Neurologist visit and Rheumy lab results

[Nancy60]

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.

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

[Sherry20]

I'm no doctor either, but the low sodium and high creatinine may point to a kidney problem.  I'd definitely get those checked out further.

Low sodium can be very dangerous, you really need to get this checked into further.

[Nancy60]

thanks Sherry,

I need to see my Internist next week so will bring it up then.  I've not had problems with my kidneys before, hope nothing is starting!

Nancy

[Epson]

Nancy,

Thanks for your post, I keep putting off a visit to a neurologist, maybe it is time now.  You just get so turned off by doctors after a while, but it sounds like you got a thorough examination.

It is unfortunate that doctors don't explane your test results throughly!  I have to bring my test results to my GP and have him explane them to me, he does a great job of unraveling the mysteries.

[pudmott]

Hi nancy,
I have been having blood tests like yours for a bit a few things out of wak here or there couple hi couple low nothing major but something obviously going on. My doc explained it to me that some of the things point to the fact that my body has been working hard to try and maintain the status quo and is a bit rundown. We just keep an eye on things and check regularly to see if there is a pattern. Sometimes with autoimmune stuff it takes a while for things to show up in the bloodwork and by keeping regular checks you can notice patterns emerging and get onto it quickly.
The sodium thing can be a problem but is one that is easily rectified. I otice when my sodium levels start to drop that i begin to crave salt and will go searching for salty foods. Keep yur fluids up.

I find when i got to the docs i have so many questions about stuff. i am starting a health diary that i will list symptoms when they occur, where and for how long. i am also going to have a bit for questions. Just before my visits i will pritoritise them and then write down whatever the doc tells me.  also keep my own medical file so that when i am at my different ologists office i can refer to bloodwork ans tests and reports if need be. Whenwe go to the ologist whichever one it may be there is so much information to be crammed into so little time and we are usually feeling unell that you get out and have forgotten to ask vital questions or remember what they just said.

Hope this helps

Pud

[Nancy60]

Thanks Pud,

A Health diary is a good idea, I can be so forgetful especially if I am anxious or nervous about a Dr. appt. 

Epsom,

I actually have been pretty fortunate with doctors lately.  When I was first going through the diagnosis stage I had some really bad experiences with  2 different PCP's and my first rheumy, but I found a wonderful PCP and Rheumy that are both very sharp and take time to talk to me at my visits. 

These latest labs were drawn after my Rheumy appt.  I called and got a copy sent to me.  I usually only hear from her if there is something significantly abnormal, she usually will call or send a send a letter if things are off that she is concerned about or wants me to follow up on (depends on how serious it is which method she will contact me with).  So I am guessing she is not overly concerned and wants to just watch my labs at this point, and discuss them at my next visit, but I will call to be sure. 

I have been trying to learn more on the creatinine levels and it does concern me some as it indicates decreased kidney function at a fairly significant level but I have never had kidney issues before and don't know if this was just a mistake or something as this is the first time it has ever been high.  All questions I will call and ask her before I start really worrying....Easier said than done.

Don't put off those ologist appt's, they are important to be able to pick up changes etc...

Thanks again for everyone's help!

Nancy