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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest tests to confirm the diagnosis of lupus

Answered by
Dr.
Dr. Naval Mendiratta

Rheumatologist

Practicing since :2007

Answered : 748 Questions

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Posted on Sat, 26 Nov 2016 in Lupus
Question: I have tested positive for ANA two times. The second time was a more detailed test done at the hospital and sent to a lab. I do not have RA but the doctor is urging me to see a rheumatoid specialist as I did test positive two times. He said there are one of several other things that it could be including lupus? I do not have a rheumatologist in the town I live in and the next closest for me is 180 miles away… So far I'm not finding anyone who is taking new patients do you have any advice on where else I can go to confirm with the positive tests mean?
doctor
Answered by Dr. Naval Mendiratta 4 hours later
Brief Answer:
Ana positive

Detailed Answer:
good evening

thank you for writing on health care magic

Well I would like to know why was ANA performed firstly. ?like what symptoms you had for which it was done. I don't want to ask leading questions, so would be more useful if you tell me your own symptoms...

Secondly, I would like to know the title of ANA.. we consider it more significant if it is more than 160...

3. do you have any öther problems like thyroid or diabetes?

4. did they perform ENA test also(the test after ANA)

ANA can be false positive in 5 to 10% people.. so we need to be sure why it was carried out. we need to Co relate it with. your symptoms and then come. to a conclusion if it is relevant in your case or not

do let me. know these queries

regards
Dr naval
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Naval Mendiratta 12 hours later
The symptoms that I am having is mainly in my esophagus and my gastric system. I do have Barrett's esophagus and have for about 10 years. I have been feeling nauseous, vomiting, and night sweats. I also have pain that seems to move to different areas of my body.
The title of the ANA test is 1–80
ANA screen positive
Rheumatoid factor is 8.6
No ENA test
That test shows (DS) Ab although I have no clue what that means.
Thank you so much for responding !
doctor
Answered by Dr. Naval Mendiratta 16 hours later
Brief Answer:
ANA interpretation

Detailed Answer:
Good evening

sorry for the delayed reply. Had a long duty

Well, as per your symptoms it doesnt look like a connective tissue disease. None of the symptoms match ANA and moreoever the titre is weak positive. We normally take 1: 160 as the significant one.

As for the felling of nausea, vomitting, you need to consult your gastroenterlogist to make sure Barrets esophagus is not active...

I would like to ask you a few more queries regarding your bodyache:

1. Is the bodyache continous or more at activity?

2. DO you get proper sleep at nights??

3. Any irritability or forgetfullness which has increased recently?

4. Any history of dry eyes or dry mouth?

5. Any history of hair fall or oral ulcers??

Do let me know these queries.. Would let you know if you need further tests

Regards
Dr Naval
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Naval Mendiratta 13 hours later
Thank you so much for your response! I feel very confident in your knowledge.
The body aches come and go and they last for a couple of days maybe a week in one area and then move to a different area.
I have not been sleeping well and I have noticed that I am snoring a lot more than before which is why I think I wake up so tired.
I have been much more forgetful lately… I thought maybe because I am quitting drinking that my body is more irritable.
I have experience blackouts for probably the last three years during the night heavy drinking binges.
I am working very hard at finding peace insobriety but I believe I may have IBS, I definitely have Barrett's esophagus, and so I often wonder if there is some sort of connection between at all .
I do have a an appointment with the gastroenterologist scheduled and I appreciate your referral for that
No dry eyes or dry mouth no hair falling out and no oral ulcers
Saving the good things for last! LOL
doctor
Answered by Dr. Naval Mendiratta 22 hours later
Brief Answer:
Is it autoimmune disease

Detailed Answer:
Good evening

Well, as per your history it doesnt fit in with autoimmune problem. The significance of ANA may not be too relevant in your case here. Never the less, I would suggest you get an ENA profile also done to be sure there are no other autoantibodies which could be harboring inside.

As per your symptoms, yes a do lot of them fit in with Alchohol Withdrawl. Blackouts are common with Heavy drinking. But i would like you to read through this Disease as well and see if your symptoms match:

www.rheumatology.org--> Patient information--> Fibromyalgia

you can read through it and see if your symptoms match...

No medicines needed for you at present...

Regards
Dr Naval
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Naval Mendiratta 4 hours later
After looking up fibromyalgia I do have some of the symptoms but most of the pain experience either in my throat or my stomach or lower back
I don't think that that is the problem?
I do feel like alcohol withdrawal is affecting my overall health and it is a struggle for me to stay sober
I have been in rehab and also been an AAA for four or five years before stopping. I'm wondering if there's any other alternatives you might suggest
doctor
Answered by Dr. Naval Mendiratta 19 hours later
Brief Answer:
Alchohol Withdrawl

Detailed Answer:
Good evening

Well, even I feel the withdrawal is causing you a bit of problems..Trust me, it is the hardest thing to do...At least we are now sure, you dont have any autoimmune problem....

With the withdrawal, there is no better treatment available than mentally being strong and be able to get over it. Since you have already done rehab, but still have the urge we need to figure out ways to suppress it...

1. If you want, I can recommend you some medications which you can get it prescribed from your GP but I would like you to overcome it without any medicines...

2. Indulge in some hobbies/activities which you always wanted to do since you were young but could never spare time for it. It is the right time to go about it and keep yourself busy

3. I would also recommend yoga and meditation. It does provide you with positive energy. Initially it is always hard to do, but once you are able to achieve the piece of mind, getting over things and meeting your eternity wont be 2 hard

4. Make a list of the side effects of alchohol and stick it on your fridge..Whenever you approach it, you can read it and it will remind you of things heavy alchohol drinking can cause

5. Make sure you are on Vitamin B 12 and B1. They tend to be deficient in people with long term alchohol use and can cause lot of harm

I hope these are helpful. Incase you want something more, do let me know and I will try to figure more ways out...You can become a social drinker later on , but only once the urge to drink and get wasted is gone....

Regards
Dr naval
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Naval Mendiratta 2 hours later
Thank you Dr. Naval!
I appreciate your honesty and straightforwardness! I do believe that drinking is my will and not God's will for my life .
I have joined a wonderful Bible study by Bethmaur called breaking free and I am a writer, I will be releasing my first book in March!
I agreed that stopping and using all the methods that you've talked about would be the best! The problem is when I get cravings sometimes they are so strong and they last for hours and hours because I can't stop thinking about having that first drink.
I wish there was a way to curve the desire to drink a little bit and assist me in my times of greatest weakness however if you don't think that's a good idea I respect that decision. I am 51 years old and have tried for at least 10 years to be sober although I've been drinking for 35.
The title of the book I wrote is called happy within minutes of faith based inspirational motivational read… I started to write it to keep myself in that frame of mind and it really has helped me to do that however I kind of go from really happy to extremely depressed and in those times it's very difficult whether I'm extremely happy or really depressed not to drink.
i'm not an every day drinker I'm what I would call a functional alcoholic and then binge drinker… But when the urge to drink comes on it feels so hard I often and not able to stop it :((
I want to thank you for writing me! You are the first doctor that has ever really had this type of discussion with me and I have to say I am really impressed! I will continue to pray and try to be active, I just hope I can get through it I am really tired of drinking And the effects of drinking in my life…
Thank you so much let me know what you think after reading this !
doctor
Answered by Dr. Naval Mendiratta 22 hours later
Brief Answer:
Further course

Detailed Answer:
Good evening

Well, must say it feels good to know a writer...That is definitely good work done by you..Maybe you can send me a copy too( just kidding). You seem to be a strong believer of god.. You can later take up writing after your this books which I am sure will be a success....

As for the drinking, you do know all the side effects of it which is a good thing. Problem comes when people dont know the side effects and still tend to do it. My only concern is the binge drinking aspect of it, since you are not a regular drinker....Everyone has the urge to drink, be it happy or sad...Once in a while a beer or two doesnt harm anyone...Even once in a while binge is ok, as everyone needs to let loose themselves...But yes, that urge you need to get over it and then you can always have it socially. Have a friend or someone to tell you not to overdo it incase you go away with the flow...

I have always felt, one does have more of a urge to do a thing when they are not suppose to, than for something when they know they can or have an access too.

So, Some more time till you are good to go and then you can always have a couple of drinks every now and then....

Have a nice day

Regards
Dr Naval
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Naval Mendiratta 46 minutes later
Thank you so very much! I can't tell you how much I appreciate your willingness to discuss this topic with me!
I would love to send you a copy of my book! It will be released in March of this year and I will even saying it for you! I believe it is very inspirational and motivational and has picked me up on several occasions myself!
Again many things you have been so very helpful! Happy holidays and best wishes always
XXXX
doctor
Answered by Dr. Naval Mendiratta 10 hours later
Brief Answer:
Closure

Detailed Answer:
Dear XXXXX

It is my pleasure I could be of some assistance to you...I wish you all the luck for your future endevours and I am sure your book will be a success, ( you have written it from your heart)

Take care

Regards
Dr naval
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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