Guest guest Posted February 2, 2009 Report Share Posted February 2, 2009 Yes, it is possible to have both the CRP and ESR low and have a flare. I've never had a high CRP or ESR, but have had swelling at the time the bloodwork was done. Even the doctors couldn't understand why swelling was affecting my bloodwork. How is your doctor changing your medications? Lori http://home.comcast.net/~queenstitcher/ http://stitchingqueen.multiply.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 2, 2009 Report Share Posted February 2, 2009 Hi andra It's rare but it's possible to have non raised ESR, CRP and seronegative RA factor and still be in a damaging flare with RA. Mine is all 3 of these - unfortunately. The highest ESR i've ever had was 4! Not sure of CRP (it's more of a general measure of inflammation - it does go up if I have an infection as was shown recently) the highest I recall was 5, and my RA factor (after 14 years) may have now changed to positive now but they just don't bother testing me for it I don't think, unless I ask. I tried to get a differential diagnoses (hey who wants RA when you might have something that you can actually get rid of right!?) but my x-rays proved wholeheartedly that my joints had some serious errosions - and not in any other form than the type you get with RA (ie marginal errosions etc), then the MRI just made it worse as you can see more - they only paid for 1 hand one - the cost just wasn't worth it, unfortunately there was no denying it. My spine is the only thing with more than RA damage. Anyway I am like you. Although my original presentation (those 14 years ago) was a very very swollen knee - size of a large softball (and still swells considerably) - my other joints as such don't appear very swollen or affected till the Rheumy starts proding and poking (or I hit one on something!) - i'm amazed at how many joints are affected simultaneously that I never realised. My feel is you gradually get used to a certain level of pain, it's only the joints that are worst affected at the time that I notice, and most RA starts slowly and gradually gets worse. When I first began high level Prednisone I couldn't believe how much different I felt - I had become so used to feeling all " tight and sore " in the morning especially around my torso (from my back and chest) and aching everywhere,that it became the norm for me and I only realised higher levels of pain that would stop me doing something. Anyway my personal opinion is if you are able to try the change in meds and see what you notice. As you already have damage you know all too well about the implications of more. I have the same pain as you speak of in my heels, I think it's because RA affects your connective tissues (ligaments, muscles etc. I have a lot of this especially in my feet, lower legs and elbows / arms) as well as your joints - I just started enbrel on Saturday and am hoping for some change soon! I wish you luck and pain free days soon! Please trust your instincts. > > Hello, > I wrote a few months ago inquiring about heel pain. At the time, > they were blaming it on plantar faciitis and a heel spur. I spent > months in an aircast and after that, it still wasn't a lot better, so > the podiatrist I was seeing sent me back to the physiotherapist... > who sent me back to my rheumatologist. NOw I've had RA for 18 years, > but haven't flared in probably 5 or 6 years. But he said it was an > RA flare as many of my joints were swollen although it wasn't > particularly apparent to me but they were very tender when he pressed > on them and my elbows and wrists had been bothering me more than > usual. Apparently all the small joints in my foot were swollen. > Usually I attribute any joint pain to all the damage I got many years > ago worsening, so I never attributed my worsening joint pain in some > joints to a flare. At that point he started changing all my meds. > Now my problem that leads me to the question is that when he did an > ESR and a CRP...the ESR was 2 and my CRP was only 8.5 (the upper end > of normal for the lab here is 8.0). Somehow I don't think that's > really indicative of a rip-roaring flare and I don't want to change > my meds if I don't have to. Now I haven't had a flare in many > years. I never did get very high ESRs and CRP is new to me. Is it > possible to have both be low and still have a flare? It seems weird > to me from what I've read. I'm scared I'm changing all my meds for > no reason and that I might have problems because of it. Advice? > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 2, 2009 Report Share Posted February 2, 2009 Hi, andra. It is possible for damage to occur even if a patient appears to be in remission. Your rheumatologist is concerned about more damage. Have you had imaging done to compare to the previous results? Not an MD On Sun, Feb 1, 2009 at 10:17 PM, andra <spine_97@...> wrote: > Hello, > I wrote a few months ago inquiring about heel pain. At the time, > they were blaming it on plantar faciitis and a heel spur. I spent > months in an aircast and after that, it still wasn't a lot better, so > the podiatrist I was seeing sent me back to the physiotherapist... > who sent me back to my rheumatologist. NOw I've had RA for 18 years, > but haven't flared in probably 5 or 6 years. But he said it was an > RA flare as many of my joints were swollen although it wasn't > particularly apparent to me but they were very tender when he pressed > on them and my elbows and wrists had been bothering me more than > usual. Apparently all the small joints in my foot were swollen. > Usually I attribute any joint pain to all the damage I got many years > ago worsening, so I never attributed my worsening joint pain in some > joints to a flare. At that point he started changing all my meds. > Now my problem that leads me to the question is that when he did an > ESR and a CRP...the ESR was 2 and my CRP was only 8.5 (the upper end > of normal for the lab here is 8.0). Somehow I don't think that's > really indicative of a rip-roaring flare and I don't want to change > my meds if I don't have to. Now I haven't had a flare in many > years. I never did get very high ESRs and CRP is new to me. Is it > possible to have both be low and still have a flare? It seems weird > to me from what I've read. I'm scared I'm changing all my meds for > no reason and that I might have problems because of it. Advice? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 4, 2009 Report Share Posted February 4, 2009 No I haven't had xrays done lately, but a bone scan was done in October. They don't mean a lot because In my worst joints, they can't really tell what's going on because I've had multiple surgeries so you can't really compare. I had another set of blood work done on Sunday and my CRP dropped from 8.5 to 1.7, so I guess for me 8.5 is high. Since it fell so much in the month since I started changing my meds, I guess it's working. My ESR was still 2. Funny thing is, I don't feel any better. Got some Tramacet today to try. I've also been getting a lot of headaches, I'm hoping those will subside too. The next step is to mix Arava and MTX. I don't really want to do that because I haven't decided if I'm having kids or not and don't really want to make that decision right now. I'm putting a lot of faith in my low CRP and ESR numbers, but from what everyone's saying, it may mean nothing since I don't really feel better. But maybe there's a lag time between a decrease in CRP and feeling better. Thanks for the input. > > Hello, > > I wrote a few months ago inquiring about heel pain. At the time, > > they were blaming it on plantar faciitis and a heel spur. I spent > > months in an aircast and after that, it still wasn't a lot better, so > > the podiatrist I was seeing sent me back to the physiotherapist... > > who sent me back to my rheumatologist. NOw I've had RA for 18 years, > > but haven't flared in probably 5 or 6 years. But he said it was an > > RA flare as many of my joints were swollen although it wasn't > > particularly apparent to me but they were very tender when he pressed > > on them and my elbows and wrists had been bothering me more than > > usual. Apparently all the small joints in my foot were swollen. > > Usually I attribute any joint pain to all the damage I got many years > > ago worsening, so I never attributed my worsening joint pain in some > > joints to a flare. At that point he started changing all my meds. > > Now my problem that leads me to the question is that when he did an > > ESR and a CRP...the ESR was 2 and my CRP was only 8.5 (the upper end > > of normal for the lab here is 8.0). Somehow I don't think that's > > really indicative of a rip-roaring flare and I don't want to change > > my meds if I don't have to. Now I haven't had a flare in many > > years. I never did get very high ESRs and CRP is new to me. Is it > > possible to have both be low and still have a flare? It seems weird > > to me from what I've read. I'm scared I'm changing all my meds for > > no reason and that I might have problems because of it. Advice? > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 4, 2009 Report Share Posted February 4, 2009 Unfortunately, there's no doubt that I have RA. I was one of the first test subjects for the anti-CCP antibody...(I happen to live where they developed the test) and my last RF was 120. As I mentioned in a previous reply...my CRP dropped from 8.5 to 1.7 over the course of a month so apparently that's indicative that my med change is actually doing something (I'm on gold injections and I'm being re- loaded over the next few months). If it's not enough, then they may add Arava and drop my methotrexate down in addition to the gold. At least I could get rid of the plaquenil!( I hate those visual field tests). I don't really want Arava as I haven't had kids and as I'm older, may not want to wait for a washout period if the time came. I cannot try a biologic until I've " failed " Arava or the insurance company won't pay. I'm also very prone to skin infections which makes a biologic not a good choice. I'm very complicated that's why I REALLY REALLY REALLY didn't want this to be a flare! We'll see what happens over the next month. I already had to cancel a trip to Europe, so it can only go uphill from here right? Thanks for the advice. Lexi > > > > Hello, > > I wrote a few months ago inquiring about heel pain. At the time, > > they were blaming it on plantar faciitis and a heel spur. I spent > > months in an aircast and after that, it still wasn't a lot better, > so > > the podiatrist I was seeing sent me back to the physiotherapist... > > who sent me back to my rheumatologist. NOw I've had RA for 18 > years, > > but haven't flared in probably 5 or 6 years. But he said it was an > > RA flare as many of my joints were swollen although it wasn't > > particularly apparent to me but they were very tender when he > pressed > > on them and my elbows and wrists had been bothering me more than > > usual. Apparently all the small joints in my foot were swollen. > > Usually I attribute any joint pain to all the damage I got many > years > > ago worsening, so I never attributed my worsening joint pain in > some > > joints to a flare. At that point he started changing all my meds. > > Now my problem that leads me to the question is that when he did an > > ESR and a CRP...the ESR was 2 and my CRP was only 8.5 (the upper > end > > of normal for the lab here is 8.0). Somehow I don't think that's > > really indicative of a rip-roaring flare and I don't want to change > > my meds if I don't have to. Now I haven't had a flare in many > > years. I never did get very high ESRs and CRP is new to me. Is it > > possible to have both be low and still have a flare? It seems > weird > > to me from what I've read. I'm scared I'm changing all my meds for > > no reason and that I might have problems because of it. Advice? > > > Quote Link to comment Share on other sites More sharing options...
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