website.

CaMama
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Date Joined Mar 2005
Total Posts : 1884
   Posted 2/17/2006 9:18 AM (GMT -7)   
Unfortunately, blood tests are not concrete - you can have the disease and the bloodwork is fine. You can feel fine and the bloodwork shows a problem.  Someone here told me that there are additional tests that can rule out lupus. (I think I might have lupus and my rhuemy has dismissed me on that converstation stating "there is no test to be sure..." and questioned that comment here on HW.)  One rhuemy did tell me that the joint x-rays can sometimes help show which form of arthritis you has since certain types degenerate your bones differently (e.g., I have psoriatic arthritis and apparently, it can show different types of problems on the x-ray.)
 
Like hippimom said, many of the symptoms listed are the same, making it confusing to know for sure where you fall in. That said, in many cases (not all) the treatment is/can be the same and therefore you will hopefully be taken care of regardless. Now my current rhuemy feels that an exact diagnosis does not matter because "it is all treated the same way,"  but I do feel that is incorrect based on my lupus concerns vs. PA and RA because I have so many other health issues I feel the correct diagnosis is important so we can figure out how to stop making it worse. But, that is another story - but don't let your doc sloff you off with "it really doesn't matter which kind you have...."
 
Good luck. **
 


areil
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Date Joined Feb 2006
Total Posts : 8
   Posted 2/17/2006 3:18 PM (GMT -7)   
Thank you CaMama, I will try to make sure my doctor figures out what I have exactly. Sometimes I feel like the doctors themselves don't know enough. I have tried to read up on RA and Lupus to figure things out myself, but I just can't seem to find enough information and the info. I do find is sometimes confusing.

erin.K
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Date Joined Mar 2005
Total Posts : 3148
   Posted 2/17/2006 5:47 PM (GMT -7)   
dear Ariel,
autoimmune disorders are so complex and so very hard to crack the case on what really is wrong.  it may take years, it may not.  it's common for a person who is not a "textbook case" of RA or Lupus to go through many rheumatologists.  mad   personally i have seen 4, with one being the best in Manhattan and still he was baffled a bit. 
the frustrating situation is the "wait & watch" plan wich many of us have to go through.  yeah, we're being treated for RA but have a lot of other abnormal blood labs for example...but, in the back of any good physicians' mind will be, "this might turn out to be Lupus in a few years."
it's a scary truth.
but again, like many have said already...the treatments and medications are very similar.
the diseases are similar as well, both being chronic, progressive autoimmune diseases with systemic complications.  but sometimes just the fact of "not knowing, or not having a definite name for it" makes a patient feel very vulnerable and a lost of control.
but i'll try to clarify a little bit to see if it helps:
RA: *bilateral (both sides of the body) joint pain, stiffness, tenderness, swelling, heat, redness.  multiple joints are usually involved.
       *loss of energy, fatigue, low grade fever, weight loss.
        *morning stiffness taht lastslonger than an hour.
        *Xrays are usefull to detect changes in the joints.  early in the disease they may be minimal.
         * serum Rheumatoid factor is positive in MOST RA patients...BUT NOT ALWAYS!
         *possible anemia
          *elevated ESR  0-20 for women under 50 is normal.  0-30 for women over 50 is within normal limits. ESR is an indicator that something of a disease process or inflammation is going on. it can show in RA or Lupus.
 
so here we see already why docs and ourselves "don't know for sure" sometimes because RA & Lupus share many of the same labs.  confused  
 
ANA: *this test is a very broad lab to screen for autoantibodies in patients suspected in having ANY systemic rheumatic disease (aka connective tissue diseases) i.e.; RA, Lupus, mixed connective tissue disease, scleroderma, Sjogren's.
          * Lupus is difficult to find and Dx because it mimics other AI diseases.
          * a positive ANA does not confirm a disease like Lupus.  along with clinical symptoms, they need to run specific titers like RNP, Smith, SSA,SCl-70 & Jo-1.  these labs should be done to investigate further.
           *a positive ANA can be caused by medicines: hydralazine drugs and procainamide.
           * in all, all bloodworks should be closely monitored at every Dr. appointment & should be done regularly to check for increases and changes.
 
there are a few types of Lupus, with SLE being probably the most serious because of multi organ involvement.
Symptoms:
* like all of RA.
* you may notice hair loss and constant infections
* a hallmark sign of SLE is a "butterfly rash" across your nose and cheeks.
*seizures
*abnormal urinalysis
* BUN and creatinine elavated
Ariel, keep at the docs and be mindful of your body & how you feel on a day to day basis. Seek 2 or 3 opinions if needed.
When do you see the doc next?
What's the docs plan of action?
If i can explain anything more please feel free to ask.  i've access to a lot of info as i intend to specialize in rheumatics (that is of course when i can get back to work and grad school!)....almost finished but had to leave due to illness....BUT I WILL BE BACK!
this is a battle, and takes courage & strength.  we might not feel it sometimes...but i think we who have AI diseases have a lot more strength than we give ourselves credit for.
Sincerely,
erin


Active, Severe RA. Crohns Disease. Chiari Malformation & Right Brain venous anomoly. AS. Emphysema. Rheumatic Lung. MVP and Tricuspid prolapse. Had Lymes disease for 10 years.
Meds: Humira 40mg every 4 days; pred; Pentasa; Imuran; dilaudid; diazepam; Avanza 30mg & too many others.

Post Edited (erin kachmar) : 2/17/2006 5:54:50 PM (GMT-7)


areil
New Member


Date Joined Feb 2006
Total Posts : 8
   Posted 2/17/2006 6:51 PM (GMT -7)   
Thank you Erin for all the info. and kind words of encouragement. I'm sorry that you are not able to continue your education due to illness. I hope you get better soon. I will see my regular physician again next month and get blood work done at that time again. I do not have a rheumatologist at this time because I changed my insurance, but my doctor will refer me to one if my next lab work shows ANA levels are high or if my ESR goes higher or stays the same. I have only been diagnosed with RA for a year now and my symptoms are ver limited. I have been anemic for a few years now, then I started having pain in my right knee especially when I would drive for a half hour or more. Then I started to have pain in my hands when I tried to write and when I cut meat or potatoes or peeled vegetables. I also get strong pain in my hands if I put then under very cold water or touch something very cold. Other than that I am fine except I am tired a lot and I get dizzy and lightheaded. So, I'm not sure if my symptoms match that of RA, some seem to, but I don't understand the dizziness and the lightheadedeness. I would appreciate any info. I can get. Thank you very much.

erin.K
Veteran Member


Date Joined Mar 2005
Total Posts : 3148
   Posted 2/17/2006 6:59 PM (GMT -7)   
sad  yeah, i can't do those things either.  and i love (loved) to cook.  but when & if i do attempt to cook, boy do i pay!  hands, elbows & shoulders are throbbing and out of order for a good week or so.
the RA i have has preogressed to all joints, it's bad and i don't like it!
i miss working and all. 
i never thought it would get this bad...but i suppose if it were treated earlier it wouldn't be this way.
 
but at your appointments, don't miss a beat!  write down EVERYTHING from head to toe, even the headaches and how often, what triggers them, makes them worse, occur atthe same time each day?, go in cycles...etc.
 
i truly wish you the very best.
will be in touch!
Active, Severe RA. Crohns Disease. Chiari Malformation & Right Brain venous anomoly. AS. Emphysema. Rheumatic Lung. MVP and Tricuspid prolapse. Had Lymes disease for 10 years.
Meds: Humira 40mg every 4 days; pred; Pentasa; Imuran; dilaudid; diazepam; Avanza 30mg & too many others.


Vane
New Member


Date Joined Mar 2005
Total Posts : 8
   Posted 2/18/2006 6:36 PM (GMT -7)   
Areil: I was diagnosed with RA about a year ago. RA factor always came back negative but had symptoms and flares. My Reumatologist ordered a blood test called Anti-CCP which measures the amount of cittruline found in the body. This test is very specific for RA. Sure enough my levels were extremely high (344) whereas, >60 is considered high positive. I was immediately placed on Enbrel. I've also read that scientists have found that the presence of Citrulline may serve as a prognosis for very aggressive RA. Please talk to your doctor about having this lab test done. Good luck.

Vane

areil
New Member


Date Joined Feb 2006
Total Posts : 8
   Posted 2/18/2006 6:54 PM (GMT -7)   
Thank you Erin and Vane. I will ask my doctor to do the blood test, I hope it helps.
Thank you again.

JacquiM
New Member


Date Joined Mar 2006
Total Posts : 3
   Posted 3/1/2006 12:53 AM (GMT -7)   
I was diagnosed 2 years ago with Anylosying Spondilitis, a form of RA, but have had back pain for over 25years. I am now 43 and have recently experienced alot of swelling in my hands, face (eyes mainly). I have been reading about the inflammation syndrome and it's relationship to all autoimmune diseases. I am realizing that diet plays an important role in the inflamation process. My pain is somewhat managed with weekly Humira injections and supplements of shark cartilidge,glucosamine and chrondroitin sulfate, but my inflammation is out of control. Just read that chronic inflammation syndrome may be a precursor to lymphoma in autoimmune patients and not that the NSAIDs cause lymphoma as previously expected.  At times, I can barely close my hands(mainly forefinger,middle finger and thumb affected) I am taking Hemp seed oil, borage oil capsules, ginger capsules. Does anyone have insight into nutritional supplements or foods to avoid and to help reduce inflammation? or any insight into the autoimmune chronic inflammation syndrome? Apparently it is a ficious cycle that needs to be broken by eliminating those foods and chemicals that cause our hypersensitive immune systems to overreact. Then apparently it is possible to reintroduce those foods back into our diets. I am having a heck of a time figuring our what causes my inflamation.

CaMama
Veteran Member


Date Joined Mar 2005
Total Posts : 1884
   Posted 3/1/2006 12:57 AM (GMT -7)   
I wonder about allergies and the such. I hear there are blood tests you can take (specialized and cost $$$) that help figure out what foods your body reacts to negatively. Much more indepth than your standard scratch test you take from an allergiest....
 
You avoid these foods completely for 3 month then can slowly add them back in.
 
Can't afford tests to try mytheory out...I do know I have problem with dairy and when I have too much, my swelling and pain increase by quite a bit.
***
 


JacquiM
New Member


Date Joined Mar 2006
Total Posts : 3
   Posted 3/1/2006 1:07 AM (GMT -7)   

Hi Curley,I just read that the treatments for high cholesterol lower the chance of lymphoma in RA patients. It was thought that the new biologic drugs caused an increase in lymphoma occurance but now it seems to be more likely that the inflammation in autoimmune diseases is what causes the increase chance of lymphoma. Apparently, cholesterol lowering drugs decrease the incidence of lymphoma. You might want to look into that and treating your high cholesterol would be beneficial  for two reasons.

curley said...
Let's see where do I want to start.Ok I have crohn's was diagnosed in 2-15-03and in 4-3-03 was diagnosed with RA and then I was told that I have OA amonth later and i came back posative for Sjerens syndrom and now I have a High HLA-B27 ANTIGEN DETECTED A.Ok this mean's that I carry the genes for these'disease's and that I more than likley have Lupus to boot.Oh and not let me forget i was told yesterday that I have ANKYLOSING SPONDYLITIS AS WELL and I high colesterol as well we tryed to get it down but was not able to do so so now I'am taking LOVASTATIN.

Just all way's be up front with your Doctor's and they will intern do the same.It is very imported to have trust in you Doctor and the same goes for him as well that way your Dovtor's can treat you a lot better.


JacquiM
New Member


Date Joined Mar 2006
Total Posts : 3
   Posted 3/1/2006 1:14 AM (GMT -7)   
Thanks CaMama for your response. I find the same intolerance with dairy. I have had a very extensive "scratch test" and I am not allergic to anything at all, which leads me to believe that much of our inflammation is truely a hypersentive reaction not an allergy. When in our inflammation stage, we seem to over react to things we would not normally overreact to. It is not so understood. I read a great book called the Inflammation Syndrome which explained alot but I want to follow up on this.

elcamino
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Date Joined Sep 2005
Total Posts : 1744
   Posted 3/1/2006 9:20 AM (GMT -7)   

From what I understand, ANA is not a test implicated in RA.  Only the rheumatoid factor (RF) is important.  In fact, if you have a positive ANA, you probably either don't have RA, or you have some connective tissue disease (.e.g, SLE, Scleroderma, etc...) in addition to RA. 

 


erin.K
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Date Joined Mar 2005
Total Posts : 3148
   Posted 3/2/2006 8:13 PM (GMT -7)   
Hey Areil!   :-) Just checkin' in to see how you're doing.  "How YOU DOIN'?" lol. :-) And welcome to HW Jacqui!  How are things?
How's everybody handling the whacky weather?
 
Sincerely,
Erin


Active, Severe RA. Crohns Disease. Chiari Malformation & Right Brain venous anomoly. AS. Emphysema. Rheumatic Lung. MVP and Tricuspid prolapse. Had Lymes disease for 10 years.
Meds: Humira 40mg every 4 days; pred; Pentasa; Imuran; dilaudid; diazepam; Avinza 30mg; MiraLax & too many others.


CaMama
Veteran Member


Date Joined Mar 2005
Total Posts : 1884
   Posted 3/2/2006 9:38 PM (GMT -7)   
Jaquie, that's why this blood test is supposed to be so good....it shows your body reacting to things that it won't necessariliy react to in a scratch test. I don't know...since I can't afford it, I haven't looked too much in to it. :-)
 
Elcamino - that is interesting about the RA factor and ANA = my RA factor is often fine, but my ANA is always positive......
 
Erin - we've had cold/rain, warm weather, cold/rain, warm weather...every other day...it's driving my joints nuts.
 
Have a good one everybody.
**
 

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