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Rheumatoid Arthritis
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Posted 6/18/2008 3:54 PM (GMT 0)
Hello All!  I thought I would properly introduce myself since I have been lurking for a while, and made a few posts a while back.  I am "pookiekidsmom", the wife of a Crohnie (have made some posts here at HW under the name "newcrohnswife") and recently dx'd with RA.  Been married to my chrohnie for 21 years (he's been dx'd with CD since November 2007).  Have 2 wonderful children, 12 and 6 who are homeschooled.  I work FT and hubby is a stay-at-home-Dad!

I saw a rheummy on 5/27 after having several months of symptoms; I work for a rheummy who doesn't actually see patients anymore, he is the head of my institution's Human Subjects Protection Program (yes, human subjects as in clinical trials).  Anyway, discussed symptoms with him and he recommended someone.  During the 6-weeks wait to see her, symptoms got more involved.  She dx'd RA-General just from talking to me (no prior bloodwork, no bloodwork ordered by her till after 3 wks on meds).  She put me on MTX 4 pills a day and Naproxyn (sp?).  Had bloodwork done after 3rd dose of MTX.  Now my question:

All of the bloodwork came back relatively normal.

C-reactive Protein = .70 mg/dL  (normal is 0.0-0.8) -----> NORMAL

RA Factor = <20 Iu/mL  (normal is 0-30) ------>why not an exact number, but again, I'm normal

CO2 = 22 mmol/L  (normal is 24-32) -----> LOW

ALT (SGPT) = 45 IU/L  (normal is 1-30) -------> HIGH, boss says this is liver stuff

Glucose Plasma = 109 mg/dL (normal is 50-100) -----> HIGH

Sed Rate = 27 mm/hr (normal is 0-20) -----> HIGH

Lymphocytes = 19.9 (normal is 20-44) ------> LOW

OK, so, can anybody give me some insight?  Boss says nothing alarming; altho, I do get the feeling from him that he's not quite sure it's RA...I know that a good doc will not just go by the numbers, but by how you feel, and by clinical presentation, but of course, since everything is "normal", well I am beginning to have doubts.

So far, I do not feel any better on MTX/NSAID; took my 4th dose of MTX last night.

Wow, this is really long, sorry.  But I am glad to join this wonderfully supportive group, and hope someone has some words of wisdom.

--pookiekidsmom   (pook for short!)

Posted 6/18/2008 4:15 PM (GMT 0)

hello pickie,

I have been dx with inflammatrory polyarthritis...I just took my 5 th dose of mtx and i too dont feel much beter, but reading these threads I think it takes 2-3 months and sometimes longer...I hope it kicks in soon....My guestion with your blood work when did u have it done after taking your mtx dose...and are u drinking enough water, the alt is just slightly elevated witch is a liver enzymes...I believe they have to much higher to cause alarm...glucose is also sl elevated  was it fasting level?  these are just  a few things I think when i look at bloodwork but again Im not a docter and wouldnt get alarmed just like your friend said...Did they do a ccp level?  I hope this helps....diane

Posted 6/18/2008 5:23 PM (GMT 0)

Hi, and thanks for the response.  Answers:  yes, it was fasting (blood glucose); I took mtx on Tues (3rd dose) and bloodwork was first thing Friday morn; I think they were supposed to do a CCP, but it wasn't in the printouts my boss gave me (he acessed the system since he's an MD)...will have to see about that--what exactly is it?

I have read that it could take several month for the meds to kick in; I was at least hoping to see some improvement with taking the NSAID though.  From what I understand my mtx dose is also low, so maybe she will raise it after my next appointment which is July 3.

--pook

Posted 6/18/2008 9:27 PM (GMT 0)
welcome pook and diane (i cant write nutty nurse-lol ) welcome to you both and yes we all travel different roads to get here with a proper diagnosis if lucky. I too on my first rhuemmy visit this time (unlike 10 years ago) was diagnosed with RA based initally on history and presentation. my hands were so inflammed they had no doubts. for me the blood wrok and xrays confirmed dx of RA. i had elevated c reatvive protiens elevated sed rates elevated alt i believe but no RA factor. as explained to me that just means i wasnt genetically predisposed to get RA but i got anyway! you can have RA without the factor or you can have the factor without RA! much luckier choice if you ask me.
also xrays will either show inflammed synovium as my did and also depletion of the synovium in some cases futher along.... like my knees hardly any left to cushion but as long as i dont press or kneel i can deal with it. well just a little ....ok a lot..... of input to your post and welcome one and all great hearing from you keep us posted this is a great forum!
Posted 6/18/2008 10:15 PM (GMT 0)
It took about six weeks for me to notice improvement on mtx and yes 4 pills is about half the regular dose but almost everyone starts at that dose. Your liver enzymes will need to be monitored the whole time you are on mtx because it can cause them to be elevated but from what I understand it is not thought to be all that serious if they aren't too high. Lyphocytes are a type of white blood cell that help fight infection if yours are low you should be washing your hands fanatically or using hand sanitizer and stay away from sick people.
SED is a measure of inflamation and though yours is high its not remarkably so and if you still have obvious joint inflamation or pain that explains your SED. Keep in mind elevated SED rates are a clinical finding that supports a diagnosis of RA.
Give your meds some more time to work make sure you are taking folic acid and drinking lots of water that will protect you from the side effects of mtx. And, I hope you feel better soon.
Sj
Posted 6/18/2008 11:18 PM (GMT 0)

well pookie,

After I wrote , our fasting glucoses limits our 110  to 120....But anyways my sedrate was74 and my rheumotiod factor was 104 intially...after my first set of labs and being on mtx for 4 weeks at 10mgs weekly my sedrate ia still 70...Of coarse my anti ccp was neg...I didnt get a dx of ra but as above stated...anyways I really em just glad that hes is treating me because I dont know what is in store for me down the road,whatever it might be. so, I gueses my lab work warrented the treatment with my symptoms...What if we didnt get treatment and these symptoms got worst than it would e too late if damage started....right...take care  diane

Posted 6/19/2008 9:55 PM (GMT 0)
Your sed and RF factor are both quite high and would along with your clinical symptoms be enough for some doctors to diagnos RA-my RF was 91 when I was diagnosed. A lot of times a doctor will start treatment before a definitive diagnosis is reached since many AI diseases respond well to the same treatments.
I hope the treatment starts making a difference for you soon.
Sj
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