Tapering, Lab Results and the Flu

[navejasjoe]

Given that my wife's first rheumy totally botched up the tapering process last year, her new rheumy is being very careful this time. Her first step was to go from 12.5mg pred to 12.0mg starting 2/27. 20 days later she took lab tests. Today, the rheumy showed her the results which showed that SDR went from 17 to 34; her CRP went from 4.4 to 40.2. Yet, my wife has felt no negative change in her symptoms. The rheumy explained that the very bad flu that my wife had had for 5 days on the lab test day, and continues to have, can create a lot of inflammation as shown in the markers.

My wife will remain on 12mg until 4/1 (her birthday, no joke), at which time she will go to 11mg. She will do the lab tests again in 6 weeks and be seen by the rheumy in 7 weeks.

Joe

[Hidden]

Hmmmmm? So she feels okay but the markers are all up... interesting. I am happy she is feeling good! and please tell her GOOD LUCK with the taper down in April. : )

[jinasc in reply to Hidden]

Hi, just to tell you that when I had a kidney infection and the blood test happened to be on the same day it was diagnosed. My CRP result was 242. Nothing to do with the GCA.

My lovely GP was at my door at 8.30am as he had read the blood results and he was so concerned about my GCA that he clean forgot that he had diagnosed me with a Kidney Infection same day. Lovely man and we had many giggles over the 5 years. He is now retired and I do miss him.

Both ESR and CRP are indicators that something is going on and then they find out what.

Some people, and some of them are on this forum, never have raised ESR or CRP even though they have and still have PMR and/or GCA.

[caterpillar in reply to jinasc]

I was in the hospital, after 3 months of so much pain around my abdomen that it used to make me vomit, they kept me in for a week, and did every test possible, all of which came back normal, the only reason they didn't send me home, was that I kept spiking a temperature every time they tried to discharge me... in desperation they decided to go in to do explorative surgery... they found that my appendix was leaking and so huge it had collapsed half my bowel.... and yet nothing found in all the inflammatory marker tests CT scan, MRI, etc etc....

[navejasjoe in reply to Hidden]

Thank you Mamici1 for your well wishes

[SheffieldJane]

Sounds like she’s in good hands this time. Fingers crossed. Wish her happy birthday from us. She might like to get involved on here too. It can be a support to talk to others with the disease.

[navejasjoe in reply to SheffieldJane]

Thank you SheffieldJane. She really is involved, indirectly. She is not conversant in English, so I read everything to her, and I translate what she wants me to post.. She says thank you for the birthday wishes.

Joe

[Hidden]

Glad they are monitoring and markers do lag behind symptoms as i understand it so if your wife starts to exhibit symptoms again they may not show a rise if tested straightaway. Before I dropped from 10mg I had flu in November and it spikes the markers in late december. I just stayed an extra month at 10mg to make sure. At 9mg now for coming up to 3-4 weeks and still not settled fully yet so staying for a bit.

[navejasjoe in reply to Hidden]

Thank you Poopadoop. The situation sounds very similar.

Joe

[DorsetLady PMRGCAuk volunteer]

Hi

Sensible second Rheumy- other things like flu do affect markers, and you shoulder never react to just one set of tests either- only if there’s a trend of rising figures and a return of symptoms.

Hopefully next time around once she’s got over the flu her markers will have reduced.

Just make sure when she reduces on April 1st that she get no return of symptoms.

In future she would be better to get bloods tested first and then reduce provided they are okay and no symptoms - that’s what most do!

[navejasjoe in reply to DorsetLady]

Yes, my wife had been on an improvement trend with her markers. The new rheumy sees my wife every 5 weeks, and she gives her a lab order to do the test a week prior to going. Unfortunately, when we went to the lab she had the flu. In hindsight, we should have waited for her to get better, and reschedule the rheumy visit.

Joe

[PMRpro Ambassador]

This guy sounds like a find - do hope it lasts!

I'd go so far as to suggest "what a waste of money" doing the blood markers when she had flu! I had an appointment recently that should have been preceeded by a blood test - I didn't bother given the state I was in! If the flu was affecting her chest, the CRP will have shot up anyway. Symptoms always trump lab results here and a single raised value without symptoms should NEVER result in a kneejerk raising of dose. You repeat it to check - and look for the trend. There are many reasons for differences in lab results - nothing to do with the illness for some of them.

[navejasjoe in reply to PMRpro]

Thank you PMRpro. The useless rheumy she had was a guy. The new rheumy is a lady. Very adorable and much more on top of things, taking sincere interest in my wife. Had we known that the markers would be impacted by the flu, we would not have gone. We were told to get the lab work done a week before her next scheduled appointment. Had we known better, we would have postponed the appointment and hence the labs.

So it was a waste of money indeed!

Joe