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Erin, Ducky, I need your expertise!

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Rheumatoid Arthritis
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Posted 5/3/2006 6:47 PM (GMT 0)
After finding out that my daughter has strep throat, and realizing that I'm probably the one who gave it to her, I went in to see my primary this morning.  He agreed with me that it sounds like I probably did have strep.  What concerns me is that he did not put me on antibiotics.  To test if I'm a carrier ('cause I was when I was a kid), he is simply doing an ASO titre.  According to what I've read that does not prove or disprove that I'm a carrier?  All it says is that I've had strep in the past and I'm producing antibodies to it, right?  Other sources I've read state that to find out if a person is a carrier, you should do a throat culture on them when they're not experiencing any symptoms.  My doctor did not do this.  I also asked him about enbrel--specifically, if I test positive for strep (elevated ASO), and go on antibiotics, do I not take my enbrel next week.  He completely did not even understand my question, and proceeded to tell me that there is no interaction between antibiotics and enbrel.  Duh!  I was more worried about a strep infection getting out of control because of the enbrel.  I'll certainly call my rheumatologist, but I was waiting to see if my ASO is even elevated.  Not sure if that's really meaningful, though.  Any advice? 

Thanks!

Elcamino

Posted 5/3/2006 10:08 PM (GMT 0)
the only way to give a definitive strep infection DX is via a throat culture. cut and dry. ASO can elevate and decrease any given day if you've had strep in the past.

i don't know how an MD can base a positive strep throat on an ASO without a culture.

when i was on antibiotics, i continued my Enbrel. didn't have to stop.

ASO is only a titer and way too inconclusive for any DX. throat cultures' are the best way to go.
so if you do not have strep...you can take the shots.

the practices of some docs really makes me scratch my head.
if you're having symptoms like sore throat and swollen glands, a culture is needed.

advice? if ya feel sick...get cultured. ASO titers? i wouldn't lose any sleep over that. antibiotics? ask the rheummy if its OK to do the shots while on antibiotics. i really wouldn't be concerned about ASO panels.
Posted 5/3/2006 10:13 PM (GMT 0)
Erin you're quick... I was just getting ready to reply... had to wipe all that I had said out, 'cause you said it all for me! :)

El Camino - As far as anti-biotics and Enbrel. I have been on antibiotics ALOT since being on Enbrel and everything has been fine. From what my doc told me (take it for what it's worth) is that sometimes on Enbrel it will take more of the antibiotic to knock out the infection... so to basically go back in and get re-tested for whatever you're being treated for. I get chronic UTIs and I take antibiotics as well as my Enbrel, then after I have finished my series of antibiotics, I provide another "clean catch sample" for them to test to make sure the infection is gone... If not, I get more antibiotics... Now if you're on antibiotics for a long time (say longer than 2 weeks) you may not be able to take the Enbrel until you are done with the antibiotic series.

Hope that helps you out some... hang in there...
Posted 5/4/2006 12:32 AM (GMT 0)

That's what I thought, Erin.  I fail to see how an ASO titer helps as well.  I don't feel sick anymore.  My sore throat is just about gone, no fever, no aches (except for the normal).  The lymph node on the right side of my neck is still a little swollen, but that's all.  So, no I'm not sick anymore.  I think the infection, if that's what I had, has resolved itself.  If I come out with a high ASO titer, I'm not sure what my primary is going to do about that. 

Ducky, He does not understand about the enbrel and the risk of infections, so I'm not sure he would even be cooperative with follow-up cultures (although he didn't even get an initial throat culture on me).  But perhaps I don't need to be on antibiotics since the symptoms are much less that what they were.

What really gets me is that my husband went in to see this same guy this afternoon (I went in this morning on my way to work).  He gave my husband the rapid strep test right there on the spot and a prescription for antibiotics?  Why didn't he just do that with me?  At least the rapid strep test?  He said my throat was still a little inflamed and my lymph nodes were still swollen?  Oh well, I'll just wait and see what he says when the  ASO titer comes back.  Maybe I'll leave him a voicemail asking him that question tomorrow.

Thanks for listening!

Elcamino

Posted 5/4/2006 12:57 AM (GMT 0)
That is odd that he gave your hubby the test but not you... can you just go in there and ask for it? Regardless of what he wants? Tell him you want one just for the heck of it... Let us know what happens! Duck
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