Had Drs appt monday, any advice?

[Mandy278]

Well everyone, I went to my family dr on monday because of the new symptoms I'm having that don't seem to MS related, When I first got there they did the normal pulse and blood pressure check. My BP was 120/60 but my pulse was 140! The dr was very concerned and she talked alittle about the new symptoms. Said she wanted to do bloodwork to check my thyroid but if that was fine she would send me to a rheumatologist.

In the meantime the nurse came back to do an EKG. My heart rate was down to 114 and it showed sinus tachycardia. Sha called a few days later and said tha bloodwork was fine and I had to go in on thurs and get hooked up to a holter moniter for 24 hours. I wont get those results for a week. But she is going ahead and setting me up with a cardiologist.

I got a copy of my bloodwork when I was there and noticed some things were flagged but not sure what it could mean so if anyone has any idea, I would appreciate it.

HCT      35.6         (37-47)
HGB     11.8         (12-16)
WBC    12.1         (4.8-10.8)
Neut Ct  8.6          (1.4-6.5)
MPV     11.4        (7.4-10.4)
RBC      4.14        (4.2-5.4)

If anyone has any ideas for me I would love to hear them. I am so confused right now. I have MS and now showing signs of lupus and family dr thinks its a possibility even though ANA negative. And now the high heart rate on top of everything else. I am only 35!

[Mandy278]

I looked at those pictures and that is exactly what it looks like. That actually terrifies be though. That something that is just seen in lupus isn't it?

I'm also concerned because I read that taking the DMD's for MS can actually cause lupus to flare up.

[jensequitur]

Sorry, I should have said couple of lesions in the pons.

[jensequitur]

Just curious - where are your lesions in the brain?

I have a couple of lesions in the brain, and sometimes my heartrate is up for no reason.

[Lulu54]

Mandy, are you describing the redness that is associated with Lupus - the butterfly rash?  Just a thought.

there are lots of pictures on the web - here is one site to compare.

http://cure4lupus.org/store/index.php?main_page=page&id=187&chapter=1

[Mandy278]

Yes, sinus tachycardia is rapid heartbeat. Mine was 140 monday at the drs office and since then it has been anywhere from 100-135. The dr said that I am not anemic enough for that to cause it.

And I actually on my face it is more like a rash on my checks and nose. I say rash but its not raised its just kind of blotchy. Hard to decribe.

[jensequitur]

Mandy, are you talking about the redness on the face?  Sinus tachycardia is rapid heartbeat, right?

[steph74]

When I've been anemic I get tachycardia (sinus tachy).  Now, granted, I've been pretty severely anemic, but the cardiologist I saw assured me that anemia can cause tachycardia.  Basically, there's less oxygen in your blood, so your heart has to pump faster to try and get oxygen to your body.

That said, I'm no longer anemic at all and I still get tachycardia.  I've had a workup from a cardiologist and everyone says my heart is fine, which is great, but no one knows what causes the tachycardia.  (And associated shortness of breath and mild edema in my feet and hands.)

[Mandy278]

Thank you for the reply. My lab work does have those things but they are normal.

RDW       14.2     (11.5-14.5)
MCV        86       (80-95)
Platelet    245      (130-400)

Do you have any opinions on the sudden sinus tachycardia? I have never had this before but it seemed to start around the same time as the hair loss and rashes in the sun. Any yesterday I didn't wear any makeup (unusual for me) and when I got back home, I had what almost looked like a sunburn on my cheeks and nose.

I just feel like this year it has been one thing right after another.

[Quixotic1]

Hi, Mandy, your bloodwork is only very slightly off, hardly enough to think much about.  You are mildly anemic.  This is pretty common for women in their menstrual years.  I forget your age.  The White Cell Count is mildly elevated, making one think of an infection, though many things can elevate it to this level - like a quick shot of adrenaline.

The Mean Platelet Volume is a tiny bit high.  I think this is a soft marker for inflammation.

I see the point in the referral to the rheum.  

Does your lab work have the RDW, the MCV and the platelet count on it?

Quix

[Mandy278]

It's fine. I do actually have thyroid disease as well. I've had it for a few yesrs but it is under control. I also have it checked every 3 months on the rebif. But I have read that the DMDs can actually cause lupus flares

[Deb61]

I just read that you just had thyroid tests and it was negative--duh!  I'm such a doof sometimes!  

[Deb61]

Best of luck!  Let us know what happens at the rheumatologist.  I have many lupus-like symptoms along with MS and I'm ANA positive.  The ANA is considered to be too low at 1:180 for a lupus diagnosis.  Many "normal" people have a positive ANA in low titer.  I no longer get the rash in the sunlight but have the classic MS Uthoff's when I get too hot.  I had a really bad all-over rash after being out in the sun early on when I first noticed I was getting sick.  It was soooooo itchy!  I will never forget that!  I do get bright red in the face across the face, and it doesn't take too long for that to happen (even when it's mildly warm) and a lot of hair loss.  I used to get the tiny red spots.  In fact I still have them on my face on on my arms.  

I do have autoimmune thyroid disease.  Has your TSH been tested?  I guess if it hasn't been  the rheumatologist will for sure test for thyroid disease.  Are you taking a DMD?  Some of these medicines (Rebif, Avonex, Betaseron) can cause thyroid issues.  You should be getting regular blood work on these medicines to monitor for things like that.

It's also not unlikely for you to have more than one autoimmune disease.  I know many people on this forum, including myself, that do.  I know that doesn't give much comfort hearing that, though.  I just hope that whatever it is, it doesn't take years for your doctor to figure it out.  

[Audrey_M]

Great idea to take pictures of the rash, especially if lupus is a consideration.

Can understand the "what's next" feeling, which is a very normal response.

I'll be thinking of you this week. Please keep us posted on how things are going.

Audrey

[Mandy278]

Thank you both for your replies. I am trying not to really stress, I just keep wondering "whats next?". I will be going back next week to have bloodwork done again. And then it will be off to the cardiologist first, then the rheumatologist.

Audrey (love the name. It is my mothers name)
The symptoms that have come up over the last few weeks have been:

hair loss
itching all over
rash that comes up after being in the sun
tiny little blood looking spots under the skin

And now, I made a quick walmart run and when I got back my husband ask what I did to my face. So  I looked in the mirror and saw my skin was red on my cheecks and across my nose and I have no idea why. But I am taking a picture to show the dr in case it goes away.

[Audrey_M]

When you say some things were flagged, could you be more specific?

The legend for my lab results include abnormal, critical, low and high. The low and high usually mean the results are just outside of the reference range. I tend to agree with the nurse who said your bloodwork came back fine, because the results that you posted seem marginally outside of the reference range.

Stress, infection, allergies or inflammation can produce some of the blood test results you report as well as an elevated heart rate. You mentioned new symptoms; what are they and could they be leading to stress?

So it would seem important not to worry or stress too much over this and trust that your doctor is taking proper steps to diagnose any possible problems.

How about a nice bubble bath, followed by a massage and a cup of chamomile tea?

Audrey

[Lulu54]

Hi Mandy,
It just stinks to have these extra worries thrown in on top of your MS, right?  I know the feeling... I had my MS thrown into the mix on top of my heart attack concerns.  Yikes, talk about causing extra stress.

The good news here is your doctor is being proactive and getting you settled with a cardiologist who can help you manage the tachycardia.  

As for the lab test results, although you are outside of the normal range, it doesn't seem to me that you are that far out of range and the variation might not be anything to worry about, other than the WBC.   For a better understanding of your test results and what each one of these mean, I would recomend one of my favorite sites...

http://labtestsonline.org

This site is run by lab scientists and they will even answer personal questions, if you have any.  

be well, Lulu