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Yipe.
I was feeling well enough to go to work today. When I came home, there was a letter in the mailbox from my doctor. It's dated 9/4/01 (but postmarked 10/10 - I have no idea why they sat on it for a month), and it has my labwork results from my trip to the doctor back in August.
At the bottom of the letter was an indecipherable scrawl, of which I could only make out the letters "ANA" - the lab test she ordered to rule out lupus. I called her office and spoke to the nurse-translator, who tells me, "Oh, I don't think the doctor meant to send that out. It was just a note to us." "What does it say?" "Well, it says... it says 'please inform patient ANA nonspecific positive, to repeat in one month." "It was positive?" "Well, it was nonspecific - it just means there was some inflammation. It could be anything. She just wants to repeat it to see if it's at the same level." "I've had osteoarthritis in the past. Could that give me a positive ANA level?" "Well, maybe, yes. Just have the test redone - I'll send you a lab slip."
I'm not going to panic. It's a nonspecific test. It could mean anything. It's not so surprising for a person who's had arthitis in the past to have some level of present inflammation. It probably doesn't mean anything is seriously wrong. I'll call my sister the doctor and ask, just as soon as I can get my voice steady.
Oh, also in the same letter: my cholesterol is apparently elevated. It's at 221. I blame Misha, for whom I have switched over to a heavily meat-based diet. Oh, and I also blame the fast food I've been having too often for lunch, and my tendency to resort to chocolate under stress, and my high-stress life. I didn't fast before the blood test, not knowing that I was going to have one, so maybe the cholesterol level is invalid. But either way, I think I probably have to give up fast food and Krusty Kremes. Damn.
On the brighter side, now we'll have to have fish twice a week. I love fish. There's always a silver lining.
Update 6:00pm
My sister the doctor not being available, I had a long reassuring conversation with my father the doctor. He says: the ANA test is meaningful if it's negative, or if it comes back specifically positive for anti-DNA antibodies. If it comes back "nonspecific positive" it's basically meaningless. It could be a little bit of rheumatoid arthritis... but the fact is that people come up with positive ANAs for reasons that are totally unknown, and never get sick. Usually when lupus has progressed far enough to have symptoms - like the rash you were tested for - the test comes back positive for anti-DNA antibodies. Have it redone, and don't worry about it. Really, don't worry about it. I'm not bullshitting you on this.
I *heart* my dad. I feel... not 100% calm, but mostly better.
At the bottom of the letter was an indecipherable scrawl, of which I could only make out the letters "ANA" - the lab test she ordered to rule out lupus. I called her office and spoke to the nurse-translator, who tells me, "Oh, I don't think the doctor meant to send that out. It was just a note to us." "What does it say?" "Well, it says... it says 'please inform patient ANA nonspecific positive, to repeat in one month." "It was positive?" "Well, it was nonspecific - it just means there was some inflammation. It could be anything. She just wants to repeat it to see if it's at the same level." "I've had osteoarthritis in the past. Could that give me a positive ANA level?" "Well, maybe, yes. Just have the test redone - I'll send you a lab slip."
I'm not going to panic. It's a nonspecific test. It could mean anything. It's not so surprising for a person who's had arthitis in the past to have some level of present inflammation. It probably doesn't mean anything is seriously wrong. I'll call my sister the doctor and ask, just as soon as I can get my voice steady.
Oh, also in the same letter: my cholesterol is apparently elevated. It's at 221. I blame Misha, for whom I have switched over to a heavily meat-based diet. Oh, and I also blame the fast food I've been having too often for lunch, and my tendency to resort to chocolate under stress, and my high-stress life. I didn't fast before the blood test, not knowing that I was going to have one, so maybe the cholesterol level is invalid. But either way, I think I probably have to give up fast food and Krusty Kremes. Damn.
On the brighter side, now we'll have to have fish twice a week. I love fish. There's always a silver lining.
Update 6:00pm
My sister the doctor not being available, I had a long reassuring conversation with my father the doctor. He says: the ANA test is meaningful if it's negative, or if it comes back specifically positive for anti-DNA antibodies. If it comes back "nonspecific positive" it's basically meaningless. It could be a little bit of rheumatoid arthritis... but the fact is that people come up with positive ANAs for reasons that are totally unknown, and never get sick. Usually when lupus has progressed far enough to have symptoms - like the rash you were tested for - the test comes back positive for anti-DNA antibodies. Have it redone, and don't worry about it. Really, don't worry about it. I'm not bullshitting you on this.
I *heart* my dad. I feel... not 100% calm, but mostly better.
no subject
I love doctors.
I fear I have no little rhyme for you.
Re: I love doctors.
I *knew* this had a double meaning! How odd. Even as I was writing it sardonically, I was thinking of a couple of docs that I like a lot.
:-) I'm glad you have such close access to at least tentative answers.
Other things
Mary, queen of high ANA ;)
Re: Other things
I'll look into it and raise the question with my doctor. Thanks a lot, Mary.
Re: Other things
My doctor told me to go tell my family members I had Hashimoto's disease (the autoimmune form that causes hypo, as opposed to Graves, which causes hyper, and runs in the Bush family). I did .... and one after another told me they already had it, or confirmed that others of us do. My aunt told me that my mom's thyroid "never worked a day in her adult life." (She died years ago.)
So yes. With high cholesterol plus hereditary thyroid disease, you need to get your TSH checked. Gradually, in fact, "correct practice" is becoming to test TSH automatically in folks with high cholesterol, as the thyroid can be the very simple cause of it.
The ANA could be caused by something else. In my case, the RA is the most likely culprit. But it's only an indicator of "something autoimmune/inflammatory," not diagnostic.
And even if your thyroid is okay now (your TSH shouldn't be much higher than 2, TSH of 3-5 should be watched carefully, higher than 5 needs treatment absolutely, but <2 is ideal), if your mom had the hereditary form (which is probable), you should have your TSH checked annually.
I'm sorry if that comes off sounding preachy, but I was untreated for way too long, and I'm still recovering from the effects. I try to help folks realize how often it's ignored by doctors. :(
Re: Other things
In my conversation with my dad, I didn't think to mention to him that my cholesterol was elevated. I called my sister-the-doctor to get her opinion, and she said that most doctors wouldn't look at a positive ANA and immediately think "thyroid disease," but that thyroid disease does cause nonspecific positive ANA results - exactly what I have. And in combination with my cholesterol and my family history, she said I should certainly call my doctor back and ask for a TSH test. She also said that hypothyroidism is no big deal - you just take Synthroid and you're fine. Which is what I'd thought, from knowing how my mother has done with it.
Mary, thank you so much for putting these pieces together for me. Hypothyroidism seems like a much more likely prospect than any of the other suggestions, and also much less scary. I'll call the doctor tomorrow.
Re: Other things
Re: Other things
http://thyroid.about.com is, as you've found, a treasure chest. So's http://arthritis.about.com.
Mary