High CRP but GP says ok

[Hirondelle]

Two weeks ago I began to feel ill, bad stomach and back pain. Lay on sofa gently moaning to my dog’s bewilderment. I took a urine sample to surgery on 8th October which showed blood and leucocytes. The nurse took some blood. I heard nothing but I raised pred from 5 to 6. Just looked on my NHS site; the blood result showed CRP at 20, GP has marked as ‘abnormal but expected’. Surely he should have discussed thus with me?

[jinasc]

Yes he should and I would be making a complaint to the Practice Manager.

In the meantime, do you still feel ill or has it subsided.

[Hirondelle in reply to jinasc]

Thanks so much for getting back. I did feel better but the stomach pains are coming back. Can that be related to PMR? When I first got PMR, the second GP I asked for help squealed with delight and said come in, then told me the practice was rubbish about PMR but she was following a seminar so she was interested in me as a guinea pig. Alas, that enthusiasm has long gone. The CRP was down a week later but I imagine that the raised level might have been a flare? Thank goodness for this wonderful website, I don’t feel so alone, a pioneer in the dark woods!

[PMRpro Ambassador in reply to Hirondelle]

Although the UTI itself could have been to blame - but why do it at all if it is to be expected ...

[PMRpro Ambassador]

I agree with jinasc - he should and I would have a complain. But:

He certainly needs some education!!! It shouldn't be expected if the dose of pred is correct because then the inflammation would be managed and the blood markers would be normal. So he needs to learn how to manage PMR properly.

[piglette]

My GP puts things like that on my notes, but I can only see them if I ask for a printout. Can you actually look up your notes on line?

[Nextoneplease in reply to piglette]

Hi piglette

I can see test results on the NHS app. However I think each surgery decides which parts of the app to use - for example I used to be able to read consultants’ letters but that section has been disabled.

Do you use the app? If so, might be worth looking 😊

[piglette in reply to Nextoneplease]

My surgery uses the patient.co.uk software. I have a strong suspicion that things are being suppressed. Luckily my consultants so far have sent hard copy letters and copied me. We can’t even email the surgery. In fact the only way to contact them is by phone or e-connect. They seem to have blocked off booking an appointment since beginning of Covid too.

[Nextoneplease in reply to piglette]

I know what you mean! My surgery doesn’t accept email either so I use econsult to send email/ text type messages….this sometimes works but I tend only to get a text message as reply. Not very supportive is it? Certainly shouldn’t count as a ‘consultation’….

Allegedly you can book appointments via the app, but the only ones available are a very few blood test / vaccination ones. For everything else, you have to use the phone and get past the patient care advisor (aka receptionist in days of yore). Then a phone triage and very rarely a f2f….

[piglette in reply to Nextoneplease]

We have never been able to book blood tests or anything to do with nurses just doctor appointments, which look like a thing of the past now. I have used e-consult twice and the first time a doctor actually phoned me back. The second time when I finished, the screen started flashing at me contact 111 immediately. Frightened me out of my wits. I had a hospital appointment within an hour so I can’t complain, although the surgery were then not involved.

[Nextoneplease]

I had something similar twice in two weeks in the run up to PMR diagnosis 😂 The answers I had put in resulted in a call from 111 to say they were sending an ambulance!! Actually nothing they could do as I needed a GP to prescribe steroids. It was a weekend and the duty GP didn’t feel she could take the responsibility…..As you say, it felt more scary than helpful 🤷‍♀️

[123-go in reply to Nextoneplease]

That's quite shocking! Surely the duty GP could have accessed your notes on the computer!

[Nextoneplease in reply to 123-go]

Thanks 123-go 😊

Perhaps I didn’t explain it well….. I hadn’t yet had my diagnosis, could barely move and was truly in a lot of pain …..the duty GP felt she couldn’t make a diagnosis that my own GP would have to follow through on 🤷‍♀️🤷‍♀️

Meanwhile my dear husband was pretty much demanding that something be done…..it was pretty awful when I look back x

[PMRpro Ambassador in reply to Nextoneplease]

Just as well it wasn't GCA then!!!

[Nextoneplease in reply to PMRpro]

True - at that point I hadn’t heard of either PMR or GCA so I wasn’t in any position to advocate for myself!

[123-go in reply to Nextoneplease]

No, it's me. I remember that horrendous period between start of symptoms and diagnosis when awful pain was spreading to every part of my body from my arms down to my feet. Crazy when I think of how much we learn here on the forum and so many GPS don't have a clue about PMR.

[Poshdog in reply to 123-go]

You would have thought so! However just changed gp practice due to moving house and told they couldn't access my notes as the surgeries had different systems which were not compatible. Progress!

[123-go in reply to Poshdog]

Just shows how diligent we need to be in keeping any records we receive. It's unbelievable that in this day and age there is not a common computerised system. It would save so much stress for patients and practices alike.

[Karendeena]

Hi there Hirondelle, I have ESR at 21 on 4mg pred doc gave me exactly the same result as you. Although my doc has told me the range should be 0 to 15, I checked and NICE guidelines say 0 to 20 for a woman under 50 and 0 to 30 for a woman over 50. Still concerns me though

[Hirondelle in reply to Karendeena]

That’s interesting Karendeena, thank you. I am puzzled however, as CRP was 4 and 5 on the previous blood tests in August and July,

[Karendeena in reply to Hirondelle]

What is the difference between CRP and ESR and are the readings different. My GP never mentioned CRP

[Hirondelle in reply to Karendeena]

Both record inflammation but CRP is thought to be more accurate

[Karendeena in reply to Hirondelle]

Thanks

[PMRpro Ambassador in reply to Karendeena]

C-reactive protein is a protein that the liver produces in response to the presence of inflammation in the body - it is an actual substance. The ESR is related to the rate at which the red blood cells (RBCs) in whole blood fall to the bottom of a vertical tube. Single cells fall more slowly than clumps of cells - and the ESR relates to the CRP because proteins in the blood on the surface of the RBCs make the cells stick together. One of those proteins is the CRP, more of it make the cells stick together more and the cells settle quicker/fall further and increase the ESR reading.

Neither are specific, any inflammation in the body will cause them to rise.

[Karendeena in reply to PMRpro]

Thanks for this explanation

[ptm2018]

You have the right to understand your lab work immediately. Unacceptable.

[Nightingales]

Just a thought Hirondelle. Are you sure the GP marked it as that and not the lab? I am asking because my lab results come back like that. I asked about it and my GP says the lab correlates it to my diagnosis. It’s up to the GP to check the results and discuss if necessary. Mine aren’t posted on line until a Dr has seen them.

[Hirondelle in reply to Nightingales]

The lab report gave the figures and the GP has seen it and noted “abnormal but expected”. It just seems odd that he didn’t see that at the same time I was complaining about pain and not feeling well. He is not a good GP, he refused to believe me in December after my physio had diagnosed PMR when I couldn’t get up her stairs, lift my arms etc. So I had a month of great pain before a locum GP saw me and prescribed the heavenly if horrible steroids.